# Help interpreting the improvement in my labs



## FloraD (Feb 17, 2018)

I started taking 25mcg Synthroid 4 weeks ago for the first time after the Dr. said maybe it would help with my low heart rate (44 bpm upon waking), low body temperature (96.2 in the mornings), difficulty sleeping at night.

Here is a history of test results:

TSH

1.88 5/3/11 (age 48)

1.51 12/5/11 (age 48)

2.66 7/10/15 (age 52)

Results immediately before starting treatment (age 55) Jan. 2018:



TSH 3.47 (reference range 0.465-4.68 u/mL)

T3, Free 3.28 (reference range 2.77-5.27 pg/mL)

T3, Reverse 10 ng/dL(range 8-25)

T4, Free 0.81 (reference range 0.78-2.19 ng/dL)

Anti-Thyroid Peroxidase AB <10 [IU]/mL (reference range 0-35 [IU]/mL)

Anti-Thyroglobulin <20 [IU]/mL (reference range 0-40 [IU]/mL)

Ferritin 53.1 ng/mL (range 11.1 - 264)

Vitamin D-25 OH, Total 43.4 ng/mL (range 30-100)

Results after 4 weeks of 25 mcg Synthroid (2/16/18)

TSH 3.30 (reference range 0.465-4.68 u/mL)

T3, Free 3.43 (reference range 2.77-5.27 pg/mL)

Unfortunately, the doctor ordered total T4 instead of free T4 by mistake:

6.23 ug/dL (reference range 5.53-11 ug/dL)

Doctor was out of the office so I have not heard back regarding whether she will increase the prescription to 50 mcg synthroid.

The improvement in TSH and T3, Free seems very slight - is that normal given that 25mcg is a very low dose?

Any other comments, or tests I should ask for?


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## jenny v (May 6, 2012)

Usually, follow up bloodwork is done about 6-8 weeks after starting or raising a dose, so yours was done a bit early. It looks like the Synthroid is doing its job but you probably need a dose increase. It's normal to have slight increases at lower levels and things gradually getting better as you slowly raise the dose every 6-8 weeks. It's frustrating but it's best to go low and slow so that you don't overshoot and go hyper.


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## FloraD (Feb 17, 2018)

Apparently there was some medical study which indicated that blood levels reach the level they are going to attain after 3.5 weeks on levothyroxine; perhaps that's why the Dr. wanted retesting at 4 weeks. Or maybe it was because she started me at the 'non-dose' dose of 25mcg...

Would someone normally feel any different after 4 weeks on 25 mcg levothyroxine with those very small changes in TSH and free T3? I don't know if it is a placebo effect, but I am able to motivate myself to get up more easily in the morning rather than want to lay around half the morning in bed (but I don't really feel much different). I do feel like I'm sleeping more soundly at night. My resting heart rate was 45 this morning, and temperature 96.3 (same as a month ago).


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## joplin1975 (Jul 21, 2011)

It's possible to feel better after 4 weeks.

TSH takes the longest to change and that usually takes 6 weeks, but your more important labs (free t4 and free t3) usually change in about 4-ish weeks.


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## Lovlkn (Dec 20, 2009)

Ditto what Joplin said - TSH lags and is also not a great test to adjust thyroid hormone replacement by. Focus your dose adjustments on your FT-4 and FT-3


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## FloraD (Feb 17, 2018)

Thank you for the replies. So I understand that I should be sure to request Free T3 and Free T4 and not just TSH when the doctor wants to reconsider dosage.

Any other feedback/comments? Should I request B12?

My fasting LDL is high (160) - I never had a problem with this before. The doctor wanted to put me on a statin. But then I 'googled' and learned that hypothyroid can increase LDL and to treat hypothyroid first before a statin. - I explained that to the nurse when I said 'no' to starting a statin. (Total Cholesterol 256, Triglycerides 73, HDL 81, LDL 160, Cardiovascular Risk of an event in the next 10 years 1.6%)

Just curious - does my progression in TSH from 2011-2018(1.5 to 3.5) look like hypothyroid that should be treated (rather than wait another few years to see if it goes out of range)?

