# New lab results.



## kimberllee (May 20, 2011)

Hi everyone. Sorry I've been so MIA. I've been so sick. I feel like I've been hit by the exaughstion bus.

I've been on a steady decline in stamina, itchy skin, brain fog, tired and wired, sore puffy eyes, major weight gain and have just had another round of labs done.

Here's where it gets Interesting:
T4 free 1.94 range .82-1.77
Tsh 0.091 range .45-4.5

My doctors are telling me my tiredness, weight gain, itchy skin, puffiness, etc... is not as a result of my thyroid or medication. As I'm in a hyper not hypo state.

Any thoughts? I'm one unhappy camper.


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## lainey (Aug 26, 2010)

I disagree with the doctor. Those symptoms are all cross-over symptoms and could be because you are being forced too far hyper.

I realize you are supposed to suppressed, but free T4 over the range is not just suppressed, but over medicated.

Did the doc agree to reduce the dose a bit to bring the free T4 down a bit? Your TSH likely won't come up that much.


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## kimberllee (May 20, 2011)

My drs have been very stumped. My tsh has rollercoastered back and forth for 6 months. This is is the first time they've been able to supress it close to where they want it which is at 0.00

I've felt horrendous since December with a steady decline. My doctors would like to keep me at the 300mcg of synthroid till further notice.

Grrrrrrrrrrrrrrr.


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## Octavia (Aug 1, 2011)

Holy %$#@....300 mcg???? That seems like an extremely large dose. Wow!!!!

Other than being tired, are you having other hyper symptoms?


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## joplin1975 (Jul 21, 2011)

I was going to say the same thing...that's a massive dose!!

Have you had your free T3 run?


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## kimberllee (May 20, 2011)

Octavia said:


> Holy %$#@....300 mcg???? That seems like an extremely large dose. Wow!!!!
> 
> Other than being tired, are you having other hyper symptoms?


I'm wired and tired, brain fog, weight gain, itchy skin, exaughstion, dizziness, puffiness in my face, insomnia (even though I'm bone crushingly tired)

My tsh has gone from .97 to 3.95 To 1.0 to 2.5 with zero explanation. While still on the same dose of 300 mcg of synthroid. Yes it's a massive dose.

No one seems to ever run anything other than tsh and t4 free ever. Ugh.


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## Andros (Aug 26, 2009)

kimberllee said:


> Hi everyone. Sorry I've been so MIA. I've been so sick. I feel like I've been hit by the exaughstion bus.
> 
> I've been on a steady decline in stamina, itchy skin, brain fog, tired and wired, sore puffy eyes, major weight gain and have just had another round of labs done.
> 
> ...


Excuuuuuuuuuuuuuuuuuuuuuuse me!!! (to your doctor I say this) Hyper has all of the above symptoms. Including weight gain.

You are tired because even when you are resting, your metabolism is speeding and this leaves you in a state of exhaustion.

I recommend you change doctors. This is pitiful. Also, you need the FREE T3 test. Make sure it is the FREE.

Free T3. Essential!

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.

http://www.drlam.com/articles/hypothyroidism.asp?page=2#diagnosis: standard laboratory test


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## Octavia (Aug 1, 2011)

kimberllee said:


> I'm wired and tired, brain fog, weight gain, itchy skin, exaughstion, dizziness, puffiness in my face, insomnia (even though I'm bone crushingly tired)
> 
> My tsh has gone from .97 to 3.95 To 1.0 to 2.5 with zero explanation. While still on the same dose of 300 mcg of synthroid. Yes it's a massive dose.
> 
> No one seems to ever run anything other than tsh and t4 free ever. Ugh.


Yeah, my doc also likes the TSH and Free T4 tests, and not much else.

With those symptoms and your astronomical dosage of Synthroid (and your lab results), hyper definitely comes to mind. Your dose is twice as high as most of us women on this forum...it is huge, huge, huge. And if "twice as high" doesn't have much meaning to you, consider this: for some people, a change in 12 mcg can be a significant difference. You are 150 mcg higher than many of us.

Are you following all of the "rules" as far as taking it first thing in the morning, waiting 30-60 minutes to eat, no calcium supplements within 4 hours, etc? Just checking!


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## lainey (Aug 26, 2010)

Re: dosage size: there are people who metabolize thyroid meds fairly slowly, and are like yourself, take much larger doses to get the same TSH that someone else might need 1/3 of the medication to achieve. While it is a little different, it's not impossible.

They're not going to run T3 tests. You are on replacement post cancer, the sole focus will be keeping that TSH suppressed and there really isn't much concern for the other numbers....hence the T4 over the range. If that is high, it is likely the free T3 is up there as well.

I would also suggest that you could ask to try a different medication.

Levoxyl and Unithroid are T4 medications. Some patients report better absorption on Levoxyl. You might get more stable results on something that is known to be absorbed a little more easily.

You can also get the suppressed number they are looking for on a lower dose of T4 medication if they add T3, such as cytomel.

Just some thoughts.


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## kimberllee (May 20, 2011)

Wow. Thanks for all the support and responses. I will add, I have malabsorption issues...my general suspects possible celiac... I've had one negative blood test. But I don't consume a whole lot of gluten in general. The next step is a small bowel biopsy.

