[Carito71 July 10, 2012 at 9:56 am Post count: 333]

#1059190

Hello,

I had labs done yesterday on the 1st day of my 4th week of treatment. It looks like the #s are starting to decrease. What do you think?

He only did FT4 ….
06/08 … 2.89 (normal is 0.8-1.70)
06/14 … 3.40 (normal is 0.82-1.77)
06/29 … 3.79 (normal is 0.82-1.77)
07/09 … 2.01 (normal is 0.8-1.70)
Would 2.89 to 2.01 be considered a change? The #s are still very close but the normal range is very small too. Should I expect the # to be in the normal range three weeks from now?

As you can tell by the normal ranges, the 1st one and the last one were done by the same place. The 2nd and 3rd by the same place.

One thing I don’t like is that my liver enzymes are still elevated but they are down from where they were before treatment. When I went to the ER my ALT was 109 and now it is 77 (normal is <32) so it makes me feel good that at least they have decreased. When I started treatment they were 76.

The Dr. didn’t do an FT3. Does yours do both FT4 and FT3? Should I ask for an FT3 also?

FT3 #s:
06/08 … 12.3 (2.6-4.4)
06/14 … 11.5 (2.0-4.4)
06/29 … 10.0 (2.0-4.4)
07/09 … not ordered

Thank you for reading me.

Caro

[KimberlyOnline Facilitator July 10, 2012 at 10:33 am Post count: 4294]

#1172831

Hello – We had a doctor comment at our 2011 conference that he had never seen two Graves’ cases that were exactly alike…even in identical twins!

So while it’s definitely a positive to see your levels moving closer to the “normal” range, no one (not even your doc!) can predict exactly where you will be or should be within a certain time frame.

As for the T3 testing, my own endo always test this along with Free T4. The latest medical guidance from the ATA and AACE requires Free T4 testing, but leaves T3 open as an option: “An assessment of serum free T4 should be obtained about 4 weeks
after initiation of therapy, and the dose of medication adjusted accordingly. Serum T3 also may be monitored, since the estimated serum free T4 levels may normalize with persistent elevation of serum T3.” Since T3 is the more powerful and active form of thyroid hormone, even if your T4 levels are normal, you can still be experiencing symptoms if T3 remains elevated.

Hope this helps!

[Carito71 July 10, 2012 at 11:26 am Post count: 333]

#1172832

Hello Kimberly,

You are right … we are all different 😎

Wouldn’t it be nice though if we could predict things a little bit … Wow, even with identical twins? That is why I tell my mother and my sister to get their thyroid checked b/c they might be affected by thyroid problems even if they are not as bad as mine.

Thank you for the information about the T3. So that I understand it correctly, it is T3 and not FT3 that they are talking about, correct? Did they say what is done when T3 remains elevated but FT4 is lowered?

Thank you!
Caro

[KimberlyOnline Facilitator July 10, 2012 at 2:25 pm Post count: 4294]

#1172833

Hello – the accuracy of the Free T3 (FT3) test versus Total T3 is a subject of some controversy — so there is quite a bit of variability in whether doctors order Free or Total T3. It just depends on the individual doctor’s office.

No, the guidance doesn’t get into specific dosing scenarios. This is a judgment call that you and your doctor would need to address if T3 remains elevated, while T4 is normal. However, it’s much more common for T3 and T4 to move in the same direction, so hopefully, this won’t be an issue for you.

Take care!

[Harpy July 10, 2012 at 11:05 pm Post count: 184]

#1172834

Not sure what the guidelines are elswhere, but our Endo always requested the three std tests:
FT4 – as the primary guide for dosage adjustment.
FT3 – to monitor as a secondary guide to dose adjustment, primarily if it was not trending in the same manner as FT4, which my partners didn’t until the latter part of treatment.
& TSH – to determine when the Pituitary gland had resumed TSH production, indicating that it was likely clear of TSH antibodies.

We would have liked more routine testing of the TSH receptor antibodies, but our Endo did not feel that it would have yielded any valuable information, but she did let us get them tested occassionally.

Good to see you are getting treatment and your numbers look like they are improving, sounds like you’re body is dealing relatively well with the Hyperthyroid symptoms and hope it all continues in a positive direction for you.

[Carito71 July 11, 2012 at 2:14 pm Post count: 333]

#1172835

Thank you Harpy. I’ve been reading your posts and I’m very glad that your partner is getting close to remission. I think I read that once the TSH starts to come back up it is a sign that you are approaching remission. Is that what you read as well? If not, how will they know she is approaching remission?

Thanks again!

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