Hypothyroidism Support Group
Hypothyroidism is the disease state caused by insufficient production of thyrohormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. Advanced hypothyroidism may cause severe complications, the most serious one of which is...
So I had my first appointment with a new doctor (actually with an NP) on Monday and my lab results finally showed up yesterday after business hours, so I couldn't call the office with questions, and they won't be open until Monday. I'm kind of annoyed because they didn't give me reference ranges, but maybe some of you who have been doing this for a long time can still help me interpret.
For the record, I have been on 50mcg of levothyroxine for 7 weeks ad do NOT feel well. More symptoms now than before I started by far. Here's what I've got:
TSH: 4.450 uIU/mL
Free T4: 1.21 ng/dL
Free T3: 3.3 pg/mL
Reverse T3: 18 ng/dL
Ferritin: 68 ng/mL
They also tested Vitamin D as well as TPO and anti-thyroglobulin antibodies, but all three of those just say "Results received. Please contact provider for more information." Based on what they told me at my appointment I think that means those results were outside of range so they need to talk to me about it.
So from what I think I know TSH, while not a good indicator in general, is obviously still way high, so I need an increase of some kind. I think my FT3 and FT4 are both a bit on the low side, and the RT3 is high (I used the calculator on the stop the thyroid madness site and it gave me a ratio of 18--they say it should be over 20). Iron is a hair low maybe, but not too bad.
My doctor is happy to prescribe Armour or consider sticking with synthetic T4and/or adding T3, so luckily I should not have to fight too much to get the right treatment, but what do you think is needed? I assume because of the reverse T3 I will need some T3 added, but will I want to increase T4 as well?
I haven't had my adrenals tested yet, but the doctor did tell me I might want to do that at some point, but it isn't covered by insurance. I'm thinking I will go ahead and do it ASAP anyway to get a fuller picture of what's going on.
For the record, I have been on 50mcg of levothyroxine for 7 weeks ad do NOT feel well. More symptoms now than before I started by far. Here's what I've got:
TSH: 4.450 uIU/mL
Free T4: 1.21 ng/dL
Free T3: 3.3 pg/mL
Reverse T3: 18 ng/dL
Ferritin: 68 ng/mL
They also tested Vitamin D as well as TPO and anti-thyroglobulin antibodies, but all three of those just say "Results received. Please contact provider for more information." Based on what they told me at my appointment I think that means those results were outside of range so they need to talk to me about it.
So from what I think I know TSH, while not a good indicator in general, is obviously still way high, so I need an increase of some kind. I think my FT3 and FT4 are both a bit on the low side, and the RT3 is high (I used the calculator on the stop the thyroid madness site and it gave me a ratio of 18--they say it should be over 20). Iron is a hair low maybe, but not too bad.
My doctor is happy to prescribe Armour or consider sticking with synthetic T4and/or adding T3, so luckily I should not have to fight too much to get the right treatment, but what do you think is needed? I assume because of the reverse T3 I will need some T3 added, but will I want to increase T4 as well?
I haven't had my adrenals tested yet, but the doctor did tell me I might want to do that at some point, but it isn't covered by insurance. I'm thinking I will go ahead and do it ASAP anyway to get a fuller picture of what's going on.
Hard to give input with out the ranges...Have you been able to reach the NP's office? Or you could contact the lab perhaps. Input is difficult without knowing where you fall within the actual ranges. Also as far as the the Vitamin D and TPO, those may take a little longer for the results, but I'm not positive.
I can't really tell ya much about Free T4 or Free T3 without the lab ranges - they vary quite a bit from lab to lab and it affects the numbers quite a bit. When you get those ranges, I'll be glad to run the numbers for you.
I think you're spot on re: TSH, getting your adrenals tested, and anti-bodies results (I'm really interested in seeing the results of those).
As far as treatment goes (and you obviously had a thyroid issue - your TSH is high), that's really up to you (and your doctor). I can give you the ups and downs for both camps:
Armour: Some say armour is the best thing EVER! Lots of people say it calms them down and decreases anxiety. The adjustments are more difficult IMHO because the T4 and T3 are combined and in a higher ratio than found in humans. This means to balance a thyroid - most people have to supplement with Synthroid or something like it (Free T4) anyway. Others claim they've never felt better on Armour (and I can't disagree with that).
Synthroid/Cytomel: Synthroid is T4 only (you know this) and Cytomel is T3 only. It's easier to adjust, meaning if you're Free T4 is fine at testing, and only your T3 needs increasing, then it's much easier just to add some cytomel. And Vice-Versa.
Many will disagree with me, but it's my opinion that it's not so much *what* you take, as are you taking the right amount of T4/T3 for YOU. Ya know?
Keep us posted on your labs, and get those ranges :)