My reverse T3 is in the low end of the range - so does that mean I am efficient at converting T4 to T3 and not under 'stress'?


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## FloraD (Feb 17, 2018)

I heard back from my doctor this morning, she said the lab may be able to use the sample from Friday to run the free T4 (they ran total T4 instead). Also, she said some people do feel perfectly fine with a TSH of 3.3 and will increase my prescription from 25 mcg to 50 mcg if I felt an improvement in my symptoms (hard to say - such a low dose to begin with and a short time).

The main things I notice are that 1) I don't get hot/cold/hot/cold during the day as much - just feel more comfortable, and 2) I sleep better at night.

Are those related to improving thyroid?

I did ask for the 50mcg Synthroid and will pick it up tonight.


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## jenny v (May 6, 2012)

Temperature imbalance can be one symptoms of thyroid problems (I am always freezing when hypo and hot when hyper, but it can swing around wildly, too). It's good that she gave you an increase, I think that will help. Thyroid symptoms improve slowly over time and it sounds like yours have begun to improve a bit, so the dose increase should help further. Did she mention testing again once you've been on the new dose for a while?


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## Lovlkn (Dec 20, 2009)

> Just curious - does my progression in TSH from 2011-2018(1.5 to 3.5) look like hypothyroid that should be treated (rather than wait another few years to see if it goes out of range)?





> TSH 3.47 (reference range 0.465-4.68 u/mL)
> 
> T3, Free 3.28 (reference range 2.77-5.27 pg/mL)
> 
> ...


These labs are hypo - it will be interesting to see how the 50mcg affects your lab results. You need to lab in 6 weeks.


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## FloraD (Feb 17, 2018)

Thank you for the helpful responses.

The Dr. said I will retest TSH in 4 weeks from starting the 50 mcg which I will pick up tonight. I did take 2 x 25 mcg this morning and yesterday in anticipation. I did message her to say I would like to retest TSH, F-T3 and F-T4, and possibly lipids and c-reactive protein in 4 weeks.

I called the lab myself just now about running F-T4 with my sample from last Friday (Total T4 was ordered instead) - and the lab is going to run it now.


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## FloraD (Feb 17, 2018)

Update: the F-T4 is 1.01 (range 0.78-2.19); an improvement from 4 weeks ago when it was 0.81.

I believe it was at the 2nd percentile and now it's at the 16th percentile.

Is the goal to get to the 75% percentile in the reference range?


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## joplin1975 (Jul 21, 2011)

The goal should be somewhere between 50% and 75%. Some people NEED to be right around the 75% range, but others feel somewhat hyper if they get too close to the 75% mark.


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## FloraD (Feb 17, 2018)

Thank you for the reply. I see your TSH results over a period of years - did you have fasting lipids done as well and/or did you ever have a problem with high LDL?


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## joplin1975 (Jul 21, 2011)

I did. My endo doesn't test for lipids - my GP does/did - so it's hard to track TSH as it relates to lipids.

I do know cholesterol labs improved when my thyroid results improved.


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## FloraD (Feb 17, 2018)

I will update with my lab results in 4 weeks after increasing to 50 mcg from 25 mcg. Dr. ordered labs for TSH, F-T3, F-T4, fasting lipids and c-reactive protein.

Thank you for your response.


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## FloraD (Feb 17, 2018)

So can anyone tell me what it means when antibodies are present, but within the reference range. Does everyone always have a small amount of antibodies (or do most people have zero)? If you have them, do you always have them (or do they come and go)? Can they be contributing to a hypothyroid even at small levels within the reference range?


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## joplin1975 (Jul 21, 2011)

It depends in the antibody.

Everyone has thryoglobulin, so Tg within reference range is generally not concerning.

