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Old 07-20-2012, 12:48 PM   #1
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Smile Got results help with interpretation

Hello,
I finally got my results and the Dr.'s office was short a person and didn't really have time to discuss with me today.
Here they are

TSH 61.670 REF. Range .450-4.500 uIU/ml

T4, Free (Direct) 0.32 Range 0.82 - 1.77 ng/dL

They did a CBC also and most of those are on the low end of normal but Neutrophils is almst too high I am looking the names of them to see what they are.

Any help will be great!
Thanks!

 
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Old 07-20-2012, 02:06 PM   #2
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Re: Got results help with interpretation

Sorry to tell you this but, you are dealing with severe hypothyroidism.

TSH is a pituitary hormone that responds to the body's needs for thyroid hormone which fuels every cell in the body. The higher the TSH level, the more the body is screaming for thyroid hormone. I'm sure you can see that your TSH level is very, very much over-range.

Your actual FreeT4 thyroid hormone level is below-range which indicates that your body doesn't have enough fuel for proper function.

You should expect your doctor to start you on some thyroid hormone replacement. If you hear otherwise, I suggest you find another doctor.
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Old 07-20-2012, 05:29 PM   #3
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Re: Got results help with interpretation

Yes, she subscribed .75 for me to start with. She will see me again in 4 weeks. I am wondering if I need any additional testing - she said she would do Free T3 if I wanted but didn't think I should spend the money right away.

I had Epstein Barr (mono) in 2007 and have had lichen plantis (autoimmune skin rash) in 2010, have had several bouts with pnuemonia 2009 and 2010 and had the pnuemonia shot in 2011. I almost freaked when I saw how FAR out of range my TSH was.

Thought maybe the 3 scorpion stings I got a few weeks ago might have triggered something as my legs have been swelling, and I am so tired the last week that I have to push to get things done. I am not a sit around kind of gal but weigh about 235 and seems I have been gaining alot of weight just under my breasts (which seem to be getting bigger too) I am taking 800milligrams of ibuprofen twice a day just so my feet and legs don't feel so tight that I can't get around. I guess this is all thyroid related. Any other suggestions would be greatly appreciated!

 
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Old 07-20-2012, 05:32 PM   #4
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Re: Got results help with interpretation

Quote:
Originally Posted by sammy64 View Post
Sorry to tell you this but, you are dealing with severe hypothyroidism.

TSH is a pituitary hormone that responds to the body's needs for thyroid hormone which fuels every cell in the body. The higher the TSH level, the more the body is screaming for thyroid hormone. I'm sure you can see that your TSH level is very, very much over-range.

Your actual FreeT4 thyroid hormone level is below-range which indicates that your body doesn't have enough fuel for proper function.

You should expect your doctor to start you on some thyroid hormone replacement. If you hear otherwise, I suggest you find another doctor.
One other thing I meant to ask - what do mean by my body doesn't have enough fuel for proper function - the thyroid hormone fuel or my calorie intake. I don't eat alot but try to eat fruits, veggies, small amounts of protein or I feel bad especially as hot as it has been outside. I eat yogurt for breakfast, some type of sandwich or salad for lunch and small amount of protein with veggies for dinner or sometimes yogurt (if I didn't have it for lunch). By yogurt I mean organic no sweeteners added but i add fruit and granola (organic all natural).

 
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Old 07-21-2012, 05:15 AM   #5
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Re: Got results help with interpretation

I'm glad you were started on meds. Please know that it's unrealistic to think that you will feel better right away. It takes time to optimize our dose/levels. In the meantime, we can have an improvement of some symptoms, the worsening of others and/or the development of new ones.

Things start to smooth out once we get closer to our optimal levels and full symptom elimination doesn't happen until after we're stable at our optimal levels.

When I speak of optimal levels, I'm referring to the actual thyroid hormone levels - FreeT4 and FreeT3. You don't need the FreeT3 test right now but, you will need it in the future.

You see, the 75mcg you were prescribed is probably Synthroid/Levoxyl/levothyroxine. This is a med that replaces the T4 thyroid hormone you're deficient in. T4 is our storage hormone and gets converted by our bodies into T3, the active hormone. The levels of these hormones that are available for use by the body are measured by the FreeT4 and FreeT3 tests, respectively.

Some people have problems with conversion. This would be evidenced by a FreeT4 level that is proportionately higher in the range than the FreeT3 level. This can be remedied by the addition of a T3 med such as Cytomel.

Both the FreeT4 and FreeT3 levels need to be optimal if we are to be without symptoms.

I suggest you get a copy of "Thyroid for Dummies" that was written by an endo to give you a basic understanding of your disease. You will learn that thyroid hormone is needed by every cell in the body for proper function. If thyroid hormone levels aren't adequate, the cells don't have what they need to function properly and the patient will have symptoms and possible health conditions. This is what I mean when I say the body doesn't have enough fuel for proper function.

