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#21 jenny v

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Posted 09 February 2018 - 07:16 PM

TSI and TRAb are different antibody tests, but sometimes insurance pushes back on TSI so if that happens, TRAb is an okay substitute.


Thyroid problems since 2002
Diagnosed with Graves Disease 2002 and Hashimoto's Disease April 2012
TT on October 10, 2013
Currently on 90mg Westhroid and 50mcg Cytomel


Information exchanged on these boards should not be construed as medical advice. We ARE NOT doctors. Please seek a qualified physician to answer your questions before acting on any information found here.

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#22 thybo

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Posted 12 February 2018 - 04:37 PM

TSI and TRAb are different antibody tests, but sometimes insurance pushes back on TSI so if that happens, TRAb is an okay substitute.

 

Okay. You mentioned earlier in the thread that usually a highish TSH is accompanied by low FT3/FT4. Is that the case even if you're already taking synthroid? 

 

EDIT: I am asking because those results would occur before starting synthroid. But those were my results after taking it for a while - high TSH and FT4, but both within range. Does that mean I might need a higher dose, to bring TSH closer to optimal range? But then FT4 might rise above the range. 



#23 Lovlkn

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Posted 13 February 2018 - 02:07 AM

 

Okay. You mentioned earlier in the thread that usually a highish TSH is accompanied by low FT3/FT4. Is that the case even if you're already taking synthroid? 

 

EDIT: I am asking because those results would occur before starting synthroid. But those were my results after taking it for a while - high TSH and FT4, but both within range. Does that mean I might need a higher dose, to bring TSH closer to optimal range? But then FT4 might rise above the range. 

 

When did you take your Synthroid in relation to your lab draw?  

 

Do you have lab's drawn around the same time ?

 

TSH is usually higher in the morning - it's wise to lab in the morning and before you take your thyroid hormone replacement


Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#24 thybo

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Posted 13 February 2018 - 02:46 AM

When did you take your Synthroid in relation to your lab draw?  

 

Do you have lab's drawn around the same time ?

 

TSH is usually higher in the morning - it's wise to lab in the morning and before you take your thyroid hormone replacement

 

I only had one blood test since I started taking Synthroid in April of 2015, and I took the pill maybe 2 hours before the lab. I'm going again Thursday, and won't be taking it before. But that means my TSH is even higher naturally. Something doesn't add up, I need the FT3 also and the antibodies done to find out what's going on.



#25 Lovlkn

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Posted 13 February 2018 - 01:47 PM

Due to the long 1/2 life - you may be surprised, it may only be a tiny bit higher.

 

It's always good to lab without taking hormone replacement though.

 

It's criminal that you have not had a lab since beginning hormone replacement in April of 2015.  You should lab 6 weeks after beginning and every 6 weeks until you reach acceptable levels.  If you change your dose be sure to lab in 6 weeks and make sure you do Free T-4 and Free T-3 along with TSH.


  • jenny v likes this
Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#26 thybo

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Posted 13 February 2018 - 05:16 PM

Due to the long 1/2 life - you may be surprised, it may only be a tiny bit higher.

 

It's always good to lab without taking hormone replacement though.

 

It's criminal that you have not had a lab since beginning hormone replacement in April of 2015.  You should lab 6 weeks after beginning and every 6 weeks until you reach acceptable levels.  If you change your dose be sure to lab in 6 weeks and make sure you do Free T-4 and Free T-3 along with TSH.

 

I meant I had one since starting, in 2017. That's when the TSH was 3.98 and the FT4 1.68. I figured it wasn't a big deal since I was only borderline hypo as my TSH was 9.8 in 2015 before starting Synthroid, and I am taking the lowest dose. 



#27 thybo

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Posted 19 February 2018 - 08:34 PM

Ok I took the test, unfortunately passed out again since it took longer than last time as my blood was coming out slow :P Results are:

 

TSH 4.8 (.45-4.5) - went up since last time, although I took the med before test last time, and this time I didn't

FT4 1.65 (.82-1.77)

TRAb .56 (0-1.75)

T3 uptake 32 (24-39)

TT3 107 (71-180)

TPOAb 90 (0-34) - Hashimoto's?

 

They forgot the FT3. The doctor said she will contact the lab. They can still check FT3 without having to do another draw, correct?



#28 jenny v

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Posted 20 February 2018 - 04:15 PM

As long as they drew enough blood, they should be able to do the FT3 test without having to draw again. How long was it between your last dose of meds and the test? You've got some funky results--a high TSH and a high-ish FT4, so it looks like your TRAb and TPOAb antibodies are to blame.


  • thybo likes this
Thyroid problems since 2002
Diagnosed with Graves Disease 2002 and Hashimoto's Disease April 2012
TT on October 10, 2013
Currently on 90mg Westhroid and 50mcg Cytomel


Information exchanged on these boards should not be construed as medical advice. We ARE NOT doctors. Please seek a qualified physician to answer your questions before acting on any information found here.

#29 thybo

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Posted 20 February 2018 - 05:02 PM

As long as they drew enough blood, they should be able to do the FT3 test without having to draw again. How long was it between your last dose of meds and the test? You've got some funky results--a high TSH and a high-ish FT4, so it looks like your TRAb and TPOAb antibodies are to blame.


