# Newbie to boards needs help with lab results



## Jason24 (Nov 17, 2010)

Hi everybody. My name is Jason. I'm so glad i was able to find this message board. I pretty much have no idea what to do at this point and was looking for some possible direction. I've been taking synthroid 200mcgs for the past 2 years+. Never had a problem while taking it. Just recently probably end of September i got insomnia and to this day i still have it. Also have some unwanted anxiety/tension that i can feel in my chest area. I went to the family doctor..he ran the blood tests and said to stay on the 200. Its the only pill i take besides a multivitamin. I asked if we could try going down to 175 just to see if that would help. He said he didn't feel comfortable doing so and i could go to an endrocronologist. I tried a test myself by cutting the pills in half and only taking(a half and half of half) which i estimated would be around 150. It got rid of the anxiety however i had a terrible headache all day long. Its hard to figure out how much 175 would be(would have to cut the half of pill 3/4 of the way but then i would not be getting the same dose consistently if i cut the pills. Any direction as to what i can do here??? Here are my test results...i have them with me at work so if i forgot something i can add it in. 
tsh 3rd generation 3.51(.40-4.50 miu/l is the range)
t4 Free 1.1 (.8-1.8 ng/dl is the range)
these results were done on September 27 and was just a regular blood test. Didn't have to fast for it.

I then went back on October 23 for a fasting blood test(no food after midnite) to check cholestorol etc and i see on the test result it says 
tsh 3rd generation and the result was 4.19 (.40-4.50 miu/l was the range again). 
Any ideas as to why it went up so much??? and possible reasons i may have this insomnia??? Of course dr just wants to push pills on me which i don't want but not sleeping normal is just killing me.

thanks for any feedback!!!


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## Andros (Aug 26, 2009)

Jason24 said:


> Hi everybody. My name is Jason. I'm so glad i was able to find this message board. I pretty much have no idea what to do at this point and was looking for some possible direction. I've been taking synthroid 200mcgs for the past 2 years+. Never had a problem while taking it. Just recently probably end of September i got insomnia and to this day i still have it. Also have some unwanted anxiety/tension that i can feel in my chest area. I went to the family doctor..he ran the blood tests and said to stay on the 200. Its the only pill i take besides a multivitamin. I asked if we could try going down to 175 just to see if that would help. He said he didn't feel comfortable doing so and i could go to an endrocronologist. I tried a test myself by cutting the pills in half and only taking(a half and half of half) which i estimated would be around 150. It got rid of the anxiety however i had a terrible headache all day long. Its hard to figure out how much 175 would be(would have to cut the half of pill 3/4 of the way but then i would not be getting the same dose consistently if i cut the pills. Any direction as to what i can do here??? Here are my test results...i have them with me at work so if i forgot something i can add it in.
> tsh 3rd generation 3.51(.40-4.50 miu/l is the range)
> t4 Free 1.1 (.8-1.8 ng/dl is the range)
> these results were done on September 27 and was just a regular blood test. Didn't have to fast for it.
> ...


Welcome, Jason! I find it interesting that no one has run FREE T3 for you. That is your active hormone and it is essential to know where it is at.

There are 2 possible things going on. Either you are not converting T4 to FT3 or there are antibodies wreaking havoc binding or blocking the receptor sites.

Here are tests that I recommend if you have not had any of these.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/unders...s/thyroid.html

And here is a good place to learn "why" the FREE T3 lab test is so important.

Understanding thyroid lab tests.....http://www.amarillomed.com/howto

It would be a good idea to check ferritin as low ferritin can cause anxiety and the inability to enjoy the full efficacy of your thyroxine replacement.

Ferritin http://www.thewayup.com/newsletters/081504.htm

Most of us like our TSH @ 1.0 or lower w/ the Frees mid-range or higher.

Once again, welcome!

Others will be along to comment further.


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## Jason24 (Nov 17, 2010)

Thanks for the info Andros. Yeah i have no idea why they didn't run the free T3 as you mentioned. Is going from a 3.51 tsh 3rd gen in Sept to a 4.19 not even a month later something i should be concerned with???


