# New Labs...MD confused.



## danny2403 (Jan 25, 2011)

Background...I have Hashi's, 1st diagnosed 2003 when became extreme hyper. After having that resolved for a number of years and being med free, I started to feel bad...gained 14 lbs over 1 yr, cold, tired, depressed, low body temp. My labs were normal and my endo refused to put me on thyroid hormone saying I was in menopause..(am 51). I found a different dr. that prescribed Armour based on my symptoms, not labs..this was November 2010 and my labs then were as follows:

TSH 1.51 (.4-5.5)
Free T4 1.0 (.9-1.8)
Free T3 3.4 (2.1-4.7)
Total T4 9.1 (4.5-12.5)
Total T3 135 (87-178)
Thyroid Uptake 28% (24-35)
Anti-TPO 21.4 (0.0-35)
Thyroglobulin 1.8 (0.0-57)
Anti-Thyroglobulin 422 (0.0-40)

I started on 30mg Armour (splitting the dose) in November 2010 and had labs done in Jan 2011..at this point still not feeling significantly better, maybe a little and lost 2-3 lbs.

TSH 0.34 (.40-4.5)
Total T3 137 (76-181)
Total T4 9.0 (4.5-12.0)

Unfortunately the lab did the wrong T3 and T4 should have been Free. But my MD agrees to up my dose of Armour to 60mg a day. I quickly start to feel huge improvement...lose all the extra weight, now am back to my normal and holding steady. More energy, body temp up (still on low side though), not sad or weepy..Had labs done last week..

TSH .27 (.40-4.5)
Free T3 2.6 (2.3-4.2)
Free T4 0.7 (0.8-1.8)

My MD sent me an email saying these results were confusing to him with low TSH and low Free T4. He said lets start with you telling me how you are feeling...I sent email yesterday waiting for reply. I am wondering what anyone's interpretation may be. My MD is not an endo and will readily admit he is not an expert on interpreting tricky labs. When I first met with him we discussed the possibility of adrenal insufficiency but he wanted to wait til I was on Armour before deciding if that was something to explore.

As I said I do feel a huge improvement, but do I think I could feel even better...YES...I value highly the advice I have received in the past from these boards so I eagerly await your replies...Thank you.


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## Andros (Aug 26, 2009)

danny2403 said:


> Background...I have Hashi's, 1st diagnosed 2003 when became extreme hyper. After having that resolved for a number of years and being med free, I started to feel bad...gained 14 lbs over 1 yr, cold, tired, depressed, low body temp. My labs were normal and my endo refused to put me on thyroid hormone saying I was in menopause..(am 51). I found a different dr. that prescribed Armour based on my symptoms, not labs..this was November 2010 and my labs then were as follows:
> 
> TSH 1.51 (.4-5.5)
> Free T4 1.0 (.9-1.8)
> ...


Okay.................first; welcome!

Now.................this is normal. When taking any form of T3,the FT4 is naturally lower and this is as it should be. T3 is your active hormone and the only reason you need any T4 at all is for..................

Deiodinases
http://www.jci.org/articles/view/29812 (peripheral deiodination)

And, my opinion is that you could still stand a bit more Armour as your FT3 is below the mid-range of the range given by your lab. Most of us feel best with FT3 at about 75% of the range.

At this point, low TSH is no longer relevant as well.

If your doctor increases your Armour as per my recommendation, you will also see the FT4 go up a bit. This is another sign of being under medicated.

How are you feeling? It is a process of getting labs every 8 weeks and titrating slowly by minute amounts. Never more than 30 mg. lest you bypass the euthyroid state.


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## danny2403 (Jan 25, 2011)

Thank you so much..I was wondering if another increase may be worth trying. I will email my MD straight away and hope he agrees.


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## Andros (Aug 26, 2009)

danny2403 said:


> Thank you so much..I was wondering if another increase may be worth trying. I will email my MD straight away and hope he agrees.


And please do let us know. I for one will be very interested.


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