Latest Labs 12/3/09

[DebM]

Hi. Got my latest labs and see the dr on Dec. 23.


TSH .07 .40-4.50

T4, free 0.9 0.8-1.8

T3, free 402 230-420

Vit D 47 20-100

Waiting on saliva testing labs report for estrogen, test and prog and cortisol

I'm 54, post menopausal

I am currently on 1/2 grain of armour or the compounded. Also on elavil 25 mg, atenolol 25 mg. Progesterone cream, Bi-est cream and testosterone cream. Also adrenal support, dhea tablet, magnesium tablets, fish oil, vit. D
(I've been without the testosterone cream for over a week and maybe feel better)

I can just hear the primary doctor who did these labs for Body Logic - "you need to get to the endocronologist because you are hyper"......

I feel pretty good right now. Not really sure if I sleep the best. I will say that at times I notice my hands shaking just a bit if I'm trying to do something like pluck my eyebrows...no diaherra, in fact I'm probably constipated.

I did have that "episode" last week where I felt weird here at work. I felt like if I was standing that my legs would give out. Kind of like a panic attack but I did not have the fast pulse like I had in the past prior to getting put on the atenolol by a former endo who I threw to the curb for his "tsh" worshiping. It lasted about 10 minutes. I checked my bp when I went home about 2 hours later and it was not low, more like 138/78 - usually runs about 126/80

I would love to lose the 10-15# that i've gained when this all started about 3 years ago but i realize that that's not the most important thing at this point.

Should my T4 be higher? Would that make me feel better or more rested?

[Ilpirata]

Hi Hon please repost the lab results with the ranges thanks!

[DebM]

I have posted the ranges - Unfortunately for some reason when you type and put in spaces, it puts them close together so they are there. (should have put them in parentees) (I'll try to edit it)

Also, I now have the saliva testing results:

Estradiol 1.1 (estrogen replacement opt 1.3-3.3)

Progesterone 1807 (200-3000 topical)

Ratio: Pg/E2 1643 H (optimal: 100-500 when E2 1.3-3.3)

DHEAS 4.6 (2-23 (age dependent)

Cortisol morning 5.7 (3.7-9.5)

[DebM]

My results:

TSH .07 (.40-4.50)

T4, free 0.9 (0.8-1.8)

T3, free 402 (230-420)

Vit D 47 (20-100)

[Ilpirata]

I'm a pirate not a doctor but to me your Free T4 is way way low (should be closer to half way up the range at least) your Free T3 is better but I'd say you could do with a med bump up dose.

[nonstickpam107]

So..you took only 1/4 grain four to five hours before the thyroid tests, right? You don't need prog. you need estradiol. Waiting on you to say what/how much/when on the Armour.
'
Pam

[DebM]

Yes Pam, I took 1/4 grain at 6:00 a.m. and then had the blood drawn at 10:30 a.m. Took my second dose at 2:30 p.m. I also fasted. ... why, I had no clue but that's what he ordered.

[nonstickpam107]

I don't like the T4 that low and the T3 that high. You might be leaning towards a little hyper again Deb..I'd say to only take the first dose in am and skip the second for awhile. Do you feel a little hyper? Hmm. OR up the estradiol a little bit..and that will bind the conversion a tad..maybe make ya 'just right'.

Pam

[DebM]

Yes Pam I think I do feel alittle hyper. That day last week when I had that weird thing going on for about 10 minutes reminded me so much of that tachycardia episode(s) that I had other than I stayed calm and tried to breathe it out. Sometimes when I do something like close work on my face (picking at it you know) I would shake alittle. Legs felt tired but not weak going up the stairs.

I'll definately cut out the 2nd afternoon dose. I also noticed the free t4 and wasn't sure what he might do with it being so low.....

[nonstickpam107]

If it were me..I'd prolly want to try taking 25mcg. T4 ONLY for six weeks, followed by FT4, FT3 with RT3 testing. Perhaps you're going to be lucky coming out of your original hyper hypo and be ok on just converting T4 if you get it. Maybe you are converting way better already but don't have enough T4 to do it with. I'd want to know. I went for quite some time on just Levoxyl coming out of 'hyper mode' of Hashi toxi cosis (have to split it when typing that here) and it was a good year before I needed T3.

Pam

[DebM]

I'm printing this out to take along with me to Body Logic on Dec. 23.

I was wondering the same thing about dropping the armour and taking just T4 but I'd read on one of the places, Stop the Madness, not sure which one that it said that taking only T4 doesn't work but that's probably if you don't have as much T3 as I do?

Also the 6 weeks is because it takes weeks to get the T4 working?

[nonstickpam107]

Well, 'eventually' even you will cease to convert, most likely Maybe next week, maybe in five years...we don't know.

I think I would have said 'Taking T4 ONLY if you do not convert and have low T3 doesn't work."

Yes, the six weeks is to get the very BEST test result to guide your further treatment.

Pam

[DebM]

For the most part I've not had much problem with my free T3 levels, it's been my free T4 all along that's been on the low end. I do have to say I didn't take the p.m. 1/4 grain and am not going to go back to the afternoon dose until I see the dr. One thing I've noticed the lights here at my work - hard to explain but the lights would bug me, like an anxious feeling where I'd have to tell myself to "stop it"!! So I do think I was starting to have some "hyper" moments. Stupid me, you'd think I'd have figured that out! I guess since I also have the very low energy times I didn't think I could be both at the same time!!

[nonstickpam107]

Well, that quite high FT3 and very low FT4 could be draining on your adrenals too.

Pam

[DebM]

back to the frickin drawing board......

[DebM]

Ok, saw the dr on Wednesday, Dec. 23.

