# Lab Results - Help please.



## smandysen (Aug 13, 2013)

Updated question: 4-26-17

Recent labs:

TSH 2.3 (0.465-4.680)

FT4 0.85 (0.64-1.79)

FT3 2.5 (2.0-4.4)

Vit D 57.47 (31-100)

Taking Levothyroxine 75 x 6 days per week

Cytomel 10mcg x 6days per week

Just transferred to regular doc from endo as I was fairly stable. Numbers have changed a bit. I asked the pcm to adjust meds and they said no because I'm in the "normal" range. My endo was great...pcm not so much. We are military moving soon so it isn't worth rocking the.boat. I'll be looking for a new doc soon. I do have plenty of T3 meds to adjust my dosage as needed. Should I add 5mcg in the afternoon to see how I feel?

Thoughts?

Original Thread:

I've looked at lots of links and need help with the "overall picture."

I was diagnosed in October 2010 with Graves, had radioactive iodine in January 2011 and have been on kind of a roller coaster since then. I had the normal "I feel great!" after getting regulated, but then for the past 18 months I just haven't felt all that great, but my numbers have appeared to satisfy the docs and so I just live with it. I have moved to a new location (husband is military) and just got these test results&#8230;can you help me understand if there is anything here that would tell me why I am always so tired and just feeling "blah"? I sleep 8-10 hours a day and wake up feeling like I got no sleep at all. Just feel out of energy all the time. I currently take 75mcg Levothyroxine every morning. My previous doc wanted by TSH levels hovering right around 1.0 but definitely less than 2.0. This blood work was ordered so I could have levels established for my next appointment in 2 weeks. I've read lots on this board about TSH not being the accurate measurement. I had to fight to get these results (Free T3 just isn't done by the military docs I've run across).
TSH 2.170 (0.465-4.680)
FT4 1.38 (0.64-1.79)
T3FREE 2.5 (2.3-4.2)

WBC 4.6(L) (4.8-10.8)
RBC CNT 4.30 (4.2-5.4)
HGB 13.2 (12.0-16.0)
HCT 39.2 (37.0-47.0)
MCV 91.2 (82.0-101.0)
MCH 30.7 (27.0-34.0)
MCHC 33.7 (32.0-36.0)
RDW 12.8 (11.5-14.5)
PLT CNT 194 (130-400)
MPV 10.6 (9.0-12.5)

NA+ 142 (137-145)
K 3.7 (3.6-5.3)
CL- 103 (98-107)
CO2 27 (23-32)
GLUCOSE 88 (70-99)

BUN 14 (7-17)
CREAT 0.79 (0.6-1.0)
CA 9.3 (8.4-10.2
PROT TOT 7.5 (6.3-8.2)
ALBUMIN 4.3 (3.5-5.0)
ALK PHOS 57 (38-126)
AST 20 (14-50)
ALT 28 (9-52)

TBILI 0.4 (0.2-1.3)
ANION GAP 12 (8-16)
GFR-NAA 93.3 (>/=60)
GFR-AA 107.5 (>/=60)

CHOLESTEROL 220(H) (50-200)
TRIGLYCERICE 114 (35-135)
HDL 50 (40-100)
LDL 147(H) (0-129)
VLDL 23 (2-49)
CHOL TOT/HDL 4.40

Thanks for your input! I'm just struggling to figure out how all the different test results (the whole picture) relate to each other. 

Sherilin


----------



## Andros (Aug 26, 2009)

smandysen said:


> I've looked at lots of links and need help with the "overall picture."
> 
> I was diagnosed in October 2010 with Graves, had radioactive iodine in January 2011 and have been on kind of a roller coaster since then. I had the normal "I feel great!" after getting regulated, but then for the past 18 months I just haven't felt all that great, but my numbers have appeared to satisfy the docs and so I just live with it. I have moved to a new location (husband is military) and just got these test results&#8230;can you help me understand if there is anything here that would tell me why I am always so tired and just feeling "blah"? I sleep 8-10 hours a day and wake up feeling like I got no sleep at all. Just feel out of energy all the time. I currently take 75mcg Levothyroxine every morning. My previous doc wanted by TSH levels hovering right around 1.0 but definitely less than 2.0. This blood work was ordered so I could have levels established for my next appointment in 2 weeks. I've read lots on this board about TSH not being the accurate measurement. I had to fight to get these results (Free T3 just isn't done by the military docs I've run across).
> TSH	2.170	(0.465-4.680)
> ...


It is my humble opinion that you are undermedicated and most of us who have had RAI don't convert the FT4 to FT3 very well. You may be a candidate for the addition of Cytomel (T3) or switch over to dessicated porcine thyroid (Armour/Naturethroid.)

Glad you won the battle to get FREE T3 done; this is your energy source. No wonder you feel so bad.

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm


----------



## Velcro (Jul 26, 2013)

So Andros, the Free T3 is where the fatigue mostly comes from? (I'm still trying to learn so I can interpret my labs).


----------



## smandysen (Aug 13, 2013)

So if I'm understanding correctly, even though I fall within the "normal" range (is there such a thing?) because it is at the extreme low end, it is something that should be supplemented? I want to go to the doc with as much knowledge as possible. Thank you for your opinion!


----------



## Andros (Aug 26, 2009)

Velcro said:


> So Andros, the Free T3 is where the fatigue mostly comes from? (I'm still trying to learn so I can interpret my labs).


Absolutely; FT3 is your active hormone. It's your energy source, your healing source and food for the brain in a very big way.

You are going into hibernation mode due to T3 deprivation.


