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    Old 05-12-2004, 02:32 PM   #1
    softcrush
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    Question what is the truth about labs?

    Hi All!


    I'm new to all this, so bear with me. I've read the other posts and plan on copying them so I can read them laying down.

    I have a question about labs. I want to know specifically why 6 weeks is the time you have to wait in between labs? What labs should be ordered and what are the ideal levels? Then...how does one determine what the proper dose of which med is to get the desired effect?

    I got a full T done just over a month ago and started 100mcg of Sythroid every morning two weeks later. I am just over 105lbs., and I take nortriptylin at night along with my ortho-lo.

    The problem is I started out going to the gym feeling fine, then BAM! Major energy drop hits me and I'm unable to get across the room. I've been this way for a week and its steadily getting worse. I'm starting to get very dizzy and the room is spinning. Since I suffered nerve damage to my vocal cords, I can barely talk now, I still have trouble swallowing too and have to be careful when drinking liquids, and feel like someone is trying to choke me. So, all in all its a little rough right now.

    Can someone give me some advice on how best to proceed. I've been told, that I shouldn't need to call the doctor for two more weeks and then its will be another two after that to get a new labs drawn. I feel like I might be dead by then. Do you think that is possible or am I just overreacting?

     
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    Old 05-12-2004, 03:28 PM   #2
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    Re: what is the truth about labs?

    I don't know the answers but I will pray for you.

     
    Old 05-12-2004, 03:36 PM   #3
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    Re: what is the truth about labs?

    Hi and welcome.

    Waiting 6 weeks for labs is because it generally takes about that long for meds to reach their peak in the body, taking the thyroid hormone does not build up your supply instantly it takes a while.

    You should always have your Free T3 and Free T4 tested as these are the actual thyroid hormones your body has for use. Both of these labs should be mid to upper in the lab range. To find mid range, take the low and high number for that particular test, add them together and then divide by 2, this would be mid range and most people feel best and have the least symptoms above this number.

    As for the meds, sometimes its a hunt and peck sort of thing, if after a few months on one med your levels are optimal, meaning they are mid to upper in the range and you still feel poorly, you may want to try a different brand of meds. Not all meds are created equal, different binders and fillers can cause adverse reactions in some people, also the natural meds, Armour, Westhroid, Nature-Throid have both T3 and T4 and a lot of people feel better on them because they are gentler on the body and more easily absorbed.

    You started on a pretty high dose, usually its best to start rather low and build up, what you are feeling may be your body adjusting to the meds. Quite often you may feel worse before you feel better as your body is adjusting to the meds, however, if the dizziness continues, you may want to call you dr and discuss possibly cutting your pills in half and trying that for a while and building up to the 100 mcg, or you may be having a reaction to one of the binders or fillers in that med.

    Hope all goes well for you.


    By the way, never hesitate to call your dr if you are concerned about something you are experiencing.

    Last edited by dea4; 05-12-2004 at 03:41 PM.

     
    Old 05-14-2004, 11:14 AM   #4
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    Re: what is the truth about labs?

    Jacqbu:

    Thankyou for your sentiment. It means a lot.

    ~S


    Dea4

    Thankyou for the thoughtful reply. I know you put some time into writing all that, and
    I'm touched by your sweetness.


    I did get my labs drawn yesterday when I went visited my Nuerologist. His man called today to say my labs were "normal." He didn't have the values to pass on, so, I guess this is where its going to get interesting. I told him to have the doctor call me with the values, since I can't manage this without that critical information.

    I am afraid I will need to find a better Endo that the one I currenly have. I dont' belive he is well versed on the particulars of labs/drugs. Too bad, I have to do the hunting while in such a weakened condition. They never tell you how to prepare yourself, do they? I was perfectly healthy before my surgery and now I'm a such a mess, and having a hard time being my own advocate with my bad voice and all. Its hard NOT to be frustrated. Unfortunately, my family has no tolerance for my condition and is downright hostile towards my annoying voice and apparent laziness.

    I'm wondering about something you mentioned there though. Is there any significance behind taking a T3/T4 combo pill? What are the other advantages besides ease of absorbtion and gentleness on the body? If they are superior, why don't doctors prescribe them more readily than the Synthroid? How does one determine the proper dose? What for instance would be equal to the 100 mgs of Sythroid I'm taking now?

    I do thank you from the bottom of my heart. You are my best support right now.

    ~S

     
    Old 05-14-2004, 11:50 AM   #5
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    Re: what is the truth about labs?

    I'm so sorry you are having to go through all this, too bad your family isn't more supportive, but you are not alone, you can come here anytime and vent if you wish.

