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    Old 03-24-2009, 10:59 PM   #1
    ngtstrm
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    Arrow Confused and need help with labs

    I just realized that, though I had requested FT3 and FT4, what I got were total T3 and total T4... AAGH! Are these of any value at all? I also have results for these tests: CBC w/ automated differential, sed rate, ccp antibody, total estrogen (due to surgical menopause), and the following:


    Thyroxine................. 6.4 (4.5 - 12.0 ug/dL)
    T3 Uptake................. 32.0 (22.5 - 37.0 %)
    Free Thyroxine Index...... 2.0 (1.01 - 4.44 ug/dL)
    TSH....................... 3.690 (0.35 - 5.50 uIU/mL)
    Triiodothyronine.......... 103 (60 - 170 ng/dL)

    Ferritin 12.4 (11 - 306.8 ng/mL)

    Vitamin D, 25-OH, Total 17* (20 - 100 ng/mL)
    Vitamin D, 25-OH, D3 17
    Vitamin D, 25-OH, D2 <4
    (There's a note that says: "Optimal levels are > 30 ng/mL" on the Vit D, 25-OH, Total.)

    Vitamin B12 490 (180 - 914 pg/mL)

    Folates 7.70 (> 3.0 ng/mL)


    I have been dx'd with Hashimoto's (no idea about lab numbers at this point - that was many years ago), fibromyalgia, PCOS, and a host of other things. I'm also in surgical menopause. For thyroid, I'm currently taking 60 mg of Armour thyroid, but for these results, I was on Levoxyl 88mcg (the change to Armour took place after these results). I still feel cold (wore a jacket in balmy 80 degree, south FL weather), have some swelling in lower legs, hair loss, fatigued and in pain (fibro?), and possible carpal tunnel in wrist (scheduled for MRI next week). I'm not sure what other info to include, so please feel free to ask if there's anything else, besides the missing FT3 and FT4 tests, that you need to know. I'll see about getting those when I go back in a month - sooner if it seems warranted. Thanks!

    Oh, and the doc also ordered a "random cortisol" test that was taken today. She said the 8AM test is better and if the "random" test shows an abnormality, we'll do the 8AM test early next week. If not, we'll see what happens with the change in my thyroid med and, if I am still symptomatic, we can do the 8AM test later.

    Thank you very much for your help, in advance. I'm still trying to learn about hypothyroidism, but it's not going as quickly as I'd like. Even though I've been diagnosed for years, I was told I was "normal" on thyroid function, so I only started thyroid meds about 2 years ago... and didn't question the endo as much as I should have... he was very discouraging of questions... I think he felt threatened or something. Anyway, I very much appreciate the help! And thanks again.

    P.S. Oops, didn't notice the icon until too late. Sorry 'bout that!
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    Last edited by ngtstrm; 03-24-2009 at 11:01 PM. Reason: Note about unintentional icon choice.

     
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    Old 03-25-2009, 07:35 PM   #2
    midwest1
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    Re: Confused and need help with labs

    Yeah, endos are like that. Must be the way they were brought up. I'm not a fan of endos for hypothyroidism treatment.

    You are apparently still undertreated. When you take Armour, your TSH will be near 0 when the dose is right for you. An optimum FT3 would be 50-70% of its lab range, and FT4 will often be proportionately slightly lower than that when a T3 drug is used. My own T3 is about 70%; my FT4 is about 40%. This is fine for me, but others may need to boost the FT4 to roughly equal the proportion of FT3 by adding a small amount of T4 med to the Armour dose.

    An average full replacement dose of Armour for most women is 120-150 mgs. You have a way to go. Get labs done each 6-8 weeks and push for dose increases until your numbers are in the ranges I described above. Evaluate your symptoms as the levels increase. Symptoms are as equally important as numbers on a lab sheet. When the levels look right, it may then take 2-3 months for symptoms to resolve. You will then know your dose is optimum for you.

    Last edited by midwest1; 03-25-2009 at 10:44 PM.

     
    Old 03-25-2009, 09:03 PM   #3
    ngtstrm
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    Re: Confused and need help with labs

    Thank you for answering me and giving me this info. I can't tell you how much I appreciate it!

