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Ntombi 03-23-2013 09:33 PM

Any insight from this?
 
1 Attachment(s)
My doctor ordered some labs last week, including some thyroid numbers. Now, I don't know if it makes a difference, but I had taken my daily 50mcg of levothyroxene before my blood was drawn.

Anyway, as much as I try, thyroid numbers still confuse me. Give me cholesterol, liver enzymes, or almost anything else, and I'm good, but thyroid still confuses me. If anyone has any thoughts about these results, I'd be grateful.

Lokarbiebarbie 03-23-2013 11:36 PM

Doctors who give T4 (only) get used to seeing FT4 'higher' in the range...so yours is plenty high (actually, I like mine slightly UNDER middle of it's range) but take a look at your FT3. Ideally, that should be above the middle range, yet it's only within bottom of the range. Most of us stop converting T4 into the 'energy, feel less achy, more alert' T3 hormone.

Also, levothyroxine (T4) takes about four to six WEEKS before it's 'working'...that's why we need it to convert (or we need to take T3 replacement...the synthetic is Cytomel) to it. You're not converting well, and most of us with hypo tend to feel much better if our TSH if around or UNDER a 1.

Leo41 03-24-2013 04:03 AM

Ntombi- I'm not a physician, and you have MS and other medical issues for any doctor to consider in evaluating your thyroid levels. Usually, when someone is taking hormones, the TSH will be closer to 1.0, but there are a variety of factors affecting your situation. I read on another section that you've had recent infection as well. That's why I think you'd be best to discuss this with your doctor.

inatic 03-24-2013 07:07 AM

can you ask/discuss with your dr if dr is open to lowering your t4 and adding T3? Most feel better with Tsh much lower and ft3 much higher.

If not, get another opinion of a dr that does use T3.

ravenrose 03-24-2013 07:20 AM

whatever you do, make sure your doc knows exactly how much before the blood draw you took your meds. Mine is generally good, but seems like a dolt about this point... he says you can't pay that much attention to free t3 and t4 when someone is taking the meds, since they jump all over they place during the day. I say, YES BUT, if I take the pills two hours, say, or three hours BEFORE the draw, won't that be a maximum number? how about taking one without the meds for a minimum and averaging them? something like that. he sorta gets it. but not really...

I suggest that if your doc tends to undermedicate you, you should not get the blood draw when your meds are at their highest point of the day.

Leo41 03-24-2013 07:30 AM

I really doubt that the levels 'jump all over the place' during the day because both of my endos (excellent doctors) said that I should just take my meds as usual before a blood draw.

Keep in mind that the OP is taking only T4. The T4 is a very slow-acting hormone that doesn't take full effect in the body for 6-8 WEEKS. Taken regularly as we do, it would not result in 'spikes' of any kind but would tend to be stable.

I take T3, which does work immediately in the body. Since I take it at exactly the same time each morning, and my blood draw is always at the same time every 4 months (about 5 hours from my T3), my doctor is getting a level that he can compare from one visit to the next. I doubt that any physician believes he/she is getting any exact amount. Lab values are always considered in relation to an individual's symptoms because we all have different levels at which we feel best.

This is why interpreting lab results should be left to physicians rather than people on an internet board who know only their personal experiences.

inatic 03-24-2013 07:37 AM

Quote:

Lab values are always considered in relation to an individual's symptoms because we all have different levels at which we feel best.
Disagree!
Leo apart from your dr and a few others.. (mine for the most part is ok too WITH ME but many patients arent getting the same 'care' i get.. Most STINK at interpreting labs values in relation to a patients symptoms.

I still say seek another opinion.. She has a 'high' Ft4 , higher than any good dr lets TSH be and very low ft3. and she doesnt feel well..

Ntombi 03-24-2013 11:18 AM

Obviously, I know that you're all giving opinions and such. That's what I asked for. And yes, with the MS and some other stuff, I know I'm not a textbook case. I just wanted to hear what y'all have to say, because my doctor is really happy with these numbers.

It's hard, because I still feel like I'm not properly medicated for the thyroid issues, but so many of the symptoms overlap with symptoms of other conditions I have, plus, I don't feel comfortable reading thyroid labs, so I'm just looking for thoughts as to whether I should look elsewhere for solutions, or keep pushing my doctor. I don't have the language or confidence to converse with her about the results, like I do on other issues. I feel a little stuck.

She's definitely better than my former doctor (who wouldn't even entertain the idea that I was hypothyroid), but she loves these numbers. I've been on this dose of levothyroxene for about six months, I don't feel any different, and none of my symptoms have even been alleviated.

Leo41 03-24-2013 02:21 PM

Ntombi- I didn't realize you were experiencing hypo symptoms. However, as you point out, they could be from other causes. A good thyroid doctor considers both labs and the patient's symptoms, so if I were in your situation, I'd initiate a conversation with my doctor about this. You say that she's happy with the lab numbers, but you should tell her that you are still experiencing symptoms and are concerned.

It's important to be very specific about the symptoms you're experiencing so that your doctor can judge whether or not they are due to your thyroid.

