# Results of Recent Labs



## andyb1205 (Aug 29, 2016)

Hi. 3 months ago I was put on 25mg Synthroid and after 6 weeks I upped the dosage to 50 mg. These are the results of my recent lab after being on 50mg for 6 weeks. I will compare them with previous results. In order, the first number is from January on no medication, the second on 25mg for 6 weeks, the last one in bold is on 50mg for 6 weeks which is the most recent lab.

TSH 2.57, 2.87, *1.70* (0.32 - 5.04)
T4 Free 11.7, 13.4, *13.5* (10.6 - 19.7)
T3 Free 4.07, 3.88, *3.94* (3.00 - 5.90)

I also had two pituitary tests done recently as I wanted to explore central hypothyroidism. I wanted the doctor to test Prolactin as well but perhaps these tests indicate my pituitary is fine. In late 2013 my TSH was 5.30 and in Spring 2014 my TSH was 4.20, in upper quarter of range (T4 and T3 were quarter-third in range, similar to now). Oddly going from that TSH to now 1.70 has been accompanied with similar T4 and T3!

FSH 5.2 (<9.5)
LH 5.4 (1.1 - 8.8)

Despite my insistence the doctor forgot to request the TPOab test this time but I had them done last two times in January and February, as well as the TGab.

TPOab 12, 18 (<35)
TGab 14 (<40)

Last summer in August 2016 I was diagnosed with Vitamin D deficiency, and barely in range B12, and while the T4 was a third in range the T3 fell just below the range. Since then my Vitamin D is in range and B12 is over range (over supplemented), will retest B12 in 6 weeks after going off supplements now. Ferritin has always been in range over the years and Cortisol AM test a couple months ago was in mid-range.

I will be meeting the doctor this weekend and request upping the dosage to 75mg of Synthroid as the T4 and T3 have barely moved. I am sure he will suggest I am improving as my TSH is now 1.70 but clearly I am not. I recently had an ultrasound that showed that I have a borderline fatty liver. The doctor suggested not only that I decrease or abstain from drinking, which I am and I never drank enough to have liver problems at age 26 in the first place, but also that I exercise vigorously to lose weight (I'm at least 50 pounds overweight). Hard to do when your T3 and metabolism is not in good range!

I will also request an ultrasound of the thyroid. I am just so confused and want my metabolism and health to improve. On top of hypothyroid symptoms I've had chronic tonsillitis for almost 4 years now!

I'm crossing my fingers that the doctor doesn't reject my request to up the dosage from 50mg to 75mg and to have an ultrasound of the thyroid.

Anyways, I would greatly appreciate any feedback.

Thanks!

- Andy


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## Lovlkn (Dec 20, 2009)

Hi Andy -

You are under-medicated - have been the whole time and your thyroid hormone movement has been minimal. Yes - TSH is improving - that's a pituitary hormone and likely improving due to the low dose levothyroxine, however until your FT-4 and FT-3 approach 3/4 of range you will not feel your best.



> TSH 2.57, 2.87, *1.70* (0.32 - 5.04)
> T4 Free 11.7, 13.4, *13.5* (10.6 - 19.7) *((15.05 - 17.337))*
> T3 Free 4.07, 3.88, *3.94* (3.00 - 5.90) *(( 4.45 - 5.175))*


(( 1/2 -3/4 ranges))

Also, - discontinuing Vitamin D all-together is probably not a good plan - your levels will fall and you will be back at the bottom of range. Rather than stop completely - might I suggest stopping for a few weeks and then taking a lower dosage? I personally need 5K IU daily to maintain 1/2 of range so I have added doubled up a few days.


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## andyb1205 (Aug 29, 2016)

Thanks for the kind reply!

I believe you misread. I am continuing to take 10,000 Vitamin D3 a week for maintenance dose, will retest in 6 weeks to see where the levels are.

It was the B12 I was talking about. In retrospect I've decided to maintain at least 5,000 a week B12 dose, at least until the hormones are better. I've read that it takes months off of B12 to get an accurate test so rather not risk falling low in the meantime.

Btw, are there any theories on what impacts the TSH? I understand it's a pituitary hormone. I'm assuming that for conventional cases the TSH can be an accurate measurement but it's not a one shoe fits all situation hence importance of always testing T4 and T3 (which costs me $50 every time as it's only covered in Canada if the TSH result is flagged as out of range).

I'm wondering if years of an unhealthy lifestyle in regards to diet and exercise had negatively affected my adrenals which in turn messed with my hormones. Either that or I am lucky to have caught the falling hormones as the TPO antibodies are low and Hashimotos is in the early stages.

Thanks.


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## joplin1975 (Jul 21, 2011)

I would guess that its more a function of antibodies impacting your TSH, as opposed to an unhealthy lifestyle. I could be wrong, but that's my knee jerk reaction.


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## andyb1205 (Aug 29, 2016)

Interestingly I've seen reference ranges for TPOab at <9, rather than the <35 in my lab.


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## andyb1205 (Aug 29, 2016)

So the doctor, while saying that my TSH, T4 and T3 are fine, thankfully agreed to give me a 6 week trial of 75mg. He said that I need to agree to lower the dose back to 50mg if the TSH falls below range, regardless of T4 and T3 numbers. Let's see, the bottom of range is 0.32 and right now the TSH is 1.70.