I head to mayo on march 21.... Here's to hoping they can out me back together and fix me


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## Enigma (Jun 13, 2011)

I had TSH numbers all over the place while on the same dosage of generic levothyroxine. Felt horrible. Switched to Tirosint and am 110% better! I also have absorption issues, but it hasn't been a problem with Tirosint. Much more stable absorption. Plus, docs told me given my TSH at diagnosis (15.4) that I'd need to be on 100-125 mcg at some point. Switch to tirosint, 75mcg, and my TSH was .5, and highest was 1.24 (then went up to 88mcg, waiting for follow up tests). I HIGHLY recommend Tirosint over the other pills. My docs hadn't heard of it, even the endo, but were willing to try. seriously, I'd try this when/if you change dosages (and be ready to have to adjust your dose down).


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## kimberllee (May 20, 2011)

Update update: spoke to my endo about being super symptomatic and her answer. shed like to see my numbers closer to 0.00 And wants me to remain on 300 mcg of synthroid. I feel like I'm worse by the day. Grrrrrrrrrrr!


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## Andros (Aug 26, 2009)

kimberllee said:


> Wow. Thanks for all the support and responses. I will add, I have malabsorption issues...my general suspects possible celiac... I've had one negative blood test. But I don't consume a whole lot of gluten in general. The next step is a small bowel biopsy.
> 
> I head to mayo on march 21.... Here's to hoping they can out me back together and fix me


It would benefit you greatly if you went 100% gluten-free! That would mean reading labels and learning all the words they use for gluten.

Let us know what Mayo has to offer on your behalf. Worried for you. Got to get you on track; it has been too long.


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## I DClaire (Jul 31, 2011)

Andros said:


> It would benefit you greatly if you went 100% gluten-free! That would mean reading labels and learning all the words they use for gluten.
> 
> Let us know what Mayo has to offer on your behalf. Worried for you. Got to get you on track; it has been too long.


I desperately want to start eating healthier but I feel overwhelmed, I don't know where to begin. Every day it seems like I'm more conscious that what I eat may be having a noticeable impact on how I feel since going on Armour (and maybe even when I was on Synthroid). Sweets, something I love dearly and have enjoyed my entire life, are getting to where they make me feel bad. I hate it but I've reached the point where I'm open to doing whatever it takes to add even a few minutes of extra energy to my day.

It is SO easy, SO comfortable to give in to old familiar foods, probably as much or more to relax or de-stress than to quench my hunger.

Old habits die hard.


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## kimberllee (May 20, 2011)

[quote name='Andros'] i got my endo to run a few extra labs today....

TSH	0.450-4.500 uIU/mL my result : 0.132 UP from 0.091 run on friday.

T4 FREE 0.82 - 1.77 my result :2.07 today. past results have been all over the map. last friday was 1.94 and 12/2 was 2.51

T3 FREE	2.0-4.4 pg/mL	my result 2.4 (never have had this run before)

my blood pressure was MUCH better today. like perfect... 121/80 pulse 83
friday i was a whopping 160/83 highest its ever been, EVER.... and had a pulse of 90.

does anyone have any thoughts? :hugs:


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## lainey (Aug 26, 2010)

I don't know if this is good news or bad news, but if you research the current thinking on post surgery suppression for Thyca, the general thinking is that after a couple of clean post surgery scans they can allow the TSH to come up a little--it would still be suppressed low in the range, but not so near to zero as they are keeping it now. It also helps if you don't have the thyroglobulin antibodies--these interfere with the tumor marker lab work, so NOT having them is a good thing, because it makes your labs more accurate for catching a regrowth (which is what they try to prevent with suppression--see, so accurate labs here are a good thing).

I think you should at least consider asking about a different brand, such as Levoxyl or even the new Tirosint. Both are said to absorb more easily, and might give you more stable results. This might help you to feel better.


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## Andros (Aug 26, 2009)

kimberllee said:


> Andros said:
> 
> 
> > i got my endo to run a few extra labs today....
> ...


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## kimberllee (May 20, 2011)

[quote name='Andros'][quote name='kimberllee']

I thought you were starting Armour as of 2/21/12. Armour is Not recommended for patients with advanced papillary thyroid cancer. Because my cancer was advanced the drs feel very strongly against anything other than synthroid.

My case is multiple layered as I also have pcos, hashi's, and I suspect celiac.....
My vitamin d hydroxy has plummeted even with taking 100,000 a week. I can barely crack a rate of 23. Rate 32-100.

So, we know for sure I have malabsorption issues. I also show both hypo and hyper symptoms. My endo has me diagnosed as hypo...but with notes listing hyper features as well. How can someone be hypo and hyper at the sime time if they have no thyroid? Her suspiscion is that my levels are swinging day to day for whatever reason I'm absorbing the meds or metabolising the meds different causing some of the issue.

Ugh. This is so frustrating.


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## Andros (Aug 26, 2009)

I DClaire said:


> I desperately want to start eating healthier but I feel overwhelmed, I don't know where to begin. Every day it seems like I'm more conscious that what I eat may be having a noticeable impact on how I feel since going on Armour (and maybe even when I was on Synthroid). Sweets, something I love dearly and have enjoyed my entire life, are getting to where they make me feel bad. I hate it but I've reached the point where I'm open to doing whatever it takes to add even a few minutes of extra energy to my day.
> 
> It is SO easy, SO comfortable to give in to old familiar foods, probably as much or more to relax or de-stress than to quench my hunger.
> 
> Old habits die hard.


Old habits do die hard. However, replacing them w/new and improved habits makes the transition so much easier. Plus, don't overwhelm yourself. Stick to one "improvement" project at a time and also chose a low goal. You can always add-on to your goal if you achieve the low one. If goals are too high, they can be counter productive.


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