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    Old 10-09-2007, 11:00 AM   #1
    jennifer35
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    Question Just got labs, feedback appreciated...

    I had a TT on Aug 9th. Doc prescribed levothyroxine 125 mcg to start. Haven't seen endo yet, couldn't get an appt until Dec. but have been experiencing weight gain and mood swings. Here are my lab results:

    T-3 Uptake 34 (ref range 22-35%)
    T-4, Total 10.6 (ref range 4.5-12.5)
    Free T-4 3.6 (ref range 1.4-3.8)
    TSH 6.55

    Doc says levels are a little high so he increased my levo to 150 mcg and ordered more labs in 6 weeks. Does this sound right? I'm so confused by all of this.

    Thanks in advance!

     
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    Old 10-09-2007, 02:13 PM   #2
    Clarissa234
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    Re: Just got labs, feedback appreciated...

    Your TSH is too high, not "a little high", definitely TOO HIGH. That's the only number your doctor must be looking at because your Free T4 is also near the high end of the "normal" range. I'm guessing doc is ignoring the Free-T's and just paying attention to TSH. Too bad he didn't check Free T3 as well. I'd be interested in seeing where that is at this time. I hope the new dose doesn't make you feel too hyper because he's giving you more T-4 and your Free T-4 is already pretty high on the range.

    I would suggest that you keep a log EVERY DAY describing what dose you took that day and EXACTLY how you were feeling. You should expect to see some changes in the next 4 weeks.

    Good luck to you. Keep us posted on how you are doing.

     
    Old 10-09-2007, 03:15 PM   #3
    jennifer35
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    Re: Just got labs, feedback appreciated...

    thanks Clarissa! I knew I wasn't gaining weight for no reason. He asked me if I had been eating more or not working out which is not the case. I feel okay but the weight gain is driving me nuts and the mood swings are driving my poor husband nuts. I hope the endo is more helpful.

     
    Old 10-09-2007, 03:21 PM   #4
    jennifer35
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    Re: Just got labs, feedback appreciated...

    Also, do you think he should have added T3 (Cytomel) to my meds? If these numbers are high, increasing my meds was the right thing to do, correct? Sorry, I'm so confused by all of this.

     
    Old 10-09-2007, 05:02 PM   #5
    midwest1
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    Re: Just got labs, feedback appreciated...

    Quote:
    If these numbers are high, increasing my meds was the right thing to do, correct?
    I added the highlight to emphasize the plural in "numbers". High TSH merits an increase; high FT4 does not. Your FT4 level is higher than most people need to feel well. I, for example, would be suffering hypERthyroid symptoms with FT4 that high. There's something odd about your numbers, because TSH that high doesn't ordinarily mesh with FT4 so high... and an MD who isn't sure what to make of that odd combination - or worse... who doesn't even notice it - isn't the one who ought to be doing the prescribing, IMHO.

    The only way to know if Cytomel should be added is to test your free T3, which wasn't done.

    I would ask the endo's staff if they keep an appointment cancellation list so you can get in sooner than December.

     
    Old 10-09-2007, 08:39 PM   #6
    jennifer35
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    Re: Just got labs, feedback appreciated...

    Thank you so much for your input. I'm so confused by all of this so I wasn't certain what to make of it but I'm definitely not feeling the symptoms of hyper. I'm gonna call tomorrow and see if the endo can put me on a cancellation list. The MD who prescribed the meds is the surgeon who removed my thyroid so I assumed he knew what he was doing as far as the prescribing goes but he did recommend that I begin seeing the endo as soon as possible so who knows. Once again, thanks for your help! I appreciate it!

    Quote:
    Originally Posted by midwest1 View Post
    I added the highlight to emphasize the plural in "numbers". High TSH merits an increase; high FT4 does not. Your FT4 level is higher than most people need to feel well. I, for example, would be suffering hypERthyroid symptoms with FT4 that high. There's something odd about your numbers, because TSH that high doesn't ordinarily mesh with FT4 so high... and an MD who isn't sure what to make of that odd combination - or worse... who doesn't even notice it - isn't the one who ought to be doing the prescribing, IMHO.

    The only way to know if Cytomel should be added is to test your free T3, which wasn't done.

