# A little confused about recent lab results



## creepingdeath (Apr 6, 2014)

I have been taking 75mcg of Synthroid for more than 4 months.

I went to my PCP last Monday.

I have been having severe Joint and muscle pain especially in my left shoulder.

Had some X rays done and a more sensitive CCP test for rheumatoid arthritis which came out negative.

Haven't gotten results of X rays yet.

Blood work for thyroid was ordered also.

I know T3 should have been done but wasn't.

My question is My TSH is high and free T4 is high normal.

TSH W/REFLEX TO F T4 (13.44) H reference range 0.40 - 4.50 mIU/L

T4 FREE (1.7) reference range 0.8 - 1.8 ng/dL

How can my TSH be so high and also the Free T4?

I would think my free T4 would be low with a TSH this high.

I do have an appointment with my Endo this Friday morning.

Hopefully he will do more extensive Lab's and have an explanation to why my levels are this way.

In the meantime any suggestions to what I think are very odd results?

<PS> I still feel like SH*T!!!!!!!!!!!!!!!!!


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## joplin1975 (Jul 21, 2011)

If you have a high free t4 and a low free t3, you TSH will be high. So, obviously, I'm guessing, but that is what I would bet is happening.


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

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.

rT3
http://thyroid-rt3.com/whatis.htm
(Copy and paste into your browser)

You do need that FREE T3 test and also rT3 (reverse T3) as you may not be converting. Be sure to insist on the FREE T3.

Info above

I can see where you might be feeling pretty terrible.

And; refresh our memories............................you have had an ultra-sound of your thyroid, yes?


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## creepingdeath (Apr 6, 2014)

Andros said:


> Understanding the Thyroid: Why You Should Check Your Free T3
> http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
> (Copy and paste into your browser)
> 
> ...


Yes I had an ultra sound.

They found two sub cm suspicious areas that the Endo did not think needed a FNA done.

I do have a very enlarged thyroid which shrinks a little bit when on thyroid med's.

Within two weeks of stopping med's it swells back up.

Also diagnosed with Hashimoto's.

From a little bit of research I've done high TSH along with free T4 can mean two things.

High T4 results along with a high TSH may indicate a pituitary condition or poor conversion.

I guess I'll have to wait to see what this Endo has to say.

I am very leery of this synthetic thyroid medication. Every time the dose is upped I get even more severe and strange symptoms.

Ever since I took this stuff in the beginning of 2013 things have just been getting worse.

I've tried generics , Levoxyl and Synthroid and always get the same results. Symptoms get worse.

I've stopped taking it a few times felt better then started feeling worse but never not had symptoms.

I am sure this Endo is going to have a negative response to me asking to try natural thyroid med's like my PCP did but I am definitely going ask.

Whenever I tell these Doctor that I think this medication is making things worse they say my blood work looks good so it's not my thyroid but something else.

But anything they suspect I have, I have tests for and they all come up negative.

I truly believe that my body just can't tolerate synthetics.

I sometimes think they are slowly killing me.

I will never know unless I'm allowed to try the alternative.

Jamie~


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## Andros (Aug 26, 2009)

FNA is the only test there is available at this time to prove or disprove Hashimoto's. All else is mere conjecture based on results after the fact; not before.

Histologic diagnosis of Hashimoto's
http://emedicine.medscape.com/article/120937-diagnosis
(Copy and paste into your browser)

Hashimoto's Hurthle cells
http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)71549-2
(Copy and paste into your browser)

http://www.thyroidmanager.org/chapter/hashimotos-thyroiditis/
(Copy and paste into your browser)

By suspicious you mean? FNA would be good. Sometimes cancer is involved when a patient has strange numbers like yours.


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## joplin1975 (Jul 21, 2011)

It likely has very little to do with synthetics vs "natural" med (my own pet peeve, desiccated meds are faaaaaaaaaaaaaaaar from natural, so calling them natural is kinda nutty) and very much to do with you needed t3 -- "synthetically" via cytomel or "naturally" via desiccated meds.


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## creepingdeath (Apr 6, 2014)

Andros said:


> FNA is the only test there is available at this time to prove or disprove Hashimoto's. All else is mere conjecture based on results after the fact; not before.
> 
> Histologic diagnosis of Hashimoto's
> http://emedicine.medscape.com/article/120937-diagnosis
> ...


Being suspicious is what was stated by the technician who did the ultra sound.

The Ultra sound results do not even mention the word nodule just very enlarged thyroid "goiter".

Endo said he does not suspect cancer because the areas in question are sub centimeter in size.


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## creepingdeath (Apr 6, 2014)

joplin1975 said:


> It likely has very little to do with synthetics vs "natural" med (my own pet peeve, desiccated meds are faaaaaaaaaaaaaaaar from natural, so calling them natural is kinda nutty) and very much to do with you needed t3 -- "synthetically" via cytomel or "naturally" via desiccated meds.


All I know is I do not feel well on this synthetic stuff.

I took this synthetic all last year under my PCP's treatment.

Slowly worked my way up to 125 mcg and was told my lab work was normal.

But my PCP was only treating by TSH and I just got worse and worse.

I am sure they call it natural because it comes from a natural source "an animal" and is not created in some lab synthetically.

Synhtroid is called bio identical when it is far from it.

You need to look up the chemical formula and structure of synthetic T4 and T4 made by the human body and you will find them very different.

Animal derived T4 is not exact either but it is much closer structurally than synthetic.


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## creepingdeath (Apr 6, 2014)

*This is what I mean by odd results.*

*Lab work as of 09/16/2014 after taking 75mcg of synthroid for a little more than 4 months.*

*TSH 13.44 H reference range 0.40 - 4.50 mIU/L*

*T4 FREE 1.7 reference range 0.8 - 1.8 ng/dL *

*__________________________________________________________________________________*

*Lab work as of 04/ 01/2014 after not taking any thyroid med's for around 4 months. *

*TSH 28.63 H reference 0.40 - 4.50 mIU/L*

*T4, free 1.0 reference 0.8 - 1.8 ng/dL *

*See how my TSH is more than twice as high without med's and the free T4 is low normal.*

*But on thyroid med's my TSH goes down but free T4 goes up to normal high. *

*It doesn't make sense. The T4 should not be this high with high TSH.*


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## jenny v (May 6, 2012)

It actually makes sense for two reasons: 1) if you've got competing antibodies at play skewing your results, and 2) TSH lags behind Frees in terms of movement (i.e., Frees respond faster to thyroid meds, TSH takes longer to "catch up" and move around).


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## creepingdeath (Apr 6, 2014)

I'm just afraid this Endo is going suggest to up my dose and that free T4 is going to go up out of range and I will even feel worse than I do right now.

Lag behind????????

I think more than 4 months on the same dose everything should have caught up by now.


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