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  • Lab results. Unsure of diagnosis and treatment

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    Old 01-30-2019, 11:35 AM   #1
    wizard81
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    Lab results. Unsure of diagnosis and treatment

    Hi,

    I'm looking for some advice. I was diagnosed with hypothyroidism in April 2018 but I'm not sure if it was because I asked to see a specialized that they offered to treat me. Initial blood labs were done by general doctor.
    Endocrinologist said it was hypothyroidism and mentioned possibly Hashimoto’s. My main complaint was being cold and brain fog. I was started on Levoxyl 25 mcg at this visit under the endocrinologist direction.

    At this point in January 2019 I've never seen much different in body heat and brain fog seems a wee bit better but not much. Anxiety has gone up a lot! I'm wondering if treatment is worth it at this point?


    Lab results below with dosage changes indicated by *'s.


    Component Test : Your Value [ Standard Range]

    January 2018
    TSH: 1.10 mcIU/mL [0.40-4.50 ]
    Free FT4 : 0.7 ng/dL [0.8-1.8]
    Free FT3 : 3.5 pg/mL [2.3-4.2]

    *April 10th 2018, Started Levoxyl 25mcg

    June 2, 2018
    Lab results after 8 weeks on Levoxyl 25mcg. Tested at 7:30 AM, no medicine before, fasted for 10 hours.
    TSH: 0.58 uIU/mL [ 0.34 - 5.00 uIU/mL]
    FT4 - Free Thyroxine: 0.80 ng/dL [ 0.60 - 1.80 ng/dL]
    Vitamin D, 25 Hydroxy: 35 ng/mL [ >29 ng/mL]
    Thyroid Peroxidase Auto Antibody: <10 IU/mL [0 - 35 IU/mL]
    T3 not tested this time.

    *June 15th, Levoxyl increased to 50mcg


    June 25th 2018: Additional private lab test
    Fasting: Yes. No vitamins taken for 84 hours.
    Ferritin: 142 [range: 20-345 ug/L]
    Vitamin B12 / Folate, Serum Panel
    Vitamin: B12 668 [range 200-1100 pg/mL ]
    Folate, Serum:15.2 [ug/L Low=<3.4 , Borderline=3.4 - 5.4, Normal > 5.4 ]

    August 14th:
    TSH: 0.45 uIU/mL [0.34 - 5.00 uIU/mL
    Free Thyroxine (Free T4): 0.95 ng/dL [0.60 - 1.80 ng/dL]
    Free T3 : 2.8 pg/mL [2.3 - 4.2 pg/mL]


    *August 17th Levoxyl increased to 75mcg

    October 15th:
    TSH : 0.09 uIU/mL [0.34 - 5.00 uIU/mL]
    Free Thyroxine(Free T4): 0.83 ng/dL [0.60 - 1.80 ng/dL]
    Free T3 : 3.1 pg/mL [ 2.3 - 4.2 pg/mL]

    *Oct 16th. Endo said my TSH was to low. Advised to take remaining 75mcg pill supply Monday-Saturday, skipping Sundays to low my overall Levoxyl intake.

    Dec 10th:
    TSH : 0.06 uIU/mL [0.40 - 4.50 uIU/mL]
    Free Thyroxine(Free T4): 1.20 ng/dL [0.68 - 1.51 ng/dL]
    Free T3: 3.1 pg/mL [2.3 - 4.2 pg/mL]

    *Dec 20th. Endo said TSH was still to low.
    Advised to drop continue using up 75mcg supply Mon/Tue/Thur/Fri/Sun Skipping Wed and Sat. Said overall intake would be 50mcg.

     
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    Old 02-07-2019, 12:52 PM   #2
    Accept
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    Re: Lab results. Unsure of diagnosis and treatment

    I also have hypothyroidism. Your TSH level is on the lower spectrum of normal. Why were you diagnosed as having hypothyroidism? A TSH of 1.1 is considered normal. Why did they start you on Levoxyl? Is there a previous test in which your TSH was high? I think I may be misunderstanding what is going on here. But traditionally Levoxyl is used to lower a high TSH. If your TSH is already on the lower end it would push you in the other direction into Hyperthyroidism.

     
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    Old 02-10-2019, 01:09 PM   #3
    wizard81
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    Re: Lab results. Unsure of diagnosis and treatment

    Quote:
    Originally Posted by Accept View Post
    I also have hypothyroidism. Your TSH level is on the lower spectrum of normal. Why were you diagnosed as having hypothyroidism? A TSH of 1.1 is considered normal. Why did they start you on Levoxyl? Is there a previous test in which your TSH was high? I think I may be misunderstanding what is going on here. But traditionally Levoxyl is used to lower a high TSH. If your TSH is already on the lower end it would push you in the other direction into Hyperthyroidism.
    Hi. Thanks for you note.
    My TSH went to 0.8 mcIU/mL at one point before I asked to be referred to a specialist. I had been always cold and sluggish thoughts in the morning. I wanted to see with a endocrinologist though and was hoping there was something they could do. The Endo said my T4 was low ( 0.71 ng/dL ) so we started Levoxyl to try and raise it.

    I'm mixed up as well. I'm not sure what to do.

