# Please help me understand these results!!!



## bjacobs71

I have been on Levothyroxine 50 mcg for a little over a year and just recently put on Cytomel 25 mcg for the treatment of hypothyroidism. In January 2011 I started gaining weight and have since put on 16 pounds. I just got my latest labs and am more confused than ever.
TSH - 0.080L (0.450 - 4.500)
Thyroxine T4 - 2.3L (4.5 - 12.0)
T3 Uptake - 29 (24 - 39)
Free thyroxine Index - 0.7L (1.2 - 4.9)
Triiodothyronine, Free, Serum - 6.6H (2.0 - 4.4)
My blood pressure and pulse have been elevated also since the beginning of the year when the weight gain started. My lab results in March 2011 were:
TSH - 0.461 (0.358 - 3.740)
T4 - 5.6 (4.8 - 13.9)
Free T4 - 0.87 (0.76 - 1.46)
T3 Total 0.51L (0.70 - 1.90)
All of my labs prior my TSH was 0.563, 0.610 and 0.753. I could see where I was hypo before but now my T3 is high which I assumed would make me hyper but why am I steading gaining weight? I feel like I just hate people, I don't want to get up in the morning and just feel awful. I have had two back surgeries in the past and have two herinated disc in my neck so I take a lot of other meds: topamax, baclofen, wellbutrin sr, vicodin hp, Xanax, and adderall. I have started cutting back on the adderall since BP & pulse issues and have been on all of these meds prior to recent symptoms. So am I hypo or hyper & how would I need to adjust my thyroid meds????


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## Andros

bjacobs71 said:


> I have been on Levothyroxine 50 mcg for a little over a year and just recently put on Cytomel 25 mcg for the treatment of hypothyroidism. In January 2011 I started gaining weight and have since put on 16 pounds. I just got my latest labs and am more confused than ever.
> TSH - 0.080L (0.450 - 4.500)
> Thyroxine T4 - 2.3L (4.5 - 12.0)
> T3 Uptake - 29 (24 - 39)
> Free thyroxine Index - 0.7L (1.2 - 4.9)
> Triiodothyronine, Free, Serum - 6.6H (2.0 - 4.4)
> My blood pressure and pulse have been elevated also since the beginning of the year when the weight gain started. My lab results in March 2011 were:
> TSH - 0.461 (0.358 - 3.740)
> T4 - 5.6 (4.8 - 13.9)
> Free T4 - 0.87 (0.76 - 1.46)
> T3 Total 0.51L (0.70 - 1.90)
> All of my labs prior my TSH was 0.563, 0.610 and 0.753. I could see where I was hypo before but now my T3 is high which I assumed would make me hyper but why am I steading gaining weight? I feel like I just hate people, I don't want to get up in the morning and just feel awful. I have had two back surgeries in the past and have two herinated disc in my neck so I take a lot of other meds: topamax, baclofen, wellbutrin sr, vicodin hp, Xanax, and adderall. I have started cutting back on the adderall since BP & pulse issues and have been on all of these meds prior to recent symptoms. So am I hypo or hyper & how would I need to adjust my thyroid meds????


Your FREE T3 is high in your latest labs. You are over medicated and I am not surprised if you went straight on to 25 mcg.of Cytomel. Most people start off on 5 mcg. and see where that takes them.

Talk to your doctor about this; it could be dangerous.

You can gain weight when you are hyper as well as hypo. One has to be euthyroid to lose weight and maintain w/proper diet and exercise.

Please let us know what your doctor has to say.


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## Lovlkn

> just recently put on Cytomel 25 mcg


25mcg is a large dose -very large to take along with a T-4 replacement medication.

How recently and how do you take the Cytomel? All in 1 dose or split? Away from your other medications?

Have you had any lab's since beginning the Cytomel?

What is your height and weight?



> I just got my latest labs and am more confused than ever.
> TSH - 0.080L (0.450 - 4.500)
> Thyroxine T4 - 2.3L (4.5 - 12.0)
> T3 Uptake - 29 (24 - 39)
> Free thyroxine Index - 0.7L (1.2 - 4.9)
> Triiodothyronine, Free, Serum - 6.6H (2.0 - 4.4)
> My blood pressure and pulse have been elevated also since the beginning of the year when the weight gain started. My lab results in March 2011 were:
> TSH - 0.461 (0.358 - 3.740)
> T4 - 5.6 (4.8 - 13.9)
> Free T4 - 0.87 (0.76 - 1.46)
> T3 Total 0.51L (0.70 - 1.90)
> All of my labs prior my TSH was 0.563, 0.610 and 0.753.