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## Lovlkn (Dec 20, 2009)

Make sure when you have labs drawn - to not have taken your levothyroxine prior to the draw.

Have a lab draw in the morning 24 hours from your last days dose.


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## andyb1205 (Aug 29, 2016)

Yes I will be sure to do that for sure. I hope my T4 and T3 reach good levels and I reach the optimal level for the hypo symptoms with TSH remaining above 0.32. If I run into a problem with that or requiring a T3 med add-on I will run into a problem and need to find a new doctor. Doctor made it clear he already is taking a risk upping my dose to 75, lol. I appreciate his honesty, but oh man, I'm crossing my fingers. At most I can see him upping it to 88 mg in the future but that's it. I'll take this one step at a time.


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## andyb1205 (Aug 29, 2016)

I still have 2 weeks left before I get my labs done to check my progress on the current 0.75 Synthroid but thought I should share my recent discovery.

Here in British Columbia, Canada, I am able to access test results online. Long story short I was able to check my parent's labs as well. My father's age is currently 56 and my mother's is 50.

From my father:

TSH: 2015 *0.65* (0.30 - 5.50)
2016 *2.85* (0.30 - 5.50)
2017 *1.38* (0.32 - 5.04)

I think his TSH in 2016 fluctuated because he had to be rushed to the hospital and had very low sodium and potassium and kidney function. Only the proper tests would confirm his thyroid function but my gut feeling on observations in my life is that his thyroid is fine.

Here are my mother's results.

2014 TSH *1.93* (0.30 - 5.50)

Feb 2015 TSH *2.59* (0.30 - 5.50) 
Ferritin L 14 (> 17) 
B12 164 (156 - 698)

Sept 2015 TSH *2.0* (0.27 - 4.20)
FSH 15.9 (Midcycle: 4.0 - 20.0)

Nov 2016 TSH *3.54* (0.32 - 5.04)
Ferritin 4 (15 - 247)

As you can see my mother's thyroid may be impacting her low B12 and Ferritin levels. It is interesting that she has similar in range but under active thyroid as me, may be a genetic connection. I will be getting tests done for my 16 year old brother.


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## jenny v (May 6, 2012)

Woo, her ferritin is low! Is her doctor addressing that?


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## Lovlkn (Dec 20, 2009)

> As you can see my mother's thyroid may be impacting her low B12 and Ferritin levels


could be the other way around as well with low ferritin and B-12 affecting her thyroid levels.

TSH is a screen and until one has FT-4 and FT-3 run it's impossabe to know what true thyroid function is.


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## andyb1205 (Aug 29, 2016)

Lovlkn said:


> could be the other way around as well with low ferritin and B-12 affecting her thyroid levels.
> 
> TSH is a screen and until one has FT-4 and FT-3 run it's impossabe to know what true thyroid function is.


That is a good point. I guess low iron and B12, if that is the cause, would only affect her TSH to rise and not her T4 and T3 levels then? Her bloodwork came back today.

Ferritin 10 (15-247)
B12 199 (153-655)
TSH 3.82 (0.32 - 5.04)

Still waiting for her Vitamin D results to come in. Will need to request self-pay T4 and T3 tests to see that picture but I'm wondering if she should get her B12 and Iron fixed first. For the B12, I'm assuming a 1000 B12 + Thorne B Complex daily should be fine.


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## andyb1205 (Aug 29, 2016)

So my mother's Vitamin D results are back. <20 (range 75-150).


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## jenny v (May 6, 2012)

Yikes, that is way too low. Did her doctor say anything? Low vitamin D can mimic or exacerbate thyroid symptoms, too.


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## andyb1205 (Aug 29, 2016)

She's seeing the doctor this Saturday. Will likely need to supplement iron and vitamin D, and bring the B vitamins higher. And I will suggest she retest the thyroid (will full panel) after bringing the other levels up.

From my own experience, fixing my B12 and Vitamin D deficiencies did not fix my thyroid (though helped with conversion) so I suspect there's a genetic relation between me and my mom's similar vitamin deficiencies linked to thyroid. And interestingly we both have the "in range" TSH that gets missed.


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## andyb1205 (Aug 29, 2016)

So after 6 weeks trial in 75mg Synthroid I got my blood test results. I'm sure the doctor will be puzzled as to why my TSH increased, though my T4 and T3 did slightly improve. Previously he said that irrespective of T4 and T3 he would decrease my dose if my TSH went below range! Only difference in preparation was that while maintaining my fasting, I took the Synthroid 24.5 hours before rather than 21 hours before at time of draw.

I'll include the last lab on 50mg and the current one in bold.

TSH 1.70, 2.19 (0.32 - 5.04)
T4 13.5, 14.1 (10.6 - 19.7)
T3 3.94, 4.06 (3.00 - 5.90)
TPOab 13 (<35)

T4 and T3 respectively have gone from 32% and 32% of range to now 38% and 37%.

Seems like the conversion is fine. I should probably request a dose increase to 100mg instead of 88mg? The doctor should agree to increase it for sure.


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