Let me offer a personal example. I have Hashimoto's and for several years, I've had to take both T4 and T3. When my T3 drops too low, I get incredible fatigue. Last year, I began experiencing such fatigue and called my endo, asking for a check of my T3. At the same time, he also ordered a B12 check because he thought that if the T3 was OK, I might be having some problem with B12. It turned out to be my T3. My point is that 'thyroid-like' symptoms can come from other things, so try to be very clear with your doctor about what you're experiencing.

inatic 03-24-2013 07:18 PM

Ntombi are you near any of these offices in Ca.
this is an awesome group.
our Locations | Holtorf Medical Group

watcher513 03-25-2013 03:08 AM

Or near Los Alamitos area?

Dr. Alex Kutas
3801 Katella Avenue #321
Los Alamitos, CA 90720
(562) 634-9803

Ntombi 03-25-2013 11:31 AM

:laugh: Two of my doctors are actually in that Los Al medical complex! It's about 15 minutes from me.

Now, if I can just convince my PCP to refer me.

inatic 03-25-2013 11:40 AM

not sure what the deal with them is with insurance..might not matter.. Call them. :)

Ntombi 03-27-2013 12:36 AM

I'm going to call tomorrow and see if they take my insurance. Thanks.

Leo41, I self-inject B12 weekly, and probably will for the foreseeable future. I've been doing that for about six months as well. Obviously, I eat meat and dairy, and even organ meats, so there's something up with my absorption. :(

Leo41 03-27-2013 04:43 AM

Ntombi-
I only used the B12 as an example of the fact that 'thyroid-like' symptoms can be from other sources, so when you speak with a doctor, it's important to explain exactly what your symptoms are so that he/she can explore all possible causes.

One of the reasons most of us had difficulty getting diagnosed initially is that thyroid symptoms are often vague and can be from a variety of causes. My PCP told me for years that my symptoms were just 'normal aging.' It turned out to be hypothyroidism from Hashi's.

GME 03-27-2013 08:38 AM

Quote:

Originally Posted by Ntombi (Post 16338520)
I'm going to call tomorrow and see if they take my insurance. Thanks.

Leo41, I self-inject B12 weekly, and probably will for the foreseeable future. I've been doing that for about six months as well. Obviously, I eat meat and dairy, and even organ meats, so there's something up with my absorption. :(

I go to the Bay Area Holtorf clinic and they don't take insurance at all. They will give you a bill to send in yourself, but my insurance doesn't come close to paying what they charge. I go to a regular lab for bloodwork and that gets paid through my insurance though.

I think a new patient visit is around $500 and ongoing visits are $295. I get reimbursed about $50. I can manage that and it is well worth it to me. I was barely getting out if bed and getting to work every day before I found them. Since seeing them I got a graduate degree, new job and a raise so I consider it an investment. :)

inatic 03-28-2013 01:31 PM

THat's awesome Gina!

Good luck Ntombi :)

Ntombi 03-29-2013 01:19 PM

I have an appointment with Dr. Kutas in a couple of weeks. Thanks, everyone.

watcher513 03-31-2013 02:01 AM

WooHoo!

Ntombi 04-12-2013 12:50 PM

I just left the appointment, and I'm trying not to cry. He confirmed so many things I've been saying for years. I finally might get a handle on this thyroid issue!

We're increasing the synthroid a bit for now, and then I'll be back I'm a few months. Part of the problem is that I'm often on steroids, which can skew thyroid results for the better (didn't know that!), and I was on them with these last tests. I'm back on them now too. Ugh. Anyway, he says I have a goiter, not yet sure about nodules, and is also wondering about Hashimoto's, which I have been too.

I'm so glad to have someone listening who seems to know how to approach things. It's going to be a long slough, and I understand that, but I feel like I'm at least moving in the right direction.

Thanks for the recommendation and support. I really appreciate it.

Lokarbiebarbie 04-12-2013 02:59 PM

I have been on daily oral and inhalant steroids for over 11 years. And if my T3 isn't in a good place for ME..I'm dead in the water so to speak.

I'm so very happy you had a good appointment though...and I'd been in a study a few years back that dealt with the effect of steroids (steroids that sustain life in my case) on thyroid and in my particular case I need more incoming T3.

GME 04-12-2013 05:54 PM

I'm glad it worked out for you. Is he a Holtorf doctor?

Ntombi 04-12-2013 06:00 PM

No.

Hmm, I see Dr. Holtorf prescribes bioidenticals; maybe I should have gone there instead. I might be fine with the right dose of synthroid, I hope so.

Ntombi 04-12-2013 07:57 PM

Rereading the thread, I see that the Holtorf clinics don't take any insurance at all. I'll have to keep that way far on the back burner; I'm barely able to swing all the copays I have to shell out, plus thousands in uncovered dental work, I can't afford to pay cash for a doctor. Obviously, if every other option fails, I'll have to figure something out, but for now, it's not an option.

Thanks again, I'm actually feeling hope today. :)

GME 04-12-2013 08:48 PM

It sounds like you found someone who will work with you anf that is what matters. I like my Holtorf doctor, but I'd love to find a good doc who would take my insurance.

watcher513 04-13-2013 12:08 AM

Ntombi, Dr. Kutas was a doctor that 2bflawless, a poster that used to live in CA found, and she's since moved out of state. He worked wonders for her so I think you've got a keeper there.

Ntombi 04-13-2013 12:10 AM

Thank you so much!


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