[linzyyyy]

#1060036

I know that no one can interpret lab results, but this is just interesting to me and I wanted to see if anyone has any insight.

I had RAI on Nov 30th, 2012. Here are my results starting at when I became hypo:

01/31/13
FT4 – .7 (0.82-1.77) HYPO

03/05/13
TSH – 17.9 (0.450-4.500) on 50mcg Synthroid for 4 weeks
FT4 – 0.86 (0.82-1.77)

04/11/13
TSH – .215 (.45-4.5) on 100mcg Synthroid for 5 weeks (had to call and get early labs, knew I was hyper)
FT4 – 1.4

06/06/13
TSH – .06 (.45-4.5) on 88mcg for 8 weeks
FT4 – 1.51

So now I have been lowered again to 75mcg Synthroid, just started today. I just think it’s weird that my TSH went even lower on 88mcg than when I was on 100mcg. Do you think it’s because my body had more time to absorb? Or maybe there’s some pesky thyroid left in there that’s giving me a hard time? RAI officially worked considering I went hypo with a TSH of 18 on 50mcg of Synthroid, right?

I’m not feeling too bad compared to my lowest TSH of .005 but I am over being hyper, even if it’s just a little.

Oh also, I haven’t talked to doc yet. I called to get early labs since I was still feeling hyper and my appt to see him is at the end of the month.
Lindsay

[karenz516]

#1179810

Hi Lindsay,

Just saw my endo today and thought we could compare labs, I am not to far behind, I had my RAI on 12/14/12:

2/19/13 Still Hyper – not taking anything

FT4 – 1.7 (Range 0.8-1.5)
TSH – <0.005 (Range 0.358-3.74)
FT3 – 5.4 (Range 1.8-4.6)

4/4/13 WAY HYPO put on 75 mg. Synthroid and two Synthroid just on Thursdays which equals 88 mg. of Synthroid per day.

FT4 – 0.3 (Range – 0.8-1.5)
TSH – 50.6 (Range – 0.358-3.74)
FT3 – 5.4 (Range 1.8-4.6)

6/11/13 Hypo increased Synthroid to 100 mg.

FT4 – 1.0 (Range 0.8-1.5)
TSH – 15.4 (Range 0.358-3.74)
FT3 – 2.2 (Range 1.8-4.6)

At least my TSH has come down, sheesh. Not happy about 15 lbs. weight gain, my endo (who I really like) said “”we talked about this, you don’t realize how sick and gaunt you were”. I had a-fib with a heart rate of 180 bpm and was hospitalized for two weeks. Anyway, I am much better than I was, but keeping an eye on my Cortisol level, I think its on the low side, Iron was good, so I am trying to be my own advocate as well and read everything I can. We are still working on adjusting my Synthroid also. So we are trying 100 mg for 6 weeks.

[Kimberly]

#1179811

Keep in mind that T3/T4 are “point in time” measurements that show where your levels are at that moment. The TSH number reflects a “running average” of where our actual thyroid hormone levels have been and can therefore lag behind changes in T3/T4. Antibody activity is also believed to affect TSH levels.

The key right now is to make sure your doc is aware of the importance of basing dosing decisions on Free T4 and T3, and not TSH. Once T3/T4 become both normal *and* stable, the TSH should eventually catch up.

Hope that you can find that “sweet spot” soon!

[karenz516]

#1179812

Hi Kimberly, what you said is confusing to me (not your fault) just that I am new to all of this and trying to find my way through this and, quite frankly, am confused by it all most of the time! My endo felt that my FT3 and FT4 were within range, I do not think he upped my Synthroid based on TSH (if I understood what you were trying to tell me) but rather on my symptoms of fatigue, weight gain, joint aches, heat intolerance, etc. I hope I am understanding him correctly. I am usually so on top of my game, but since the Graves diagnosis and RAI, I feel like a deer in headlights when he is talking. ugh

[msled]

#1179813

I am new to this forum but like most not new to Graves. I was diagnosed in 2002 and have had RIA twice and been on several different doses of synthroid in the past two years to try to stabilize things. my TSH is suppressed <.005 Free T4 14.8 and Free T3 4.7. I spoke to my endocrinologist about a reduction in dose as I am experiencing symptoms which are very confusing, Hypo and hyper...apparently there is a lag (which was not mentioned to me two years ago when this all started) so I am in a catch 22. Also to add insult to... I require estrogen for post menopausal symptoms. After reading all of the prescribing information and contacting the pharmaceutical companies I require additional synthroid as estrogen is the dominant hormone. Progersterone is not prescribed (which supports thyroid) if you have already had a hysterectomy. My question to everyone... will my TSH level come back up? I am going to start a reduction to .112 3 days a week and .1 4 days. I have been on .112 7 days a week and experienced the panic/anxiety et al problems. I have also had four surgerys on my eyes (including orbit decompression).... I do want to find my calm sweet spot. Before all this started I was high normal with TSH.78 FT4 16.5 FT3 3.8 and felt great!!! Wish I were there again. Apparently it takes 1-10 years to kill off all the thyroid cells I guess I have hit that spot!! Marg

[linzyyyy]

#1179814

I’m going to start asking to have FT3 tested when I get my labs done. My T4 has been “in range” for a long time but I’ve still not felt great. I actually felt pretty awesome when I was hypo. That lazy tired feeling and a pulse of 58 was like a dream come true compared to always feeling like a jittery, anxiety-ridden spaz. Maybe my FT4 sweet spot is in the low range? Oh well.

karenz – how are you feeling? while i appreciate skipping the super hypo state and only gaining about 5-7lbs, i would rather have a little extra weight and not be hyper. I. hate. feeling. hyper.

I always do my best to think positively, be easy on myself and tell myself that considering the circumstances, I actually have it pretty good! I tell myself that eventually I will feel better if I’m patient, but I’m so frustrated right now. I just feel like I’m *so* close and I want to be there. I’ve had a few random weeks of feeling awesome and I think to myself “this is it! I’ve made it!” and then I just return to feeling crappy again. It’s discouraging.

Anyway sorry for my negative rant. I know you guys don’t even need to hear that crap.

I’m thankful for this board.

[Kimberly]

#1179815

@Linzyyyy – No worries…that’s what we’re here for!

@Karen – I wasn’t commenting on yours or Linzyyyy’s labs…just making a general observation that TSH is not a reliable indicator for making dosing decisions early in the treatment process. If you have a doc that is looking at Free T4, T3 *and* asking you about symptoms, you’ve hit the jackpot.

[Kimberly]

#1179816

msled wrote:

My question to everyone… will my TSH level come back up?

Hello and welcome! Once you get to a point where your T3/T4 are both normal and stable and antibody activity has diminished, TSH will *usually* rebound…but it’s really difficult to predict what will happen in any given individual.

I’m hoping that Shirley will chime in here, as she has had a suppressed TSH for quite some time, many years after thyroidectomy for Graves’.

It’s great that you keep track of your labs and know where in the “normal” range that you personally feel your best. Hope that this latest dose adjustment gets you back to that “sweet spot”!

[Author]

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