I took it the day before at 9 am. The test was at 930 am. Do you think I should increase the dose to try to be in the 1-1.5 TSH range? Or try to find the cause of hashimotos and fix it? Most likely that's what I have since the TRAb is fine.

#30 joplin1975

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Posted 20 February 2018 - 06:58 PM

There is no known cause of hashi's nor is there any known fixes. 

 

I would wait for your free t3 test results before making any changes. 


  • thybo likes this
Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#31 thybo

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Posted 20 February 2018 - 07:32 PM

There is no known cause of hashi's nor is there any known fixes.

I would wait for your free t3 test results before making any changes.


I will wait for FT3. I was looking at this site for causes: https://hypothyroidm...key-to-healing/

#32 joplin1975

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Posted 20 February 2018 - 08:00 PM

I think if you feel there is merit to those kinds of articles, go for it! I'm completely supportive of people taking control of their health. 

 

There is so little concrete scientific evidence that any of those issues listed are "really" the cause of Hashi's that I chose to focus on keeping my labs in a good place. But that works for me and this thread isn't about me. :)


  • thybo likes this
Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#33 thybo

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Posted 20 February 2018 - 08:53 PM

I think if you feel there is merit to those kinds of articles, go for it! I'm completely supportive of people taking control of their health.

There is so little concrete scientific evidence that any of those issues listed are "really" the cause of Hashi's that I chose to focus on keeping my labs in a good place. But that works for me and this thread isn't about me. :)


There is nothing wrong with that, and I will try to get my labs in a good place too, but I want to find out more. It's confirmed an autoimmune disorder is causing my thyroid problem, and supplementing thyroid only solves that part, but the underlying disorder remains and can cause other problems. So I want to prevent them. There has been a sudden rise in autoimmune disorders lately, which I suspect is environment/food related and not genetic.

#34 jenny v

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Posted 21 February 2018 - 05:31 PM

Just a note, your TRAb isn't fine; fine would mean it's at zero. You've got a smidge going on but it's still a positive antibody test.


  • thybo likes this
Thyroid problems since 2002
Diagnosed with Graves Disease 2002 and Hashimoto's Disease April 2012
TT on October 10, 2013
Currently on 90mg Westhroid and 50mcg Cytomel


Information exchanged on these boards should not be construed as medical advice. We ARE NOT doctors. Please seek a qualified physician to answer your questions before acting on any information found here.

#35 thybo

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Posted 22 February 2018 - 06:03 AM

Just a note, your TRAb isn't fine; fine would mean it's at zero. You've got a smidge going on but it's still a positive antibody test.


So I have Hashimotos and slight Graves? By the way I didn't mention it but I work out pretty hard at the gym 4 days a week for the past 2 years now. I read it can mess with the thyroid.

#36 joplin1975

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Posted 22 February 2018 - 04:02 PM

I had Hashi's and antibodies related to Grave's. It's basically hashitoxicosis, although you are likely at the beginning of it. 


Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#37 thybo

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Posted 24 June 2019 - 08:28 PM

I did a blood spot test recently through ZRT labs. Results were:

 

FT4 1.1 (0.7-2.5 ng/dL)

FT3 3.6 (2.4-4.2 pg/mL)

TSH 2.5 (0.5-3.0 uU/mL)

TPOaB 108 (0.150 IU/mL, 70-150 borderline)

 

I've been taking 25 mcg Levothyroxine daily at the same time consistently, eliminated everything that can make hypothyroidism worse from my diet (besides coffee), and didn't take the pill before this test. These numbers are good now, correct?



#38 Lovlkn

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Posted 26 June 2019 - 11:16 AM

I did a blood spot test recently through ZRT labs. Results were:

 

FT4 1.1 (0.7-2.5 ng/dL)  ((1.6 - 2.05))

FT3 3.6 (2.4-4.2 pg/mL)  ((3.3 - 3.75))

TSH 2.5 (0.5-3.0 uU/mL)

TPOaB 108 (0.150 IU/mL, 70-150 borderline)

 

I've been taking 25 mcg Levothyroxine daily at the same time consistently, eliminated everything that can make hypothyroidism worse from my diet (besides coffee), and didn't take the pill before this test. These numbers are good now, correct?

Labs look a bit hypo to me on your FT-4 but have to say your FT-3 has recovered quite nicely.  I have edited in bold the 1/2-3/4 of your range next to your actual range.

 

How do you feel?


Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#39 thybo

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Posted 27 June 2019 - 04:48 AM

Labs look a bit hypo to me on your FT-4 but have to say your FT-3 has recovered quite nicely.  I have edited in bold the 1/2-3/4 of your range next to your actual range.

 

How do you feel?

 

This is actually the first time they did FT3 for me. My TSH improved though. Are those ranges the ideal ones? I feel ok but seem to sleep more than I should.



#40 Lovlkn

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Posted 27 June 2019 - 11:37 AM

Goal is to have both FT-4 and FT-3 to fall somewhere between 1/2-3/4 of the ranges. 

 

Alot of people report a TSH of 1 is optimal.  I for one do not run TSH due to stimulating antibodies.

 

If your FT-4 or FT-3 is too high - most people would report higher TSH.

 

If you get your FT-4 a tad higher your TSH will likely fall.


Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.




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