    A lot of people feel better on a T3/T4 combo because the T3 is actually the useable form, its the one used at a cellular level, T4 is converted to T3 in your liver and a lot of people just don't convert it well and find that the combos give them more energy and less symptoms.
    The only T3/T4 synthetic combo is Thyrolar, and then there is T3 Cytomel which is often added to the synthetic T4, but a lot of people find the most relief with the natural meds (Armour, Westhroid, Nature-Throid) because they not only contain the T3 and T4 but are suppose to also contain all the T's. Our body actually makes many T's (T, T1, T2, T3, T4 and so on) but drs don't really know what the others are used for, they know that we need the T3 and T4, there is some thought that the T2 is needed for metabolism. So, if the natural contains them all, its no wonder that we may respond better to it, our bodies obviously made them for a reason and needed them when the thyroid was working properly.

    1 grain (60mg) of Armour is equal to 74mcg of synthetic T4
    1-1/2 grain (90mg) is equal to 111mcg synthetic T4

    So you would probably need the 1-1/2 or 1-1/4 would be equal to 92.5mcg synthetic T4.

    I hope you can get some relief and feel better soon.
    Take care.

     
    Old 05-14-2004, 12:44 PM   #6
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    Re: what is the truth about labs?

    Wow!

    You are full of enlightening info! I feel so much better now. I really appreciate your support and I really appreciate your support!

    I just got a call back from the Neurologist's office with some values. He says they are as follows:

    3.38 TSH
    16.1 T4
    25.1 T3
    4 T7

    According to him they are "normal."


    Prior to gettting my T removed, I had a T4 Free value of 1.3 and a TSH valued at 2.24. I felt perfect back then. Do these new lab values strike you as messed up as they do me?

    ~S

     
    Old 05-14-2004, 02:33 PM   #7
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    Re: what is the truth about labs?

    Do you have the lab ranges? I need those to know whats going on, all labs have different ranges. And did they do the frees or are those totals?
    I'll check back.

     
    Old 05-14-2004, 03:25 PM   #8
    softcrush
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    Re: what is the truth about labs?

    The T4 Free.... is ref. to be 0.8-1.8 ng/dL
    The TSH .........is ref to be .70-6.40mIU/L

    I may actually be confused on this score though. Is the T4 the same as Free T4?

    What is the difference between a "Free" and a "total" value? Is there something I am missing here?

    Since I was just provided those figures over the phone and presently without hardcopy its hard for me to give you other ref. ranges. Sorry about that

    If I need get the labs done again, I'll see if I can get them ordered. I thought I had requested a full panel. What do you recommend I order specifically?

    Sorry about the ***** thoughts. Forgive me, it real hard to think right now.

    By the way, the Endo's office failed to return my calls. Two days in a row. Nice Huh?

     
    Old 05-14-2004, 07:31 PM   #9
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    Re: what is the truth about labs?

    Quote:
    Originally Posted by softcrush
    The T4 Free.... is ref. to be 0.8-1.8 ng/dL
    The TSH .........is ref to be .70-6.40mIU/L

    I may actually be confused on this score though. Is the T4 the same as Free T4?

    What is the difference between a "Free" and a "total" value? Is there something I am missing here?


    By the way, the Endo's office failed to return my calls. Two days in a row. Nice Huh?
    Just T4 is usually total not free, to be free it generally says Free or FT4.
    Your free T4 range [0.8-1.8] would have a mid range of 1.3, you will want your free T4 above 1.3

    The Free T3 and Free T4 are both the actual thyroid hormones, they are what your body has to "run on" they are "free" because they are not bound by protiens. If you arn't getting enough meds or too much it would show up in the free test results.
    The Total values are bound and active hormone, they are bound by protiens and don't tell you how much of the total is free and how much is bound.

    Ask for the Free T3 and Free T4, you have to say FREE or they will most likely order totals.

    Figures endo didn't call you back, I hate that when that happens

    Take care.

    Last edited by dea4; 05-14-2004 at 07:36 PM.

     
    Old 05-15-2004, 05:53 PM   #10
    softcrush
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    Re: what is the truth about labs?

    Hi Again:

    Thanks for the heads up on all that. I guess I'll have to get the bloodwork done AGAIN as I know something is serverly out of kilter here, and needs to be addressed ASAP. I'll order the Free T4 and The Free T3 as you suggested, and try to make sure there is a way to get the lab ranges along with the results.

    I got a letter in from the Endo confirming I was hypo two weeks post surgery even though he told me there was no way that was possible at the time. I didn't feel quite right then, and he had told me that I was imagining things. I felt tired and groggy and like I was gaining weight and there was a very odd coldness. Go figure. Since I am out of disability I thought it was important to get the meds straightened out before sending me back to work and he refused, saying I should be feeling fine and there was no reason not to go. Don't you just love that?

    I have pins and needles, and horrible aches all over and feel like I weigh a thousand pounds now. I have an insatiable need for sleep, and feel utterly miserable. The Nuerologist on Thursday said my BP was low. Somehow, I'm not surprised.