    I would ask the endo's staff if they keep an appointment cancellation list so you can get in sooner than December.

     
    Old 10-10-2007, 06:47 AM   #7
    slkanger
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    Re: Just got labs, feedback appreciated...

    My daughter who is 26 has Thyroid Disease (Hashimoto's) and also was diagnosed with PCOS. She has gain quite a bit of weight this last year. The doc she was seeing for Thyroid is a jerk. She finally got an appt. with an Endo doctor but has to wait 2 months to get in! (12/3/07). Her husband was telling us last night about her mood swings and how she just cries. He thinks she's depressed. She goes back to the jerk next week for thyroid test again. He keeps saying her's is normal and she gained weight because she eats too much. She's never been a big eater and eating habits have not changed. She wants to sleep all the time also. It's driving her hubby nuts. HELP!

     
    Old 10-10-2007, 10:51 AM   #8
    Clarissa234
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    Re: Just got labs, feedback appreciated...

    To Jennifer35 - I wanted to clarify my prior post.

    You should see some changes in the next 4 weeks from the increase in your medicine, but I'm not so sure you're going to like those changes very much. Your FreeT4 is really close to the high end of the range and I worry that by giving you more T4 (that's Synthroid, Levoxyl or any of their substitutes), that your doctor is going to make you hypER-thyroid instead of hypO-thyroid. What midwest1 said is right, you probably need a different doctor, especially since he completely disregarded your current FT4 and didn't even bother to check FT3.

    That being said, if it were me and I was feeling hypO-thyroid symptoms, I'd probably take the Synthroid or Levoxyl prescribed to "test it". But you need to be really sure how you are feeling every day and keep a chart or log, because you can easily go into hypER-thyroid with too much T4 and your doc needs to know how your body is reacting, when it started, how long it lasted. If he's not interested in any of that information at your next visit, then that's just further evidence that he's not the right doctor for you. Too much thyroid medication is just as bad as not getting enough, however, it sometimes has a different set of unpleasant symptoms.

    I guess it could be worse. The doc could have looked at your current TSH and said you didn't need any adjustment to your treatment and completely disregarded your current hypO-thyroid symptoms.

    To Slkanger - she probably is depressed. It's a side effect of the condition when not properly medicated. It can get worse before it gets better. It's unpleasant but everyone around her needs to try to be understanding. Don't just settle for "hers is normal". Get some real numbers. Get a copy of the lab report or at the very least have them tell her over the phone what her actual lab results were and what the range the lab uses. As Midwest1 has posted on this board numerous times, "normal" is not necessarily "optimal" for her. They have to share that information with her.

    Best wishes to both of you.

     
    Old 10-10-2007, 05:38 PM   #9
    jennifer35
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    Re: Just got labs, feedback appreciated...

    Thanks Clarissa! At this point, I might welcome the changes. I'm usually an energetic person who bounces off the walls and, lately, I've been exhausted and irritable. I thought it was just from the surgery but after reading some info on this forum, I can see I was wrong and this isn't normal. My surgeon is an ear, nose and throat guy so I'm pretty sure he's not real concerned with my meds. He even suggested that I go to the endocrinologist after I told him how I was feeling. I'm quite concerned that he didn't check my FT3 also and I don't even know what that means. As I said before, this is all new to me so I really appreciate your feedback since you all seem to be very informed about this. Can you elaborate on what these numbers (ie. T3, T4, etc) mean? Sorry to sound so stupid but everything happened so fast as far as finding the mass, having my thyroid removed, that I just didn't even think ahead at the time and never asked these questions. I will definitely keep track of how I'm feeling on the new meds so I can let the endo know everything once I'm able to see her.

    Quote:
    Originally Posted by Clarissa234 View Post
    To Jennifer35 - I wanted to clarify my prior post.

    You should see some changes in the next 4 weeks from the increase in your medicine, but I'm not so sure you're going to like those changes very much. Your FreeT4 is really close to the high end of the range and I worry that by giving you more T4 (that's Synthroid, Levoxyl or any of their substitutes), that your doctor is going to make you hypER-thyroid instead of hypO-thyroid. What midwest1 said is right, you probably need a different doctor, especially since he completely disregarded your current FT4 and didn't even bother to check FT3.

