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Old 09-16-2012, 07:12 PM   #1
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Question General lab question

Hello all. Just a general question regarding labs for hashi's hypo. Just a little background: I've been on synthroid 25mcg once daily since may 2012. Then went to 25mcg on monday thru Thursday and 50mcg on weekends in July 2012. I had an episode the last week of August of feeling very "hyperthyroid" as I would guess. I was having noticeably increasing anxiety, tremors of hands and inner shakiness/jittery. My resting heart rate was climbing to 90's-100's. Then one day, I suddenly felt very dizzy and my heart rate went to 150's and my blood pressure was high. I was in the ER that day.
So, I have lots of lab results from around this time as my doctor is very good about checking them often. I noticed that during July and early August, my TSH was coming down to low 3's and then mid 2 range, but my FT4 is staying the same and then even went down a little one week after my "episode".

I'm wondering if I had a bout of Hashitoxicosis which lead to my symptoms that day in the ER. Although, my labs that day still showed a TSH in the mid 2 range and a low normal FT4 and FT3.

I also had repeat labs done not quite 2 weeks after this episode and my TSH is about he same but my FT4 and Ft3 have both dropped lower in the normal range. Again, this makes me think that maybe that was a hashitoxicosis attack which now means I have a little less thyroid function than I had before.

I'm also wondering if my low dose of synthoid is making me worse by possibly tricking my pituitary into thinking that I have just enough T4 to where it is not stimulating my body to make more. Therefore, my TSH is coming down but the T4 is not budging??? Any thoughts? I know that I need the thyroid replacement because my free levels are in the basement of normal range, but my symptoms are becoming more and more bothersome.

 
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Old 09-17-2012, 09:59 AM   #2
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Re: General lab question

Quote:
Originally Posted by naturegal76 View Post
I'm also wondering if my low dose of synthoid is making me worse by possibly tricking my pituitary into thinking that I have just enough T4 to where it is not stimulating my body to make more. Therefore, my TSH is coming down but the T4 is not budging??? Any thoughts?
This is probably the case. Twenty-five mcgs is a "non-dose", very rarely a therapeutic one. It absolutely can have the effect of lowering FT4/3 instead of raising it. I suspect you are underdosed and still very much hypo.

You can't judge thyroid status by symptoms alone. They can "lie", hypo ones seeming like hyper and vice versa. Your low level (and falling) FTs are telling, and your cardiac-like symptoms are probably related to them.

An optimally-treated patient taking Synthroid (levothyroxine) only would have TSH around 1. If yours is as high as 3 with low FTs, you're definitely undertreated. No Hashitoxicosis about it.
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hashimoto's disease, hashitoxicosis, hypothyroid



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