# Changes in labs since last year



## marathonmom626 (Apr 3, 2016)

Hello-

My primary care doc. has had me on thyroid "watch" for the past two years...My original labs in June of 2016 were as follows:

Free T3: 2.3

Free T4: 0.9

TSH: 1.617

Thyroid antibodies: 47

Just got my newest results back and they are:

Free T3: 2.9

Free T4: 0.9

TSH: 3.907

(she did not run thyroid antibodies this time)

My Ferritin in improved - up to 40 from 14, so that is looking much better. My Alk Phosphate, however, has been and remains low at 40, and the notes from the lab say that low alk phosphate is sometimes noted with hypothyroidism and to correlate with clinical symptoms.

When I first saw my primary doc. in 2016 my main complaint was hair loss and fatigue...I did grow quite a bit of hair back with iron supplementation though just in the last month or so it seems very brittle and dry. My biggest issue now is that I feel achy and fatigued all the time, and I've noticed that I've become quite forgetful lately. I'm a very active runner but have been excessively sore lately and haven't been able to work out the way I'm used to.

Anyhow, I just got all these results back through MyChart online so I haven't spoken with my doc. yet. Just curious - it is unusual for Free T3 to improve but for TSH to rise? Also, anyone here on thyroid hormones with results similar to mine? I'm worried that my doc. won't offer me medication since I'm not out of the reference range yet for TSH (my lab goes up to 5). I've been supplementing with selenium and magnesium per my docs recommendations now for 2 years and was feeling o.k. until now, which I'm guessing is due to the sudden jump in TSH. I did have my numbers checked in 2016 as well and they were virtually the same as the year prior, so this is the first real change I've seen.


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## joplin1975 (Jul 21, 2011)

Any chance you could edit your post to include reference ranges for your lab work?


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## marathonmom626 (Apr 3, 2016)

Sorry, yes! Here are my lab's ranges for my current set of results:

Free T3: 2.9 2.2 - 4.0 pg/mL

Free T4: 0.9 0.8 - 1.5 ng/dL

TSH: 3.907 0.350 - 5.000 mcUnits/mL

And since she didn't test antibodies this time, last year's results and range is as follows:

47 <60 Units/mL


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## Pamzilla13 (Sep 9, 2013)

Hello,

You are hypo.I had similar labs to yours (your first set) when I was diagnosed with hypothyroidism. Like you, I am a super active person...bodybuilding and running...very lean.

I experienced extreme fatigue, brittle hair, low body temp, depression, severe muscle pain and I could not recover even with appropriate rest. My training suffered.

My doctor explained that I was hypo at the cellular level based on my Free T3 and Free T4 results. They were at the very bottom of the range....I had no gas in my gas tank. He prescribed Armour thyroid (desiccated pig thyroid that has both T4 and T3 in it, biologically close to humans). The goal was to get my Free T3 to 3.8ish (2.2-4.2) and my Free T4 to 1.2ish. He explained that most people feel better at these thyroid numbers. As far as TSH goes, he ignores that because it is not a thyroid hormone and will be suppressed on hormone therapy. So, he treats based on FT3 and FT4 and symptoms.

TSH is a pituitary hormone in the brain that signals the thyroid to make hormone. Traditionally, it is used as a diagnostic for hypothyroidism and most docs only run that test and nothing else. So, as your TSH increases in value it is trying very hard to communicate with the thyroid to put out T4 hormone which converts to T3 and based on your last labs...it is trying hard but the values of hormone that you have available to use are very low. Hence, no gas in your tank...

How does this happen? It can be for a number of reasons from genetics, disease, over exercise, age, very low carb diet combined with heavy exercise, hormonal imbalance, birth control, stress, etc...

Your last labs show a very slight improvement in FT3 and a person really can't say if its from the supplements (because your TSH is not improving TSH should be around 1.0 and your FT4 has not improved)....keep in mind that your labs are a snap shot in time and thyroid values are always fluctuating. In the future, be sure to test at the same time of day. If your doc decides to treat you, take your thyroid hormone at the same time of day and when you go for labs do not take your thyroid hormone before your lab it will show a false high.

