# Question on LAbs



## tagblg (Mar 17, 2011)

i! I Just recently started seeing an Endo doc for what I thought might be pre-diabetes/hypoglcemia. Well after running tests Endo doc say no go to the diabetes. My doc called me today and told me she would like to start me on 75 mcg of levothyroxine. I am female and weight 169 pounds. I feel like total crap. My test level was

TSH~4.6698 0.45-5.0
Free T4~1.07 0.71-1.85

Questions??

Is this a high starting dose?

Are these levels high/low?

I have had numerous of the symptoms when I looked up Hypothyroidism for many years. Thanks so much for any Advice!


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## Andros (Aug 26, 2009)

tagblg said:


> i! I Just recently started seeing an Endo doc for what I thought might be pre-diabetes/hypoglcemia. Well after running tests Endo doc say no go to the diabetes. My doc called me today and told me she would like to start me on 75 mcg of levothyroxine. I am female and weight 169 pounds. I feel like total crap. My test level was
> 
> TSH~4.6698 0.45-5.0
> Free T4~1.07 0.71-1.85
> ...


Hi and welcome! You are so lucky that a doc would treat you with your TSH in the range but high in the range. Most of us do feel best w/TSH @ 1.0 or less.

I think the dose is appropriate given your weight.

Did your doc run any antibodies' tests?

If my TSH was where yours is at, I would feel very sick. So, I hear you!! Loud and clear.

What are your symptoms?


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## tagblg (Mar 17, 2011)

What are the free4's? what does my results suggest as linked to my TSH?


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## McKenna (Jun 23, 2010)

It would be helpful if you get a Free T3 level to go with your TSH and Free T4. Free T3 shows the actual amount of unbound hormone that is available for immediate use.

TSH is a pituitary hormone and when it's high, it means your pituitary is screaming at your thyroid to make hormone. Your thyroid then produces more, or tries to, and that shows in your Free T's. When your TSH is high and your Free T's are low, that means that despite the screaming from your pituitary, your thyroid can't produce enough hormone. This is where antibody levels can be helpful, to see if something autoimmune is causing your thyroid to underproduce hormone.

You have a TSH creeping toward high, and a lower Free T4. I agree with Andros that you are lucky to have a doc agree to treatment with your TSH technically "in range".


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## Andros (Aug 26, 2009)

tagblg said:


> What are the free4's? what does my results suggest as linked to my TSH?


Your FT4 is unbound hormone (as is the FT3) and it is below the mid-range of your lab range which is 1.28. This is "typical" when TSH is on the rise.

Here is info.................

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


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## tagblg (Mar 17, 2011)

I am even more confused now!! The tests i have listed is the only test my doc did! I have read many posts and the reply are saying numbers like mine would make you feel like crap. Are you saying with my lab results, I am lucky my doc would treat me? I really don't want to take this med and deal with possible symptoms and effects for m that if these are not treatable numbers. Most people are saying anything over one is very symtomatic numbers.

Help!!
http://www.thyroidboards.com/images/smilies/sad0049.gif


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## tagblg (Mar 17, 2011)

McKenna said:


> It would be helpful if you get a Free T3 level to go with your TSH and Free T4. Free T3 shows the actual amount of unbound hormone that is available for immediate use.
> 
> TSH is a pituitary hormone and when it's high, it means your pituitary is screaming at your thyroid to make hormone. Your thyroid then produces more, or tries to, and that shows in your Free T's. When your TSH is high and your Free T's are low, that means that despite the screaming from your pituitary, your thyroid can't produce enough hormone. This is where antibody levels can be helpful, to see if something autoimmune is causing your thyroid to underproduce hormone.
> 
> You have a TSH creeping toward high, and a lower Free T4. I agree with Andros that you are lucky to have a doc agree to treatment with your TSH technically "in range".


How am i in range if most are stating the high is now three? I am so confused!!!


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## Andros (Aug 26, 2009)

tagblg said:


> How am i in range if most are stating the high is now three? I am so confused!!!


According to AACE, you are above the range. Your doctor clearly is aware of the AACE guidelines otherwise, I doubt he would treat you.

How long have you been taking this Armour?


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## McKenna (Jun 23, 2010)

It's confusing, isn't it?

Your numbers are showing that you are hypo-thyroid. You SHOULD be treated, IMO, which is what your doctor is doing. Most doctors will not treat someone with a TSH "in range". I use the quotes to show that even though your numbers are technically in range, they are at a level where most of us would feel sick with. You are correct in that the AACE now recommends range as being .3 to 3.0, but most labs use a higher range and most doctors do not know/acknowledge the AACE range when diagnosing/treating people who are hypo. You are lucky to have a doctor who is willing to treat you even though your TSH is not over range. It's a good thing!

Most of us have found that doctors are not up on the latest thyroid treatment. They dose by TSH only, or not run the proper tests to see what the thyroid is doing. If you have a thyroid issue, you will have to be your own advocate, request the proper tests and work with your doctor for optimal treatment. Doing what you are now, reading and learning, is the important first step.


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## lainey (Aug 26, 2010)

tagblg said:


> I am even more confused now!! The tests i have listed is the only test my doc did! I have read many posts and the reply are saying numbers like mine would make you feel like crap. Are you saying with my lab results, I am lucky my doc would treat me? I really don't want to take this med and deal with possible symptoms and effects for m that if these are not treatable numbers. Most people are saying anything over one is very symtomatic numbers.
> 
> Help!!
> http://www.thyroidboards.com/images/smilies/sad0049.gif


Keep in mind that there are a lot of posts here from people seeking treatment, seeking answers for their symptoms, and quite a lot of them in the recent past have quite "normal" numbers.

In research journals, you are not "overtly" hypothyroid until your TSH is in excess of 10, sometimes 20 with a free T4 below the range.

There is a line of thinking, that like any group, the ACCE lowered the ranges on diagnosing thyroid conditions (it has happened for diabetes, high cholesterol and high blood pressure too) to allow more people to be treated earlier.

Everyone feels well at different levels, and the TSH of 1 that you see "most" people feeling well at is actually the 50th percentile for thyroid levels--this means that people can feel well above and below that number, and it is a guide, not a goal.

You're lucky, your doctor is being pro-active. You should be scheduled for labs in 6 to 8 weeks to see what your levels are, and by then you should be feeling some improvement in your symptoms.


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