# What labs are needed for Hashi's?



## Nickel395 (Apr 2, 2010)

I recently had lab work done but the doc only ordered FT4 and TSH so I checked off FT3 myself. Results were:
FT4 1.49 range 0.82-1.77
FT3 2.8 range 2.0-4.4
TSH 1.660 range 0.450-4.500

I am currently on 75 mcg of Synthroid (brand name medically necessary) and while many of my symptoms have lessened a few remain including some skin conditions, constipation, inability to lose weight although it has stabilized somewhat. My energy level is at what I believe is 75percent of my potential. Do you believe adding T3 would help with the remaining issues?
Also, I just found out I have Hashimoto's. I asked the doctor and she looked back at my chart and said "yes you do as it was indicated on the biopsy report". I told her nobody ever told me this and I was glad I asked. She then checked off TPO antibodies test on my lab slip for September 2011. Looking back on all my labs since 2007 they never ran this test!!!! What results will I be looking for from the antibodies test?
Thank you


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## Andros (Aug 26, 2009)

Nickel395 said:


> I recently had lab work done but the doc only ordered FT4 and TSH so I checked off FT3 myself. Results were:
> FT4 1.49 range 0.82-1.77
> FT3 2.8 range 2.0-4.4
> TSH 1.660 range 0.450-4.500
> ...


Your FT3 is rather low. It should be @ about 75% of the range given by your lab give or take. Also, most of us feel best w/TSH @ 1.0 or less.

My take on this would be to first try an increase of Synthroid; it could be that you are just under medicated by a smidgeon. If that does not work w/ the FT3, I would ask to benefit either from a small dose of Cytomel or to be switched over to dessicated thyroid (T4 and T3.)

Welcome to the board!









FNA is the only way to really diagnose Hashi's in my humble opinion. Apparently the pathologist did find and identify Hurthle Cells indigenous to Hashimoto's.

TPO is "suggestive" of Hashi's. What was your TPO?


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## Nickel395 (Apr 2, 2010)

Thanks for the quick response. I won't have my first TPO until September


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## Andros (Aug 26, 2009)

Nickel395 said:


> Thanks for the quick response. I won't have my first TPO until September


Oh, okay. Wow; Sept. is a long way off but you have been diagnosed and are being treated.

Do you think your doctor would be amenable to raising your Synthroid a bit to see?


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## Nickel395 (Apr 2, 2010)

I'll ask her. I also have appointment in August with another doc not an endo but who seems to be very sought after in Maryland because of his willingness to listen and help to make you feel your best. I understand he is T3 friendly. Hopefully between the two I will get more relief.


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## Andros (Aug 26, 2009)

Nickel395 said:


> I'll ask her. I also have appointment in August with another doc not an endo but who seems to be very sought after in Maryland because of his willingness to listen and help to make you feel your best. I understand he is T3 friendly. Hopefully between the two I will get more relief.


It would seem you are stuck at a bad place and you cannot be feeling your best w/FT3 that low. So....................see what you can do before Aug..

Let us know.


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## northernlite (Oct 28, 2010)

I also agree and would ask for a Synthroid increase. I was at TSH of 2.02 and a FT4 near the midpoint. My doc was satisfied but I told her I felt only 80% better. Many symptoms were gone and a few remained but were improved. I got the increase I asked for. My TSH is now around 0.82 and I feel great.

Good luck.


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## Nickel395 (Apr 2, 2010)

Thanks for the advice, I'll contact my doc today and ask for in increase in the Synthroid or the addition of cytomel. I'll let you know!


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## Andros (Aug 26, 2009)

Nickel395 said:


> Thanks for the advice, I'll contact my doc today and ask for in increase in the Synthroid or the addition of cytomel. I'll let you know!


That is good. Please let us know and I hope your doc shares your goal of becoming completely well which is possible if your numbers are right.


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## Nickel395 (Apr 2, 2010)

Well I just got a call from the doctors office with a definate NO to Cytomel or and increase in Synthroid. Their reason... Your numbers are perfect, just where we want them. I said not my FT3 and their answer was oh yes it's in the range the lab set. I said it's low. They said Cytomel is used very rarely. I knew I was getting nowhere with them so I got off the phone. August can't come soon enough for me to see the new doc. Does anybody know of T3 friendly doctorsnin Maryland?? Just wondering.


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## northernlite (Oct 28, 2010)

Your battle begins. I too got no where calling the office. I got the same answers, your numbers are in range. I would make another appointment with the doctor and sit in front of him or her and explain yourself again. I would specifically go in and ask for two months of Synthroid 88 mcg. Tell them just a little increase! I actually was on 50 mcg, talked them into letting me split a 25 and add 12.5 mcg to my dose. It actually turned out to be perfect for me and I now take 1/2 of a 125 mcg for my daily dose. My doctor is still shaking her head, I think I have driven my TSH lower than anyone she has had.

I used the argument that I deserve to feel well, not 80% of well and there was not a tremendous risk in trying for that other 20% and we could always back off if I went into hyper land. The extra 12.5 mcg every day sounds silly but make all the difference for me and makes me symptom free and euthyroid.


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## Nickel395 (Apr 2, 2010)

I was on 100 mcg generic synthroid from Jan 27, 2010 to June 1, 2010 with my TSH lowest point at 0.072 and a FT3 at 3.6 range 2.0-4.4 but not feeling well at all. The endo swiched me to brand Synthroid 88 mcg. on June 2 2010 and by July 1, 2010 I could tell a difference with the brand name and my TSH was 0.041 but she said that was too low (range 0.35-5.50) and deceased it to 75 mcg. My TSH has creeped up to 1.666 and my FT3 is 2.8 range 2.0-4.4 Any advice? I read Selenium can help with conversion. I bought 200 mcg, is that suffucuent?
Thanks


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## Andros (Aug 26, 2009)

Nickel395 said:


> Well I just got a call from the doctors office with a definate NO to Cytomel or and increase in Synthroid. Their reason... Your numbers are perfect, just where we want them. I said not my FT3 and their answer was oh yes it's in the range the lab set. I said it's low. They said Cytomel is used very rarely. I knew I was getting nowhere with them so I got off the phone. August can't come soon enough for me to see the new doc. Does anybody know of T3 friendly doctorsnin Maryland?? Just wondering.


Did you tell them that the numbers were not where you want them? OMG!! How I hate this close-minded thinking. It makes me wish they all would get thyroid disease!

I am so disheartened for you right now; I truly am. It is a travesty and unconscionable. That is putting it mildly.

See if you can get on a cancellation list! Try that and let us know.


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