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...
The Endo that i saw a week ago only tested TSH and if im not mistaken, the nurse told me the number was somewhere around 1.69.....my nurse practitioner check several months back and she checked TSH which was 3.851 and free t4 which was 1.59...ive tried to research these numbers but still dont quite understand where i stand since i have just been diagnosed with hashi's, but have been on 75mcg's of levothyroxine for several years...can anyone help???
TSH - especially once your taking synthroid - doesn't tell the whole story.
If you're on treatment, your TSH should be BELOW 1. Anything over that, and you're hypo and need a dosage increase.
But to be able to tell what dosage increase you need - you must have your FREE T4 and FREE T3 levels pulled.
Once you get those tests run, we can help you decide how to balance your thyroid levels.
Without them, your doc is shooting in the dark.
I used to fall in the trap of worrying about the FT3 and FT4 until I realized that it is the same as glucose for diabetics. It does fluctuate however, a diabetic needs the insulin adjusted often where the thyroid is not so.
"I used to fall in the trap of worrying about the FT3 and FT4 until I realized that it is the same as glucose for diabetics. It does fluctuate however, a diabetic needs the insulin adjusted often where the thyroid is not so"
Just as with diabetes and insulin and sugar, Free T3 and Free T4 are the thyroid hormones you feel because they are unbound. If they are not balanced, one will not feel well.
This information comes from thyroid text books. It's not just my opinion. Oh, and if someone is taking armour - the TSH level should be .02 or below. That's directly from the armour dosage and testing label and website.
The TSH test is incomplete and since they widened the "normal" range years ago, so many people have suffered needlessly. Many are diagnosed and treated for things they never had. And, many people have what's called "sub-clinical" hypothyroidism where the TSH level falls within the normal range while Free T3 and Free T4 are in the basement and cause a great deal of suffering. This is common in people with Hashimoto's.
As for Free T4 - *most* thyroid savvy doctors try to balance one level and then the next - meaning they try to optimize Free T4 then tackle Free T3. This is usually done with synthroid (to optimize Free T4).
You're right in that we need Free T3 balanced - this is where many docs drop the ball. This can be done using either cytomel to supplement synthroid or armour to supplement synthroid.
Some naturopaths or DO's (also doctors) will start with Armour - optimize Free T3 and then add Free T4 (synthroid) to get both levels balanced.
Symptoms can lie - Free T3/Free T4 labs don't lie. The TSH is an indicator of a brain hormone released to stimulate the thyroid gland (which you probably know) - but the "normal range" has been adjusted so many times that it's pretty much useless when treating thyroid disease and even more useless when trying to balance a thyroid.
In the US - "normal" used to be 1-2. In the 1980's they changed it to 1-5 (leaving many patients to suffer). In the UK they changed it to a normal range of 1-10. Meaning more than 2/3 of hypothyriod patients will remain undiagnosed. And, once diagnosed they WILL suffer if the TSH is kept around 10.
My goal is not to antagonize, but to educate.
This will give a clearer picture as to what's going on with your Free's and your thyroid condition in general. Meaning, you'll get the appropriate treatment.
Are you adjusting your FT3 and FT4 with your meds all day long then too? Lets hope not---that would be very dangerous to do.
As far as MY TSH being below 1 when I am on Armour---no way, been down that road and I was starting with all the symptoms of "hyperthyroid". For me I feel best if my TSH is around 2.
If you are telling me that EVERYONE should follow some "number" game and there are certain rules with FT3 and FT4 -- you are incorrect. That is exactly why there are ratios with the tests high and low numbers---everyone is different (this is a recording)..........these numbers are just starting points to work with.
And using Cytomel, Armour, and Synthroid mixing them up in some cocktail??? You are treading in dangerous waters to give anyone that info. Taking treatment slowly and watching how the body reacts and MOSTLY how a person feels. For heavens sake, isn't that what it is all about how we feel ??? Not about following some numbers game and no matter what stick to those even if you feel rotten.
A person has to use common sense and be logical ---- just like our DNA is all different so is the approach to medicine different for each person. I am very sensitive to most all meds, so was my dad and my sister is too. I need about half a dose of most meds to work well for me. I stay tuned very well to what my body is telling me or pay the consequences when over-dosed.
By the way.....don't believe all you read in textbooks. They are only as accurate as the author writing it. Chances are most authors have never been down the "Thyroid Road" anyway.
Definately we need to be aware of symptoms. For me, #1. #2 FT3 and FT4 lab results follow very close behind. The combination, evaluated properly is most likely the most logical approach to well being.