You should not have any TgAB.

Most people always have low levels of TPO and while those people are at higher risk for developing autoimmune disease, not all people with low levels of TPO develop autoimmune thyroid disease. Its one of those things you have to watch, but its not an immediate cause for concern.

You should not have any TPO AB or auto-TPO.

You should not have any TSI.


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## FloraD (Feb 17, 2018)

I can't tell you how much I appreciate your responses and knowledge.

So from my first post, here were the antibodies tested:

Anti-Thyroid Peroxidase AB <10 (range 0-35) - This one should be zero, so it could be concerning - What might this indicate - what is the concern? (and thanks in advance).
Anti-Thyroglobulin <20 (range 0-40) - since everyone has Tg, it is not concerning in the reference range.

Are there other antibodies to be tested? I had to ask for these since the Dr. only initially ordered TSH.

I did not ask for TSI - should I? What is it?


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## joplin1975 (Jul 21, 2011)

Anti-Thyroid Peroxidase is TPO AB -- again you should not have any. It means you *likely* have an autoimmune issue brewing.

Likewise, Anti-thyroglobulin is TgAB, also something you should not have. TgAB only exists when there are elevated levels of thyroglobulin -- that is TgAB is a reaction to Tg (if that makes any sense!).

Elevated levels of Tg happen when thyroid cells are being destroyed. That can happen because of an autoimmune issue or it can happen because of thyroid cancer...or, technically, if can happen when both occur simultaneously.

You should probably have a thyroid ultrasound, just to be sure.


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## FloraD (Feb 17, 2018)

I have sometimes had a strange feeling in my throat/neck. Like last night, it felt like pressure in my head coming from my neck.

My mom was treated for hypothyroidism for years, then stopped the meds when she aged (she developed osteoporosis).

I did 23andMe a few months ago, and uploaded my results to Promethease - I had a couple of genes or indications of a higher likelihood or higher risk for hypothyroidism (and I think thyroid cancer, too).

I will see it I can get the Dr. to authorize an ultrasound of my throat. I'm guessing she will say she doesn't 'feel' any nodules.

My mom always doubted that I had hypothyroidism - she said if you had it you would know because you wouldn't be able to get out of bed or do any housework. I just always thought I was a generally lazy/sleepy person...

Thanks again.


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## joplin1975 (Jul 21, 2011)

Eh.

I was severely hypo and still ran everyday and also rode my horse everyday. People react differently. My biggest issue was joint pain.


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## FloraD (Feb 17, 2018)

Hello - I had more blood draws today, the results seem strange since after increasing levothyroxine from 25 mcg to 50 mcg, the TSH and F-T4 got worse. Can anyone tell me what it could mean? I am glad that my LDL decreased from 160 to 134, but my Ferritin decreased from 53.1 (1/5/18) to 22.7 (3/19/18).

TSH (.5-4.5)

3.47 1/5/18

3.30 2/16/18 after 25 mcg synthroid for 4 weeks

3.35 3/19/18 after 50 mcg synthroid for 4 weeks

F-T3 (2.77-5.27)

3.28 1/17/18

3.43 2/16/18 after 25 mcg synthroid for 4 weeks

3.49 3/19/18 after 50 mcg synthroid for 4 weeks

F-T4 (.78-2.19)

0.81 1/17/18

1.01 2/16/18 after 25 mcg synthroid for 4 weeks

0.82 3/19/18 after 50 mcg synthroid for 4 weeks

Thank you!


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## joplin1975 (Jul 21, 2011)

You mentioned being sleepy/lazy in your other posts. Has your activity levels changes at all since the increase in dose?


