Dear Friends: I had a thyroid panel done after being on the new Levoxyl approximately 4 weeks. They have changed from normal ranges to a bit high on these recent lab tests. My endo is lowering my daily medication from .137mcg to .125mcg of Levoxyl. Here's what my numbers said:
TSH - .6 (Normal .4 to 5.5)
T4 - 14 (Normal 4.5 to 12)
Didn't say anything about T3 - not sure he checked it.
So my absorption of the new levoxyl has changed my lab numbers a little. He's going to check it again in about 4 weeks. Interesting. Has anyone else been rechecked recently while on Levoxyl? There may be other factors here such as my diligent attention in avoiding soy products. Don't know if maybe that had some effect also.
I know what you mean TreeFrog. I was feeling over medicated at first then things settled down pretty well, although I have been somewhat restless at night and not sleeping continuously and a little too warm sometimes. Other than that I wouldn't want to change anything. It didn't seem like these numbers were off enough to warrant a change but I have the concern about bone demineralization while being even somewhat hyper. What do you think - don't we have to be rather careful about that particular issue? This doctor seems like the type who will work with me on dosage if I need to.
Thanks TF, I'll give it a try on the lower dose. As for the previous Levoxyl formula (.137mcg that I was on) I felt pretty well and my endo felt my lab results indicated that we shouldn't change it. At least I was sleeping well and did not have warm puffy skin like I do now on this higher dosage. I've also been a bit onery and argumentative which I had under control before. (I don't like me when I act that way. LOL)
I have previous lab results but my then endo used a different lab and the numbers for the normal ranges look quite different. I don't know how to equate them with this new lab and my most recent lab tests. Maybe someone can help me. My TSH was 1.08 (normal .32 - 5.00);
Free T4 1.88 (normal .71 - 1.85); Free T3 3.3 (normal 2.3 - 4.2)
Now they read TSH .6 (normal .4 - 5.5);
T4 - 14 (normal 4.5 - 12) I don't know enough about lab numbers to equate or compare the two.
Can someone please explain the difference between FreeT4 and T4 lab testing? And why would my endo check FreeT4 and not T4, at least one time I noticed? Does Free T4 tell him anything about protein binding?
Hi blondegal. Meep is the best at explaining the technical differences of the blood tests as well as the protein-binding qualities that some tests study. But I have found the following post to be helpful:
The following describes tests you may encounter during your return to health:
<B>Thyroxine (T4)</B>: This shows the total amount of the T4. High levels may be due to hyperthyroidism, however technical artifact occurs when estrogen levels are higher from pregnancy, birth control pills or estrogen replacement therapy. A Free T4 (see below) can avoid this interference.
<B>T3 Resin Uptake or Thyroid Uptake</B>: This is a test that confuses doctors, nurses, and patients. First, this is not a thyroid test, but a test on the proteins that carry thyroid around in your blood stream. Not only that, a high test number may indicate a low level of the protein! The method of reporting varies from lab to lab. The proper use of the test is to compute the free thyroxine index.
<B>Free Thyroxine Index (FTI or T7)</B>: A mathematical computation allows the lab to estimate the free thyroxine index from the T4 and T3 Uptake tests. The results tell us how much thyroid hormone is free in the blood stream to work on the body. Unlike the T4 alone, it is not affected by estrogen levels.
<B>Free T4</B>: This test directly measures the free T4 in the blood rather than estimating it like the FTI. It is a more reliable , but a little more expensive test. Some labs now do the Free T4 routinely rather than the Total T4.
<B>Total T3</B>: This is usually not ordered as a screening test, but rather when thyroid disease is being evaluated. T3 is the more potent and shorter lived version of thyroid hormone. Some people with high thyroid levels secrete more T3 than T4. In these (overactive) hyperthyroid cases the T4 can be normal, the T3 high, and the TSH low. The Total T3 reports the total amount of T3 in the bloodstream, including T3 bound to carrier proteins plus freely circulating T3.
<B>Free T3</B>: This test measures only the portion of thyroid hormone T3 that is "free", that is, not bound to carrier proteins.
<B>Thyroid Stimulating Hormone (TSH)</B>: This protein hormone is secreted by the pituitary gland and regulates the thyroid gland. A high level suggests your thyroid is underactive, and a low level suggests your thyroid is overactive.
T4 (also know as Thyroxine or Total T4) is a measure of how much T4 i sin your blood, even if they are bound to proteins in your blood. If you are eating soy products, taking Estrogen, or pregnant, this test won't tell you much since much of your thyroid hormones are likely bound to proteins and aren't immediately useable to your body.
Free T4 Measures ONLY the free hormone in your blood that is immediately useable by your body and is probably the most useful test in most cases.
Getting BOTH done can accurately tell you quite a bit about protein binding. Otherwise, the traditional panel that includes Total T4, T3 Uptake (Measures T4 binding proteins and has nothing to do with T3, actually) and FTI can tell you the same thing, though not as accurately (in my opinion).
I prefer to see a Free T4, Free T3 and TSH when I have my blood work done to get a more complete picture, and have never had the Total T4 test done.
Wow!! thanks you all are wonderful. So bottom line: Free T4 for someone on estrogen replacement therapy should be given the most weight? I've learned to take nothing for granted - do I need to call my endo to make sure he is going by FreeT4 and not just T4 when basing his decision to adjust my thyroid med? (He just adjusted it down this past week.) Am I on track? Thanks again - great information has just been posted for me!!!!!
OMG is it nice coming down off too much levoxyl. I've actually been able to sleep the last few nights and my skin does not feel so hot and puffy. Hyperactive patients have my sympathy - I think it's much harder to try to get through the day when you're climbing the walls during the day and fidgeting all night. (Not that either condition - hyper or hypo - is a picnic but I sure do feel better.)
VERY good for YOU, blondegal! <IMG SRC="http://www.healthboards.com/ubb/smile.gif">
I think always being hyper would be VERY hard.
I had a doc visit today, and found that my Armour had to be upped. I have been freezing cold, so I was not at all surprised.
My TSH had shot up to above 6, and she went by the free t4, but I didn't notice the number. I will get my copy in the mail, soon. The lab sends free T3 requests out to another lab, so that will come in later. My new doc orders those, and she also is letting me titrate my own dose for a month. I know I have been definitely hypo. She will check my lab values again in a few months of med dose trials, she says.
It is great to have a doc that listens and trusts my judgement as to what I feel.