----------



## smandysen (Aug 13, 2013)

So this could be part of the reason why, even though I've cut out the "trigger foods" that have always made me gain weight in the past, that I'm not losing anything right now. I'm seriously getting frustrated with the whole lack of energy, food issues, weight gain/stagnation, mental fog, freezing extremities, etc. BUT....I'm feeling some hope now. If only I didn't have to wait 2 more weeks before my next appointment.....  Thank you!


----------



## jenny v (May 6, 2012)

It could be a big part of the reason you're having all of those symptoms, smandysen. When my Free T3 is in the lower part of the range (even if it's still in the range), I can't lose weight to save my life and I could fall asleep standing up. Your Free T4 is good, but I think you could use the addition of a T3 medication like Cytomel to help you out.


----------



## smandysen (Aug 13, 2013)

Thank for the encouragement. Will update after my appointment in a couple weeks. Praying for a med change.


----------



## smandysen (Aug 13, 2013)

I finally had my appointment. "Your labs look great! They are within the normal range."

I politely replied that they may be within normal range but I still feel lousy. I talked about Free T3 being low, TSH being higher than my last endo liked (he prefers between 1-2) and that i want to try a T3 medication or One that has T3 and T4. She replied "We don't get into those specifics here. I will have to refer you somewhere else."

So-10 days for the referral so I can call someone else to make an appointment.

And because I mentioned I'm having a hard time losing weight due to this mess, she is referring me to a wellness center to talk about diet, exercise, etc. seriously!?!? I don't have an issue with weight when my thyroid is regulated. I'm 10 pounds over where my body is really comfortable and at its best. Ugh.

So, I'm praying for an excellent endo in our area. (Harrisburg, PA if anyone has a recommendation...)

I just want to cry. I'd really like to feel better before my trip in a month...not holding my breath.


----------



## Andros (Aug 26, 2009)

Velcro said:


> So Andros, the Free T3 is where the fatigue mostly comes from? (I'm still trying to learn so I can interpret my labs).


DEFINITLEY!!! This is your active hormone and energy source!

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.


----------



## smandysen (Aug 13, 2013)

Just got new lab results. 
Endo upped Synthroid to 88 from my last appt and I go back Tuesday to meet with him. He isn't convinced I need T3, but I'm still tired all the time. 
So...latest labs:

FT4 1.5 (0.64-1.79)
TSH 1.7 (0.475-4.680)
T3 73.4 (80-200) (wouldn't run FT3)
Cortisol 9.9 (6.2-19.4)
ACTH 21 (6-50)
NA+ 139 (137-145)
K. 3.9 (3.6-5.3)
CL- 103 (98-107)
CO2 29 (23-32)
GLUCOSE 84 (70-99)
BUN 16 (7-17)
CREAT 0.78 (0.6-1.0)
ANION GAP 7 (low) (8-16)
GFR-NAA 94.1 (>/=60)
GFR-AA 108.4 (>/=60)

What are your recommendations? Still get on a T3? I want to go to my appt with as much info as I can....and I still want to feel better! Thanks!


----------



## smandysen (Aug 13, 2013)

I'm soooo excited! The Endo prescribed 10 mcg Cytomel today! I'm praying for ENERGY!

He said to take it in the morning with my synthroid. I will try it this way, but is that the best way to do it? I've seen posts about people splitting the dose, etc. just looking for some suggestions. 

Thanks!


----------



## smandysen (Aug 13, 2013)

Question and update:

Recent labs:

TSH 2.3 (0.465-4.680)

FT4 0.85 (0.64-1.79)

FT3 2.5 (2.0-4.4)

Vit D 57.47 (31-100)

Taking Levothyroxine 75 x 6 days per week

Cytomel 10mcg x 6days per week

Just transferred to regular doc from endo as I was fairly stable. Numbers have changed a bit. I asked the pcm to adjust meds and they said no because I'm in the "normal" range. My endo was great...pcm not so much. We are military moving soon so it isn't worth rocking the.boat. I'll be looking for a new doc soon. I do have plenty of T3 meds to adjust my dosage as needed. Should I add 5mcg in the afternoon to see how I feel?

Thoughts?


----------



## Lovlkn (Dec 20, 2009)

We like to see FT-4 and FT-3 approach 3/4 of range. You are actually quite hypo.

If you only add Cytomel it may increase your FT-3 levels but your FT-4 is too low.

I used to get refills as soon as I was able to - that way you accumulate a few extra pills with each refill. If it were me, I would increase both levothyroxine and the Cytomel.

Are these last labs similar to the prior labs? Do you have any thyroid function as far as you are aware?


----------



## smandysen (Aug 13, 2013)

I have a good 4-5 months of T3 and just got a refill for my T4...not as abundant in that area. I am only taking them 6 days a week, so I can certainly up them to 7 days per week and then add in an extra 5mcg of Cytomel at night. We move and will be in transition from one location to the next over the next 3 months, but certainly have enough through that time.

Lab history:

Please see attached jpg

January 2016 labs were done after I had taken my meds in the morning - completely forgot to not take them...

Current labs were run on the same dosage as the previous labs.

I had RAI done in 2011 and I do have functioning thyroid, although I don't know how much it produces on its own.

I will be looking for a new PCM and Endo once we arrive. Hopefully the referral won't take too long.

Thank you for your comments. I knew my numbers weren't good, however my endo released me back to my PCM with instructions that as long as my numbers are "normal" range, my meds should stay the same. I don't have enough time here to try and reeducate the pcm. Ugh.


----------