Your January labs show you more hyper than your March labs -

Can you post your other lab's tests and ranges that you might have copies of so we can see when you began taking your replacement.

The Free T- 4 and Free T-3 tests would be the most helpful tests to run on yourself to get your dosing correct.


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## bjacobs71

The first labs I found for my thyroid are from 9/15/09, they only checked my TSH which at the time was 3.710 (0.450 - 4.500). At this time I was having a lot of fatigue and actually falling asleep at work. My Ferritin, Serem level was only 7 (10 - 291) so I was put on an iron supplement. I have since stopped the iron about a year ago because of the constipation and my levels have stayed within range. My other thyroid labs were:
5/26/10:
TSH 0.745 (0.453 - 4.500)
Thyroxine T4 4.2L (4.5 - 12.0)
T3 Uptake 41H (24 - 39)
Free Thyroxine Index 1.7 (1.2 - 4.9)
7/26/10:
TSH 0.610 (0.350 - 5.50)
T4 4.8 (4.5 - 12.0)
T3 39 (24 - 39)
Free Thyroxine 1.9 (1.2 - 4.9)
10/14/10:
TSH 0.563 (0.450 - 4.50)
This was the only thyroid level check during this lab
2/15/11:
TSH 0.787 (0.350 - 5.50)
Again the TSH was the only level checked
3/9/11:
TSH 0.461 (0.350 - 3.740)
T3 Total 0.51L (0.70 - 1.90)
Free T4 0.87 (0.76 - 1.46)
T4 5.6 (4.8 - 13.9)
I also had an ultrasound done in March 2011. I don't have it in front of me right now but will in a couple hours. It said something to the effect of a small 2-3mm nodule and it gave the dimensions of each lobe and the was a difference in size. I can post the exact info in a bit.
Then I have the most current labs posted above.
I started out on the levothyroxine 50 mcg at 5:30am so not to interfere with any other meds or food. Then after the March 2011 labs he added the Cytomel. He actually wrote the Rx for 50 mcg but the pharmacy gave it to me as 25 mcg with twice the quanity. I assumed I would take one in am then the other at night but I have only been taking one at approx 8am after I eat. My weight gain started with a couple pounds in Dec 2010, then went into high gear after first of year 2011. It got really bad around the spring. I really appreciate all help and feedback because I am being treated by my GP and I sometimes wonder if he understands this anymore than me. I will post ultrasound and any other lab results I find within a few hours.


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## bjacobs71

Also my height is 5'7" and my current weight is 166lbs. This time last year I was between 149-151lbs and was trying to lose about 10 more then. I have not changed any eating habits. I don't do alot of exercise because of my spine problems. To date I have had 5 herniated disc, two of which have had surgery on. I was using the Mirena IUC from 3/08 until 4/11 when I had it removed because of side effects and went back on Ortho Novum 777 which I had used for years prior to having my daughter in 2000.


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## Andros

bjacobs71 said:


> The first labs I found for my thyroid are from 9/15/09, they only checked my TSH which at the time was 3.710 (0.450 - 4.500). At this time I was having a lot of fatigue and actually falling asleep at work. My Ferritin, Serem level was only 7 (10 - 291) so I was put on an iron supplement. I have since stopped the iron about a year ago because of the constipation and my levels have stayed within range. My other thyroid labs were:
> 5/26/10:
> TSH 0.745 (0.453 - 4.500)
> Thyroxine T4 4.2L (4.5 - 12.0)
> T3 Uptake 41H (24 - 39)
> Free Thyroxine Index 1.7 (1.2 - 4.9)
> 7/26/10:
> TSH 0.610 (0.350 - 5.50)
> T4 4.8 (4.5 - 12.0)
> T3 39 (24 - 39)
> Free Thyroxine 1.9 (1.2 - 4.9)
> 10/14/10:
> TSH 0.563 (0.450 - 4.50)
> This was the only thyroid level check during this lab
> 2/15/11:
> TSH 0.787 (0.350 - 5.50)
> Again the TSH was the only level checked
> 3/9/11:
> TSH 0.461 (0.350 - 3.740)
> T3 Total 0.51L (0.70 - 1.90)
> Free T4 0.87 (0.76 - 1.46)
> T4 5.6 (4.8 - 13.9)
> I also had an ultrasound done in March 2011. I don't have it in front of me right now but will in a couple hours. It said something to the effect of a small 2-3mm nodule and it gave the dimensions of each lobe and the was a difference in size. I can post the exact info in a bit.
> Then I have the most current labs posted above.
> I started out on the levothyroxine 50 mcg at 5:30am so not to interfere with any other meds or food. Then after the March 2011 labs he added the Cytomel. He actually wrote the Rx for 50 mcg but the pharmacy gave it to me as 25 mcg with twice the quanity. I assumed I would take one in am then the other at night but I have only been taking one at approx 8am after I eat. My weight gain started with a couple pounds in Dec 2010, then went into high gear after first of year 2011. It got really bad around the spring. I really appreciate all help and feedback because I am being treated by my GP and I sometimes wonder if he understands this anymore than me. I will post ultrasound and any other lab results I find within a few hours.