There is no need to attack MB and perhaps that was not your intention. We are all here to help one another with our personal experience and knowledge. We are here to support one another.
I am not one to blend in or follow the crowd, ask anyone on this forum about that !!!! But, the information provided here is in the spirit of recovery and renewed health and there will always be different approaches to that goal. Let's share that in the best spirit.
Take what info you can use and if you can't use it or don't want to then just leave it be. Each of us has our own personal story to tell but we all have to remember it is only 'our story'. Sometimes we just agree to disagree and that is ok too all a part of life.
I hope you have better days ahead GageL, I saw your smile face was "red" so you must be in pain. Take care and best wishes ....
taking it slow and easy before adding any other meds. You have a
good attitude.
Dee
EXACTLY. There's no need for personal attacks.
Everyone else:
This information is for the original poster and everyone reading this thread (it may help you understand a bit more where I'm coming from and what you can do to help yourself and your doctor to get better treatment for your thyroid issue):
I was merely pointing out some incorrect information for the original poster. A TSH over 1 for some people will merely cause them to feel "meh" - for others it can be deadly. I've seen some people have a TSH of over 100, and they felt poorly, but their symptoms weren't severe and they didn't die. Others, have a TSH of greater than 2 but less then 3 and still have Free T4 and Free T3 levels in the basement - and have some *serious* effects from it. Why? Because of auto-immune diseases and the affects that the antibodies have on the thyroid itself. That is why the TSH test is, in many cases, useless. Free's tell the story and do so much quicker than the TSH test.
In my own family, more than one member was permanently affected, and another died. Their TSH never got above 3 - but their Free T3 and Free T4 levels didn't register at all - resulting in myxedema coma that ended in death from heart failure.
For some, hypothyroidism is a nuisance. For others - it's deadly.
No. I don't test my Free T3 and Free T4 all day long (te-he). That would be expensive and time consuming (and something of a waste of time since thyroid medications generally take 4-6 weeks to get into ones blood stream). I do, however, have it tested every 4 - 6 weeks This is the regular interval that thyroid savvy physicians test someone with a thyroid disease - why? Because it's highly unusual for someone to stay at the same dosage for more than a few months and feel well (and actually have a balanced thyroid). Does it happen? I'm sure it does, but it's the exception, not the rule.
Then, Based on the Free T3 and Free T4 levels, and with the help of my doctor(s) we adjust the medication (armour and/or synthroid) to the upper 1/3 of the range for Free T4 and the upper 1/2 of the range for Free T3. This is important because most people feel well at those levels and individuals with auto immune issues of all kinds - seem to have fewer issues (many of which can be life threatening) when their Free T4 is in the upper end of the range. There's lots of research to back that up...as well as personal experiences.
It is true that "symptoms can lie - labs don't" in the case of thyroid disease of an auto-immune nature. Many symptoms that some people have seem like HYPER symptoms, when in fact they are HYPO symptoms and will never be alleviated until they are treated for HYPO labs.
In my particular case - I have a Free T3 issue - in that I have more than one auto immune disease and keeping my Free levels where they should be has a direct impact on my health and well-being. I need extra T3 because of certain medications I must take that interfere with Free T4 to Free T3 conversion (this of course does not apply to everyone, but more people that one might think - especially if Hashi's or Grave's is the culprit - both of which are auto-immune diseases).
Many labs use different ranges.
Anxious---you didn't cause any riff at all as far as I am concerned. I am pretty confident in all I have learned and the bad experiences I have had with synthetic T4 and personally I have to wonder if all the chemical meds are any good for people. Everyone has a right on here to speak their mind on their experience in hopes of helping others. That is what DS is for to help one another in this way. So please feel free to tell us what you learn. Lately I haven't found many drs that humor me, sure hope you do. =) Take care and best wishes.
The goal is to help YOU (the one asking for help). You're on the right track. You're finding out things for yourself and searching for a doctor to help you and do the right tests.
You can do this. I know how hard it is when you feel terrible, but you can do this.
Please keep us posted. We *want* to help when/where we can.
No riff here (at least not on my part). People take what they will from the boards, and most often when people are hypo and hurting they say things they don't mean or say things in a way they normally wouldn't. I've been there too. We all have our own learning curve and our own time in selecting what is right for us as individuals.
I'm here to help you -as are most of the people here - so ask away! And don't apologize. You did NOTHING wrong. :)
Hugs to you and I wish you wellness.