# 6 week blood levels



## Familytreenutfinder1970 (Mar 26, 2012)

Hi all,

I had bloodwork done this morning for my 1st six week check since being diagnosed. So far only things like MCV, RBC Distrib Width, Hemoglobin and such are showing up in my labs online. Everything is normal so far. No Thyroid results yet.

Some might recall I was having joint pain and fever last week,well, the fever is gone but still having a bit of joint pain, just happy to be feeling better (though I over did it 1st thing in the morning yesterday and so I was totally SPENT by noon! I don't have a slow down button!)!


----------



## Andros (Aug 26, 2009)

Familytreenutfinder1970 said:


> Hi all,
> 
> I had bloodwork done this morning for my 1st six week check since being diagnosed. So far only things like MCV, RBC Distrib Width, Hemoglobin and such are showing up in my labs online. Everything is normal so far. No Thyroid results yet.
> 
> Some might recall I was having joint pain and fever last week,well, the fever is gone but still having a bit of joint pain, just happy to be feeling better (though I over did it 1st thing in the morning yesterday and so I was totally SPENT by noon! I don't have a slow down button!)!


Let us know what your numbers look like and please get us the ranges as different labs use different ranges.

Glad the fever is gone. I hope it is a "simple" as being treated properly for hypothyroid.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Thanks!

I just took a look and my Sensitive TSH ( is it just called "TSH"?) is 1.4 (normal range they say where I go is 0.3-5.0)! hugs6

Will post when I have the other 2 scores back. I just couldn't resist posting the one they just added!


----------



## Andros (Aug 26, 2009)

Familytreenutfinder1970 said:


> Thanks!
> 
> I just took a look and my Sensitive TSH ( is it just called "TSH"?) is 1.4 (normal range they say where I go is 0.3-5.0)! hugs6
> 
> Will post when I have the other 2 scores back. I just couldn't resist posting the one they just added!


Well; we can't resist either. Even if it is one at a time. That looks good; will be anxious to see the rest.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Well, I'm very disappointed.

My Doctor only tested my TSH this time.

The nurse called me and told me "everything is normal" and I asked about the other results for my thyroid.

I told him "I'm still having fatigue and I want the same thyroid tests done as last time". He said he'd run it by her and get back to me.

He said it could be related to something else ( fatigue) and I'm sorry, but I told him "I have ADHD, I don't get fatigued, ever. She told me it'd all go away when my levels are normal".

Not sure what to think, but very disappointed she didn't do the same ones as last time to be sure.


----------



## Andros (Aug 26, 2009)

Familytreenutfinder1970 said:


> Well, I'm very disappointed.
> 
> My Doctor only tested my TSH this time.
> 
> ...


We are all disappointed. It looks like you will have to go doctor shopping. What a dang shame. A TSH worshipper is a very very scary doctor. Truly.

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=2#diagnosis: standard laboratory test

Dr. Mercola (FREES)
http://www.mercola.com/Article/hypothyroid/diagnosis_comp.htm
Dr. Woliner
http://www.thyroid-info.com/articles/freet3woliner.htm

I especially like Mercola's article.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Andros said:


> We are all disappointed. It looks like you will have to go doctor shopping. What a dang shame. A TSH worshipper is a very very scary doctor. Truly.
> 
> 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.
> 
> ...


Thanks Andros. I will be looking for another one, but right now, I'm not through with this doctor yet lol.

I will demand the thyroxine free be done like last time. Even though it wsa 0.6, it was still marked as not normal and well, my TSH was only 5.3!

With how miserable the fatigue was with such "barely" abnormal numbers, I'm not about to just take what she says and be content.

What do most here do, do you see an Endo doctor or just stick with a primary for following?

It sounds like they may still have my blood there, and even if they don't...I will go back in and have blood drawn again if i have to. I will check out the links you posted. Thanks again.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Oh,no he di'nt..... so the nurse I was talking to, he starts being nurse witchy now.

He says that my doctor said "i'm happy to see her and discuss her medications because it's what is causing the fatigue" ( yeah they thought that too before I was diagnosed with hypothyroid).....no it's not. I've been on these meds for yeeeeeaaaarrrrrs.