     
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    Old 02-10-2019, 06:41 PM   #4
    yayagirl
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    Re: Lab results. Unsure of diagnosis and treatment

    Dear wizard81,

    Whoever first named these levels did a rather confusing job, at least for the average person.
    Similar labels do mean not enough thyroid hormone and the other label means too much.

    A TOO HIGH TSH level can mean a diagnosis of hypothyroidism or inadequate thyroid hormone production.
    A TOO LOW TSH might mean hyperthyroidism or over treatment of hypothyroidism.

    You can trust that you doctor is treating your low thyroid appropriately. It takes about six weeks of treatment to see just how your body will respond. Hormone treatment is never a quick fix and every person's body has it's own thyroid hormone requirements.

    According to the Mayo clinic website the most common form of hypothyroidism (which means not enough thyroid hormone) is indicated when the main thyroid hormone T4 is low, while the TSH level is high.

    You do have the common symptoms of a too low of a level of thyroid hormone for you to be symptom free.
    Which indicates that you are hypothyroid and very well may benefit from supplemental thyroid hormone.

    I know it sounds confusing, but your doctor knows what it means. The doctor is right on to heed your symptoms of low thyroid and to start you on a trial dose to see if that helps the common hypothyroid symptoms which you have.

    In my case, My TSH needs to be kept suppressed BELOW 1, or I am sluggish, cannot think or stay awake.
    You can trust this doctor knows what to do for you.
    __________________
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    Last edited by Administrator; 02-10-2019 at 07:07 PM.

     
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    Old 02-24-2019, 08:49 AM   #5
    wizard81
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    Re: Lab results. Unsure of diagnosis and treatment

    Thank you so much for your help yaya. I'm sorry it took so long for me to reply. That is good news to hear and I appreciate you taking the time to write back. I did read your reply when you wrote it and it put me more at ease regarding my doctor. My next blood draw is in a few weeks and I'm curious to see the results from it. I'm still not feeling great overall.

     
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    Old 02-25-2019, 12:38 AM   #6
    yayagirl
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    Re: Lab results. Unsure of diagnosis and treatment

    Dear wizard81,

    No worries. I am only online sporadically anyway and I cannot get notices of when someone replies to my posts, so I try to check back in. I'm very glad to get to see that you are getting some peace about this trying situation you are in.

    Thyroid imbalance recovery is just not a fast process. Try to relax about this normal process. I think it helps if we study these things for ourselves, anyway I like to do that.

    Your doctor does seem to have a good understanding that with thyroid issues the "Free" numbers are the critical ones to consider. The healing time for thyroid issues is like comparing recovery from a broken fingernail with recovery from a broken bone. We know some recoveries are much quicker than others. Thyroid is a hormone. Hormone imbalance treatment just is not a quick recovery. The more we can accept and relax about it the quicker we will feel better about living with thyroid issues.

    Even when we get enough of a hormone the body may still need time to completely settle down so we feel our best. It appears you are blessed with a doctor that understands appropriate thyroid treatment. There are many doctors that try to treat thyroid imbalance and cannot follow up to recovery because they don't understand the process or they give some hormones and don't pay attention to the results.

    At six to eight weeks at that dose you are on if you still have low thyroid symptoms or your symptoms change to feeling hyper and jittery, report this to your doctor who should discuss either upping or lowering your dose and then you will be back in a six to eight week trial period. This is normal, no worries. It's something we can accept and live with if we make ourselves relax about it.

    If you think you might need a trial of a higher dose of thyroid, then it is fine to ask your doctor for a trial. What works for you would not be what works for everyone. And, as time goes by our thyroid needs change. In my case I not only take T4 thyroid hormone, I need additional of a thyroid component called T3 because my body is not converting T4 into enough T3 anymore. A doctor that really understands thyroid issues knows these things.

    Keep on keeping on!
    __________________
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    Old 06-25-2019, 10:38 AM   #7
    wizard81
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    Re: Lab results. Unsure of diagnosis and treatment

    Here is an update on my labs and how I feel right now.

    --
    March 16th 2019
    TSH 0.33 uIU/mL [0.40-4.50 uIU/mL]
    Free Thyroxine(Free T4) 0.90 ng/dL [0.8-1.8 ng/dL]
    Free T3: 3.0 pg/ml [1.7-3.7 pg/ml]

    Endo doctor said I could continue 50mcg dose but use 50mcg pills (up till now using up 75mcg with skipping 2 days to equal 50mcg spread out through the week per doc)

    --
    June 21st 2019
    TSH 0.91 uIU/mL [0.40-4.50 uIU/mL] TSH
    Free Thyroxine(Free T4) 0.80 ng/dL [0.8-1.8 ng/dL]


    Right now I feel more confident but at the same time my sleep during the work week is not great. On the flip side I do feel less tired and angry on less sleep which isn’t “normal” for me so that’s a plus! Also I do feel anxious/jittery still but it’s hard to tell how much is normal for me vs now since I’ve always been anxious to some level.

    Endo doctor has said based on my labs and feelings we could try reducing my medicine to 25mcg. I’ll make the adjustment later this week.

     
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    Tags
    anxiety, hypothryoidism, levoxyl, thyroid blood test, tsh level



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