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## FloraD (Feb 17, 2018)

I am less active these past 2 weeks; I used to get my 10,000 steps in of walking every day, but these last 2 weeks, only 2 out of 14 days. This is related to my work schedule (60 hour work weeks), though I am exhausted every night and feel that I'm not getting enough sleep and can't fall asleep very well (job stress) even though I am tired. My heart pounds in the evening, but this happens every year January-April 15th due to work; i.e. it happened in years past when I was not on levothyroxine. My heart does not pound during the day/at work; only in the evenings.


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## joplin1975 (Jul 21, 2011)

Well, it was a shot in the dark! 

The thing with thyroids is it isn't a straight trajectory. Sometimes your body is lower in hormone than you realize...when you "feed" it, it "eats" it up a lot quicker.

You can give it another two weeks so that you can officially say you hit the six week mark, but in the long run, you will likely need a dose increase.


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## FloraD (Feb 17, 2018)

I heard back from the Doctor's office today about a slight increase in my Synthroid prescription.

I had taken 25 mcg for 4 weeks, and then 50 mcg for 4 weeks. My TSH (3.30 to 3.35) and FT4 (1.01 to .82) got worse these past 4 weeks while FT3 improved slightly (3.43 to 3.49). My ferritin decreased from 53.1 to 22.7 over the past 6 weeks.

Now she has prescribed 50 mcg Monday-Friday, and 75mcg Sat-Sun. I thought the Dr. would go straight to prescribing 75mcg for 7 days a week since my FT4 and TSH got worse this week.

Does the thyroid hormone process use up iron or prevent iron from being absorbed?? Wondering why my ferritin would decrease (though my iron serum/total iron binding capacity is 46%; I read that over 45% is 'iron overload'?)


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## FloraD (Feb 17, 2018)

I had new labs today after 4 weeks of 50 mcg synthroid M-F and 75 mcg Sat-Sun. I also stopped taking a kelp supplement because I didnt know if it was helping or hurting things.

Here are the new labs:

TSH
2.72 (improved from 3.35)

F-T4
.86 (improved from .82)

F-T3
2.54 (dropped from 3.48)

Ferritin
23.6 (improved from 22.7)

Lipids
TC 228
Triglycerides 74
HDL 99
LDL 114

The FT3 is below the range (bottom of range is 2.77). This is lower than when before I started synthroid. I wonder what this all means.


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## Lovlkn (Dec 20, 2009)

Kelp is not wise To take with autoimmune thyroid disease. The kelp is likely affecting your thyroid hormone levels

Be sure to avoid calcium and ito. Supplements 4 hours either side of your levothyroxine too.


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## FloraD (Feb 17, 2018)

I stopped taking kelp and calcium supplements a month ago.

Any thoughts on what could cause the FT3 to drop so much?


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## joplin1975 (Jul 21, 2011)

Those labs are perplexing...

I think you need to try 75mcgs seven days a week.


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## FloraD (Feb 17, 2018)

Wow, I am very frustrated. The nurse messaged me that the Dr. says she reviewed my labs, and I need no changes to my medication, and to retest in 3-4 MONTHS.

This is the general practitioner doctor who told me in January that endos aim for a TSH of around 1.5 and that's what she would do, too. My TSH is 2.7, and FT3 below range and FT4 at the bottom of the range. My morning pulse today was 47, my morning temperature was 96.6, I am very tired and lack energy during the day.

I messaged back and asked for 75 mcg 5 days a week, and 50 mcg 2 days a week (trying to compromise) and to retest in 4 weeks.

I'll report back when I get a response.


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## FloraD (Feb 17, 2018)

I just heard back from the nurse and she says that 'given my concerns, the doctor will prescribe 75 mcg for Mon-Fri and 50 mcg Sat-Sun and retest in 1 month.


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## FloraD (Feb 17, 2018)

I am going for labs again on 5/18. I'm requesting B12 level for the first time.

Does it make since to repeat the thyroid antibodies labs? I had them done in January and they were present, but 'within range'.

For several weeks now I have had an occasional feeling/twinge or sensation in my lymph node(s) on the front right side of my neck. What could that be?