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## Andros (Aug 26, 2009)

Jason24 said:


> Thanks for the info Andros. Yeah i have no idea why they didn't run the free T3 as you mentioned. Is going from a 3.51 tsh 3rd gen in Sept to a 4.19 not even a month later something i should be concerned with???


It certainly is given your current dose of Synthroid. Hopefully you are not consuming soy products or L-Carnitine both of which are goitrogenic?


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## Jason24 (Nov 17, 2010)

No soy or L Carnitine that i can recall.I have had the same diet for years. i'm a person of routine and rarely change my habits. Today i took the full dose of synthroid 200 and can feel the anxiety pressure in my chest. I have scheduled an appointment with an endocronologist but earliest i can get in is mid december which stinks. May have to switch MD's as well.


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## Andros (Aug 26, 2009)

Jason24 said:


> No soy or L Carnitine that i can recall.I have had the same diet for years. i'm a person of routine and rarely change my habits. Today i took the full dose of synthroid 200 and can feel the anxiety pressure in my chest. I have scheduled an appointment with an endocronologist but earliest i can get in is mid december which stinks. May have to switch MD's as well.


Get the TSI done if you can. You could be flip flopping to hyperthyroid also. Many of us have done that.

See if you can get on a "cancellation" list for that endo.


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## Jason24 (Nov 17, 2010)

Will do Andros.

thanks so much!


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## Andros (Aug 26, 2009)

Jason24 said:


> Will do Andros.
> 
> thanks so much!


You are welcome and do keep us in the loop.


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## Debbie from Milwaukee (Apr 18, 2010)

Jason:
I agree with the advice from Andros. I would also throw in that you could ask your doctor if he/she would authorize an every other day regimine of .200 mg. and .150 mg synthroid on the alternate day. I can understand why you were trying a lower dosage for a day just to see how it was affecting you, but you should NOT experiment with any lasting dosage change apart from a physician's oversight. This would be especially important if it could be a while before you can get in to see an endo.

RE: the insomnia, it would be good to check with the endo when you finally see him/her about the possibility that your adrenal gland may be also out of whack. Thyroid imbalance can often mean that more metabolic function falls to the adrenals. When this happens, your adrenal "clock" can get turned upside down: less cortisol in the morning when you need it, and more of it at bedtime (when it prevents you from sleeping).

Good luck, and hope you get in to see a competent doc soon!


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## Jason24 (Nov 17, 2010)

Thanks for the great information Debbie. I have an appointment with my MD in a week or so. I will discuss all of these options at length with him. And in the meantime, i may get some references for a new MD ; )


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## Jason24 (Nov 17, 2010)

Ok...finally got all the testing done and i'm set to see the endo on Monday afternoon. Here are my most current results. Any suggestions or info would be helpful..especially if Andros is around ; )
tsh 3rd gen 1.33(.40-4.50 MIU/DL)
t4 total 10.2 (4.5-12.5MCG/DL)
free t4 index(t7) 3.2 (1.4-3.8)
t4 free 1.5 (0.8-1.8NG/DL)
t3 free 3.2 (2.3-4.2PG/ML)
t3 total 98 (76-181 NG/DL)
t3 uptake 31 (22-35%)
thyroglubulin antibodies less then 20 (range is less then 20 IU/ML)
thyroid peroxidase antibodies 78 (range is less then 35 IU/ML) OUCH!!!
FERRITIN 148 (20-345 NG/ML)

So the only result out of range was the tyroid perox. antibodies...and i still have this awful insomnia. The anxiety has gone away but i'm still struggling for sleep...any ideas guys?
Again the only pill i take besides a multivitamin is the synthroid medicine 200 mcgs.

Thanks in advance!


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## CA-Lynn (Apr 29, 2010)

Actually, the TPO isn't that bad.

Regarding the insomnia: It could be a side effect of the Synthroid; if it started shortly after beginning Synthroid, then it might possibly be a logical cause. However, there are a zillion and one life events that could cause insomnia and it shouldn't be a surprise that we all go through bouts of insomnia now and then for no reason other than "life."