Is it possible, sure, but I doubt it.

He then starts "dictating" to me that he has to decide if my request to do the thyroxine free will be put through to her because sometimes messages seem unnecessary. Yeah, put it through.

Sorry, I'm a spit fire when it comes to my health.

He starts giving me his opinion but then jumps on the other side of the fence and says "i'm just the messenger". Then tells me "she may not order the Thyroxine free to be done" so I said "then I will go to my primary who I know will."

Finally, he says "I will have her call you"....yeah, that is what I wanted in the 1st place! That or the Thyroxine free ordered. Uh Doy.:rolleyes:

Sorry, i just hate it when I have to deal with people like him.


----------



## McKenna (Jun 23, 2010)

That's very unfortunate that you're having a difficult time with this nurse and getting the doctor to order the proper tests. 
If I may add my 2 cents....you really need both the Free T3 and Free T4 tests, not just thyroxine (free T4). Free T3 (triiodothyronine) is equally important and needed to get the full picture.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

McKenna said:


> That's very unfortunate that you're having a difficult time with this nurse and getting the doctor to order the proper tests.
> If I may add my 2 cents....you really need both the Free T3 and Free T4 tests, not just thyroxine (free T4). Free T3 (triiodothyronine) is equally important and needed to get the full picture.


So they did the TSH initially and then yesterday, so you're saying I want the Free T4?

Is the Free T4 the Thyroxine test?

Is the TSH test they did the Free T3?

I get confused still.

This doctor is ticking me off, I told the nurse to have her call my home number, but she called my cell and left a message that she is gone tomrrow and back Friday. I may as well talk to my actual primary doctor, because he is back then if that is the case! The only reason I had her, is because last month my primary was on hospital duty. Sorry to vent, I just don't have patience for doctors like her.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

I'm used to dealing with doctors that don't really care that much.....but I won't allow myself to feel it's acceptable.

The doctor I saw, she left a message on my cell phone.....I didn't have it with me, but then again I specifically asked that she call my home phone! She said d she is off tomorrow but back Friday.

Grrrrr....Yep, I'm going to call my actual primary doctor, this is ridiculous. She never tried my home phone.


----------



## McKenna (Jun 23, 2010)

Familytreenutfinder1970 said:


> So they did the TSH initially and then yesterday, so you're saying I want the Free T4?
> 
> Is the Free T4 the Thyroxine test?
> 
> ...


There's a lot to keep track of when you're first diagnosed with a thyroid issue. And you do have to do your own research and be your own advocate because there is a lot of mis-information out there. You might have to search for a while to find a doctor who is knowledgeable on thryoid issues.

You just had a TSH (thyroid stimulating hormone) so you might not want that repeated, but you need a Free T3 (free triiodothyronine) AND a Free T4 (free thyroxine). They are three different hormones but all are needed for an accurate picture of what your thyroid is doing.

Have you ever had a Free T3 or Free T4 test run? Or any antibody testing? (TPO, TSI, ANA, Thyroglobulin AB, etc.?) I haven't been following your posts so I wouldn't know what testing you've had. But if you're on replacement, was this based on only a TSH level?


----------



## Familytreenutfinder1970 (Mar 26, 2012)

McKenna said:


> There's a lot to keep track of when you're first diagnosed with a thyroid issue. And you do have to do your own research and be your own advocate because there is a lot of mis-information out there. You might have to search for a while to find a doctor who is knowledgeable on thryoid issues.
> 
> You just had a TSH (thyroid stimulating hormone) so you might not want that repeated, but you need a Free T3 (free triiodothyronine) AND a Free T4 (free thyroxine). They are three different hormones but all are needed for an accurate picture of what your thyroid is doing.
> 
> Have you ever had a Free T3 or Free T4 test run? Or any antibody testing? (TPO, TSI, ANA, Thyroglobulin AB, etc.?) I haven't been following your posts so I wouldn't know what testing you've had. But if you're on replacement, was this based on only a TSH level?


