kittyroo;
Am I going in the right direction here? Am I converting properly? Anybody see anything I should be asking about?? My endo is aware that I am not regulated yet so I am still on the blood work-every-4-to-6-weeks-then-up-my-dose-train. My next labs are in a couple weeks.
What supplement regime are you on? Brand, how much, how do you take it and any other medications? No you are not converting properly, you are over converting your T4.
I want to know where I am as far as being anywhere close to optimal. I don't want to be just "in range". Not good enough. I want to be optimal. I also want to know if a T3 supplement would be appropriate for me.
You do not need a T3 supplement given on the trends I am seeing. Now I am getting out the calculator.
Did you take your thyroid meds before having your blood work done. What time are you getting your blood work done at?
Labs on 6-20-08
TSH 12.93 (.30-5.00)
FT4 .98 (.71-1.85) You are 23% of normal range here. This is suboptimal and indicates you need to boost your T4. However your Ft3 level is giving you a cautionary flag.
FT3 3.39 (2.30-4.20) You are 57% of normal here. This is out of balance with your Ft4 result. This would indicate that you are over converting your FT4. The most common reason for this is suboptimal to low cortisol.
Throglobulin Antibodies: <20 Range <20 IU/ml
Tpo AB 3700 This means you have a Really nice and ACTIVE case of Hashimoto's going on and at war with your TPOs. Quite impressive. I only hit 1675 here.. that I know of

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COrtisol total: 8.0 (4.0-22.0) This is 22% of range. What time of day did you have this taken? You need to have an ACTH taken as well. I would also recommend and ACTH stim test and cortisol saliva 24 hour rhythm test. Depending on the time of day you may need cortisol supplementation to achieve thyroid conversion balance.
Labs on 7-7-08
TSH 6.85 (.30-5.00)
FT4 1.08 (.71-1.85) Once again knowing your supplemental amount and regime would help here. You are at 32% now, but this is still suboptimal.
FT3 3.38 (2.30-4.20) Not much change here. Still 57% of range.
Labs on 8-18-08
TSH 2.80 (.30-5.00) Once again knowing your supplemental amount and regime would help here. Also the Ft3 should not have been ignored given the 30% percent deviation. Turning a blind eye on it is a sure way to drive a person with adrenal issue hyperT in T3 while remaining hypoT/normal in T4.
FT4 1.32 (.71-1.85) 53% of normal. Well this is definitely better. What are you doing supplement wise here. Also how did you take your meds this day? What time of day was your blood draw.. the standard questions.
Labs on 9-17-08
TSH 3.11 (.30-5.00)
FT4 1.19 (.71-1.85) What time of day did your take this. What supplements are you on? You know the usual... 42% of normal. This is suboptimal and could use a boost.
FT3 3.02 (2.30-4.20) This is 37% of normal. Not bad with respect to your Ft4 and Ft3 balance. You are near optimal. There is a 5% deviation. This implies that your conversion issues are stabilizes and T3 levels are not in need of added supplementation. You are however in need of more T4 supplementation to get BOTH your FT4 and Ft3 levels up!
Tpo Ab 3700 Are you taking a vitamin with B12 and selenium in it? You may need to check your levels to make sure that you are not deficient and suffering from a lack of these important thyroid supporters.
Cortisol 11.2 (4.0-22.0) You have just hit optimal range.. the low side or it. OPtimal range is 40-60% of normal according to my MD. My body likes closer to 80%.. but I really like to over convert my T4. My adrenals died and i have to supplement for them. Yours may have just been fatigued due to hypothyroidism. It is a VERY common issue and can take 6mo to a year to correct.
I think you are going in the right direction and that you could handle another boost in T4 supplementation. i also think that you should have your Ferritin, B12, vit D, and Mg levels checked if the MD has been remiss in that check up to now. My recommendations may change AFTER you answer my questions. They are important on how your lab results can be effected.
MG