He is changing me from armour to a compounded T4 with teeney tiny % of T3. He doesn't think that I was converting T4 to T3 even with the small 1/4 to 1/2 grain of armour. He's just not sure of taking away all T3 (since in the past I was barely past 1/2 way without anything). We'll see how that goes.

We're stopping the compounded testosterone. Right now we're leaving the prog/biest as is because the prog does seem to help me sleep. I think I'll fight to add more biest after the next hormone testing.

He upped my vit D to 3000 a day. It's 47 and he says I've got a way to go to 100.

[nonstickpam107]

That sounds like a good plan Deb...I'm glad you are seeing a doctor who will help you figure things out too (but, then again, you're a smart cookie! ...um...a low carb cookie that is).

Give it about four to six weeks to see where it goes (unless you start having symptoms). What he's proposing is quite smart given your recent labs...but I think you are converting perhaps 'too well', meaning you're not only converting some of the T4 in Armour to T3, but you are also getting T3 with Armour...double wham.

Pam

[DebM]

at my appt we compared my free t4 since I started going to him:

1/30/09
free T4 1.0 (0.8-1.8) (and this was while on methizole by former endo who thought i was hyper due to low tsh)
free T3 367 (230-420)

3/26/09 free T4 5.2 (5.0-11.0) this was without the methizole for 4-5 weeks
free T3 2.8 (1.8-4.6)
started armour 1/4 grain 2 weeks, then 1/2 grain

5/26/09 free T4 1.2 (0.8-1.8)
free T3 389 (230-420)
This was at the appt that I felt the best....still only on 1/2 grain armour

9/1/09 free T4 1.1 (0.8-1.8)
free t3 352 (230-420) at this appt he wanted me to cut back on the armour to 1/4 because of my bad morning cortisol to see if it would resolve it somewhat. Only did 1/4 a few weeks and called him to see if I could up it back to 1/2 grain because of low energy

12/3/09 free T4 .9 (0.8-1.8)
free T3 402 (230-420)
so now we're going to the compounded T4 with tiny amount of T3

of course I've been on progesterone, biest since 9/09 and we're tweaking that off and on.

But notice how my free T4 hasn't moved much and I felt the best 5/26 when the T4 was 1.2.....

This is the body logic dr. in Columbus....
Anxiously awaiting the new T4!!!

[nonstickpam107]

Um, you're still not telling me when you TOOK the Armour in relation to when you had that blood test on 12/3 ???? How much Armour did you take, what TIME did you take it, and what TIME did they draw that blood?

Paam

[Unicorn212]

Pam - She posted that on 12/8 above. She said: "Yes Pam, I took 1/4 grain at 6:00 a.m. and then had the blood drawn at 10:30 a.m. Took my second dose at 2:30 p.m. I also fasted. ... why, I had no clue but that's what he ordered." I do not understand one comment though - she says she is taking compounded T4 with a tiny amount of T3? Is that the 1/2 grain of Armour? A half grain does not seem like anything at all....

[nonstickpam107]

Thank you Unicorn....and I think you kind of need to know her 'background' medically (I know it) to understand about the 1/2 grain. She's actually a lot like I started out...and I needed a 'block and replace' medical/hormone strategy for well over 2 years before I could take 'unbuffered' Armour (I had to have it compounded with T4 being higher than T3 with beta blockers and other hormones infused...before I could tolerate it...and I'd swing wildly from hyPER to hyPO at any given moment). Sure wish Deb could come HERE and be under the care of my doctor (who is an endo, but he specializes in block and replace and BHRT/thyroid). I have Hashi toxi cosis (I can't put that word together here, the site sees it as 'naughty' lol) and she also has BOTH hypo and hyper with autoimmune tendencies. I've met about 100 patients in the USA so far over a 20 years period who have this.

Pam

[DebM]

For me the 1/4 or 1/2 grain seems to have been enough as I'm not that far off I guess. I just want to feel better and not have a doc say, "oh, your hyper we need to shut down your thyroid" like they have in the past. (my tsh has always been low - under range and they (old endos) flipped when they saw that....

I'm just saying that since my free T4 hasn't moved much but I felt better end of May that that tells me that if my T4 is just a bit higher I'd maybe feel better, thus, that's why my doc is doing compounded T4 with teeny tiny T3 (not quite like armour-more T4)

Thanks Pam and all!

[DebM]

very interesting to me.....

I switched from armour 50 mg to T4 25 mg and T3 5 mg eight days ago. I know that I'm not supposed to feel a whole lot better for 6? weeks but my bp is very interesting. Prior to the med change my bp was in the 130/80+ range. It had risen slowly the past year. I am and have been on atenolol 25 mg for about 3 years now because I do have a tendency and a family history of high bp (my pappy and all siblings are on meds) along with the hashimotos/hyper stuff.

School Nurse took my bp last Thursday (only one day after starting the T4/T3 combo) and it was 120/70 which is wonderful for me. She just took it about an hour ago and it was 116/78. It's been at least a year since it was that - if then and on meds for sure!! Today my pulse was 68 and regular - normal is 80 for me and regular.......

[nonstickpam107]

My BP (really high, much higher than yours even) came down when I finally got the 'correct' dosage of thyroid hormone too. For me, it was Armour (or any porcine thyroid) but for many (and you need to be 'fine tuned' IMHO) it is a combo so that you can get PRECISELY the right amount of hormone. I'm glad it's working for you!

Pam

[watcher513]

Wow. I never thought of bp being connected to thyroid. hmm.

[nonstickpam107]

Yeah, and then to have it go UP instead of down because I wasn't on ENOUGH hormone...how screwy is that? But it DOES do that too! Try telling a TSH worshipping doctor that one, ha ha. The looks on their faces!

Pam