# Is she a poor converter?



## Jlgsmom (Feb 11, 2013)

Just wanted to put up my daughter's labs after 5 weeks on Synthroid 112 mcg. New lab values from 3/20/13 are:

TSH 0.019 (.450-4.500)
FT4 1.61 (.93-1.60)
FT3 3.00 (2.5-5.0)

The Dr. is decreasing her Synthroid to 100mcg since the TSH was so low and she's just barely over the FT4. I'm wondering if she's a poor converter or could she just need more time on the Synthroid. Dr. said we can come any time we want for labs but we aren't scheduled for another appointment for 4 months. From all the information I've read on this board, it seems to me like she could use her FT3 to be a little higher. I'm guessing with the decrease in medication it's only going to go lower. I'm trying to have some patience but I'm just ready for her to be well and feel good. She is feeling much better, but not necessarily 100% symptom free at this point. I do think she may have been having a few hyper moments, she has on occasion had a hot flash and one night could not sleep. Right now her main complaint is her hair is still falling out. She was previously tested for TPOAB and Antithyroglobulin AB and is negative. Should I be pushing for the addition of synthetic T3 or switching to natural thyroid hormone at this point? Or should we ride out the next four months and see what happens, unless of course things go downhill?


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## Andros (Aug 26, 2009)

Jlgsmom said:


> Just wanted to put up my daughter's labs after 5 weeks on Synthroid 112 mcg. New lab values from 3/20/13 are:
> 
> TSH 0.019 (.450-4.500)
> FT4 1.61 (.93-1.60)
> ...


It does not appear that your daughter is converting well. I would not ride it out; 4 months is a long time for your child to be feeling badly.

It may be a very very good idea to find a different doctor and you don't need an endo. This doctor you have now is a TSH worshipper.

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

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.


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## jenny v (May 6, 2012)

How long has she been on the Synthroid now? Do you have her previous labs so we could compare the results before and after the Synthroid?


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## Jlgsmom (Feb 11, 2013)

Yes, here are the previous two labs. She's been having symptoms for years but just finally had lab values go out of range this year and finally cause the Dr. to take notice.

2/6/2013
TSH 0.881 (.450-4.500)
FT4 0.87 (.93-1.60)
FT3 1.4 (2.3-5.0)
TPOAB 7 (0-26)
Antithyroglobulin AB <20 (0-40)

1/8/2013
TSH .293 (.450-4.500)
FT4 1.04 (.93-1.60)
FT3 1.8 (2.3-5.0)

I appreciate the help. She started on 112 mcg of Synthroid 5 weeks ago, this is her first dose of the medication.


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## Octavia (Aug 1, 2011)

The 112 dose seems a bit high to start with, given those labs...I'm glad she got a decrease (and I suspect she'll need another decrease later). I agree that she does not seem to be converting well.


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## lainey (Aug 26, 2010)

> 2/6/2013
> TSH 0.881 (.450-4.500)
> FT4 0.87 (.93-1.60)
> FT3 1.4 (2.3-5.0)
> ...


Has anyone looked at her pituitary?

She does not have high antibodies to speak of.

Low, out of range T4 and T3 with normal TSH would indicate secondary/central hypothyroidism, and the pituitary in this case deserves a close look.

In the case of secondary hypothyroidism, the TSH becomes less important, and dosages need to be based on the frees.

See:
http://www.pituitarydisorder.net/central_hypothyroidism.html


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## Andros (Aug 26, 2009)

Jlgsmom said:


> Yes, here are the previous two labs. She's been having symptoms for years but just finally had lab values go out of range this year and finally cause the Dr. to take notice.
> 
> 2/6/2013
> TSH 0.881 (.450-4.500)
> ...


It would be wise to get an ultra-sound of your daughter's thyroid.


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