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  • Should I be on meds?

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    Old 11-11-2008, 04:14 AM   #1
    skays
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    Should I be on meds?

    I have been trying to get diagnosed for a few years, believing all my symptoms are thyroid and/or perimenopause in nature. I have a DR. appointment next week and am thinking I need to convince her (someone I have not seen before) to let me try something. With these labs what meds would be best?

    Recent labs as well as last two years:

    10/08:

    TSH: 1.716 (.350-5.5)
    Free T3: 2.6 (2.3-4.2)
    Free T4: 1.15 (.80-1.80)
    TPO: 252 (0-60)
    Ferritin: 43 (10-295)

    10/07:

    TSH: 1.69 (.40-4.50)
    Free T3: was not tested
    Free T4: 1.1 (0.8-1.8)
    TPO: 37 (<35)
    Ferritin: 21 (10-232)

    9/06:

    TSH: 1.65 (.40-5.5)
    Free T3: 2.48 (2.3-4.2)
    Free T4: 1.1 (0.8-1.8)
    TPO: 43 (<35)
    Ferritin: 31 (10-232)

    Thanks for any advice/suggestions!

     
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    Old 11-11-2008, 08:30 AM   #2
    mkgb
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    Re: Should I be on meds?

    skays,

    Yes I believe you should be on medication.

    Why? Well not by the TSH but because you are suboptimal in range and have Hashimoto's antibodies. Proactive treatment of subclinical hypothyroidism has been proven helpful for slowing Hashimoto's destruction and relieving the patient of their hypothyroid symptoms.

    Recent labs as well as last two years:

    10/08:

    TSH: 1.716
    (.350-5.5) (0.35-2.5) Is the range recommended by the A A C E in 2006. 2002 saw the recommendation of 0.3-3.0. Your lab is well out of date with ranges here.

    Free T3: 2.6 (2.3-4.2)
    This is your kicker. You are 15.7% of normal range. You are LOW here and as a result will manifest many physical hypothyroid symptoms.

    Free T4: 1.15 (.80-1.80)
    You are 35% of the normal range here. This is also suboptimal in range. however you are 20% higher in T4 than in T3. You need to test your adrenal function (ACTH and Cortisol 8 am blood serum fasting) and you need to test your T4 to T3 conversion by measuring RT3. If your RT3 is high you need T3 supplementation. If you are hyper adrenal you need to treat the hyper ACTH production and medicate your thyroid after the fact.

    TPO: 252 (0-60)
    This is a positive identifier of hashimoto's if this is a TPOAb test result and range.

    Ferritin: 43 (10-295) -
    You need a ferrous fumerate supplement. At least 30 mg a day. Maybe more. First make sure you are taking a multivitamin with selenium and ferrous fumerate in it. This may be all you need to bring up your ferritin. You want a ferritin above between 70 minimum. 70 on your scale is only 21% of normal range. You will probably need a higher ferritin to get relief.. 150 is approximately 50% of normal range.

    10/07:
    TSH: 1.69 (.40-4.50)
    Wrong range again. Nuff said.
    Free T3: was not tested Not surprised many MDs you have to practically bite their ankles and hang on til they give in and test the Ft3.

    Free T4: 1.1 (0.8-1.8)
    You are 30% of normal range here. This is suboptimal. Given the lower TSH one can hypothesize that your Ft3 was a bit higher at this time.

    TPO: 37 (<35) This is showing early signs of active Hashimoto's.

    Ferritin: 21 (10-232) You need a ferrous fumerate supplementation. This is really low.

    9/06:
    TSH: 1.65 (.40-5.5)
    *SNORT*

    Free T3: 2.48 (2.3-4.2) You are 9.5% of normal range. This is a cry for help especially given the LOW TSH. I suspect your pituitary gland is not doing its job and your liver is improperly converting your T4 to RT3.

    Free T4: 1.1 (0.8-1.8) You are 30% in range here. This is suboptimal. You want to be 50-80% of normal range in both your Ft3 and Ft4 levels. You are far from it in the T3 region.
    TPO: 43 (<35) Hashimoto's treat it proactively before it gets out of hand.

    Ferritin: 31 (10-232)
    Add iron.

    My recommendations are additional testing of the pituitary gland function, adrenal function, and RT3. I believe you should be on a thyroid supplement regime and that you should be on one that supplements T3 as well as T4 given your low T3 T4 imbalance issues. make sure you are going to a forward think MD that is willing to find the source of your issues and treat your proactively with T4 and/or T3 supplementation as needed.

    MG
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    Old 11-11-2008, 06:33 PM   #3
    mkgb
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    Re: Should I be on meds?

    They exist. I have found one that is open minded and uses me as a living reference and researcher. I save her time in that regard. She admits she doesn't know as much as me now with regards to sinus infections and my specific endocrine issues and the issues that my family suffer from.. I ahvfe made a life study un derstanding and helping my own. People here are my extended family and benefit as well. Why? The support I got here helped me fight and get my family behind me and now my one true MD gem and I together are muddling through better than the Endos I have plagued... well they treated me like a plague. At least they didn't try and belittle me after I dumped 100+ medical references on their desks with 5 years of tabulated and graphed blood work and symptom logs. This tended to sober them up.. but they still resisted working to solve my issues. The first one passed me off to all the separate specialists and ignored them when the specialists wanted me to be treated. Then there was the one that flat out admitted that he had no clue how to treat hashimoto's let alone my mess.. then Endon't number three. He told me everything I was doing was wrong. Told me I would need to get off my adrenal meds and more.. then did tests and told me to get back on everything and keep doing what I was doing.. he couldn't add anything to my care.. OKAY! SO WHY PAY YA! SO I looked over all the tests he had run and picked up on the insulin re3sistance and PCOS anomaly. Went back to my IM and buddy. We tested for PCOS, insulin resistance, and hypoglycemia. I was positive for all three and EnDUM 3 was oblivious. EXCUSE ME! All conditions are endocrine in nature and my blood work was classic for it. He just didn't bother to look beyond the NORMAL TSH. I hate TSH watchers. They really get my britches in a wad and make me want to belch fire... no that is my pizza. *sigh*

    Anyway do not give up. Educate yourself and keep shopping. I went through A LOT of MDs to get them to listen to me. I had an OB for a SIL and a Neurologist friend supporting me and helping me research and prepare for each MD visit. This added to my dual Masters in Chemistry and Chemical Engineering back ground. I still had MDs try and tell me I was mistaken and imagining things. WELL if they do the appropriate tests AND LOOK at them.. Blood rarely lies and ANTIBODIES never lie.

    MG
    __________________
    If we learn by our mistakes, I am working on one hell of an education.

    Last edited by mkgb; 11-11-2008 at 06:35 PM.

     
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