That isn't the best set of tests.
You need tests for TPO and Tg antibodies. Both, not just TPO. If either or both are positive, that will confirm the reason your thyroid appears to be failing. But note... negative antibody tests don't necessarily mean you don't have autoimmune thyroid disease. The test has a false negative rate of up to 20%. They aren't infallible tests.
A healthy person would be expected to have a free T4 level around 1.5 on that range. Symptoms can start to occur when thyroid hormone levels fall below 50% of their ranges. Your FT4 is only 20% of its range. That's not "subclinical". It's hypothyroid level.
You also need a free T3 test done. Odds are it's similarly low. Too low.
MDs decide to treat based mostly on TSH, without taking into account the actual thyroid levels or symptoms. That's erroneous, but they continue to believe the stupidity of relying only on TSH. Thankfully, there are a few who know better and will agree to treat when TSH is still within that dreaded "normal" range.
"Subclinical" does not apply in your case. "Subclinical" means without clinical manifestations". You have clinical manifestations. You have low T4 and symptoms. Nothing "sub" about that.
Pursue treatment if you believe you could feel better. I will tell you it can be tough - first - to get diagnosed; second - starting supplemental hormone can be rough on a body until it gets used to having the hormone it's been missing. But it's well worth it eventually.
Edit to add: I just looked up some of your other posts and found you were diagnosed 5 years ago, and went on and off various meds. Guess you eventually quit them altogether?
It's really anybody's guess whether you'll feel better on hormone than off. It's a matter of trial and error, really. And it takes a pretty big commitment and effort to get it just right.
Thanks for your reply. My total T3 had been done on a previous test and was 94 with a range of 97-213. So that is looking a little low as well.
I was on Levothyroid for 4 years and went off it in 2004. I did pinpoint the dose on which I felt best as 112 mcg, 6 days per week, skipping one day. The problem is this kept my TSH down to about .01. My other thyroid measurements stayed about the same, either while on or off thyroid meds, except for my total T4, which increased to about 8 from 6 while on thyroid medication.
Based on this, my doctor said it looked like the thyroid meds were just replacing what I would be making naturally anyway and he wasn't sure I needed it. So I tried going off. It was tough, but after a few months I felt okay.
Do I feel lousy while off meds? No. I feel fine. But I have no other health problems at this time. I only get tired if I don't get enough sleep, but then I get REALLY tired. Did I feel better on meds? Slightly - but only on a high enough dose, like 112. Otherwise I feel no different. A low dose, like 88, shut down my own production but didn't replace what I needed. I felt like death warmed over. A "middling" does of thyroid medication does not work, in my opinion.
Based on the above, what do you think? All opinions are welcome!
I think you could be faced with some serious health problem if you have such low levels and don't treat. Your T3 is very low and I'm surprised you don't feel like death (I sure did when mine was sub-range).
The idea is to raise the thyroid hormones until you don't have symptoms, not based on the stupid TSH. If it takes a high dose to do this then so be it.
My total T3 had been done on a previous test and was 94 with a range of 97-213
I had read that to be a Free T3 so I can't say where you are at because unfortunately Total T3 and T3 uptake are not useful tests. These are the tests you really need:
All those other tests are a big waste of time and money and won't tell you much.
But even more important, how are you feeling? If you are here I'm assuming you have concerns because you have symptoms. Your Free T4 is low enough(at 20% of the range) to say hypothyroid. I'd personally want more hormones on board just to reduce my chances of serious health consequences later down the road. I hope this clears things up for you. Good luck with your endo!
These are recent blood tests. I am not on any thyroid medication. I am a 55 year old female.
TSH, 3rd generation - 2.19; Range 0.40 - 4.50
T3 Uptake - 32; Range 22-35%
T4, Free - 1.0; Range 0.8 - 1.8 ng/dl
T4 Total - 6.1; Range 4.5 - 12.5 mcg/dl
Free T4 index (T7) - 2.0; Range 1.4 - 3.8
Thanks for any and all opinions and feedback! Including if you think I'd feel better on thyroid meds.
I would stongly suggest staying off the thyroid med unless it's absolutely necessary. Taking thyroid med (misdiagnosed hypo) caused me to suffer a substantial hair loss among other problems; worst decision I ever made. You may want to look into other ways to improve your thyroid function, such as supplements (possibly L-Tyrosine), diet, and exercise.
