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Old 01-03-2013, 05:49 PM   #1
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new test results- help!

These results are from testing 5 weeks after my dr. lowered my levothyroxine dose from 125mcg to 112mcg. I was feeling hypo- worst symptom was brain fog, also lethargy & no appetite- when the test was done. The pharmacy filled my prescription for the 125 mcg the day of the test. That was a week ago & I already feel much better. The dr. has only been ordering the tsh, but this time I went on my own & had the whole panel done.

T4, free- 1.77: range .82-1.77
reverse T3- 20.7: range- 9.2- 24.1
T3- 96: range- 71-180
TPO- 10: 0-34
Antithyroidglobulin- <20: 0-40
T3, free- 3.1: range- 2.0-4.4
TSH- .454: range- .45- 4.5
T4- 11.0: range- 4.5-12
T3 uptake- 36: range- 24-39
Free throxine index- 4.0: range- 1.2- 4.9

I've read that there is a link between hypothyroidism & high blood pressure. Does this mean that when my medication is adjusted properly my cholesterol will go down, or will I need medication for that as well? I am fit & not overweight & eat a healthy diet.

My total cholesterol is high- 229: range- 100-199
triglycerides 70: range- 0-149
HDL- 74: range->39
LDL- 141: range- 0-99

Thank you for any input!

Last edited by northfortyfarm; 01-04-2013 at 08:24 AM. Reason: wrong tsh

 
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Old 01-03-2013, 07:24 PM   #2
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Re: new test results- help!

northfortyfarm;

These results are from testing 5 weeks after my dr. lowered my levothyroxine dose from 125mcg to 112mcg. I was feeling hypo- worst symptom was brain fog, also lethargy & no appetite- ..

The symptoms alone make me think hypot or low T3 levels. I took the liberty to delete the tests that are redundant and the least accurate in my personal opinion.

TSH- 3.1: range- .45- 4.5
This is trending hypothyroid in my opinion. But why?

T4, free- 1.77: range .82-1.77

You are at 100% of normal range here. Trending hyperT in t4. This in conjunction with the TSH hints at a conversion issue and possible low t3 as a source. Your T4 and T3 levels should be with in 10% of each other. I always ran high t3 and low t4... The opposite of you.

T3, free- 3.1: range- 2.0-4.4

This is 45% of normal range way low in comparison to your t4 levels. In my none md experience I think you need to add t3 to your regime and cut back on your t4 supplementation.

reverse T3- 20.7: range- 9.2- 24.1. 77% of range. This is a bit high. You want this between 40-60%.. According to my MD.

Here is the main culprits... You are converting a good portion of your t4 to reverse t3 instead of the actual t3 you can use. Think of reverse t3 as Splenda and regular t3 as sugar....


TPO- 10: 0-34
Antithyroidglobulin- <20: 0-40


T3 uptake- 36: range- 24-39

This is your t4 conversion rate to t3 and reverse t3...
80%. That is a good number.. But... Think of the additional ~20% rt3 uptake. Supported by your 2:1 (t4:t3 ratio) I think yu really need t3 supplementation.

Do you need Armour. Not necessarily. Do you need to go on a purely natural thyroid hormone kick. Not necessarily. You and your md need to use the ft4 and ft3 tests to guide you to your optimal level of t3 and t4. Many if us need some t3 addition to be balanced and optimal. I needed it during pregnancy and lactation. Now I am fine on t4 only again. It was a good thing that you had the additional tests run in my opinion
.

I've read that there is a link between hypothyroidism & high blood pressure. Does this mean that when my medication is adjusted properly my cholesterol will go down, or will I need medication for that as well? I am fit & not overweight & eat a healthy diet.

My total cholesterol is high- 229: range- 100-199
triglycerides 70: range- 0-149
HDL- 74: range->39
LDL- 141: range- 0-99

I am not an expert here. But when I reached my optimal state for thyroid hormone. My triglycerides halved. My cholesterol has always been low.. It lowered more. My heart issues and hormonally induced migraines went away.


Hope this helped.
MG
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Old 01-04-2013, 07:04 AM   #3
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Re: new test results- help!

Quote:
Originally Posted by mkgbrook View Post
northfortyfarm;

These results are from testing 5 weeks after my dr. lowered my levothyroxine dose from 125mcg to 112mcg. I was feeling hypo- worst symptom was brain fog, also lethargy & no appetite- ..

The symptoms alone make me think hypot or low T3 levels. I took the liberty to delete the tests that are redundant and the least accurate in my personal opinion.

TSH- 3.1: range- .45- 4.5
This is trending hypothyroid in my opinion. But why?

T4, free- 1.77: range .82-1.77

You are at 100% of normal range here. Trending hyperT in t4. This in conjunction with the TSH hints at a conversion issue and possible low t3 as a source. Your T4 and T3 levels should be with in 10% of each other. I always ran high t3 and low t4... The opposite of you.