Starting thyroid hormone is a journey. When you get your "optimal" level you will know based on how you feel...better energy, better recovery, better mental function etc.

You don't say how old you are, but sex hormones such as progesterone, estrogen, and testosterone affect thyroid function....do you have labs for those?

If your primary doc won't treat you or blows you off, find another doctor. If you have a compounding pharmacy in your area speak to the pharmacist and ask what doctors are prescribing Armour thyroid or bio-identical hormones,,,,(you may need thyroid and sex hormone supplementation). If you don't have a compounding pharmacy, call a few regular ones and ask the same thing. Google bio-identical hormone doctors or women aging and wellness and see what you get. If you find you need sex hormones, do not settle for synthetics (Mirena coil, birth control pills....you will have more problems...you can google that info.)

I live in Fl, so if you do, I can suggest some doctors that I know will treat you...just PM me.


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## Pamzilla13 (Sep 9, 2013)

Oh, have you been checked for vitamin D and B12?


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## Lovlkn (Dec 20, 2009)

> Free T3: 2.3
> 
> Free T4: 0.9
> 
> ...





> Free T3: 2.9 2.2 - 4.0 pg/mL
> 
> Free T4: 0.9 0.8 - 1.5 ng/dL
> 
> TSH: 3.907 0.350 - 5.000 mcUnits/mL


While you believe your labs have improved they are basically the same - except for TSH which is your body screaming for some thyroid hormone.

What sort of doctor is monitoring your continued hypothyroidism - with symptoms??

Your FT-4 and FT-3 labs should be pushing 3/4 of the lab range for optimal thyroid function. TSH should be around 1


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## marathonmom626 (Apr 3, 2016)

Thank you for all of your responses! To answer some of the above questions, yes - my doc did check my Vitamin D and B12. They are as follows:

B12: 603 pg/mL (211-911 pg/mL)

Vit D: 33.2 ng/mL (30.0 - 100.0 ng)

Ferritin: 40 ng/mL (8 -252 ng/mL)

I am 44....Symptoms started when I was 42. I used to be quite lean as a marathoner and have gained about 8 lbs. since then, though due to hip problems I am not running high mileage anymore so that could be a factor. BMI went from about 18.5 to 20 so I'm still at a healthy weight, though I feel like it is much easier for me to gain than it used to be and I have to be quite diligent about eating well and exercising. I'm definitely not over-exercising now, though, and I don't eat any sort of extreme diet so I don't think that is a factor. I am on BCP's and have been forever, with the exception of my pregnancies. I guess I didn't realize that could contribute? When I'm not on them, I have very heavy periods and end up anemic despite iron supplementation.

My primary doc. (I'm in the Milwaukee area) did her fellowship in holistic integrative medicine so she really likes to try natural supplements first...I was fine with that initially since I did see improvement and had a good run for a while. She did say back in 2016 that I could call anytime for a trial of thyroid medication if I felt that I wasn't seeing improvement, but I was feeling better so I never did. At that time, my ferritin was only 14 and I assumed maybe my symptoms were more from low iron than the thyroid.

Anyhow, I think she will be open to me going on meds. now but I'm ready to fight for them if not . I'm usually pretty medication avoidant but this has become a pretty major quality of life issue. Thanks again for all your responses!


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## Pamzilla13 (Sep 9, 2013)

Your vitamin D is low. It should be at 70. Heavy bleeding during periods is another symptom of untreated hypothyroidism many women experience...my sister is one of them. So, you may have been hypo for a long time now. As we age hypothyroidism is a common occurrence in women. At age 42 I wouldn't be surprised if you have low progesterone....having low progesterone also may contribute to heavy bleeding (I have experienced this). I have yet to meet a person with hypothyroidism to recover with supplements. I wish you luck.


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## Lovlkn (Dec 20, 2009)

> Vit D: 33.2 ng/mL (30.0 - 100.0 ng)
> 
> Ferritin: 40 ng/mL (8 -252 ng/mL)


Ferritin needs to be pushing 3/4 range . I had low ferritin and heavy monthly cycles when my ferritin was this low.

Vitamin D should be closer to 70.

You might consider asking for a trial of thyroid hormone to increase FT-4 and FT-3 levels which are really hypo.


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