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Please help with new labs. Even my doc is confused


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Old 12-31-2009, 09:16 AM   #1
tigger67
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Please help with new labs. Even my doc is confused

These labs are after being on 90mg compounded dessicated thyroid for two weeks. My doc is even confused and since I've never been on T3/T4 meds, I don't understand how they work and why my FT4 is so much lower than my FT3. He wants me to see an endo, but I don't trust them after going thru 4 in 6 months and all telling me I'm hyper based on my low tsh.

TSH .021 (.35-4.5)
FT4 .85 (.89-1.8)
FT3 3.0 (2.3-4.2)

 
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Old 12-31-2009, 10:39 AM   #2
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Re: Please help with new labs. Even my doc is confused

In your thyroid med there's relatively more T3 than T4 compared to what the healthy human thyroid produces. Therefore when on NTH FT4s tend to be lower compared to their range than FT3s. Because your med contains T3 it really easily suppresses your TSH - therefore TSH should be ignored and stay focused on your symptoms and those free T's (especially FT3 which has more meaning anyway). Your free T's are both still fairly low but 2 weeks on this med is quite a short time on this med to have absolutely accurate labs. How are you feeling?

Last edited by FinnMaid; 12-31-2009 at 10:46 AM.

 
Old 12-31-2009, 11:57 AM   #3
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Re: Please help with new labs. Even my doc is confused

Also ask the compounding pharmacist if they're adding cellulose to the meds, it could be you aren't absorbing them well if they are.

I would test your reverse T3 levels next and see if you have high RT3. But you are on a pretty low dose of the desiccated thyroid still so you most likely need to keep increasing it 1/2 grain every couple of weeks and see if symptoms relieve and those lab levels come up. And like FinnMaid says, ignore the TSH!

Last edited by javelina; 12-31-2009 at 11:58 AM.

 
Old 12-31-2009, 02:02 PM   #4
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Re: Please help with new labs. Even my doc is confused

I just picked up the new px for 120mg. The pharmacy does use cellulose, but my dr. said if it were a case of not absorbing well, the FT3 would be a lot lower too. I definately don't worry about the TSH so much. It's been low for over a year now, even when I was on synthroid, and I've never been hyper.

I'll keep you posted on how I feel on the new px. I get new labs in a couple weeks.

Do you think that seeing an osteopath doctor (D.O.) would be helpful since I also have other hormonal problems that could be causing the thyroid problems?

 
Old 12-31-2009, 02:28 PM   #5
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Re: Please help with new labs. Even my doc is confused

I'm of the opinion that the thyroid and adrenals are the crux of the problem with us. If they are out of whack then all the other functions suffer as well, including sex hormones. Once you get your thyroid under control and optimized then look at your other hormone levels and see how they are faring.
As far as seeing a DO, some are great, some are not, just like MDs. DOs are supposed to have more of a "mind, body, spirit" training and listen to patients but I've seen some that are indistinguishable from their more narrow-minded MD collegues in that regard too.

 
Old 12-31-2009, 02:43 PM   #6
tigger67
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Re: Please help with new labs. Even my doc is confused

My problem is I don't know if this doc is going to want to keep helping me. I've had two rounds of labs done and because my levels aren't "typical", he doesn't know quite what to do. He's willing to keep increasing my meds because I practically beg him too, but he told me today he thinks I should see someone who's better trained to deal with all this. He thinks endos are the answer. I know they're not. So that's why I think I need to find someone new. This doc is only a primary doc and I doubt he'll test hormones for me. My last primary doc wouldn't do it.

Also, if your cortisol is elevated, won't that prevent thyroid meds from working right?

 
Old 12-31-2009, 03:14 PM   #7
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Re: Please help with new labs. Even my doc is confused

If your cortisol is elevated then you might convert your T4 to RT3 instead of T3. That's why it's a good idea to do some RT3 labs. But I think you just might not be high enough with your hormones yet since your free T levels are still pretty low... hard to say.
You do need a doc who will continue to help you with this and I agree, endos are rarely the answer unless you know someone who has had a good experience with one. It's tough to find a good doc who won't just look at that TSH and keep you hypo forever. Keep looking and ask for some recommendations in your area.

 
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