# New labs are in...



## GOLGO13 (Jun 13, 2018)

New test results are interesting. So my current Synthroid dose is 94 (half 88 and 50 combined) five days a week and 100 two days a week. The Febuary test was 100 once a week. And luckily my PCP ran FT4 and FT3 which my endo wouldn't.

April 11 2019: TSH 2.763 uIU/mL 0.350 - 5.000 uIU/mL

Feb 6 2019: TSH 4.829 uIU/mL 0.350 - 5.000 uIU/mL

April 11 2019: FT4 1.08 ng/dL 0.70 - 1.25 ng/dL

Feb 6 2019: FT4 1.01 ng/dL 0.70 - 1.25 ng/dL

April 11 2019: FT3 2.6 pg/mL 1.7 - 3.7 pg/mL

Feb 6 2019: TSH 2.5 pg/mL 1.7 - 3.7 pg/mL

I do find it interesting that every time I increase T4 meds the FT4 goes up and the FT3 goes down. While my TSH has gone in a positive direction, I'm not sure it's actually a positive thing overall. In a lot of ways I have felt better in general except the last few weeks. But that could be related to other issues.

Any ideas on when a dose change would take effect? I track my resting heart rate when I sleep. The days I take 100, that night my heart rate drops. But I don't know if that's actually a few days behind or not. I take my 100 pills on Saturday and Tuesday.

I know based on these numbers I probably should have some T3 like Cytomel. I'm going to talk to my new Endo about that in a few weeks. But I also wanted to be patient with name brand Synthroid. I will say I do prefer it over levo. But I still think these types of meds don't work too well inside me.


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## Lovlkn (Dec 20, 2009)

> April 11 2019: TSH 2.763 uIU/mL 0.350 - 5.000 uIU/mL
> 
> Feb 6 2019: TSH 4.829 uIU/mL 0.350 - 5.000 uIU/mL
> 
> ...


These labs are reason enough to never ever rely on TSH only for medication dosing - mainly because your FT-4 and FT-3 are barely different.

You can also choose to say - the slight increase in FT-4 and FT-3 has lowered your TSH. The thing about lab results is they do vary based on time of draw, what you ate the day before, the time of taking your pill among some things.

Also - because you are splitting pills MCG are extremely small measurements and there is no telling what dose you are actually getting with your pill split - unless you split the pill and keep them in the same week of ingestion - which you would still have a daily dose variance and since you are only taking 5 days - you do not have exact weekly amounts.

That said - you are trending in a better direction - absolutely should ask for some T3 hormone - then you will start over again getting your T-4 hormone in a good place to accept the T-3 hormone. I think getting your T3 up you will feel even better


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## GOLGO13 (Jun 13, 2018)

Thanks Lovlkn! I'm working on things, but yeah, doesn't look like I can budge my FT3. My new endo appt is in a few weeks. But I don't have too much hope there.

After this, assuming it doesn't work out, I'll try to find a functional doctor in the larger city.


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## Lovlkn (Dec 20, 2009)

> I'll try to find a functional doctor in the larger city.


Probably a good idea but you need to be careful because most functional's want to prescribe high doses of T3 hormone.

If you can afford it brand Cytomel is great. I was on for years and was stable. Since changing to generic lilothyronine I have had more lab variations, however, I am post menopausal and older so who knows whats happening?


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## GOLGO13 (Jun 13, 2018)

I'm cautious in general...and I'm weary of functional medicine providers (as I am Endos). I think for this issue finding the right doctor of any kind seems to be challenging. But I'm in a somewhat rural area now, so it appears any types of services are tricky.

My PCP is really good in general though. She's generally the normal treatment for thyroid, and I can't blame her for that. But she's been willing to do a lot of tests for me and has a great kindness. So I at least have my PCP locked in. Plus her office is only 200 yards from where I live.

I really want to solve the issue that's causing lower T3, but I know sometimes that's hard to do.


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## Lovlkn (Dec 20, 2009)

I could never get a Endo to treat me properly - their hang up about TSH is alarming.

They are the doc's that are suppose "to know" - the fact they don't is ridiculous.

All I know is - until I added Cytomel I felt all the hypo symptoms.

Keep speaking with your GP - they are running the right tests which is fantastic. I fee a OD now who treated a friend who developed Graves. I'm so thankful I found him - and did actually arrive to him with suppressed TSH, in 1/2-3/4 range FT-4 and FT-3. My dose has not changed with either medication since I began seeing him. I self manage at this point and buy self pay labs if I feel the need.


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## GOLGO13 (Jun 13, 2018)

I don't think they know how to handle people without a thyroid. Especially if they go on TSH.

I've been feeling pretty good since upping my dose slightly. So maybe I'm onto something.

It will be interesting to see what my next set of tests show.


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