I haven' yet asked for an ultrasound, which was suggested on this board earlier since my antibodies are positive.


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## joplin1975 (Jul 21, 2011)

I wouldn't bother re-testing antibodies. They will likely be there. Whether or not they've increased or decreased won't really matter that much. You should focus on free t3 and free t4 to dose.

I'm a big believer in having a baseline ultrasound done if you have an autoimmune thyroid condition.


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## FloraD (Feb 17, 2018)

Thank you for the input.

The Dr. did not approve Lipids and did not approve Antibodies, but did approve TIBC, Ferritin, CBC, Vitamin D OH 25, B12 (in addition to the already-approved TSH, FT4, FreeT3).

After I get the results on Thursday/Friday, I will ask about getting a baseline ultrasound.


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## joplin1975 (Jul 21, 2011)

Great -- good luck!


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## FloraD (Feb 17, 2018)

Lab results after taking 75 mcg Synthroid Monday-Friday and 50 mcg on Saturday and Sunday for 4 weeks. (Previous month was 50 mcg M-F and 75 mcg Sat-Sun):

TSH 1.63
FT4 1.05 (.78-2.19); 19th percentile
FT3 3.52 (2.77-5.27); 30th percentile

I am concerned my doctor will think I don't need an increase since TSH is between 1 and 2. My frees have not improved much since 4 months ago.

Here are my original labs from January before starting Synthroid:

TSH 3.47
FT4 0.81 (2nd percentile)
FT3 3.28 (20th percentile)

Any advice what I should say to my doctor? I basically feel just as lethargic/tired as before. Should I ask for 75 mcg for 7 days a week since FT3 (30th percentile) and FT4 (19th percentile) are still low?

What is the optimal TSH I should shoot for - 1.0? Between 1-1.5?

Thank you.


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## FloraD (Feb 17, 2018)

The nurse called and says to stay on the 75 mcg M-F and 50 mcg Sat-Sun for 4 more weeks.

She said this is because TSH came down to 1.6 and because it can take more than 4 weeks for full effect of a dosage change (didn't tell her about a PubMed study that it only takes 3.5 weeks).

She said I only need TSH checked in 4 weeks because the FT3 and FT4 are somewhat steady. I felt incredulous! I explained to her that they are supposed to increase (and not stay steady) and are around the bottom quartile but should be 50-75 percentile.

I told her TSH is not a thyroid hormone. I told her FT3 and FT4 are thyroid hormones and are still low, and I am still having symptoms.

Sheesh!

Update: FT3 and FT4 labs now approved for 4 weeks from now.

(I also discussed my abnormally high B12 result with the nurse. I told her that since B12 is water soluable, any excess is excreted in the urine so it is unusual to have a high result (lab value just shows 'greater than 1,000'). She was unconcerned and said it can take a few years after stopping a multivitamin to return B12 to normal. This does not sound right to me - while B12 is nontoxic and excess is excreted in the urine, having a high B12 level can mean liver/kidney problems. Not sure what my next step is here).


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## FloraD (Feb 17, 2018)

Any comments or advice regarding my last post?


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## FloraD (Feb 17, 2018)

I had labs today after continuing for another 4 weeks on the same dose (75 mcg M-F and 50 mcg Sat-Sun).

The results were disappointing. It has been 5 months since I started taking Synthroid with not much improvement.

TSH 2.04

FT3 3.22

FT4 .91

Posting here for comments/suggestions.

It feels pointless to have spent 5 months and $300-$400 on co-pays for next to no change.


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## joplin1975 (Jul 21, 2011)

I assume you still have the same symptoms?

I think its clear that its time to go up to 75 seven times a week.


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## FloraD (Feb 17, 2018)

I should have mentioned that as well; along with almost no improvement in FT3 and FT4, I feel the same as I did before; somewhat tired, not much motivation to do anything physical, morning body temperature around 96.8 degrees, low pulse in the morning.