Hmmm, I did have my tests and the results in my signature, maybe they're not showing up? Not sure how to correct that if so.

I've had these done initially:

FREE Thyroxine 0.6
Sensitive TSH 5.3
TPO Antibodies <0.3

The results this week, are my 1st follow up blood work.

As you can see, the initial results... not REAL extreme numbers by any means, but don't let it fool you, the fatigue was unreal.

I know the doctor is going to say "TSH is more then enough to see where your levels are at". What would you say to that?


----------



## McKenna (Jun 23, 2010)

I see your FT4 now.

TSH is a pituitary hormone, useful for helping to diagnose thyroid issues. However, it is not a measurement of the actual thyroid hormones you have. TSH alone should not be used by itself to diagnose or regulate thyroid replacement. Each time you get blood work, you should get all three; TSH and Frees, to get the whole picture.

*I* would tell my doctor that I would like the Frees run also, to get an idea of what the actual thyroid hormone levels are in the body. You are on a 
T4-only medication, but without knowing your FT4 and FT3 levels, how do you know how much actual thyroid hormone you have circulating in your body? And without a FT3 level, how do you know if you're converting properly? If you have insurance, I would remind the doctor that you pay for insurance for times like these, when you need answers. And if you have a co-pay I would tell him that you don't mind paying it if it helps to get you feeling better.

The bigger issue is that it doesn't appear that your doctor is knowledgeable enough on thyroid issues if he is dosing on TSH-only. You might want to consider finding a new doctor. JMHO. 



> As you can see, the initial results... not REAL extreme numbers by any means, but don't let it fool you, the fatigue was unreal.


I believe you. I'm blessed that my endo believes in considering symptoms as well as labs when dosing. At my last appointment he told me he feels that lab ranges are to be used as reference, but not as concrete numbers to be used for everyone. He feels that each person needs to be seen as an individual, and not "one size fits all" when it comes to treating thryoid disease. He listens to my opinions and will work with me, allowing me to make active choices in my treatment.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

McKenna said:


> I see your FT4 now.
> 
> TSH is a pituitary hormone, useful for helping to diagnose thyroid issues. However, it is not a measurement of the actual thyroid hormones you have. TSH alone should not be used by itself to diagnose or regulate thyroid replacement. Each time you get blood work, you should get all three; TSH and Frees, to get the whole picture.
> 
> ...


Great advice! Thank you! I am going to make notes of all that!

When the doc called today ( I only have this doctor because my REAL primary doc was doing hospital duty all of March), I told her right off the bat:

"I want my FT3 and FT4 done". She said "FT3 converts to FT4" (or something like that) so you only need the FT3 done because of that".

So I said "well, I don't feel it's ok, for you to just test my TSH level, when last time, my TSH was high and my FT3 was low. Do both like you said you would. The remaining fatigue is not from my other meds, I'm sure of it, especially since, that was your theory last time and you were wrong, because the blood test showed I have Hypothyroid. Things have gotten better being on synthroid, but the fatigue is still lingering. I am very disappointed that you told me you would run the same tests at my 6 week check, and you didn't, you did only the TSH."

She said "What I meant was, I'd run the same tests if your TSH levels came back high still....THEN I would test the FT3".

I told her "But that isn't what you SAID, unless you tell me that, how am I supposed to know that? I have no way of knowing "what you meant".

So after I got done saying my peace, she told me she would do my FT3 only, and after this, she will only test my TSH ....unless it indicates my level is high, then she will test my FT3.

I won't be seeing her after this anyway, as she isn't my "real" primary and I do not feel a connection with her of course. I hope my REAL Primary calls me Monday, because I will ask him:

1. If I should see an Endo rather then a primary 
2. Will I probably find this type of resistance to wanting TSH, FT3 and FT4 done

If he says no to having an Endo, then I will have him give me a name of a good primary like himself, that actually listens (which he said he would. He leaves the end of May).

I will not be able to deal with a doctor that is "TSH only". So I need to have a plan.

Sorry so long!