For most of my life, I've exercised regularly - minimum 40 minutes aerobic exercise per day, which may be what has kept my metabolism up. In fact I've wondered at times if that's why my thyroid measurements are within normal ranges, but in the lower half of the range. Maybe I don't produce as much because the exercise keeps me a bit revved up anyway, and if I produced more, I'd be too hyper?
how did you come off 112 mcg? Did you lower it slowly or just dropped it altogether? While going off, what were your TSH numbers? I would assume, it went up initially. If so, what did your doctor say? I would appreciate your information on my question. Thank you.
I dropped off it cold turkey. It was tough, as I felt really tired for about 6 weeks while waiting for my pituitary to kick into normal gear again, but I wanted to get it over with ASAP. I remember adding some Cytomel for awhile for energy. Some people add phentermine instead, which probably also would have worked.
We didn't do any tests for two months after I went off the hormone, and my measurements turned out to be around where they are now. TSH went up to over 3.00 temporarily but went down again.
I'm a perfect example of why you can't go by blood tests though. All my thyroid doses, which were 50, 88, 100 and 112, gave me thyroid and TSH levels which were technically "in range." At 112 mcg of medicine every day, my TSH was too low, the doctor though, so I took it only 6 days per week and felt fine.
But how I felt was drastically different on some doses than others. 88 was probably the worst. It was high enough to shut down my own production, but not give me what I needed. 50 was what I used for a few months when I first started and I felt okay on that, but have no idea how that would have worked out long-term. 100 or 112 were okay for me, with 112 giving me that little extra energy boost. More than that I definitely didn't need.
If you try to go off, you will probably be tired for 6 weeks as I've heard that's how long it takes for your own system to totally kick into gear again. That's how long it took for me.
Thank you very much for reply. I sort of have a close picture. I tried to experiment with my doses, and my bloodwork returned pretty much the same, except for TSH which tends to rise above the range. I read somewhere that thyroid hormone replacement should be weaned off slowly though. (112-100-88-75.. ?? I don't really know. There is no such a protocol as to return to your normal thyroid function, I guess..) Especially if taken for a long time.. Anyways, thank you for your inspirational story and good luck with your former thyroid problem.
I have heard that thyroid hormone should be weaned off slowly too if you don't want to feel really tired. I figured in my case, since I had felt lousy on lower doses like 88 mcg, going off too slowly might just prolong the agony, so that's why I opted to do it all at once. For someone who has been on a high dose for a very long time, doing this might not be good for your health though. I was on thyroid hormones for a little more than 4 years before I went off.
I have felt very good lately, but occasionally have times in life lasting for several weeks where I feel tired. But tiredness can have so many causes that I can't necessarily connect it to a thyroid problem. That's why I'm having mine checked out periodically as I get older.
I did not have hypo originally, neither did I have any antybobies. Checked AB twice - before treatment, and years later, both timers came back 0 and less than 5. However, they (the doctors) slowly replaced my normal function, convinced me to do so. At that time I did not understand much and just followed the advice. I was on Synthroid for years, and ended up on good 175 mcg. Then I decided to get back to my own thyroid, but nobody cared to do so, as soon as I lowered the dose, TSH rose and the doctors said to go back. Anyways, I was frustrated, and made my own way down very slowly from 175 to 112, where my bloodwork is in range now. It was not quite easy way, but I am glad I did so. Still full replacement though. I can put up with tiredness and anything. However, I am not sure if my gland was atrophied and can function at all. I was doing slowly because I thought my gland was so suppressed, and cannot jump start right away. it's not the matter of agony (I can deal with it), but with the medical issues. I also fear to over stimulate by pituitary gland, because I am not a specialist, and don't know the consequences of it. Even though the doctors did not support my "reduction", they did not mind as long as numbers are in range.
You're right, if your thyroid gland had become atrophied it could have been dangerous to go off all at once. For me, 112 of Synthroid or Levoxyl was full replacement also. How do you feel on that, and how long have you been down to that dose?
I feel fine on 112, I am here for about 4 months already. Every time I reduce my dose I feel bad first for a while, and then, after some period of time, I start feeling much better, good mood, confidence, strong and happy again. I thought, that it was that my body adjusted to a new, lesser dose. I wonder, is there any way to learn if my thyroid is cold dead due to a long suppression, or is it still capable of producing something.? The other issue with my story is the bloodwork. I do not expect it to be perfect right away, after years of treatment. How long should I wait to see if they stabilized or not? What if I feel well, and bloodwork is not good??? (I had my T3 and T4 numbers in a lower half, and felt the best ever.) From where I am at now, what is the best strategy for me? Unfortunately, all these questions I can only address to myself. The doctors support only standard procedure of replacement therapy.
Last edited by Summer2928; 08-14-2009 at 08:04 AM.
Reason: typo, spelling