# New Labs- Someone, please help!



## Melissa907 (Sep 6, 2010)

Hello all!
So, I initially was tested in the beginning of September and my TSH level was at 4.5. I was diagnosed with Hashimotos. I was immediately put on 25 mcg of Synthroid per day. Needless to say, I've still be feeling very tired, lethargic, deperssed, and have gained about 5lb in a month. I am usually very active, healthy, and haven't gained weight in years prior to this.

I was retested two days ago and my labs were as follows:
TSH: 1.73
Total T3: 76
Free T4: 1.1

My doctor said my TSH is pretty good now as well as my Free T4. However, my total T3 seems low. So, he upped me to 50 mcg Synthroid per day.

I am worried that this might not be the right move. I am curious if I need more T3 instead of more T4 (due to lack of converting?). I am not sure!

What are your thoughts on my lab values?

I started the 50 mcg Synthroid today and am honestly feeling very dizzy, shakey, and lightheaded like I just drank coffee. Not sure if its due to the meds or not.

Thank you for your help!
Melissa


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## Melissa907 (Sep 6, 2010)

I meant I was originally in the beginning of SEPTEMBER, then again two days ago. Sorry.


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## Andros (Aug 26, 2009)

Melissa907 said:


> Hello all!
> So, I initially was tested in the beginning of September and my TSH level was at 4.5. I was diagnosed with Hashimotos. I was immediately put on 25 mcg of Synthroid per day. Needless to say, I've still be feeling very tired, lethargic, deperssed, and have gained about 5lb in a month. I am usually very active, healthy, and haven't gained weight in years prior to this.
> 
> I was retested two days ago and my labs were as follows:
> ...


Your TSH could be a bit lower; most of us feel best @ 1 or less. However, basing a med increase or decrease on the results of T3 is poor practice as this is bound, unbound and in many cases rT3 (reverse) as well. Therefore leaving no clue as to what the FREE T3 might be which is your active hormone.

I would take the increase as suggested but next labs, I would insist on TSH, FREE T4 (which you did have) and FREE T3.

In the future if you could please post the ranges w/ your results it will be much appreciated as different labs use different ranges.

Hope you feel better, Melissa and truth be told, the first few days of a thyroxine increase can make you feel a little jittery. If it persists for more than a week or if you feel really really ill before that time, do not hesitate to call your doctor.

And always check to make sure that you have the correct Rx. I once got someone's heart medication instead of my Levoxyl. Eeeeeeeeeeeeeeeeeeeeeeeeks. I almost slammed it into my mouth when I took a second look.


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## Melissa907 (Sep 6, 2010)

Thanks for the help! My mistake on not posting the ranges. I actually did request FREE T3 and the doctor still ordered just T3. When I questioned him on this, he claimed that the lab just did it that way. I was very upset because I asked him for FREE T3 and he did not test that. So, for now, I am going to increase to 50 mcg and see how I feel for 2 weeks. My other doctor suggested maybe adding a small dose of Armour or something similar for the T3 if I'm still feeling sluggish. Oh the joys!


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## Andros (Aug 26, 2009)

Melissa907 said:


> Thanks for the help! My mistake on not posting the ranges. I actually did request FREE T3 and the doctor still ordered just T3. When I questioned him on this, he claimed that the lab just did it that way. I was very upset because I asked him for FREE T3 and he did not test that. So, for now, I am going to increase to 50 mcg and see how I feel for 2 weeks. My other doctor suggested maybe adding a small dose of Armour or something similar for the T3 if I'm still feeling sluggish. Oh the joys!


I think it is pretty bad when the patient requests a certain test and the doctor does not comply. Very very bad, indeed! Who are they working for? It makes you wonder!


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## Melissa907 (Sep 6, 2010)

He's just an internal medicine doctor and I really feel like he has NO idea what he is doing. I am not going to go to him anymore. It was just convenient because I could get in to see him at a moment's notice and I am having a heck of a time finding an endo who can see me anytime in this month! So, due to that, I am just doing the easier thing but it's not paying off. I need to see someone who can help me and who cares!


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## Andros (Aug 26, 2009)

Melissa907 said:


> He's just an internal medicine doctor and I really feel like he has NO idea what he is doing. I am not going to go to him anymore. It was just convenient because I could get in to see him at a moment's notice and I am having a heck of a time finding an endo who can see me anytime in this month! So, due to that, I am just doing the easier thing but it's not paying off. I need to see someone who can help me and who cares!


Yes you do and don't confine your search to an endo. Think outside the box. Most endo docs specialize in diabetes. DO, GP a different Internist, PCP.............any doctor who is interested in getting you well, will listen and learn along with you is the key here.


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## Melissa907 (Sep 6, 2010)

You're right. The funniest thing is, my gyno back home is actually the one I've been talking to most about this because she deals alot with thyroid disease in relation to fertility. So, I have her as a support. I just need to find a good doc. If anyone in Colorado knows of anyone, let me know!


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## CA-Lynn (Apr 29, 2010)

How do you know you have Hashimoto's?


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## Melissa907 (Sep 6, 2010)

Due to antibodies tests and inflammation.


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## Andros (Aug 26, 2009)

Melissa907 said:


> Due to antibodies tests and inflammation.


I meant to ask the same thing. If you had high TPO (antimicrosomal antibodies), that is merely "suggestive" of Hashimoto's but it is also "suggestive" of a myriad of other things.

It would be good to get a radioactive uptake scan to see if your thyroid presents in the "typically" nodular fashion as Hashi's (once again only suggestive) and if there are nodules to have an FNA (fine needle aspiration to see if there are Hurthle cells indigenous to Hashi's. If there are, that would clinch the case.

Anything else would be supposition and conjecture.

Here is a good read on Hashimoto's.

http://www.thyroidmanager.org/Chapter8/8-frame.htm

As you read through, you will see the Hurthle Cell slides.


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## CA-Lynn (Apr 29, 2010)

I disagree with Andros on her statement that most endos deal with diabetes. In my area that's not true at all. There are general endo's, then there are endo's who specialize in diabetes, then there are endo's who specialize in thyroid, then there are endo's who specialize in other hormonal and fertility disorders.

You need to call an endo and ask the office which sub-field of endocrinology that doctor specializes in.

Granted, you may not find specialists in these sub-fields in smaller towns, but it's worth asking. Also, you can often google a doctor's name and pull up his/her bio and all the papers that physician may have written.


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