----------



## Andros (Aug 26, 2009)

Familytreenutfinder1970 said:


> Oh,no he di'nt..... so the nurse I was talking to, he starts being nurse witchy now.
> 
> He says that my doctor said "i'm happy to see her and discuss her medications because it's what is causing the fatigue" ( yeah they thought that too before I was diagnosed with hypothyroid).....no it's not. I've been on these meds for yeeeeeaaaarrrrrs.
> 
> ...


Actually, he is being paid to dissuade you. Insurance does not want to pay. You are on insurance, right?


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Andros said:


> Actually, he is being paid to dissuade you. Insurance does not want to pay. You are on insurance, right?


Yes, we have insurance and it is pretty good luckily.


----------



## Lovlkn (Dec 20, 2009)

Familytreenutfinder1970 said:


> Great advice! Thank you! I am going to make notes of all that!
> 
> When the doc called today ( I only have this doctor because my REAL primary doc was doing hospital duty all of March), I told her right off the bat:
> 
> ...


To save your sanity and also build your case you can order all 3 tests from healthcheckUSA.com for around $85. If your doctor resists this may be your only option. Thyroid panel II is what you are looking for. You can use discount code 12345 and get a 10% discount if they still offer it.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Lovlkn said:


> To save your sanity and also build your case you can order all 3 tests from healthcheckUSA.com for around $85. If your doctor resists this may be your only option. Thyroid panel II is what you are looking for. You can use discount code 12345 and get a 10% discount if they still offer it.


Really, I never knew you could do that. So how does that work, to get the blood work and send it to them?

Do others here do that?

Thanks much for the info. : )


----------



## Lovlkn (Dec 20, 2009)

Familytreenutfinder1970 said:


> Really, I never knew you could do that. So how does that work, to get the blood work and send it to them?
> 
> Do others here do that?
> 
> Thanks much for the info. : )


Upper right hand corner to see if there is a location near you to have the blood drawn. Some states do not allow patients to use the online generated lab draw.

Check first to see if there is a location near you.

I used to have a lab slip on hand for when my doctor would give me trouble getting tests or if I decided to mess around with my dosing to see how the labs changed.

I am on my 5th doctor post op - so far so good for the last 2.5 years - he runs TSH, FT-4 and FT-3 every 6 months plus he runs a T-4 for some reason (wasting my $) but at least he runs what I need to dose off of. He considers my use of Cytomel as "unconventional" , whatever.... got to walk away from some battles with the medical field. He still prescribes it - just thinks I'm a nutcase I guess. I walked into his office telling him what "I" needed and he gave it to me and runs tests - having a "chronic" condition likely makes me a profitable patient so he plays my game.

I've asked for annual testing as I have been on the same dose for over 2.5 years with minimal changes in lab results but he insists on every 6 months.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Lovlkn said:


> Upper right hand corner to see if there is a location near you to have the blood drawn. Some states do not allow patients to use the online generated lab draw.
> 
> Check first to see if there is a location near you.
> 
> ...


The nearest to me is about an hour and a half. But, for now, I will talk with my REAL primary doc (the one giving me a hassle is NOT my REAL primary, she is "what I got" when my real primary was on hospital duty for a month. My REAL primary is a guy and wonderful) and see if he will do the FT4 also ( even if I have to go in for another blood draw) and remind him I have good insurance.

I just hope that the female primary doc I have had to see, does NOT note in my medical records that *I* requested the FT3, because I don't know if insurance will pay if they know that?

But the outside lab is a back up plan right now, though I am pretty sure Mayo will NOT (please note, I'm not yelling when I bold a word) acknowledge blood work done outside Mayo (and I have no choice but to go to Mayo because they have seen me since I was born really and are "in" network for me, and are a Godsend. They have made me healthy. But that doesn't mean I won't put up a stink if they won't do these simple tests for me mind you. Maybe I need an Endo if no one will wake up and do what I ask?).

I have made more notes! Thank you so much! I feel much better with all who have posted and welcome others to post too!n With me, I am the kind that just needs a plan, and a back up plan. For some reason, it helps give me a sense of calm and that I know what to do next.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Hi all,

Well I got my results back for my FT3 test that I demanded they do, and it was 0.8, they say this next to the results:

"Reference Range: 0.8-1.8 Elevated values are seen in patients on thyroxine therapy".

