# Latest labs



## northernlite (Oct 28, 2010)

Been three months since my Hashi's diagnosis and this is where things stand -

At diagnosis (no medication), textbook case of most hypo symptoms
TSH 8.44 (0.47-4.53 uU/mL)
FT4 1.22 (0.84-2.26 ng/dL)
Both TPO Ab and TgAb positive

6 weeks later on 50 mcg Levothyroxine, many symptoms gone, all improved, main complaints were that I was still experiencing some afternoon fatigue crashes and had only been able to push my nighttime collapse to 8:30 pm, some joint pain left and shortness of breath better but still there while climbing stairs and carrying things.
TSH 2.09 (0.34-3.00)
FT4 1.03 ng/dL (0.50-1.50)
Doctor was satisfied, I said not good enough and got an increase

6 more weeks on 62.5 mcg Levo, joint pain gone, able to stay up to 10 or 11 pm like a normal adult, all other symptoms gone except still some fatigue and still have the shortness of breath climbing the stairs and carrying things. Both are better but not gone.
TSH 0.82 (0.34-3.00)
FT4 1.15 ng/dL (0.50-1.50)
Dr says, "62.5 is where you stay". Reasonable given the TSH, I guess.

I know everyone's first response is that I need a FT3 and I agree and am going to ask for one next time I am in.

My question is the TSH path downward looks pretty normal and expected to me. Why so little movement in the FT4? Does it really matter? I was very symptomatic at diagnosis with a FT4 in the normal range. Different labs and ranges between the first blood test and the last two. How can two labs using the same units of measure have such different ranges?

So next steps...PCP sent me off to the cardiologist. Not a bad call on her part, I am 50, mom and grandma died of heart attacks both at age 42. We have been treating my modifiable cardiac risk factors since I was 30. Went to one of the top cardiology hospitals in this area this week. First dr (resident) said I had mitral valve prolapse. 2nd dr (the real cardiologist) said she wasn't sure about that but my mitral valve was clicking. She wants me off my beta blocker for a stress echo on Tuesday to check out my entire heart function as well as the valve.

I am a very physically active person and funny, I never had shortness of breath prior to having thyroid problems and now I do. Thyroid, heart, lungs????

But overall, I feel SOOOOOOOOOOOOO much better than I did in November. I told both doctors, I can function and do everything I want to do now so if I had to live like this with these symptoms, I could.


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## McKenna (Jun 23, 2010)

> Why so little movement in the FT4?


You have had a huge movement in your Ft4. Your first set of labs have you near the bottom of range, your second set has you a little above 50% and your recent set has you closer to 65%. I looks like you are responding well to treatment, IMHO. It would be good to see where your FT3 is though, since that number shows a more accurate picture.

It's wonderful that you feel so well. I'm still titrating my dose up and am looking forward to feeling better too. I'm happy for you.


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## Andros (Aug 26, 2009)

northernlite said:


> Been three months since my Hashi's diagnosis and this is where things stand -
> 
> At diagnosis (no medication), textbook case of most hypo symptoms
> TSH 8.44 (0.47-4.53 uU/mL)
> ...


Progress is being made but you are ever so right about the FREE T3. You must insist on this test. FT4 would stay pretty stable because you are supplementing OR because you are not converting to FT3. So you see the dilemma, I am sure! We need to find out! You are on such a low dose of thyroxine, that does make me suspect you are not converting well. Meanwhile, pituitary is getting the signal to not produce TSH. Hence the low TSH. Humble opinion, of course.

If you are in need of T3, you could be experiencing myopathy of the muscles surrounding the lungs. Hence the difficulty breathing.

Please let us know how the stress test goes for you this coming Tues.. I hope and pray all is well. If you are "undermedicated", it does make it hard for your heart to work. Once again, myopathy enters the scenario as the heart is a huge muscle.

http://www.mda.org/publications/PDFs/FactsAboutMyopathies.pdf

http://www.lef.org/protocols/metabolic_health/thyroid_regulation_01.htm

I wish I was 50; you have lots of living to do and I sincerely hope you can get to feeling really really good so you can keep up with those grand kids.


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