T3, free- 3.1: range- 2.0-4.4

This is 45% of normal range way low in comparison to your t4 levels. In my none md experience I think you need to add t3 to your regime and cut back on your t4 supplementation.

reverse T3- 20.7: range- 9.2- 24.1. 77% of range. This is a bit high. You want this between 40-60%.. According to my MD.

Here is the main culprits... You are converting a good portion of your t4 to reverse t3 instead of the actual t3 you can use. Think of reverse t3 as Splenda and regular t3 as sugar....


TPO- 10: 0-34
Antithyroidglobulin- <20: 0-40


T3 uptake- 36: range- 24-39

This is your t4 conversion rate to t3 and reverse t3...
80%. That is a good number.. But... Think of the additional ~20% rt3 uptake. Supported by your 2:1 (t4:t3 ratio) I think yu really need t3 supplementation.

Do you need Armour. Not necessarily. Do you need to go on a purely natural thyroid hormone kick. Not necessarily. You and your md need to use the ft4 and ft3 tests to guide you to your optimal level of t3 and t4. Many if us need some t3 addition to be balanced and optimal. I needed it during pregnancy and lactation. Now I am fine on t4 only again. It was a good thing that you had the additional tests run in my opinion
.

I've read that there is a link between hypothyroidism & high blood pressure. Does this mean that when my medication is adjusted properly my cholesterol will go down, or will I need medication for that as well? I am fit & not overweight & eat a healthy diet.

My total cholesterol is high- 229: range- 100-199
triglycerides 70: range- 0-149
HDL- 74: range->39
LDL- 141: range- 0-99

I am not an expert here. But when I reached my optimal state for thyroid hormone. My triglycerides halved. My cholesterol has always been low.. It lowered more. My heart issues and hormonally induced migraines went away.


Hope this helped.
MG
I really appreciate you taking the time to respond. I am slowly learning and this definitely helps. Unfortunately in my rush to post my long awaited results, I made a mistake. My TSH is .454. It has always been on the low side when I felt the best. Does this make more sense now? Thank you so much!!

 
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Old 01-04-2013, 10:31 AM   #4
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Re: new test results- help!

In my personal non-MD opinion. If you have the Free T values, the TSH is irrelevant.

I stand by my opinion on balancing your t4 and t3 levels. You have too much T4 and too little T3.

Easiest solution cutting back your t4 intake and supplementing T3. The hard part is finding a md willing to work with and prescribe t3 supplementation. This requires close free t3 and free t4 following for management. If your md is anti free t watching you may have problems getting the care you need.

Sincerely,
MG
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northfortyfarm (01-04-2013)
Old 01-04-2013, 07:42 PM   #5
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Re: new test results- help!

Northfortyfarm January 4, 2013

My story is similar to yours. I was on 125 mcg Synthroid (T4) for over 20 years, until problems with SVT, then started doing research on my own. Congratulations on getting all those tests done.

I think your fundamental problem is the same as mine and many others who are only taking T4. The problem is that FT3 will be low relative to FT4 if you only take T4. It is not a problem of your ability to convert T4. This was the research topic for the research paper for which I give the title below. They showed that the FT3 to FT4 ratio is lower in T4 treated patients than in euthyroid people (people with normal thyroid function).

So putting this into ``farmer language`` (no offence intended), if you only take T4, you have to drive up your FT4 to above normal if you want to get your FT3 up to normal. And if you want to get your FT3 higher yet, you have to drive up your FT4 even higher. This is when you start to get into problems, because FT4 gets converted to both FT3 and RT3. If you increase T4 you will increase RT3. RT3 is not neutral - it blocks T3 from working. It can make you feel hypo if RT3 is above normal. So this is why you do not want to go too high on your T4 intake.

A few comments on your labs. If you look at Table 1 of the research paper below, you will see that they give median values for "Euthyroid controls", in other words these are median values for normal people. I think you can use these numbers as a starting point for where to target for your labs.

On Table 1, the median values for females under 60 are:
TSH 1.40
FT4 13.4 pmol/L
FT3 4.44 pmol/L

Converted to the same units as your labs, the medians are:
TSH 1.40
FT4 1.04 ng/dL
FT3 2.88 ng/dL

You can see that your FT4 is way higher (+70%) and FT3 is only a bit higher than these levels, but you are not feeling good. Again that is typical of taking T4 only.

So you are now at the point where you learn why a lot of people take both T4 and T3 - because this way you can get your FT3 to optimal level without driving your FT4 to way above normal. And that's what I am doing. Hopefully you have found a doctor who knows how to do this.

Re the cholesterol, I am waiting until my thyroid is optimized. Most docs will tell you to take statins. I did for a long time. I quit because I now believe they can do as much harm as good.

Good luck...

RESEARCH PAPER:
Levothyroxine monotherapy cannot guarantee euthyroidism in all athyreotic patients.
Gullo D, Latina A, Frasca F, Le Moli R, Pellegriti G, Vigneri R.

 
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