# Odd test results



## davea (Feb 4, 2011)

Hi, sorry for the cross-post, I think I had this posted in the wrong section, anyways:

I introduced myself in January (2011) with blood test results that indicated and were later confirmed I was hyperthyroid (Graves).
The results then were T4 free=2.41 (.82-1.77) and TSH=<.005 (.450-4.500)

I had several tests since:
May: TSH=4.98, T4=.56

June: TSH=3.96, T4=.83

My medication (Methimazole) went from 20mg at first and adjusted several times to now 7.5mg.

My concern and question now is that I had a blood test recently which was unrelated and not ordered by my doctor. The results were TSH=0.015, T4=1.50.

So, my T4 goes from high to low to back in acceptable range while my TSH goes from nonexistent to somewhat normal to very low again. I may be misunderstanding these results, but I thought the numbers would or should be opposites of each other until they normalize with meds.

Anybody? Any ideas, I need to know something on my own before I make an appointment with my class A jerk of a doctor.


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## lainey (Aug 26, 2010)

Well, no the blood tests make sense if your ATD meds were lowered too far.

How long after your last ATD dose change was the recent blood work?

When do you see the doctor that is managing your hyperthyroidism for labs again?

You likely need slightly more methimazole than you are taking now.

Unfortunately this is somewhat of a balancing act.


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## Lovlkn (Dec 20, 2009)

TSH readings lag by 6 weeks - plus you should never ever dose blocking or replacing thyroid med's by TSH anyway.

Optimal dosing of mes is best done with Free T-4 and Free T-3 tests

When I was on Tapazole my med dose was adjusted monthly so it's not odd to have very different tests like yours.


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## Andros (Aug 26, 2009)

davea said:


> Hi, sorry for the cross-post, I think I had this posted in the wrong section, anyways:
> 
> I introduced myself in January (2011) with blood test results that indicated and were later confirmed I was hyperthyroid (Graves).
> The results then were T4 free=2.41 (.82-1.77) and TSH=<.005 (.450-4.500)
> ...


One thing I notice is that some of the tests are for FREE T4 and some are for Total 4 (T4.) They are not the same. The Total 4 is bound and unbound hormone.

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=3

understanding thyroid labs
http://www.amarillomed.com/howto/#Thyroid

The above links may help.


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## davea (Feb 4, 2011)

The most recent blood work was about 3 months after the last med adjustment to 7.5. If I recall correctly, the last reduction was from 10mg to 7.5. It sounds like the sweet spot may be above what I'm taking now.

Thank you for the input, this makes a little more sense to me now. (As if it will ever make sense!)http://www.thyroidboards.com/images/icons/icon7.gif


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