Synthroid is thyroxine right?

So to summarize, I went from 0.6 to 0.8 (now)....but with my TSH I went from 5.3 ( range is 0.3-5.0 I think) to 1.4 (now)....a huge difference....weird.

When she calls, I'm going to tell her, that my test result is exactly on the cut off line.... it's not a huge difference like my TSH ( or should I not do that?).

Obviously my system is very sensitive (which is kinda unusual really), because for me to be having the extreme fatigue with a measly test result of 5.3 for my original TSH test and a measly result of 0.6 for my FT3 originally, doesn't convince me I'm out of the woods yet.

But I am hopeful that maybe in another 6 weeks, all of the fatigue that is lingering will be gone and the medicine will be fully working.

I've been lucky that in the last week or so I've felt better and it's only been like 6ish weeks since starting the meds.

So tell me this, my TSH is 1.4 now....what if my levels go from 1.4 to below the cut off of 0.3? What does that mean?


----------



## McKenna (Jun 23, 2010)

Ok, I think there's some confusion here...
Here's your sig line:


> March 6th 2012 Sensitive TSH 5.3
> March 6th 2012 FREE Thyroxine 0.6
> March 6th 2012 TPO Antibodies <0.3
> 
> ...


You initially had a free T4 (free thyroxine) done in March. NOT a Free T3 (free triiodothyronine). So the results you're quoting now


> So to summarize, I went from 0.6 to 0.8 (now)....


 are not the same hormone, if you did indeed have the Free T3 done this time around.

Free T4 and Free T3 are two completely different hormones. And for reference, the lower (or closer) to the bottom of the range for your Free T3 and/or Free T4, the worse you're going to feel. If you are testing at the bottom of range for either of those, you will likely feel symptoms, like fatigue.

Which-ever test this was, Free T3 or Free T4, you are at the bottom of the range:


> Well I got my results back for my FT3 test that I demanded they do, and it was 0.8, they say this next to the results:
> 
> "Reference Range: 0.8-1.8 Elevated values are seen in patients on thyroxine therapy".


The part about "elevated values are seen in patients on thyroxine therapy" doesn't mean anything. You're nowhere close to being overmedicated.



> So tell me this, my TSH is 1.4 now....what if my levels go from 1.4 to below the cut off of 0.3? What does that mean?


It depends on what your other numbers are, if it ever comes to you testing below the range. The important tests you need, every time you are tested, are:

TSH (thyroid stimulating hormone) 
Free T3 (free triiodothyronine) 
Free T4 (free thyroxine)


----------



## Familytreenutfinder1970 (Mar 26, 2012)

McKenna said:


> Ok, I think there's some confusion here...
> Here's your sig line:
> 
> You initially had a free T4 (free thyroxine) done in March. NOT a Free T3 (free triiodothyronine). So the results you're quoting now are not the same hormone, if you did indeed have the Free T3 done this time around.
> ...


So sorry I am confused, thank you for clearing that up.

So yes, I just had done:

Sensitive TSH(S) 1.4 mIU/L
Thyroxine,Free(S) 0.8 ng/dL

and originally they did those 2... and TPO Antibodies.

So the sensitive TSH, is just TSH.
The Thyroxine Free is T4.

Is that right?

So for the T4 or T3, if they have a higher number (then the cut off), how do people tend to feel? Does it tend to be similar to if it were a lower number?

Sorry so many questions.


----------



## McKenna (Jun 23, 2010)

> So sorry I am confused, thank you for clearing that up.


No problem! It's like learning a foreign language, isn't it? :winking0014:



> So the sensitive TSH, is just TSH.
> The Thyroxine Free is T4.
> 
> Is that right?


Correct. And you did not have a Free T3 run.



> So for the T4 or T3, if they have a higher number (then the cut off), how do people tend to feel? Does it tend to be similar to if it were a lower number?