    And I'm glad you're not an "endo fan". I'm not either... in fact, the last endo I went to wouldn't even DISCUSS Armour treatment... he went off into a 15 minute rant about it. Needless to say, I don't see that endo any more. It was actually a NP who ran these tests for me and who, thankfully, is local and agreed to help me find out what's wrong with me, whether it be thyroid or fibro or whatever. Since I've been looking for someone to help me for over 4 years, this was a relief!

    Now that you've told me what to look for, I'll be sure to get the FT3 and FT4 next month. The NP will be checking thyroid function (incl FT3 and FT4 ), and also checking the Vit D again, since it was low. She (the NP) actually does labs every 4 weeks until the dosage is stablilized, then does labs every 3 months (MUCH better than my last endo - he only did labs once a year!). Is 4 weeks too soon to change the Armour dose? Is there any other test I should get done too... like a new antibodies test for Hashi's or anything?

    Thanks again for your help!

     
    Old 03-25-2009, 10:42 PM   #4
    midwest1
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    Re: Confused and need help with labs

    I'm happy for you that you've found a better "thyroid-ician" than an endo. And an Armour believer to boot! I'd be a bit wary of the 4-week increases, though. Seems a tad speedy for most folks. The adrenals can be thrown for a loop when fast increases are attempted. Otherwise, I like that NP's cooperative style. So much different than the garden-variety endo.

    I don't think there is anything to gain by repeating antibody tests now. IMO, they are useful for diagnostic purposes; but since the treatment for antibody-induced hypothyroidism is the same as it is for hypoT from any other cause, there's no real point to repeating the AB tests over and over.

    I thought your name was unfamiliar on this board, so I looked up more of your posts to see which other boards you've posted on. Interesting to see that most are on Fibromyalgia. Are you aware that some thyroidologists believe that fibro is actually based on a thyroid hormone dysfunction? The two symptoms lists are nearly identical. I hope you'll find that once you're properly dosed with Armour that "fibro" will be a thing in your past.

    Welcome officially over here.

     
    Old 03-26-2009, 05:12 AM   #5
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    Re: Confused and need help with labs

    I would like to comment on your ferritin level. Your ferritin is way too low, even though technically in the normal range. Are you anemic? I saw you mentioned a hysterectomy. Is this from heavy periods? Hopefully with no more periods, you can raise your ferritin levels. Low ferritin (and anemia if you are anemic) will give you all sorts of symptoms too.

    It sounds like you have a lot of different things going on and hopefully you can knock them out one by one and start feeling better.

     
    Old 03-26-2009, 07:23 AM   #6
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    Re: Confused and need help with labs

    Someone correct me if I am wrong, but I think she has the FT3 lab..it is the triiodothyronine that has the value of 103.

     
    Old 03-26-2009, 08:14 AM   #7
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    Re: Confused and need help with labs

    Quote:
    Originally Posted by sparkie View Post
    Someone correct me if I am wrong, but I think she has the FT3 lab..it is the triiodothyronine that has the value of 103.
    "Triiodothyronine" without the "free" designation attached would be a total measure.

     
    Old 03-26-2009, 09:09 AM   #8
    ngtstrm
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    Re: Confused and need help with labs

    Hi y’all. Thanks for the help and for the welcome and the well wishes!

    Midwest1: I’m not sure my NP is a believer, but she was willing to let me try the Armour, for which I’m grateful! Even though, as you said, I’m still suboptimal, I already feel SO much better on it than the synthetic T4 that lovely, ranting endo had me taking. By the time I get my labs back from next month, it will be about 6 weeks since my last dosage change on the Armour, but I’ll be careful after that not to take it too fast. I don’t need to add any more symptoms than I already have… :grin: Thanks for the warning!