    That being said, if it were me and I was feeling hypO-thyroid symptoms, I'd probably take the Synthroid or Levoxyl prescribed to "test it". But you need to be really sure how you are feeling every day and keep a chart or log, because you can easily go into hypER-thyroid with too much T4 and your doc needs to know how your body is reacting, when it started, how long it lasted. If he's not interested in any of that information at your next visit, then that's just further evidence that he's not the right doctor for you. Too much thyroid medication is just as bad as not getting enough, however, it sometimes has a different set of unpleasant symptoms.

    I guess it could be worse. The doc could have looked at your current TSH and said you didn't need any adjustment to your treatment and completely disregarded your current hypO-thyroid symptoms.

    To Slkanger - she probably is depressed. It's a side effect of the condition when not properly medicated. It can get worse before it gets better. It's unpleasant but everyone around her needs to try to be understanding. Don't just settle for "hers is normal". Get some real numbers. Get a copy of the lab report or at the very least have them tell her over the phone what her actual lab results were and what the range the lab uses. As Midwest1 has posted on this board numerous times, "normal" is not necessarily "optimal" for her. They have to share that information with her.

    Best wishes to both of you.

     
    Old 10-20-2007, 04:46 PM   #10
    jennifer35
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    Re: Just got labs, feedback appreciated...

    Hi again, just reporting back now that I've been on the 150 mcg of levo for about 11 days. I'm noticing that I've got more energy and my hair is growing like crazy but no change in my weight. I called the endo to see if they could get me in for a cancellation but no response yet, the nurse said they don't usually get too many cancellations. I think I'm gonna see my regular doc who found all of this to start and have him order the bloodwork again to see where I'm at. In the meantime, I'm still confused about the numbers, the levels and what not so any help is appreciated. I'd like to know what I'm asking for if I need to get aggressive with my docs. Anyone?

     
    Old 10-22-2007, 06:34 AM   #11
    Clarissa234
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    Re: Just got labs, feedback appreciated...

    Jen - Sorry it took me so long to get back to this message. Sometimes I'm off this board for several days at a time. You should consider checking out the book Thyroid for Dummies by Dr. Alan Rubin. It's a wealth of information.

    T3 and T4 are thyroid hormones. A normal working thyroid gland makes T4 and the body converts some of the T4 to T3. Since you had your thyroid gland removed, you are taking synthetic T4 (Synthroid, Levoxyl, levothyroxine). If you don't have some other endocrine or hormonal disorder like Addison's disease (adrenal insufficiency), then your organs should convert some of that T4 to T3.

    If your lab work shows your Free-T4 is at least 80% of the highest number in the lab range, and your TSH is closer to the lower end of the lab range, and you are still feeling crummy (hypo-T symptoms), then you really should have your Free-T3 checked. If your Free-T3 is closer to the low end of the lab range, you may not be converting T4 to T3 very well. You may need to supplement with a separate Rx for T3 (Cytomel). You may need your adrenal function checked.

    If you are starting to feel better and your only complaint is that you are not losing weight, then you are probably getting better. Lab work should not be tested until you've been on your Rx for at least 4 weeks. Actually better to check after 6 weeks because it takes the medication that long to build up in your body and reach it's full potential. Having labs done after 11 days your new prescription is not a good idea. If your lab work shows your thyroid hormone levels are not good, they might increase your dose, which might be too much medicine in 6 weeks from now when it reaches its full potential.

    Hope that helps!

     
    Old 12-28-2007, 02:06 PM   #12
    jennifer35
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    Re: Just got labs, feedback appreciated...

    Thank you all for your help. I saw the endocrinologist on the 12/24 and had new blood tests done that same day. I went in today to pick up my labs and she only tested my TSH and nothing else. She said the Free T3 and Free T4 tests weren't necessary. I'm concerned by this. She also switched me to Unithroid from generic Levo as she said that the pharmacies tend to change brands. I only have another week supply left of the Levo so I don't know what to do. It took me 2 months to get an appt with this woman and I don't feel like she's doing what should be done. Any advice/suggestions? Please!

     
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