[genuinruby]

#1064209

Just a thought…Lab Tech’s are just people and we humans are not exempt from making mistakes. One tiny decimal point in the wrong place can make an entirely different meaning in a TSH test. Your next Lab Test should confirm as to whether the high lab value was just a fluke or not. In the meantime, welcome to the boards!

Ruby in Reno ” title=”Very Happy” />

[karilcole]

#1018353

Hola all!

Just as I think I have learned something….I’m more confused then ever! LoL
My Dr (Family dr) checked my TSH on 8/4/10. It was 0.203 He changed my synthroid from 88mcg to 75mcg. BUTTTT, I have not got the new one b/c of insurance issues. I have skipped 3 to give me a little less. (thinking by the time it was rechecked, I would have been on the 75mcg for 7 weeks.) I know that is NOT the right thing to do, but I knew my insurance issue should be taken care of anytime.
So, my new Dr (family dr) has it checked 8/24/10 now it says its at 20.400! All (but the 1) of my results since ’03 have been between .02 & .33 (normal range is 0.465-4.68) SO can it really jump from 0.203 to 20.400 in 20 days w/ only 3 skipped doses??? Its the same lab & same test both times.

Basically I have had a low TSH everytime its been checked for the past 8 years. He has had a hard time getting it the right dose I guess. I finally changed Dr’s 2 weeks ago. I see him again monday. Now my list of questions is going to get bigger for him. I dont even know where to start when it comes to asking about this & my graves. This guy actually knows quite a bit about thyroid & graves. He would have to refer me to an endo…waiting for insh ( But in the meantime…

What tests would be important at this point of too high dose of meds for so many years? I have read concerns for bone & heart. I am just now learning about all of this & I was diagnosed hypER in ’98, has RAI in early ’99. I have ALOT to catch up on..LOL Help anyone???
THANKS!

I am SO lost! Can anyone tell me why

[Kimberly]

#1064210

Hi Kari – Hopefully, others who are on replacement hormone will respond with their experiences. However, a couple of comments…

I know that TSH can remain suppressed for quite some time in Graves’ patients. Mine has been fairly suppressed after 3 years of Anti-Thyroid Drug therapy…although you would certainly have me beat at 10 years! Perhaps your pituitary gland (which produces TSH) is finally waking up!

With RAI, the thyroid destruction can occur over a number of years, especially if you were not given an ablative dose (enough to destroy the entire gland) with your initial treatment. It’s possible that you have had *some* thyroid function over the years, which has since been reduced.

TSH is generally considered a “running average” of where our actual thyroid hormone levels have been over the last several weeks. I hope that you can get your insurance issue addressed so that you do NOT have to skip doses to get the right amount of replacement hormone…but I seriously doubt that 3 missed doses would be responsible for that large of a change.

TSH is usually used as the benchmark for dosing in patients who have stabilized on replacement hormone. However, with such a huge change in a short period of time, it might not hurt to get your Free T3 and Free T4 tested, just to see what is going on there.

Hope this helps!

[karilcole]

#1064211

Hi there again!

My free t4 was 1.9 (1.0-4.0)
t4 6.55 (5.53-1.0)
t uptake 28.90 (23.5-40.5)
TSH 20.40 (0.465-4.68)

These were taken 8/24 I’m sure he will just recheck it if he feels the need. My RAI was suppose to be enough to kill my thyroid. Dr checked it 1 time shotly after, then retired. Never checked again. If a person does not have a thyroid, what range in dose of synthroid should that person be on? My new Dr said something about maybe there was some thyroid still there & it is producing again. I found that VERY interesting!!
Thanks so much for responding to my post!

[bluewave]

#1064212

Hola a usted!

I can’t address your other questions, but I can tell you that recently my TSH was 21.010 and exactly 28 days later it was 0.060.
I was ds w/ GD earlier this year and the dr over-blocked w/ too much methimazole, causing the high TSH. He then took me off it completely, and in just 4 wks it dropped dramatically. I was then put on it at 5mg/day.

[Kimberly]

#1064213

karilcole wrote:I’m sure he will just recheck it if he feels the need. My RAI was suppose to be enough to kill my thyroid. Dr checked it 1 time shotly after, then retired. Never checked again. If a person does not have a thyroid, what range in dose of synthroid should that person be on? My new Dr said something about maybe there was some thyroid still there & it is producing again. I found that VERY interesting!!
Thanks so much for responding to my post!

Hi Kari – Dosing is very personal. The initial dosing decision is based on conditions such as age, weight, and whether the patient has any other medical conditions. Then dosing is traditionally adjusted periodically based on the patient’s labs. The right dose for one person might not necessarily be the right dose for you.

You might call your doc to see when he plans to recheck your labs, given that your TSH was out of range on the high end. Only your doctor (and a new set of labs) can tell you if this was just a weird fluke…or if you might need a dosage adjustment, but it wouldn’t hurt to follow up.

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