# Still learning, need advice about levels



## christina20003 (Sep 27, 2011)

I've had Graves for a while but only recently have been asking for copies of my lab results. I could use a little advice on how to interpret these results. I just saw the endo last week and he said my numbers were much improved since my last labs in November. I don't have a copy of the Novembers labs, but am going to get it. I do have a copy of the most recent labs from this January and some from last July(tested by obgyn as part of an infertility workup).

Jan 2012
TSH <0.05 µUI/mL (Range: 0.30 - 4.20) LOW
Free T4 1.34 ng/dL (Range: 0.70 - 1.40)
Total T3 235.00 ng/dL (Range: 76.0 - 181.0) HIGH

July 2011
TSH <0.02 uUI/mL (Range: 0.40 - 4.00) LOW
Free T4 1.62 ng/dL (Range: 0.30 - 1.90)

Is my endo checking all of the important levels? What about Free T3, Total T4? Which ones are the most important especially as it pertains to trying to get pregnant?


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## Andros (Aug 26, 2009)

christina20003 said:


> I've had Graves for a while but only recently have been asking for copies of my lab results. I could use a little advice on how to interpret these results. I just saw the endo last week and he said my numbers were much improved since my last labs in November. I don't have a copy of the Novembers labs, but am going to get it. I do have a copy of the most recent labs from this January and some from last July(tested by obgyn as part of an infertility workup).
> 
> Jan 2012
> TSH <0.05 µUI/mL (Range: 0.30 - 4.20) LOW
> ...


Your endo should be running the FREE T3 as the Total 3 is bound, unbound and rT3 (reverse) hormone. It's anybody's guess what the numbers would be for each of the 3.

Are you taking anti-thyroid meds?


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## christina20003 (Sep 27, 2011)

Yes. I'm currently taking 20 mg of methimazole daily. I was on 30 mg since December I was very hyper. He just lowered my dose at my appointment last week. I'm getting labs done every 6-8 weeks. Does that sounds frequent enough?


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## Andros (Aug 26, 2009)

christina20003 said:


> Yes. I'm currently taking 20 mg of methimazole daily. I was on 30 mg since December I was very hyper. He just lowered my dose at my appointment last week. I'm getting labs done every 6-8 weeks. Does that sounds frequent enough?


Maybe if you "feel" stable. My endo did labs every 4 weeks w/Graves'.

How your doctor can decide your dose w/o FREE T4 is beyond me. One reason why is that FT4 convert fast to FT3 with Graves'. So a low FT4 means nothing whereas a high FT4 might mean something altogether different.

There binding, blocking and stimulating antibodies and immunoglobulins.

Have you ever had any of these tests?

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/


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## Lovlkn (Dec 20, 2009)

> Jan 2012
> TSH <0.05 µUI/mL (Range: 0.30 - 4.20) LOW
> Free T4 1.34 ng/dL (Range: 0.70 - 1.40)
> Total T3 235.00 ng/dL (Range: 76.0 - 181.0) HIGH


You need (as does your endo) to ignore the TSH and adjust your dosing by your FT-4 and FT-3. Currently your Total 3 is still above range - a FT-3 would give you a better picture of where your levels are. Your FT-4 is at high range. I'm not sure I would agree with such a large dose reduction. Please have new labs in 3 weeks to be sure you do not go hyper of sooner if you notice an increase in hyper symptoms.

How long have you been taking Methimazole?

I was tested every 4weeks while on Tapazole for 4.5 years.

Antibodies are likely suppressing your TSH


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