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## Andros (Aug 26, 2009)

Jason24 said:


> Ok...finally got all the testing done and i'm set to see the endo on Monday afternoon. Here are my most current results. Any suggestions or info would be helpful..especially if Andros is around ; )
> tsh 3rd gen 1.33(.40-4.50 MIU/DL)
> t4 total 10.2 (4.5-12.5MCG/DL)
> free t4 index(t7) 3.2 (1.4-3.8)
> ...


Hi there!! Well, I am so glad you got a Free T3 test!! It just so happens, the result is smack dab in the middle of the range. So, that could account not being able to sleep. Ironically, when the numbers are not just right for you, it makes little difference whether you are hypo or hyper as it interferes with your sleep.

It is good to get the FT3 somewhere above that mid-range number of 3.2. Most of us feel best when it is 1/2 way between the mid-range and the top of the range.

So, I think you have some wiggle room here. Since you are on 200 mcg. of Synthroid, I think you should talk to the doctor about either increasing the Synthroid a little bit or adding some Cytomel (T3.) If doc agrees to Cytomel, no more than 5 mcgs. to start out.

OR, you could try adding Selenium 200 mcgs. to your daily regimen for Selenium helps in the conversion of FT4 to FT3. FT3 is your active hormone as I am sure you know. (Some things I type are for the benefit of new readers.)

And now, the $64,000.00 question is, what has your doctor had to say about your labs?

Also, taking about 400 mgs. of Magnesium at bedtime aids sleep.

Ferritin looks good.


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## Jason24 (Nov 17, 2010)

Hi Andros!! To be honest, my regular MD had no idea what half of the tests you recommended i get were. So i'm not surprised he had no real input. I'm hoping the Endo does when i go on Monday. This insomnia is killing me slowly ; (


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## Jason24 (Nov 17, 2010)

Andros, 
In regards to the thyroid peroxidase antibodies being 78 (range is less then 35 IU/ML)....is this a major concern???


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## GD Women (Mar 5, 2007)

Jason24 said:


> Ok...finally got all the testing done and i'm set to see the endo on Monday afternoon. Here are my most current results. Any suggestions or info would be helpful..especially if Andros is around ; )
> tsh 3rd gen 1.33(.40-4.50 MIU/DL)
> t4 total 10.2 (4.5-12.5MCG/DL)
> free t4 index(t7) 3.2 (1.4-3.8)
> ...


My FT3 is in the upper mid range and I still have sleep issues. I can't figure it out and I blame it on just being thyroid. I get 1 to 1 1/2 hours sleep sometime 4 and I am very lucky to get 6 to 6 1/2 and it doesn't matter how late I go to bed. This has been going on for 13 years. I rely on either prescribed sleeping pills or my anxiety medication, thats when I get the 6 hours sleep. So I wouldn't suggest that adjusting levels are going to correct the issue, they may or they may not. A Mid FT3 is not all that bad. I would be leery to increase the med. dose, it might make things worse. The spread between your FTs doesn't state conversion problem. Raising FT3 might make insomnia even worse.

Nothing wrong with taking sleeping aids. They might help regulate your sleep back to normal, so taking them doesn't necessarily mean forever.

Just my prospective.


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## Andros (Aug 26, 2009)

Jason24 said:


> Andros,
> In regards to the thyroid peroxidase antibodies being 78 (range is less then 35 IU/ML)....is this a major concern???


Only to the extent that it does confirm that you have autoimmune issues.

TPO is "suggestive" of many autoimmune diseases including the thyroid.

What does the test result mean?

Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto's thyroiditis and Graves' disease. 
In general, their presence suggests that there is autoimmune thyroid involvement and the higher the level, the more likely that is. Rising levels may be more significant than stable levels as they indicate an increase in autoimmune activity.

You may wish to read the entire article..............
http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/test.html


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## McKenna (Jun 23, 2010)

> In regards to the thyroid peroxidase antibodies being 78 (range is less then 35 IU/ML)....is this a major concern???


