[ProActivePatient]

#1059548

I found that after I had RAI my TSH remains low or suppressed, but my Free T3 and Free T4 are in range. My Endo (since fired) said I’m hyper still because of the low TSH and wanted to dose my synthroid based on the TSH result. What do you think? What has your experience been?

[gatorgirly]

#1175612

Exact same boat. Except my RAI was almost two years ago and I spent a few months hypO last year. I’m seriously exhausted by my never normal levels. My endo only ticks off the TSH and T4 boxes when he sends me a lab slip every six weeks. I always check off T3, too.

[Kimberly]

#1175613

@ProActivePatient – Be sure that your doc is familiar with the latest guidelines from the American Thyroid Association and American Association of Clinical Endocrinologists regarding testing post-RAI:

“Since TSH levels may remain suppressed for a month or longer after hyperthyroidism resolves, the levels should be interpreted cautiously and only in concert with free T4 and T3 estimates.”

If you are interested, you can find the guidance document in full in the “Treatment Options” thread in the announcements section of the forum.

[Carito71]

#1175614

gatorgirly wrote:

My endo only ticks off the TSH and T4 boxes when he sends me a lab slip every six weeks. I always check off T3, too.

I have been temped to do this also. Finally my Dr. ordered free T3s on his own for next labs. I’m glad he did b/c I was going to mention it. I didn’t mention it last time because I got him to run TSIs. Some times I feel like I’m playing a game of give and take

[Carito71]

#1175615

ProActivePatient wrote:

I found that after I had RAI my TSH remains low or suppressed, but my Free T3 and Free T4 are in range. My Endo (since fired) said I’m hyper still because of the low TSH and wanted to dose my synthroid based on the TSH result. What do you think? What has your experience been?

My Dr. always goes by what my Free T4 is doing. He tests TSH as well but he seems to concentrate on the Free T4s more. The TSH is the hormone produced by the pituitary and the Free T4/T3 is produced by the thyroid (these 2 are the ones that make us feel sick and that make our metabolism go crazy), so, just knowing that information makes sense as to why Free T4/T3 is more important to use for adjustment purposes.

I would have fired him too if all he cared about was the TSH.

Hope all gets resolved soon.

Caro

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