# Confused about lab results / symptoms



## Hypoman (Aug 7, 2010)

Hi,

I'm a 25 year old male. I'm 6'6", 195 lbs (if that makes any difference). I was diagnosed Hypothyroid 2 years ago (it runs in the family) and have been taking Synthroid ever since then. I started at 100mcgs, went up to 125, then 137, then back down to 125, which I have been taking for the last two months. I just received my most recent lab results, and I'm a bit confused by them:

*TSH, 3RD Generation*
1.85 (0.40 - 4.50)

*FT4*
1.5 (0.8 - 1.8)

*FT3*
3.0 (2.3 - 4.2)

The doctor tells me these look good and to stick with 125mcgs Synthroid. The thing is, I haven't felt as good since coming down from 137mcgs. I still have symptoms that I am attributing to my thyroid:

Depression
Lightheadedness
Major indigestion 
Water retention (especially around the stomach and legs)
Aches and pains (joints and muscles)
Hair falling out
Sexual dysfunction and low libido
Minor discomfort / pain in thyroid

I'm not sure these symptoms are all thyroid related, but I just don't feel _right_. I should also mention my Testosterone was checked during the previous round of blood work, and it was in the 400 range -- is that way low for a 25 year old? Low enough to treat? Also, my vitamin D level was checked, and it was low at 33. I'm supplementing that now.

Do my current thyroid labs really look good? I just think I felt a little better at 137mcgs, although the transitioning period between new doses was very uncomfortable. I must be sensitive. The doctor brought me back down to 125 because my labs indicated I was borderline hyper (at the top of normal -- FT3 1.8). I'm really confused by all this. I just want to get on with life and feel stable again. I don't feel like myself anymore. Should I be looking into Armour, or another hormone replacement option. What about testosterone? Any insight would be greatly appreciated.

Thanks!


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## Andros (Aug 26, 2009)

Hypoman said:


> Hi,
> 
> I'm a 25 year old male. I'm 6'6", 195 lbs (if that makes any difference). I was diagnosed Hypothyroid 2 years ago (it runs in the family) and have been taking Synthroid ever since then. I started at 100mcgs, went up to 125, then 137, then back down to 125, which I have been taking for the last two months. I just received my most recent lab results, and I'm a bit confused by them:
> 
> ...


It might look good to the doc but is not good for you! Welcome to the board.

Firstly, most of us feel best w/TSH down around 1 or less. Your FT4 is only slightly above mid-range and I don't view that as being good for the T4 is what converts to the T3. Lastly, your FT3 is very low. 3.2 is roughly mid-range on that. I like to see the FT3 about half-way between the mid-range and the top of the range or even closer to the top of the range depending on how active you are. FT3 is your active hormone.

So...............to sum it up, it is my humble opinion that you are undermedicated. Apparently your doc does not understand what the euthyroid state is (you feel great and resume all normal activities w/gusto.)

You may have to go doctor shopping. I don't know much about the testosterone levels but we have a few here who may.


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## Hypoman (Aug 7, 2010)

Thank you Andros. I have a feeling you are right. The doctor has been great so far in trying things -- seems pretty openminded. I'll ask about maybe upping the Synthroid again. She might want me to try alternating 125 and 137 for a month or so, as I seem to be very sensitive to dose changes (feel like I'm going crazy actually; I get really emotional and...hormonal). I am a very active person, and I feel sluggish right now. Would adding T3 be something to consider, or do my results not really call for that?

Also, does anyone have any insight or knowledge about the testosterone levels? At what point do you treat low t?

Thanks again!


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## midgetmaid (Jul 22, 2010)

I would check with a urologist about the testosterone level. For a person your age, it might need to be a little higher.

Renee


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## Andros (Aug 26, 2009)

Hypoman said:


> Thank you Andros. I have a feeling you are right. The doctor has been great so far in trying things -- seems pretty openminded. I'll ask about maybe upping the Synthroid again. She might want me to try alternating 125 and 137 for a month or so, as I seem to be very sensitive to dose changes (feel like I'm going crazy actually; I get really emotional and...hormonal). I am a very active person, and I feel sluggish right now. Would adding T3 be something to consider, or do my results not really call for that?
> 
> Also, does anyone have any insight or knowledge about the testosterone levels? At what point do you treat low t?
> 
> Thanks again!


It would be something to consider if you are not converting. The only way to tell is to up your thyroxine replacement (with doc's approval of course), then in 8 weeks get that FREE T3 test. And also pay attention to how you feel.

If you are active, the doc has to make sure you have enough FT3 to get through your day.


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## GD Women (Mar 5, 2007)

Your FT3 is mid range as Andros stated. However mine has been there only to go higher all on its own next Lab test. I would suggest a few more test done 6 to 8 weeks apart to see where FT3 goes before adding or adjusting meds. dose. I personally feel your FTs are not far enough apart to relate to a conversion problem, but that is my personal opinion as to what I have read. 
For a man TSH 1.85 is not too bad depending on your size. Your FT4 is high enough as it is. Tweaking in levels might back fire and make things worse than they already are. I have been that route myself and made levels much worse. You stated feeling better at a higher dose but things can change since last being there. Levels do not stay steady especially if there is still an functioning thyroid (med. under dose 200/300) regardless of what type of treatment opted for. 
Not all symptoms are thyroid especially when levels are in Labs and could be other health issues. I personally believe that some symptoms just come with thyroid territory regardless of levels or treatment, and we just have to live with them. Then sometimes the thyroid disease need time to run its course, in some cases many years, before healing. Also, a lot of us treat symptoms separately from thyroid where feasible and find better and fast results.

