Originally Posted by lincolnsmom16
Thank you CD!!
I have my past 4 lab results since i jumped on this thyroid bandwagon
My first lab test: (11/19/10)
TSH was 5.030 (.45-4.5)
T4 1.09 (.82-1.77)
End result-doctor prescribed me 25mcg of levothyroxine
2nd lab test (1/10/11)
TSH 4.220 (.45-4.5)
T4 1.45 (.82-1.77)
End result-prescribed me 50mcg of levothyroxine
After about 2-3 weeks of taking the 50 i started to have hot flashes and sweating (however i was a little under the weather) and still had really bad anxiety. I went to a care clinic here and they said i had allergy issues and i asked if they could check my thyroid levels bc i had been really hot feeling the last few days and they complied.
My test results were: 1/28/11
TSH 1.83 (.40-4.5)
T4 1.1 (.8-1.8)
T3 73 (76-181) **Why did my t4 go back down after increasing my meds? and why didn't my GP ever test my T3 like this care clinic did?
They called me and told me that my results were normal and i asked what my TSH was and thought it had dropped a lot for having only taken 50mcg for two weeks so i thought i was going HYPER so i reduced my meds back to 25mcg which was a HORRIBLE idea!! Anxiety got worse and i felt awful again so i went to the care clinic and asked for my results so i could interpret them and i saw that i was still borderline hypo...not hyper.
My next lab results at my GP's office (2/18/11)
TSH 4.13 (.45-4.5)
T4 1.31 (.82-1.77) *Why is my t4 back up after reducing my meds and my TSH back up as well?? It doesn't make sense to me.
I don't have weight issues...i'm 135 and 5'8 and very active. I just came down with extremely bad anxiety and felt really weak and sore all the time...it got so bad i didn't want to leave the house which is not like me at all.
After reducing the cytomel the last two days i actually feel pretty good and I think this will actually do the trick!!
So now i am waiting for a good time to go get my levels checked again...i'm currently living out of state so i can't go see my normal GP-i will have to find another doctor when we move again and get settled in 2-3 weeks.
I will try to answer your questions in the order in which they were posed.
Our T4 (your results are actually the preferred FreeT4) will go down if the meds dose isn't high enough.
Also, it takes a good 4 weeks for a levo dose change to reflect in levels - you had your levels checked 2 wks. after the dose increase so, the FT4 level at that point was more indicative of the lower dose.
Even though TSH isn't reliable once we are taking the proper meds dose, when it rises, that is an indication that the thyroid needs to be producing more thyroid hormone to meet the body's needs for proper function.
Many doctors don't think to check the vital T3 (FreeT3 level is better)
You see, T4 is our storage hormone and the body converts it to T3, the active hormone - the one we feel.
There isn't much of a difference between FT4 1.1 and FT4 1.3....and, levothyroxine has a very long half-life so, even though you reduced your dose, the effects of the higher dose are still in your system and that probably accounts for the slight increase in your FT4.
TSH isn't a reliable indicator of thyroid function AT ALL.....once we start taking thyroid hormone replacement meds, all bets are off as far as TSH is concerned....this most especially applies to T3 meds since taking exogenous T3 impacts the HPT (hypothalamic-pituitary-thyroidal) feedback loop...not in a negative way - but TSH will be virtually undetectable.
TSH information is sort of like FSH (follicle stimulating hormone used to gauge menopause).....TSH levels out of the normal range aren't physiologically problematic - they're just telling you about stuff going on in the body.
Always better to evaluate thyroid function by looking at thyroid hormone levels which DO impact the function of the body.
Now, your most recent FT4 level indicates that it's still lower than optimal...most people feel/function best with FT4 level in the upper third of the range, if not towards the very top end of the range. Your doctor did the right thing in January by raising your levo dose to 50mcg when your FT4 came back at 1.45.
And, as I already mentioned, your FT4 dropping down again was a sign that 50mcg isn't enough....very few people take 50mcg as a regular dose - it's one step in the titration process.
Just to give you some idea - I started 25mcg levo back in March '10 and slowly increased my dose as labs and symptoms indicated. I started taking 5mcg Cytomel in January 'cuz my FT4 was 1.7 (range .8-1.77) yet my FT3 dropped and I had hypo symptoms.
After that, my FT3 rose to 4.0 (my setpoint) but my FT4 dropped so, my levo dose was increased to 88mcg.
I felt better after 2 weeks but, last week, some hypo symptoms returned - this is a sign that a dose adjustment is necessary.
It was time for my monthly appointment anyway (otherwise, I would have gone in sooner - not good to wait out symptoms) My doctor increased my levo to 100mcg, pending lab results due back tomorrow....my ultimate dose moving forward will be predicated on those results.
My setpoints are FT4 1.7 and FT3 4.0....either/both meds dose will be adjusted depending on the results.