When someone is hypothyroid, their thyroid hormones (T3 and T4) tend to be lower, and their TSH tends to be higher. Your higher TSH in March combined with your low T4 show that your thyroid was not producing enough hormone. Your doctor put you on thyroid hormone, in the form of levothyroxine, and it brought your T4 up a tiny bit, and brought your TSH down. Both numbers are heading in the right directions.

When thyroid hormone is adequate (in our case, from supplementing thryoid hormone) then your symptoms would be much better and your labs would reflect that you were receiving enough hormone, meaning your T4 and T3 would not be at the bottom of the range. Most people feel better with their Frees above the mid range mark, but not exceeding the top of the range.

You are still pretty new into treatment so waiting seems wise. It does take a while for your body to adjust and to reflect in your labs. Just be sure that when it's time for your next round of labs in a few weeks that you tell the doc you want Free T3, Free T4 and TSH.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

McKenna said:


> No problem! It's like learning a foreign language, isn't it? :winking0014:
> 
> Correct. And you did not have a Free T3 run.
> 
> ...


Thanks so much for your patience. I appreciate it! I'm going to call my REAL primary tomorrow and see if he will order those labs a week before he is done in may so I have a record of getting them done. That way, maybe I can use the "my old Primary doctor was fine with it".


----------



## Familytreenutfinder1970 (Mar 26, 2012)

I put another call in to my REAL primary just now, and the nurse said there was a message for me from the "other" primary.

The message was: "Tell patient that her level of 0.8 is in the norm and we will see her back in 3 months". 

So I put another message in to my REAL primary and hope to hear back from him soon. I don't have much faith that I will find a new primary similar to him where I go, before he leaves. Thought about asking him if an Endo doc would be better ( but I don't know if they take hypo patients and I know my original levels are barely "abnormal").

Where I go is in network for me and I have always gone there and over all they are excellent. So sorry this thread has dragged on, I'm a newbie and if it wasn't for the fact my REAL primary is leaving end of next month (and was on hospital duty last month), I doubt I'd be having issues.


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Oh happy day!

My REAL primary called me back just now and he agreed to do T3, T4 and TSH in 6 weeks. He said that sometimes symptoms can hang on for a while before all is better, even though a person can start to feel better.

He said it took his wife almost 6 months for the symptoms to totally dissolve. He said that sometimes if you get too low of a TSH, you will become hyper (as in hyperthyroid I think?), can't sleep and such ( If I recall) and so we will watch the numbers.

I told him my T3 isn't much better, but he said it has gone up a tiny bit and that we will see where it is at in 6 weeks.

I need to tough it out for a while I guess. I forget that maybe the meds aren't fully working yet. This is all so new. Thank you all for your help and I always welcome any feedback!

Do you think what he has as a plan is reasonable?

I am going to look for a good book on Hypothyroid.


----------



## McKenna (Jun 23, 2010)

> My REAL primary called me back just now and he agreed to do T3, T4 and TSH in 6 weeks.


Sounds like a good plan. Just make sure when he runs the tests that he writes for the lab to do a "free T3 and Free T4". They need to say "free" in front of them, otherwise they will do a total T3 and total T4, and that's not as accurate.



> He said that sometimes if you get too low of a TSH, you will become hyper (as in hyperthyroid I think?), can't sleep and such ( If I recall) and so we will watch the numbers.


Again....you need all three: TSH, Free T3 and Free T4, to see what your complete thyroid picture is. All three numbers are equally important in relation to each other. Thyoid doses should never be adjusted by TSH alone.

Best to you..


----------



## Familytreenutfinder1970 (Mar 26, 2012)

Thank you!

What do they mean when they say "T3 converts to T4" and so they don't need T4 done?

Sorry, I don't know if I got an answer before.


----------



## Andros (Aug 26, 2009)

Familytreenutfinder1970 said:


> Thank you!
> 
> What do they mean when they say "T3 converts to T4" and so they don't need T4 done?
> 
> Sorry, I don't know if I got an answer before.


T4 converts to T3 via peripheral deiodination which then becomes your FREE T3 which is biologically active.

http://thyroid.about.com/cs/testsforthyroid/a/freet3.htm


----------