    The Endo's letter also said findings indicate there are antibodies against thyroglobulin present and the recovery was only 65%. He states this in the letter after saying the thryroglobulin level itself was undetectable.

    What????

    The other thing that bugs me, I was asking for these results when I got the blood drawn back on April 23, 2004 and I'm just getting this cryptic letter on May 15, 2004?
    Do these people not understand the ramifications to the patient when they are so lax in their responsibilty? This letter fails to give the critical values or lab results, even though I had requested that info in writing nearly a month ago. ARG!!!

    Thankyou very much for your support. It means a lot to me.

    ~S

    Lets hope I'll be able to hold it together a little longer. I'm fading fast here.

     
    Old 05-16-2004, 04:35 PM   #11
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    Re: what is the truth about labs?

    DEA:

    I just returned from the hospital ER. I must be their least favorite type visitor. They seemed really ****** to be used for aquiring labs. Oh well. At least I got some firm data. Not all that I wanted, but some.

    The readouts pretty much confirm my worries. Let me know if you concur.


    range ref.
    T3 uptake 31 31-39
    T4 Free .071 0.59-1.17 NG/DL
    TSH 4.95 .034-4.82 HIGH

    Monocyctes 10.0 1.7-9.3 HIGH
    Basophils 1.3 0.0-1.0 HIGH
    Glucose 101 70-100 HIGH

    There are many more labs I could list. I figure the ones I have here are the most important. I had wanted a free t3, but the doctor there just sort of told me, that she should be the one to be ordering the labs.

    I gave it my best shot anyway. I'm thinking I'm hypo and that I should switch to the Armour.

    Thanks for caring and taking the time to get me through this. I feel so alone right now.

    ~S

     
    Old 05-16-2004, 07:10 PM   #12
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    Re: what is the truth about labs?

    Quote:
    Originally Posted by softcrush
    range ref.
    T3 uptake 31 31-39
    T4 Free .071 0.59-1.17 NG/DL
    TSH 4.95 .034-4.82 HIGH

    Monocyctes 10.0 1.7-9.3 HIGH
    Basophils 1.3 0.0-1.0 HIGH
    Glucose 101 70-100 HIGH


    ~S

    Your labs are hypo, that TSH is way too high and the range is outdated anyway, it should go only to 2.5. Your Free T4 is too low to feel well, no wonder you feel so awful. The T3 uptake is T3 from a test tube used to measure binding protiens in your blood (not your T3 either) so it no way tells what your T3 is actually doing.
    I disagree with the dr saying "she should be the one ordering the labs" you should have told her when she is the one dealing with health problems she can decide what labs to order, but for you they should order what you request because this is your life and health not hers. (bet that would have gone over wonderfully, but sometimes you just have to put your foot down)

    You are on the right track, you are hypo and its no wonder you feel badly. Can't believe the dr told you that you should be feeling fine, what an idiot, they have no idea and as long as they arn't suffering they don't care, they're only treating your lab sheet and doing a poor job at that.

    You keep pushing to ge the care you need.
    Take care and keep us updated.

     
    Old 05-18-2004, 02:04 AM   #13
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    Re: what is the truth about labs?

    I have gone round and round again today with my endo's office. They refuse to treat my condition saying I have to wait two more days to see the doctor and my symptoms sound too extreme to even be an endocrine problem now. They say the labs are "normal" and not hypo. I'm like what???? You insist on taking out a vital organ, which was working beautifully, and now that I'm dying without it you tell me there must be something other than the missing organ causing my pain?

    I'm increadulous.


    I'm am classic hypo...tired, endless fatigue, anxiety feeling, muscle pains, muscle weakness and brain fog, with cold peircing knives into my numb hands and feet. Its hell. I just want to die. These are the same symptons I started having a week after they took out the thyroid.

    My old Pre-op labs show values so much higher on the T4 free and so much lower on the TSH, and glucose.

    Who would it hurt to change the med to Armour? Why are they so hell-bent on witholding the one thing that is might help me, or at least just shut me up? I just don't get it.

    Thank you for understanding and listening. I am so stressed right now...I feel like I'm going to really go out of my mind. Thankyou for being there.

     
    Old 05-18-2004, 07:09 AM   #14
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    Re: what is the truth about labs?

    You hang in there, either its time to find another dr or grit your teeth and go after that dr fighting mad because if they can't see that your levels are not right they are idiots. A TSH of 4.95 is too high and its even above their outdated lab range. And, your free T4 is just too low to feel well, I can't believe they are telling you its something other than thyroid related, ARGH!!!!
    Keep us posted.

     
    Old 05-18-2004, 11:14 AM   #15
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    Re: what is the truth about labs?

    ((((Softcrush))))

    Bless your heart, I hope you are able to get this all worked out soon. I'm telling you, reading these posts on here just makes me get tears in my eyes. What Dea4 said is right.......time to find a new doc or go in there "fighting mad".

     
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