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Old 07-06-2012, 09:00 PM   #1
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Rainlie HB User
Latest Lab Results

Hello,

I have posted quite a few times before. I am not any closer to getting anything resolved than when I first began. I still am fatigued, feel bad, no energy, losing more hair than I should, can not lose weight no matter what I do. I had some bloodwork a few weeks ago. My TSH was 4.55, reference range 0.2-2.80. My T4 was 6.99, reference range4.5-12. i was taking 37.5 mcg of levothyroxine. I went back 2 weeks ago. My bloodwork was sent to another lab. This time cortisol was 9.4 Range 6.0-23.0 . T4was 8.6 range was 4.5 -12. TSH was 3.70 Range was 0.27- 4.2. My family phyisician said something was not right, why was the reference range so different. In the later it is saying my TSH was normal. I can not get my thyroid medicine regulated. I have been from 25mcg. to 75 mcg a day, bouncing from Hypo to hyper. I have been to 2 Endos. THey have both told me that I am not hypothyroid. My latest family physician knows and understands that I have a thyroid problem but doesn't know what to do. He has me on 50mcg of Levothyroxine a day now. I have been on this for 3 weeks. He also had a test for Epstein Barr Virus. It showed that I was positive. It was the EBV Early Antigen- EA-D,IgG the Immune Ratio was 0.90 ISR Negative 0.91-1.09 ISR Equivocal 1.10 ISR Positive My result was 1.32 (High). I am positive for Epstein Barr Virus. I asked him if maybe that was why my thyroid medication could not be regulated. He said that he did not know. he wanted me to go see another endocrinologist. I just do not know who to see. i am so tired of feeling this way. Does anyone know if the epstein barr virus has anything to do with messing up the thyroid and maybe not being able to get the medication because of it? Any help would really be appreciated!! Thanks a lot!!

 
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Old 07-07-2012, 05:06 AM   #2
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sammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB User
Re: Latest Lab Results

Sorry to hear of your struggles!

While I'm glad to hear your GP is trying to help, a little basic thyroid knowledge would help him a lot (he clearly doesn't have it). You could share a book like "The Complete Idiot's Guide to Thyroid Disease" with him so he would know the right tests to run (FreeT4 and FreeT3) to properly monitor your treatment.

He would also be aware of the fact that the AACE recommended TSH ranges similar to the ones your first lab used and how many labs haven't changed their ranges (as your second lab hasn't).

He would also learn that your TSH level really doesn't matter except that it should be 1.0 or lower if you are optimally medicated.

A quick look at your previous posts revealed the fact that your doctor had declared you hyper when your TSH went low. That isn't accurate. True hyperthyroidism only happens when the actual thyroid hormone levels - FreeT4 and FreeT3 - are over-range.

In addition, your doctor did not titrate your meds dose appropriately. That alone could be responsible for the adverse effects you had on 75mcg. It could simply have been a matter of too much too soon.

Unfortunately, you had to backtrack and start all over.

Doses should be increased in 12.5mcg increments and, very occasionally, in 25mcg increments. Slow and steady wins the thyroid disease race.

Recent studies have shown that the EBV is strongly associated with autoimmune diseases of all types and there is thought that it triggers Hashi's....even if Hashi's doesn't develop for many years later. It was also found that people with Hashi's tested positive more often for EBV than people without it.

If the EBV is at its most active stage, you'd be bedridden with mono. It sounds like you're "just" dealing with inappropriate thyroid hormone levels.

So, it's not that you're having trouble getting regulated, it's that you are not taking an appropriate dose of meds and/or might have been titrated inappropriately.

Hopefully, your current dose of 50mcg represents an increase from your prior dose.

Labs in 6 wks. after starting this dose will show just what 50mcg accomplished. More likely than not, your FreeT4 and FreeT3 levels will show room for improvement so, another dose increase will be in order.

The next dose size in line is 62.5mcg and you'd need to take that dose for 6 wks.

The meds titration process is a slow one. However, with labs every 6 wks. and appropriate dose adjustments, levels can usually be optimized within a year.

Your doctors' lack of knowledge has delayed your return to wellness. You are clearly hypothyroid and need meds in an appropriate dose.

Since your GP is willing to work with you, I suggest you empower yourself with knowledge and guide him.
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Graves' 2007...remission 2009....hypo 2010

Last edited by sammy64; 07-07-2012 at 05:29 AM.

 
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Old 07-07-2012, 08:50 AM   #3
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Rainlie HB User
Re: Latest Lab Results

Thank you so much for responding and for all the information. I have been having these symptoms for about 2 years trying to get something done. My first family physician tried to get my medication at the right doses but could not. Actually I asked him to put me on medication and try, because all my lab results were considered normal which was usually at the upper end of the scale, above 2.5 on tsh. My Free T4 at that time was barely within range. The Endo that I went to my Free T4 was 0.68 reference range was 0.58-1.64 TSH was 2.10 Reference range was 0.34-1.64 TPO Ab 1.0 IU/mL Reference range <9.0 IU/mL She did not check my Free T3. She said wonderful results. You do not need to be on any medication. I have been on 50 mcgs. for 3 weeks, so in 3 weeks I need to get my TSH Free T4 and Free T3 checked again. This has been a roller coaster for me. My TSH has only been actually high 3 times during all this time but I have been having all the symptoms when they consider everything thing in range. On June 5th of this year my TSH was 4.54. Thanks for your concern and help. It really means a lot. I have not seen a post from MY BOO lately, I have been really concerned about her. She was having some bad problems with her thyroid and going from doctor to doctor. Have you seen anything posted from her lately?

Thanks again!!

 
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