    And, no, I didn’t know some thyroidologists [a new “-ologist” for me!] think fibro is a thyroid hormone dysfunction… interesting that I thought something similar myself, yes? That’s so weird… If you look through my posting history again, you’ll come across an older thread of mine “Yet another Fibromyalgia theory/question” where I asked for feedback on a similar theory that I had come up with from my own research – not that I’m an expert or anything, believe me! The data I’ve since received, however, is indicating something else a little “deeper”, if you will… hypothalamus dysfunction or injury, maybe… just a personal theory though… not to get too much off topic here, but it is an interesting question of some immediate concern to me… as you might imagine! LOL And I too am hoping that the fibro symptoms will cease or at least decrease enough for me to start working again after I get on the optimal Armour dosage. I miss working, strange to say… Thanks again and take care.

    herekittykitty: I’m glad you mentioned the low Ferritin… it seemed low to me too, but the NP didn’t seem concerned about it at this point… maybe because we were too busy concentrating on my thyroid and fibro issues. Various “flavors” of anemia do run in my family, along with porphyria, so I wondered. I didn’t want to post what are seemingly “normal” values over on the Anemia board, so I asked someone privately from the Anemia board about my labs and she seemed concerned too. I’ve not been diagnosed anemic, except for my last visit from Auntie Flow. The reason I had to have the hysterectomy last Dec. is that my OB/gyn and I could not get my last flow to stop… 49 days of very heavy bleeding, even with us trying everything the OB knew to try to stop it… my only options were hysterectomy or slowly bleed to death and as I’m not a ghost writer, I guess it’s obvious what I chose, huh? Most of my red blood cell counts are at the low or extreme low end of normal, but normal nonetheless, so I’m not sure whether or not to be concerned. Shouldn’t I have recovered from all of that bleeding by now? What do y’all think?

     
    Old 03-26-2009, 09:27 AM   #9
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    Re: Confused and need help with labs

    If you aren't familiar with the work of Dr. John C. Lowe, look him up. He has written The Metabolic Treatment of Fibromyalgia and has strong convictions about the use of Armour vs. synthetic T4 for the treatment of hypoT/fibro.

     
    Old 03-26-2009, 09:42 AM   #10
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    Re: Confused and need help with labs

    Quote:
    Originally Posted by midwest1 View Post
    If you aren't familiar with the work of Dr. John C. Lowe, look him up. He has written The Metabolic Treatment of Fibromyalgia and has strong convictions about the use of Armour vs. synthetic T4 for the treatment of hypoT/fibro.
    I've heard of many fibro books, but not this one. I'll definitely check into it. Thanks, midwest!
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    Old 03-26-2009, 11:04 AM   #11
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    Re: Confused and need help with labs

    Midwest, thanks for correcting me. I don't need to confuse someone whose post starts with "confused". I guess I didn't look at my lab sheet close enough. In any event, I noticed your notation of Dr. Lowe. Do you have any opinions of what he has written? I ask because he is located in my area and I have seen his site and what he has written about thyroid hormone resistance, something the MD I am seeing now has mentioned but also promptly dismissed.

     
    Old 03-26-2009, 11:42 AM   #12
    herekittykitty
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    Re: Confused and need help with labs

    Shouldn’t I have recovered from all of that bleeding by now? What do y’all think?

    I think your slight anemia will clear up a lot quicker than your low ferritin level, especially since you have taken care of the source of your problem through having the hysterectomy. Did your doctor mention taking any iron supplements?

    I have a ferritin level of 2. After supplementing with 300 mg. of iron daily for a month, my ferritin went up to a 4. So you can see it is a slow process, but I still have my source of bleeding, heavy periods. Hopefully for you, it will happen faster.

     
    Old 03-26-2009, 08:11 PM   #13
    ngtstrm
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    Re: Confused and need help with labs

    Quote:
    Originally Posted by herekittykitty View Post
    I think your slight anemia will clear up a lot quicker than your low ferritin level, especially since you have taken care of the source of your problem through having the hysterectomy. Did your doctor mention taking any iron supplements?

    I have a ferritin level of 2. After supplementing with 300 mg. of iron daily for a month, my ferritin went up to a 4. So you can see it is a slow process, but I still have my source of bleeding, heavy periods. Hopefully for you, it will happen faster.
    Wow! Can I ask what symptoms such a low ferritin level gives you? I don't think I should be complaining about mine, now! Does the iron supplement help?

    My doc didn't seem to think any of my low-normal levels were a problem, since they're still, technically, in the normal range. I have an iron supplement that says it is 65 mg of iron (equivalent to 325 mg Ferrous sulfate) left from previous days. I don't know the significance of that equivalency, unfortunately, but should I go ahead and take this? If so, how much? Or should I wait and have her recheck the Ferritin when I go back in 4 weeks? Thanks a bunch!
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