Just things to ponder. Good luck!


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## Hypoman (Aug 7, 2010)

Thank you to everyone. I have to admit, I don't love switching up doses, so staying here for another few months wouldn't bother me. I feel like my thyroid is acting up though -- I have slight pain, like a mild sore throat, right where the gland is. Could be a flare up?

I agree that learning to just cope with some of these symptoms may be necessary, and I think I can do that. The only symptom that is difficult to deal with is the depression. That's why I want to make sure my testosterone is under control, because I have read that low levels there can wreak havoc on mental health.

One more question. What do people know about vitamin D levels, and has anyone had and treated low levels? What is the best supplement? I'm being told liquid is the way to go. Some say 1,000iu daily, some say 5,000iu. My vitamin D level is at 33, and the doc wants it up around 50 - 80.

Thanks again!


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## Debbie from Milwaukee (Apr 18, 2010)

Our doc has put my husband and me on doses of 2,000 iu, then return in a few months for a blood check. My vitamin D level on Sept. 7 (after an entire summer with no supplement, just sunshine) was 27.8 (normal 32.0-100.0). Actually, our doc stated that she has NEVER found anyone in our lattitude to be normal for D (we live in Wisconsin). I order from Puritan's Pride online and get 2000 iu of D3 in these tiny gelcaps. 6 bottles (600 pills) for $20, including shipping, is a steal!


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## Andros (Aug 26, 2009)

Hypoman said:


> Thank you to everyone. I have to admit, I don't love switching up doses, so staying here for another few months wouldn't bother me. I feel like my thyroid is acting up though -- I have slight pain, like a mild sore throat, right where the gland is. Could be a flare up?
> 
> I agree that learning to just cope with some of these symptoms may be necessary, and I think I can do that. The only symptom that is difficult to deal with is the depression. That's why I want to make sure my testosterone is under control, because I have read that low levels there can wreak havoc on mental health.
> 
> ...


Have you ever had a sonogram or a radioactive uptake scan (RAIU) of your thyroid? I don't like the pain part. It might be a good idea. RAIU is best in my humble opinion.

Thyroid cancer symptoms
http://www.cityofhope.org/patient_care/treatments/thyroid-cancer/Pages/symptoms.aspx

Do you get outdoors much? Do you consume foods that are rich in Vitamin D?

As you scroll down on this site, you will find a chart of foods that provide Vitamin D. Either natural or fortified.

http://ods.od.nih.gov/factsheets/vitamind/

I guess Cod Liver Oil would be the best. What did your doctor recommend?


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## GD Women (Mar 5, 2007)

I took with my regular regime of separate vitamins - approx 3,200 iu VD halibut fish oil in capsules with 32,000 iu VA in case of toxicity and 500 mg magnesium for absorption. Vitamin D is safe when used in physiological doses (those used by Nature). Physiological doses are doses of at least 5,000 IU per day, from all sources . Scientists recently say Vitamin D 10,000 IU/day.

Magnesium and calcium are one of the pairs of minerals that work together, supplementing one requires supplementing the other. Supplementing magnesium alone will work to an extent, but eventually calcium needs to be added to prevent muscle cramping and bone and tooth deterioration. However, taking calcium without magnesium is one of the worst things you can do because this increases the magnesium deficiency and increases the heart rate and arrhythmia. This is one of the reasons why dairy products, which are high in calcium and low in magnesium, need to be restricted until magnesium levels are replenished. Calcium/magnesium supplement best taken with a 1:1 ratio

Remember to take all vitamins/minerals at last four hours from thyroid medication.


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## Debbie from Milwaukee (Apr 18, 2010)

I didn't know that about taking vitamins/minerals several hours apart from thyroid. My daughter has been prescribed iron supplement (and is taking vitamin C for absorption). What happens when the supplements are taken at the same time as thyroid replacement (in her case, Armour thyroid)?


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## GD Women (Mar 5, 2007)

Some vitamins/minerals can interfere with thyroid medication absorption. While others can enhance the dosage. Same with foods such as citrus or foods containing such vitamins/minerals as supplements. Grapefruit interferes with the absorption of some prescription medications as well as thyroid medication.


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## Hypoman (Aug 7, 2010)

Andros said:


> Have you ever had a sonogram or a radioactive uptake scan (RAIU) of your thyroid?


I have not had an RAIU scan. I will ask the doctor about this.

Regarding the vitamin D, the doctor said to take 1,000 IU a day. She recommended pill form, but said it really didn't matter what kind. I wonder if 1,000 IU a day is enough.

I wonder if what I am experiencing is a thyroiditis attack. Obviously I have a list to take to the doc next visit. How do you all cope with these roller-coaster symptoms? I would especially be interested in a man's point of view regarding the loss of libido.


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