# Odd Lab Report (T7) + Caffeine Questions and More



## cam7770 (Mar 30, 2013)

So, I had never followed my thyroid too carefully but early last year my TSH came back slightly above normal range (somewhere around 5.5 I think). I looked at old labs and in 2009 my TSH was something like 1.4, then 2.8 in 2010, then 3.5 in 2011, etc. I didn't think much of it but my doctor ran anti-TPO and anti-TG Abs just for kicks...all normal! I was told I could start meds if I wanted, but for me the fatigue, dry skin, being cold, etc. just seemed like something most women (does being 24-years-old make me a woman?) could complain about if they wanted to.

These were my labs in November 2012...look decent enough to me:
TSH = 1.89 (0.45-4.5)
Total T4 = 5.1 mcg/dL (4.5-12)
T3 uptake = 34% (24-39)
Free T4 Index = 1.7 (1.2-4.9)

Different doctor in new city decided he said we would go ahead and check my thyroid just to be safe (for some hair loss I wasn't sure if I was imagining).

Labs in February (now these are done a bit differently):
TSH = 3.48 (0.27-4.20)
Total T4 = 4.25 mcg/dL (5.10-14.10)
T-Uptake Units = 1.07 TBI (0.80-1.30)
T7 = 3.97 mcg/dL (6.00-12.00)

The units for T7 are driving me nuts! If T7 is supposed to be the same thing as free thyroxine index, then it should be some sort of standardized unit, not mcg/dL. I know the T3 uptake is given in a standardized unit and not a percent, but I would still think T7(FTI) would be calculated from total T4 and T3 uptake, but no matter how hard I try I can't make 4.25 x 1.07 = 3.97. I'm not questioning my labs or treatment or anything (started 25 mcg of levothyroxine and recheck 6 weeks from start date) but I just wanted to ask if anyone else's lab does it this way.

Either way it seems my total T4 has dropped considerably, and took my free T4 down with it....that was quick, thanks body. My TSH is trying I guess, but I've always learned in school that TSH is the most sensitive and will rise before a decrease in T4 is seen. Anybody else's labs start off like this, with 'normal' TSH and decreased free and total T4?

This first little bit of treatment hasn't been the best. I think the tiny dose of levothyroxine has initially caused my HPA axis to just stop trying at all. I gained about 4 pounds in 4 days WHILE running about 25 miles during that time (I'm 115 lbs and short so that 4 pounds was a BIG weight change for me). My body has balanced itself a bit since then but I'm still sure I'll probably end up needing to increase my dose. No big deal, I can be patient.

One last quick question: did anyone have difficulty drinking caffeine before starting treatment? I enjoy coffee and would like to drink it during the day to help with my sleepiness/productivity, but it keeps me up too late at night (even though I'll feel tired). Maybe I'm not metabolizing it enough now and I might have better luck when I'm on the right dose of meds..? It makes sense in my head but probably won't work out as I hope haha.

Sorry for rambling, I just get curious with these sorts of things!


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## hashimotocoaster (Mar 22, 2013)

cam7770 said:


> One last quick question: did anyone have difficulty drinking caffeine before starting treatment? I enjoy coffee and would like to drink it during the day to help with my sleepiness/productivity, but it keeps me up too late at night (even though I'll feel tired). Maybe I'm not metabolizing it enough now and I might have better luck when I'm on the right dose of meds..? It makes sense in my head but probably won't work out as I hope haha.
> 
> Sorry for rambling, I just get curious with these sorts of things!


Before I started replacement hormones I could sometimes drink tons of coffee (I needed it!) and sometimes I just couldn't handle it--I'd get really shaky and just feel generally terrible. Since I've been on Synthroid things are a bit more steady--I drink 1 or 2 cups of coffee a day, but no more.


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## Andros (Aug 26, 2009)

cam7770 said:


> So, I had never followed my thyroid too carefully but early last year my TSH came back slightly above normal range (somewhere around 5.5 I think). I looked at old labs and in 2009 my TSH was something like 1.4, then 2.8 in 2010, then 3.5 in 2011, etc. I didn't think much of it but my doctor ran anti-TPO and anti-TG Abs just for kicks...all normal! I was told I could start meds if I wanted, but for me the fatigue, dry skin, being cold, etc. just seemed like something most women (does being 24-years-old make me a woman?) could complain about if they wanted to.
> 
> These were my labs in November 2012...look decent enough to me:
> TSH = 1.89 (0.45-4.5)
> ...


Bumping up in case someone can shed some light. You are hypo though and I sure hope your doc increases your thyroxine replacement at the time of your next labs.

Your lab is confusing; note the TBI which is thyroid binding index.


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