One of the best things you can do to expedite your return to wellness is to learn how to interpret your labs. Then you can work with your doctor to try to achieve the types of levels healthy people have. For most of us, those types of levels or levels very close to that are the ones that eliminate symptoms.

In addition, keeping a symptoms journal as it relates to labs is a very good idea. For clarity purposes, I will post the method I used in a separate post.

Best of luck to you moving forward - please keep us posted!
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Last edited by sammy64; 07-21-2012 at 05:19 AM.

 
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Old 07-21-2012, 05:17 AM   #6
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Re: Got results help with interpretation

Some of you might have read my suggestion in threads about keeping a symptoms journal as it related to labs. This was an idea shared with me by the members of my first-ever thyroid forum.

For those of you who might be interested in knowing what worked for me, I can tell you that keeping a journal was key towards identifying my optimal levels.

I soon realized that noting "feeling good" or "not feeling good" on my lab reports wasn't enough.

I maintained separate Word documents that covered the period of time in between labs. This way, each document represented what was going on with me in relation to whatever dose(s) I was taking at the time.

I would title each document with a date range that reflected the date of the most recent labs and the date of my upcoming labs.

My daily entries weren't particularly long and they were based upon what symptoms I might have been dealing with at the particular time.

Even though I had easily 30 symptoms during the early months of the meds titration process, many of those dissipated once my FreeT4/T3 levels were above mid-range.

This confirmed for me that I was like many people in the fact that I needed both my FreeT4/T3 levels above mid-range to feel well.

I was then dealing with a cluster of fluctuating symptoms. Watching the patterns that developed after a dose increase helped me to realize that my levels weren't necessarily optimal just yet.

This period of time often showed an improvement of symptoms after a dose increase....and then a worsening of some before the time of my next labs. This is a typical experience that tells us our dose(s) and levels still aren't optimal.

Since each of us has his/her own typical cluster of symptoms, it makes sense to note only what applies to the individual.

Therefore, my journal consisted of daily notes about the quality of my sleep, digestion, energy level, strength, stamina and mental function.

I would also note anything that might have been going on that particular day that could have affected how I felt.

An example of this would be noting the chills I had at night and also noting I attended my son's hockey game and/or it was below-freezing outside. I certainly don't want to blame my thyroid for everything

You can only imagine my excitement when my journal entries only consisted of improvements. This was a sign that the labs I had 6 wks. after starting the particular doses could very well be my optimal.

Sure enough, my FT4 level came back around 90% of range (my optimal FT4 is higher than the 60-80% of range most people need to be symptom-free) and my FT3 level at 75% of range (typical for most people)

Moving forward from there, I continued to make occasional notes only if something questionable was going on. I found that there could be many days when I didn't make entries.

There were times when I found the need to make more entries because my digestion was slowing down or my sleep quality had deteriorated. Sure enough, those upcoming labs showed my FT4/FT3 levels to be lower in the range than the levels I had when I was symptom-free.

I had two times during the meds titration process when my levels optimized and I was symptom-free for about 3 months.

By sharing my journal with my doctor as it related to my labs and the times I felt best, she accepted my determination about my optimal levels.

Since my thyroid has been somewhat erratic, my doctor has me get labs every 6 wks. She has adjusted my doses (I take T3 & T4) to maintain my optimal levels.

This has kept me symptom-free and I feel awesome.

I share this with you in the hopes that it might help you to feel the same.
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Old 07-21-2012, 05:23 AM   #7
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Re: Got results help with interpretation

Me again

I forgot to confirm with you that your doctor told you to take your meds on an empty stomach at least one hour before or two hours after last food/drink other than water.

Hopefully, you were also told to avoid soy which wreaks havoc with thyroid function. In addition, I hope you were told that it's important to have a consistent intake of fiber and cruciferous vegetables since these can affect the absorption of your meds.
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Old 07-21-2012, 07:00 PM   #8
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Re: Got results help with interpretation

No the Dr. didn't tell me anything just called to say she had sent a prescription. I was told 30 minutes before I ate in the am nothing else. I have a call into her as I told them I wanted to go over my test results and see what else I could do nutrition wise.

Glad to know and I will follow your suggestions! Thanks again for all the help. I will buy that book! I have found that today my legs are cramping from the knees down so bad I can hardly stand it.

I know it is unrealistic to expect quick results. I will keep reading the back posts as well to try to help understand more.

I really do appreciate the time you take to answer my concerns!

 
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Old 07-22-2012, 06:08 AM   #9
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Re: Got results help with interpretation

Unfortunately, even the most thyroid-savvy doctors don't seem to tell us everything.

1/2 hour before you eat should be OK but, you definitely should avoid coffee/caffeine when taking your meds. And, if you take any iron and/or calcium supplements, those need to be taken 4 hours away from your meds.

I'd be curious to hear what your doctor recommends re nutrition - that might help tell you just how thyroid-savvy he/she is.

Sorry to hear about your leg issues - they sound like yet another manifestation of improper thyroid levels.

Happy to help - we're all in this together.
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