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New Lab Results... Making progress!?


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Old 04-26-2012, 11:53 PM   #1
ABQpam
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New Lab Results... Making progress!?

Hello All -

Once again, seeking your thoughts on my latest lab results. Frees have come up & my TSH is down. Although my symptoms have not improved that much. Some days I have a little more energy, but still so exhausted, muscle aches, unable to concentrate, trouble falling asleep and staying asleep...

Here are my prior labs for reference;

*** Dec. 5, 2011 ***
25mcg Levothyroxine for 8 weeks

TSH = 1.13 ...... (.358-3.74)
FT4 = 1.0 ........ (0.8-1.5) - 27.8%
FT3 = 2.7 ........ (2.2-4.0) - 28.5%

Anti TPO Ab = < 10 .... (< 40)
Anti TG Ab = < 20 ...... (< 35)
......TSI Ab = 105 ....... (<= 110)

- - - - - - - - - - - - - - - - - - - - - - - - - - - - -

*** April 20, 2012 ***
50mcg Levothyroxine for 12 weeks

TSH = .762 ...... (.358-3.74)
FT4 = 1.2 ........ (0.8-1.5) - 57%
FT3 = 3.1 ........ (2.2-4.0) - 50%

I picked up these results from the lab today as I have not been able to reach my doctor. Should I consider a 12.5mcg increase? 25mcg? Even though I hate even mentioning TSH - is mine getting too low in relation to my Frees? Could it be those TSI lowering it? (Stress has been high this last month.)

Thanks for all the continued support. I appreciate any input on these results and value your opinions about where to go with my dose.

Hugs,
Pam

 
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Old 04-27-2012, 04:37 AM   #2
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Re: New Lab Results... Making progress!?

Hi Pam

Great to hear from you! I just love, love, love your signature

My doctor always liked the slow and steady approach and that seems to work well for people in general. Once levels get above mid-range, dose increases are usually done in 12.5mcg increments.

People who are optimally medicated on T4 meds will have TSH 1.0 or lower. Since you do have TSI in the picture, that can cause a lower TSH than "usual".

The only levels that "count" are the levels of free hormone - FreeT4 and FreeT3.

I'm happy to see you're making progress - sorry it's such a long journey.

Why was there so much time between labs? You really don't need to go longer than 6 wks.

What does the doctor say about your TSI, etc.? (inquiring minds would like to know

No matter what, best of luck to you moving forward!!
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Old 04-27-2012, 05:09 AM   #3
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Re: New Lab Results... Making progress!?

hi Pam,

always happy to hear from you. I had to chuckle a bit with your signature. :-)

how are the hypers these days? did the option BRT come up or are those better and you don't feel the need too at this stage?

I would not worry about TSH since as Sammy said TSI can falsely suppress it.

An increase of 12 mcg would be a good idea imo.

take care

 
Old 04-27-2012, 05:33 AM   #4
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Re: New Lab Results... Making progress!?

Me again

If your doctor ever questions your TSH, I can direct you to the ground-breaking study about TSI causing suppressed TSH and the conclusion that the HPT (hypothalamic-pituitary-thyroid) axis is still intact. (thoughts used to be that suppressed TSH meant something was wrong with the HPT feedback loop and efforts need to be taken to "restore" TSH)

No matter what, thyroid-savvy doctors do not dose based upon TSH.
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Old 04-27-2012, 10:53 AM   #5
ABQpam
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Re: New Lab Results... Making progress!?

Hello Sammy -

Good to hear from you too. . Thanks. (LOL)

I was happy (yet surprised) to see my Frees had hit the 50% mark, since I'm still feeling so sluggish. But progress is progress.

The time lapse... My doctor is pretty adamant about the 6 weeks thing and I was scheduled for labs and follow up at the 6 week mark. But I had to cancel due to going out of town on business for 10 days. Things were backed up at work when I returned. Then the "out of town business" became a BIG issue that completely took up my time, energy and brain function. Needless to say, I just couldn't deal with everything on my plate simultaneously. Not making time to get to the lab and reschedule with doctor - completely MY BAD.

I have not been able to reach my doctor since returning!?! You may remember she has a Micro practice - no employees, so you reach her by leaving a message with her answering service. It is a frustrating process at times, but I do like her and believe she is pretty thyroid savvy. So I will try to be patient.

In that regard, we have had no further discussion about the TSI since its discovery in December. I am looking forward to seeing her as I suspect she did some thinking and researching after my last appointment.

I appreciate you sharing your great wisdom on the whole TD process. It really has kept me moving forward.

I'll keep you updated.

Pam

 
Old 04-27-2012, 11:08 AM   #6
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Re: New Lab Results... Making progress!?

Hi Lisa -

Thought I might catch you last night (your morning) when I posted. I'm always happy to hear from you. Oh, the signature... It came to me after yet another frustrating conversation with a hypoT friend. She, after 20 years of still feeling poorly, just won't let go of basing her treatment on the TSH level (nor will her doctor). I so wish she would come to this board.

The Hypers have been leaving me alone lately! I'm grateful for that. I haven't seen doctor again to discuss BRT, but I am hoping I won't have to go that route if they stay away!

As you and Sammy advised, I will continue to ignore my TSH.

I think I'll call my doc (again) and ask for the 12.5 increase.

Hope you are feeling OK. We'll chat soon.

Hugs,

Pam

 
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