If I'm just going to feel the same as before, it's pointless to take Synthroid.

I have an appointment to see the Dr. on Thursday.

I think it was sometime during the second month that I had a week or two where I felt energized and wanted to run instead of walk up the stairs at work. Now I just take the elevator; not feeling any 'umph'.


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## joplin1975 (Jul 21, 2011)

I get it...I do. I was so sick for a long, long time. Hang in there...


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## FloraD (Feb 17, 2018)

I messaged the clinic today about increasing my dose to 75 mcg for 7 days a week. The nurse replied that since my labs are all within normal ranges I should just discuss it with the Dr. at my appointment in two days.

This is frustrating since the labs were in 'normal' limits 5 months ago before I started taking Synthroid.

I also remember during that brief period when I felt energized, that I actually had a libido (gone again).


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## joplin1975 (Jul 21, 2011)

Ugh, that's terribly frustrating. Just underscore the symptoms with your doc. My husband is in the medical field and he admits that its hard to hear patients "dump" a sob story on them. They want a concise list of symptoms and your concerns. Sometimes writing things out can be helpful.


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## Lovlkn (Dec 20, 2009)

I've read back through this post -

Do you have labs drawn at the same time everytime?

Your ferritin likely came in lower that one time due to a monthly cycle as ferritin levels will rise and fall throughout the month,

Do you NOT take your hormone replacement prior to your lab draw?


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## FloraD (Feb 17, 2018)

I have labs drawn around 8 a.m. every time.

I stopped having a monthly cycle 4 years ago.

I don't take my synthroid until after the lab draw.

Thank you for reading my posts.


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## FloraD (Feb 17, 2018)

I talked to my Dr. today. I said I feel about the same as 5 months ago (tired, hair loss, low pulse and body temp, low libido, etc.). She will increase my prescription to 75 mcg for 7 days a week, but it was a battle.

She said she only looks at TSH and went to a medical conference recently which affirmed dosing based just on TSH. She asked why I keep coming every 4 weeks for labs (umm... she authorized them!).

She said her thyroid patients get mad and write her letters and ask for pig hormone and referrals to endocrinologists... She said endos don't want to see thyroid patients.

I showed her my FT4 and FT3 labs and that from January to June they have not really improved. I explained that they should be increasing (she had asked 'What should I be looking for when the results come back?).

She did bring up the option of adding in cytomel. I said I wanted to try one thing at a time (i.e. increasing to 75 mcg x 7 days a week). She agreed and said we could keep cytomel in mind.

She also said my symptoms could be from menopause (i.e. low estrogen) and not from hypothyroid at all.

She asked why I started on synthroid - I said it was her idea back in January at my physical when I brought up various symptoms (cold at night, can't sleep soundly, low libido, etc.).

(I was ready to stop taking synthroid altogether today if she didn't increase it since it seemed pointless because FT3 and FT4 were about the same as before I started taking it and not much change in how I feel).

I will have labs again in 4 to 6 weeks.

When is cytomel a good idea? Is that for good FT4 but low in range FT3?

She also told me to stop googling and reading up on medical information on the internet...


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## FloraD (Feb 17, 2018)

Newest labs this morning after 75 mcg for 4 weeks (previous dose was 8 weeks of: 75 mcg 5 days per week and 50 mcg two days per week):

TSH 1.68 (.465-4.68)
FT4 .90 (.78-2.19) 8.5 percentile
FT3 2.95 (2.77-5.27) 7.2 percentile

I still feel tired/lethargic and have gained weight. Just no 'oomph' or energy.

Any suggestions? Please.

The Dr. argued with me last time when I pushed for 75 mcg daily and it was apparent she doses on TSH alone since she said she doesn't know what to look at regarding FT3 and FT4 numbers. She recently went to a conference on treating hypothyroidism...