It means that you have something autoimmune cooking. IMO, it's not a huge number, but something you should keep an eye on.

Personally, I would steer clear of the sleep aids and anti anxiety meds. They can cause interdose withdrawals, tolerance and anxiety symptoms when the half life of them wears off. I know this from personal experience with Ativan a few years ago and it took me a while to wean off them. I wouldn't touch them with a ten foot pole.

When I was having hyper symptoms my endo tried to get me to take an antidepressant. I refused. Stick to your guns if you don't want meds b/c most doctors will prescribe at the first mention of anxiety or depression.

I had to push to get my TSI tested b/c I had hyper symptoms but my endo would not test it. I finally got my family doc to do it. Don't give up going after the testing.


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## Jason24 (Nov 17, 2010)

Thanks for all the input guys! I will see what the endo suggests tomorrow and report back.


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## Andros (Aug 26, 2009)

Jason24 said:


> Hi Andros!! To be honest, my regular MD had no idea what half of the tests you recommended i get were. So i'm not surprised he had no real input. I'm hoping the Endo does when i go on Monday. This insomnia is killing me slowly ; (


Do you spend much time out doors? That encourages the pineal gland to set the circadian cycle in preparation for a restful sleep every night.

As mentioned in a previous post, evening dose of magnesium should help as well.

It is really hard to say because I don't believe you ever did get a doc to do the TSI (thyroid stimulating immunoglobulin) test, did you?

You see? You could have your thyroid panel come in in range and be hyper "if" you have TSI which of course would account for not being able to sleep.

TSI

Results and Values
What do the test results mean?
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html


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## lavender (Jul 13, 2010)

I too would steer away from the anti-anxiety and sleeping meds. They are highly addictive and the body quickly adapts to their presence, causing them not to work.

Sleeping meds are addictive, and the body quickly adapts to their presence, meaning that you need a higher and higher dose to achieve the same effect. Then, if oyu stop taking the med, you have rebound insomnia. Sleeping meds don't work for me. I was put on lunesta during my thyroid storm, and could stay awake all night after taking the highest dose available. It is supposed to make you instantly fall asleep and is also the medication that they warn can make you sleepwalk and even drive without remembering! I hid my car keys from myself the entire time I was on it. Not my idea of fun!

The body quickly adapts to the presence of benzodiazapines aka anti-anxiety meds causing dependence. Higher and higher doses are needed to achieve the same result. These are meds such as valium, xanax, ativan, klonopin, librium. Once someone is on a high dose, it can be very dangerous to stop cold turkey, causing a withdrawal that is more dangerous than alcohol (I used to work in a detox center, people coming off benzos had to stay for weeks verses days with alcohol). I won't touch them.

Anti-depressants are commonly prescribed for their anti-anxiety properties. They too can cause withdrawal, although it is not dangerous like benzodiazapines. I have seen recommendations that one anti-depressant be prescribed to eliminate the withdrawal effects of another, meaning that you are just switching meds rather than getting off something entirely. I have been on anti-depressants without much relief several times-usually not for outright depression but for symptoms such as migraines, insomnia, fatigue, muscle aches. In fact, I usually feel worse on them. I would rather adjust my thyroid meds and treat that issue first. I think I might consider an anti-depressant if I felt like my thyroid was being properly treated and I was still having symptoms.

Just my opinion.


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## GD Women (Mar 5, 2007)

Some anti-anxiety and sleeping meds. are not addictive. Over the counter sleeping aids work for some like Tylenol PM. Prescribed meds. can be taken so as not to be addictive. They do more good than harm if taken properly. I take magnesium and spend a lot of time out door especially summers and that has not been helpful with sleep issues. Or maybe I am just an old fool. But Jason maybe they will work for you.

I have never nor am I now addictied to any medications, let me make that clear!


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## Jason24 (Nov 17, 2010)

Andros,
I did have the TSI done..it was at the top of the page and i missed it 

TSI and TBII 6.8 (range is <=16%)
TSI was 40 (range was <140% baseline)

And i try to get outside as much as possible. Walks etc.


