[elisebeary]

#1018634

I’d be interested in any insight people may have on this..

My latest labs came back and my TSH is now 1.63, my free T4 is .72

I had been on 10mg methimazole for a while, and with these latest labs my endo says I’m now normal and can go to 5mg.

I’m wondering though, with the free T4 where it is, couldn’t this be hypo, not "normal"? Prior to this lab test, my results had put both my T4 and T3 in the normal range (though on the low side), but my TSH had been <.0015

I really want to avoid being hypo and am just wondering if the meds should be dropped even more (eg 2.5 or 0)?

thanks for any advice!

Elise

[Bobbi]

#1066137

The numbers all by themselves are meaningless. You need to have the lab’s established range of normal next to your numbers to see where your numbers "fit." To satisfy yourself, you need to get your lab report, where the published range is listed next to your numbers.

Second, the actual free T4 can fluctuate a lot more rapidly up and down than does the TSH, so it is not the most important reading. What your doctor is looking at is the overall picture of where your thyroid hormones are, so he/she is going to look at the TSH number which is like a moving average of the flow of your thyroid hormone levels. Also, unless things have changed recently, the test for TSH is a finer test, reading tinier amounts of it than the tests for actual thyroid hormone levels. The TSH is like using a ruler that measures to eighths of inches next to a ruler that measures to quarters of inches( the tests for actual thyroid).

Third, don’t believe anyone online who tries to interpret your lab results for you. You have a doctor who is much better qualified to do that.

I do hope you are feeling much better now that your hormone levels are getting stabilized. But don’t expect to feel "normal" right away — you won’t. Our bodies take a beating while hyperthyroid, and it takes time AT normal levels of hormone for the body to heal. In addition, depending upon how long you were hyper, you might have adjusted your thinking to assume that some level of hyper is "normal." That is particularly true if you were diagnosed before you felt really sick. Anyway, getting back to normal levels can feel a bit sluggish at first to some folks.

[Kimberly]

#1066138

Hi Elise – I’ve been on the methimazole see-saw for about 2 1/2 years now. When I was first diagnosed, my endo’s office only wanted to order TSH tests…I had to fight to get them to order Free T3 and Free T4 tests. Now, they routinely test my Free T3 and Free T4, as research is showing that TSH can remain supressed for an extended period of time in some Graves’ patients. For these patients (and I’m one of them), the "Frees" are better indicators for determining dosage adjustments.

No one on this board is qualified to make dosing recommendations, as we are not doctors…and we don’t know your entire medical history. However, I would encourage you to speak up and ask your doctor about dosing questions during your office visit. For example, "My Free T4 has decreased from X to Y in Z number of weeks. Are you sure this reduction in dose is enough to keep me out of hypO territory?" Then you can get a dialogue started with someone who *is* qualified to make dosing decisions.

If you still have concerns about your doctor’s dosing recommendations, I would encourage you to keep a close eye out for symptoms of hypO and tell the doc’s office that you want a new set of labs ASAP if these symptoms start to appear. (Symptoms of hypO can vary by individual, but common ones include fatigue, cold intolerance, slow pulse, constipation, dry skin, weight gain, and heavy menstrual periods). If you truly don’t feel well, don’t feel like you are stuck waiting until your scheduled appointment to get a new set of labs. The squeaky wheel gets the grease!

Best of luck!

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