She did say I could ask to add cytomel. Should I do that (if so how much and keep levothyroxine at 75mcg)? or should I ask for 88 mcg levothyroxine 5 days per week and 75 mcg Sat-Sun with no cytomel?

Why can't I get my frees to increase?


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## joplin1975 (Jul 21, 2011)

I'm a big believer in not adding cytomel until your free t4 is in a good place. But I haven't tried cytomel, so I could be wrong about that...

I would defnintely push for 88 X 5 days and 75 X 2 days.


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## FloraD (Feb 17, 2018)

Thank you for replying!

Do you think 88mcg for 7 days would be too big of an increase?


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## joplin1975 (Jul 21, 2011)

No, people often go up at increments of 25 mcgs at a time. Your labs are not great so I think you'd have a problem!


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## FloraD (Feb 17, 2018)

I was happy with my Dr. appointment today. I explained my symptoms of continued fatigue and (new symptom) of choking/my throat closing. I asked for an increase to 88 mcg x 7 days per week. This time the Dr. did not bring up my 1.6 TSH like she did two months ago (when she said it was normal/fine), and she agreed with prescribing 88 mcg x 7 days/week.

I was also approved for a thyroid ultrasound due to the new symptom. It's in 2 weeks.

Labs approved (TSH, FT4, FT3) for next month.


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## WhatHappened (Nov 12, 2015)

Awesome... your labs on Jul 16 were, well, meh. It will be incremental improvement, but it will be interesting to see where you land at 88 x 7.

I see she offered cytomel, but is stingy with the levo (lol). I wouldn't be surprised if you went the full 100 mcg, but you may have to argue around your tsh. That's just going to look lower even though your ft4 is still not going to be great on 88 (really just 13 x 2 more, right? But more is more... )


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## FloraD (Feb 17, 2018)

It's 13 mcg x 7 days more per week so it is 91/525 = 17% more.


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## WhatHappened (Nov 12, 2015)

Better still...


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## FloraD (Feb 17, 2018)

I just had my first thyroid ultrasound. Here are the comments:

"Multiple small thyroid nodules. Nothing that requires intervention or biopsy.

Findings:

Thyroid gland is normal in size, right lobe 4.5 x 1.3 x 1.3 cm, left lobe 5.1 x 1.4 x 1.3 cm, isthmus 0.15 cm.

A mild heterogeneous echo pattern throughout the thyroid gland.

Multiple very small colloid nodules throughout the thyroid gland, largest on the right measures 8 x 4 x 6 mm, largest on the left measures 6 x 5 x 5 mm.

Negative for significant predominant nodule within the thyroid gland.

Negative for significant adenopathy on both sides of the neck.

Impression: Multinodular thyroid gland with multiple benign colloid nodules. Negative for significant thyroid nodule."

My questions: would it be normal to request to repeat the ultrasound every so often to check size? At what size should a nodule be biopsied? Are small nodules very common? What causes these nodules?


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## FloraD (Feb 17, 2018)

Removing double post


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## joplin1975 (Jul 21, 2011)

Yes, people have repeat ultrasounds. The frequency depends on how large the nodules are - sometimes it's every six months while other times it's annually.

Nodules should have one measurement over 1cm before they are biopsied.

Small nodules are common. Especially in women.

Some nodules just happen, but most (especially if you have multiple nodules) are essentially scar tissue. It's evidence that antibodies have been attacking your thyroid.


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## FloraD (Feb 17, 2018)

Thank you, that was very helpful!


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## GOLGO13 (Jun 13, 2018)

Good luck FloraD. I've been working on adjusting medication also and have been frustrated. It takes a lot of time for some of us. It is a journey. I wish I could help. One thing I have heard is go to your local pharmacist and ask what doctors prescribe t3 pr pig thyroid. That's a way to find a doctor who may be more open to helping. Or if you wanted to try it. I'm hesitant, but I will ask my new endocrinologist about the possibility. Good luck!


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## FloraD (Feb 17, 2018)

Thank you!


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