Please get your GP to run your FREE T3; this is your active hormone and it will give a very good clue as to your status re hyper or hypo. Most of us do well with the FREE T3 @ about 3/4 of the range given by your lab. That would be 1/4 above mid-range.

The reason your ferritin was staying in range was probably because you were taking iron. It would be wise to get a ferritin test.

And yes, we would love to know the results of your ultrasound.


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## bjacobs71

Is the Triiodothyronine, Free, Serem the same as Free T3? That is listed on my latest labs & I remember they said they were checking my Free T3 so I assumed that was it. If so it is 6.6 pg/mL which is high, the range is 2.0-4.4. My ultrasound results were:
The right lobe measures 4.15 x 1.29 cm. There is a tiny hypoechoic nodule located within it, probably 2 to 3 mm in size. The left lobe measures 4.17 x 4.18 cm. No masses or cysts noted.
IMPRESSION:
Tiny cyst or nodule located within the right lobe. Otherwise, unremarkable ultrasound of both lobes of the thyroid gland.
This was done March 17, 2011.
Also on my 3/9/11 labs were these but I don't know if the mean anything.
Thy Peroxidase <6f Units-see footnotes Ref.- 0-34
09MAR11 1113 Units: IU/mL International 
Thyr Antiglb AB <20f Units-see footnotes Ref.- 0-40
09MAR11 1113 Units: IU/mL International 
I had my Vitiamn D checked 2/15/11 which was 39, range 32-100.
It seems I went from having low t4 & TSH with high t3 uptake then put on 50 mcg levothyroxine and all came into a somewhat normal range (but some still on low end). Then after first of year T4, TSH & free thyroxine index dropped why below range and free t3 went above range. Could the Cytomel have caused this or switching from the Mirena to ortho novum caused a hormonal change? I did not take any T4 or T3 meds today because I feel like something is making it worse.


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## Andros

bjacobs71 said:


> Is the Triiodothyronine, Free, Serem the same as Free T3? That is listed on my latest labs & I remember they said they were checking my Free T3 so I assumed that was it. If so it is 6.6 pg/mL which is high, the range is 2.0-4.4. My ultrasound results were:
> The right lobe measures 4.15 x 1.29 cm. There is a tiny hypoechoic nodule located within it, probably 2 to 3 mm in size. The left lobe measures 4.17 x 4.18 cm. No masses or cysts noted.
> IMPRESSION:
> Tiny cyst or nodule located within the right lobe. Otherwise, unremarkable ultrasound of both lobes of the thyroid gland.
> This was done March 17, 2011.
> Also on my 3/9/11 labs were these but I don't know if the mean anything.
> Thy Peroxidase <6f Units-see footnotes Ref.- 0-34
> 09MAR11 1113 Units: IU/mL International
> Thyr Antiglb AB <20f Units-see footnotes Ref.- 0-40
> 09MAR11 1113 Units: IU/mL International
> I had my Vitiamn D checked 2/15/11 which was 39, range 32-100.
> It seems I went from having low t4 & TSH with high t3 uptake then put on 50 mcg levothyroxine and all came into a somewhat normal range (but some still on low end). Then after first of year T4, TSH & free thyroxine index dropped why below range and free t3 went above range. Could the Cytomel have caused this or switching from the Mirena to ortho novum caused a hormonal change? I did not take any T4 or T3 meds today because I feel like something is making it worse.


Yes; Triiodothyronine is FREE T3 and it really should never be over the range.

Also, if you had a T3 uptake that came in high, that also indicates hyper.
T3 Resin Uptake (hyper if high)
http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm

And, it might pay to have an estrogen lab test as if you are estrogen dominant, that can impede the efficacy of your thyroxine replacement.

When taking any form of T3; it is natural and expected for the T4 and the FT4 to drop.

Hope you are feeling better and I know you know that several of us are very concerned on your behalf.


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