Most Recent Thyroid Labs

[cahill]

I have taken synthyroid for years.

I was diagnosed with Hashimoto's back in May.

I recently saw my endocrinologist and had follow up labs done.

My TSH was 2.46 with the range being .5-6.40

My T4 was 1.20 with the range being .53 -1.80

She is retesting in three months.

My questions are:

does the T4 levels show how well the synthyroid is being utilized/ converted ?

being on the higher end does that mean that my body is not using the synthyroid as well as it could?

When she starts trying to explain this stuff to me I get a bit confused , please help me understand :)

[burdee]

I have taken synthyroid for years.

I was diagnosed with Hashimoto's back in May.

I recently saw my endocrinologist and had follow up labs done.

My TSH was 2.46 with the range being .5-6.40

My T4 was 1.20 with the range being .53 -1.80

She is retesting in three months.

My questions are:

does the T4 levels show how well the synthyroid is being utilized/ converted ?

being on the higher end does that mean that my body is not using the synthyroid as well as it could?

When she starts trying to explain this stuff to me I get a bit confused , please help me understand :)

Since Synthroid provides only the T4 thyroid hormone, you won't know how well that supplemental thyroid is being utilized/converted until you get a free T3 test. The body (cells) actually utilize T3. T4 must lose a molecule to become T3 before the cells can utilize the synthetic thyroid supplement. You can have a normal (midrange) T4 result (which you do), but still have hypothyroid symptoms if your body doesn't easily convert T4 to T3. A normal T4 result with a low T3 result may indicate you don't easily convert T4 to T3. Also a reverse T3 test can show how well your body converts T4 to T3. Normally T4 is converted to 60% reverse T3 and 40% free T3. If the reverse T3 test is very high, you may not be converting T4 to enough T3. However other illnesses can also cause high reverse T3 results.

I wanted to repeat that your T4 score was midrange normal, not the high end. Also a good indication that your synthroid is being utilized is your lack of hypothyroid symptoms. What were your presenting hypothyroid symptoms (fatigue, weight gain, feeling cold all the time, hair loss, etc.)??? Have those symptoms decreased?

Finally, did your doc test your Hashimoto's antibodies (TPOab test) when you had your recent labs?

[cahill]

Since Synthroid provides only the T4 thyroid hormone, you won't know how well that supplemental thyroid is being utilized/converted until you get a free T3 test. The body (cells) actually utilize T3. T4 must lose a molecule to become T3 before the cells can utilize the synthetic thyroid supplement. You can have a normal (midrange) T4 result (which you do), but still have hypothyroid symptoms if your body doesn't easily convert T4 to T3. A normal T4 result with a low T3 result may indicate you don't easily convert T4 to T3. Also a reverse T3 test can show how well your body converts T4 to T3. Normally T4 is converted to 60% reverse T3 and 40% free T3. If the reverse T3 test is very high, you may not be converting T4 to enough T3. However other illnesses can also cause high reverse T3 results.

I wanted to repeat that your T4 score was midrange normal, not the high end. Also a good indication that your synthroid is being utilized is your lack of hypothyroid symptoms. What were your presenting hypothyroid symptoms (fatigue, weight gain, feeling cold all the time, hair loss, etc.)??? Have those symptoms decreased?

Finally, did your doc test your Hashimoto's antibodies (TPOab test) when you had your recent labs?

Thanks burdee that helps

In May my thyroid antibodies were ;

TG AB 36.94 range being <28.70

TPO AB 998.76 range being <10.10

she is retesting them in Nov.

Most of my symptoms have decreased since May with a med increase.

I will call her office Monday to see if she did a Reverse T3 and/or Free T3.

Is there a med that provides T3??

Someone once suggested to me that Cytomel was a med that could be use in addition to Synthyroid. I have not questioned my doc about this yet.I would like to learn more before I do .

Thanks again

[pricklypear1971]

I am on combo t3/t4. I have used synthetic and natural and respond to both.

Its really something you have to try, I think. Some people don't feel well without both, others don't notice, and some react negatively. I always insisted ont t3/t4. I will be going off thyroid usp to synthetic combo soon. My dr. Did increase one hormone but not the other to achieve optimal levels...you can't do that with natural.

Ask your dr. to try it. See if you feel better.

[pricklypear1971]

Go to the about.com boards, thyroid section. Lots of info there. Also, get one of Mary Shomon's books.

[Skylark]

It is RARE to not convert T4 to T3. The reason so many of us feel better on T3 is becasue the damn doctors under-dose T4. Insist on getting enough thyroid hormone that your symptoms resolve, whether it's T3/T4 or a decent dose of T4. T3 is absorbed better than T4, and I think that's another reason people feel better on it. It is preferable to be on pure T4 if it works for you because your blood levels are more stable and each organ in your body converts its own, special amount of T3. Your TSH is high enough right now that you probably feel kind of tired. Usually with Hashi's you want TSH below 2.0 to suppress thyroid gland activity and inflammation.

Cytomel is the brand name for synthetic T3. Armour and Nature-throid are natural porcine thyroid gland extracts that contain a mix of T3 and T4.

T3 testing is worthwhile if you're still feeling ill, and you do want to make sure you're not one of the 1% who doesn't convert.

If you find you're feeling "speedy" or losing weight, make sure you get your dose lowered. Being too high on thyroid is hard on your heart and bones, which is why doctors are conservative.

[burdee]

It is RARE to not convert T4 to T3. The reason so many of us feel better on T3 is becasue the damn doctors under-dose T4. Insist on getting enough thyroid hormone that your symptoms resolve, whether it's T3/T4 or a decent dose of T4. T3 is absorbed better than T4, and I think that's another reason people feel better on it. It is preferable to be on pure T4 if it works for you because your blood levels are more stable and each organ in your body converts its own, special amount of T3. Your TSH is high enough right now that you probably feel kind of tired. Usually with Hashi's you want TSH below 2.0 to suppress thyroid gland activity and inflammation.

Cytomel is the brand name for synthetic T3. Armour and Nature-throid are natural porcine thyroid gland extracts that contain a mix of T3 and T4.

T3 testing is worthwhile if you're still feeling ill, and you do want to make sure you're not one of the 1% who doesn't convert.

If you find you're feeling "speedy" or losing weight, make sure you get your dose lowered. Being too high on thyroid is hard on your heart and bones, which is why doctors are conservative.

I'm one of those 'rare' people. After 6 months on Levoxyl, a T4 supplement, I still had hypothyroid symptoms. A blood test showed my TSH and T4 were normal. However, my T3 was very low. I had plenty of T4, but it wasn't being converted to T3. Because Cytomel and the T3/T4 combo product (forgot the name) contained my diagnosed allergens, I requested generic liothyronine (straight T3). My doc added that to my T4 supplement. I now take 50mcg Levoxyl once daily and 25mcg Liothyronine in 2 divided doses and have no hypo symptoms.