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## lavender (Jul 13, 2010)

GD Women said:


> Some anti-anxiety and sleeping meds. are not addictive. Over the counter sleeping aids work for some like Tylenol PM. Prescribed meds. can be taken so as not to be addictive. They do more good than harm if taken properly. I take magnesium and spend a lot of time out door especially summers and that has not been helpful with sleep issues. Or maybe I am just an old fool. But Jason maybe they will work for you.
> 
> I have never nor am I now addictied to any medications, let me make that clear!


GD Woman,

My intent was not to accuse you or anyone of being addicted to a medication. I have no idea what your relationship with your medications is, other than what you have shared on this forum, and addiction requires a lot more information to diagnose.

I was attempting to point out that benzodiazapines (anti-anxiety meds) and sedative-hypnotics (sleep meds) cause physical dependence. Most are not effective beyond an initial two week period, making higher and higher doses necessary to achieve the same effect (tolerance). That is why most sleeping medications are not intended to be used every night. When these medications are stopped after a long use, especially at high doses, they do cause withdrawal symptoms that can be very dangerous.

I think patients have a right to know the risks involved with taking these meds ahead of time. Unfortunately, I think many doctors do not warn patients when they are prescribing them. I know this from my own experience. It is possible that the doctors do not know themselves because these medications are not classified as highly addictive by the DEA. At best, they are listed as schedule IV, "mild abuse potential."

My experience, based on 7 years of working in the field of addiction and quite a few courses in addiction is quite different. I have seen many people unknowingly become dependent on these medications after taking them for a valid medical reason, just as I have seen chronic pain patients become dependent on opiates.


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## midgetmaid (Jul 22, 2010)

I was told by a nurse that works at a drug rehab that a med can be psychologically addicting even if not physically addicting, and to not take anything you don't absolutely have to have.


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## Jason24 (Nov 17, 2010)

Back from the Endo...and all i can say is....what a waste of a $50 co pay to see a so called "specialist"! She looked at my labs and basically said all was in range and the thyroid is definitely not the cause of my insomnia. She then felt my thyroid gland in my neck and i was on my way. What a crock! I have another appt that i had scheduled previously with a different endo. I'm gonna wait and see what he says...
May try the magnesium and calcium combo to see if that will help me sleep...i gotta try something besides rx sleep meds...anybody have any other home remedies??? Any suggestions would be appreciated.


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## McKenna (Jun 23, 2010)

Did you have a TSI antibody test?

Sorry to hear it didn't work out well with the endo.


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## Jason24 (Nov 17, 2010)

McKenna said:


> Did you have a TSI antibody test?
> 
> Sorry to hear it didn't work out well with the endo.


Sure did...here are the results...

TSI and TBII 6.8 (range is <=16%)
TSI was 40 (range was <140% baseline


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## Andros (Aug 26, 2009)

Jason24 said:


> Andros,
> I did have the TSI done..it was at the top of the page and i missed it
> 
> TSI and TBII 6.8 (range is <=16%)
> ...


There you go. You should not have any and if you do that is responsible for hyperthyroid activity.

TSI

Results and Values
What do the test results mean?
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html


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## Jason24 (Nov 17, 2010)

Unreal. And i asked the Endo about this and she didn't even seem concerned one bit which sort of ticks me off. Ok, so then i need to get the TSI lowered i'm assuming? Would it be beneficial for me to try a round of selenium to see if that will help me?


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## lavender (Jul 13, 2010)

From what I read about selenium recently, it will speed up the conversion of T4 to T3, making you even more hyperthyroid. Not what you want to do when hyper since T3 is your active hormone and a rapid increase could send you into thyroid storm.


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## Jason24 (Nov 17, 2010)

Gotcha...so thats not the way to go then. Hopefully the endo i see next week can help me. Thanks everybody for your replys and great info. Happy Holidays


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## Andros (Aug 26, 2009)

indithinker said:


> I find vitamin e (800iu) before I go to bed has stopped all my insomnia.


Hi there and welcome!!! I like your tip about the Selenium also.


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