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  • Frustrated by Lab Results, please help

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    Old 04-01-2009, 04:41 PM   #1
    malaprop
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    Unhappy Frustrated by Lab Results, please help

    Here's my story: Over the last few years I grew steadily more tired and my short term memory seemed to be going. I gained 30 lbs. for seemingly no reason... I felt like I was getting old before my time! (I'm 28.) Well, you guessed it, I was diagnosed with being hypothyroid this last September.

    My numbers are kind of funny... when I was diagnosed, I was only "subclinically" hypothyroid with a TSH of 3.1. My free T4 was 0.75. So my doctor had me tested for thyroid antibodies. It was negative. However, she ALSO had me tested via some kind of radioactive thyroid scan. The radiologist said that he was confused by the results of my scan... that he would put money on my having Hashimoto's from my scan... but my antibodies had been negative. He said that 10% of people who have Hashimoto's do NOT have antibodies... so it was likely that I was one of those 10%, but there was no real way to tell. Luckily, my doctor decided that from my TSH and the scan that I was probably in the earliest stages of Hashimoto's. So I have been treated with Unithroid since then.

    I am feeling MUCH better since receiving treatment. Before treatment I could sleep 16 hours a day and still wake up tired and needing a nap. Now I feel rested after about 10-11 hours of sleep, not "normal," but better.

    However, I just got my most recent lab results back, and I'm really confused. Although I feel better, I don't feel normal, but according to my lab results my TSH is 0.94. Which sounds perfect, EXCEPT... Two months ago my TSH was 2.5. How did it drop so much in 2 months with only a 25 mcg increase in meds? My first dosage (25 mcg) took me from 3.1 to 2.8. My second dosage (50 mcg) took me from 2.8 to 2.5. This last dosage (75 mcg) took me from 2.5 to 0.94?! Why did it drop so much more than the previous dosages?

    So, right now my lab results are:

    TSH: 0.94
    FT4: 0.77
    FT3: 3.15

    And why has my FT4 only risen 0.02?! When I was first diagnosed with hypothyroidism, my doctor said that .75 was the lowest 1% of normal. Well, 0.77 doesn't sound much better.

    What is going on??? I'm so frustrated! I just want to feel normal!

    Last edited by malaprop; 04-02-2009 at 07:10 AM. Reason: typo

     
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    Old 04-01-2009, 05:24 PM   #2
    katkatdd
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    Re: Frustrated by Lab Results, please help

    I feel your pain. Although I really don't have much of a clincial answer for you as there are much better people here on the boards to answer that I just thought I would put my 2 cents in and let you know that I also feel your pain!!

    The med dance sure seems like a common dance doesn't it? They need to make a name for it it's so common.. Sheesh.... And why our labs jump all over and seem very unpredictable and uncertain is another mystery to me as well....

    I had a test in feb come back normal and then not even a month later come back wayyy ABnormal.. Crazy stuff...

     
    Old 04-01-2009, 07:53 PM   #3
    midwest1
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    Re: Frustrated by Lab Results, please help

    Your story is an absolutely perfect example of why TSH-watching is such a futile and stupid exercise in thyroid treatment. Until your MD understands that the point of thyroid replacement is not to merely lower TSH, but to raise FT4 (and FT3), you will never feel any better than you do at this moment.

    The dose of 25 mcgs is a "non-dose". It usually only serves to lower TSH, but leaves the FT4 static and - often -actually lower than it was before treatment. It's just enough med to interrupt the pituitary/hypothalamus/thyroid feedback loop by reducing the pituitary's output of TSH. Lower TSH causes the thyroid gland, which was already producing too little hormone, to produce even less than it was before the med was introduced. That's why your FT4 didn't rise at all. The lowest therapeutic dose is 50 mcgs, and that's what you should have been given to start. A full replacement dose for most women is about 150-175 mcgs. Your dose should be increased until your FT4 and FT3 are between 50-70% of their lab ranges.

    When you provide lab results for comment, we must see the lab's reference ranges with them. Different labs use different references. If your lab uses the most typical ones, your FT4 would need to be between 1.3 and 1.5 before you will feel well. Provide your lab's ranges, we can tell you more about your FTs.

    Feel thankful that your endo knew enough about Hashi's to give you your diagnosis. That's half the battle. But I urge you not to accept undertreatment. There are more understanding MDs around who know to watch the FTs, not just TSH... and who actually care about symptoms. Most endos couldn't care less about how you feel, and they want to only watch the "almighty TSH".

    Good luck!

     
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