Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Symptoms should be the first consideration before the labs. For complete symptom resolution, many of us need the Free T4 at least mid-range and the Free T3 in the upper end of the range. I found over time that my Free T4 also decreased on the same dosage. Our bodies are not static and thus our needs do change. Also, many of us need a bump in colder weather. I feel much better with an increment in my levothroid. It would seem to me that you might benefit from increases in both your T3 and T4 and thus, an increase in ERFA might help. Natural progesterone might also help. Most of us need all of our hormones well balanced to feel well. You don't mention where your estrogen is, but that balances with progesterone. I found that I felt much better after the doctor put me on estradiol (natural) along with the progesterone. As far as dealing with doctors, I don't recommend begging I have found the best approach is clearing telling them your top 3 symptoms and also highlighting to them that your Frees have dropped even lower (and are below mid-range). While your TSH has decreased, once you are taking replacement hormone, it is a very poor indicator of whether you are receiving adequate replacement hormone. And, even values of Frees can change even on the same dosage, thus the most accurate indicator as to whether you are properly medicated is how you feel, which is back to my initial point. If the doc doesn't get that, then as Jan would say, you need a doctorectomy. B. I am pasting below a message that was lost either through my own fault or a Yahoo hiccup. Hello Everyone. I have new labs and was hoping you could take a look at them and let me know if you are thinking the same as I am...Recap: I'm 49, female, No " thyroid " (AB) antibodies per 10/2010 test Current labs:TSH ..... 1.13..... (Range 0.450 - 4.500)FREE T4..... 0.90 .....(Range 0.82-1.77)FREE T3.....2.8 .....(Range 2.0 - 4.4)My TSH is down from October 2010, which was 2.3 (Range 0.3-5.1) December 2010, which was 2.13 (Range .45-4.5)My FT4 is down fromOctober 2010, which was 1.21 (Range 0.73-1.95)December 2010, which was 0.95 (Range .82-1.77)My FT3 is about the same from October 2010 2.8 (Range 2.3-4.2) December 2010 2.9 (Range 2.0-4.4)I am taking 90 mg Armour thyroid, split twice a day.I DID NOT TAKE any hormone before any testing, per advice from thyroid forums...Dr. Elmore said labs look great, to stay on 90 mg of Armour. I asked nurse if she would consider raising to 2 grains, and answer was no. I requested a follow up for next Wednesday, 1/28. QUESTION. I realize we aren't getting a picture of FT3 because I didn't take 4-5 hours prior to blood draw. However, my Ft4s are dropping and my Ft3 seems awfully low. Do you think I could ask her for some Cytomel? or ERFA? or ??? I know she is happy the TSH is 1.13, and I'm happy for her, except I know it doesn't give a true picture of what is happening to me. I feel like all of my symptoms are actually the same or even worse than when I started. I am very much a newbie at this, and I don't want to doctor shop if possible. However, maybe I'm not a good Armour person after all? I was happy to get NDT, and thought maybe, just maybe, since I don't have the antibodies, even if Dr. Elmore was conservative, I oould manage with her. Any thoughts? Please feel free to be very blunt with me...If you think I'm whining and should be happy with these numbers, say so. If you think I'm needing to go through the data base and find someone else to help, say it plainly, because I am pretty brain foggy. If you think begging will help, I'll try that, too, in person...and since my progesterone is non-existant (October labs) maybe adding that in would help?I need your 2 cents, please!Thank you in advance. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2011 Report Share Posted January 19, 2011 Symptoms should be the first consideration before the labs. For complete symptom resolution, many of us need the Free T4 at least mid-range and the Free T3 in the upper end of the range. I found over time that my Free T4 also decreased on the same dosage. Our bodies are not static and thus our needs do change. Also, many of us need a bump in colder weather. I feel much better with an increment in my levothroid. It would seem to me that you might benefit from increases in both your T3 and T4 and thus, an increase in ERFA might help. Natural progesterone might also help. Most of us need all of our hormones well balanced to feel well. You don't mention where your estrogen is, but that balances with progesterone. I found that I felt much better after the doctor put me on estradiol (natural) along with the progesterone. As far as dealing with doctors, I don't recommend begging I have found the best approach is clearing telling them your top 3 symptoms and also highlighting to them that your Frees have dropped even lower (and are below mid-range). While your TSH has decreased, once you are taking replacement hormone, it is a very poor indicator of whether you are receiving adequate replacement hormone. And, even values of Frees can change even on the same dosage, thus the most accurate indicator as to whether you are properly medicated is how you feel, which is back to my initial point. If the doc doesn't get that, then as Jan would say, you need a doctorectomy. B. I am pasting below a message that was lost either through my own fault or a Yahoo hiccup. Hello Everyone. I have new labs and was hoping you could take a look at them and let me know if you are thinking the same as I am...Recap: I'm 49, female, No " thyroid " (AB) antibodies per 10/2010 test Current labs:TSH ..... 1.13..... (Range 0.450 - 4.500)FREE T4..... 0.90 .....(Range 0.82-1.77)FREE T3.....2.8 .....(Range 2.0 - 4.4)My TSH is down from October 2010, which was 2.3 (Range 0.3-5.1) December 2010, which was 2.13 (Range .45-4.5)My FT4 is down fromOctober 2010, which was 1.21 (Range 0.73-1.95)December 2010, which was 0.95 (Range .82-1.77)My FT3 is about the same from October 2010 2.8 (Range 2.3-4.2) December 2010 2.9 (Range 2.0-4.4)I am taking 90 mg Armour thyroid, split twice a day.I DID NOT TAKE any hormone before any testing, per advice from thyroid forums...Dr. Elmore said labs look great, to stay on 90 mg of Armour. I asked nurse if she would consider raising to 2 grains, and answer was no. I requested a follow up for next Wednesday, 1/28. QUESTION. I realize we aren't getting a picture of FT3 because I didn't take 4-5 hours prior to blood draw. However, my Ft4s are dropping and my Ft3 seems awfully low. Do you think I could ask her for some Cytomel? or ERFA? or ??? I know she is happy the TSH is 1.13, and I'm happy for her, except I know it doesn't give a true picture of what is happening to me. I feel like all of my symptoms are actually the same or even worse than when I started. I am very much a newbie at this, and I don't want to doctor shop if possible. However, maybe I'm not a good Armour person after all? I was happy to get NDT, and thought maybe, just maybe, since I don't have the antibodies, even if Dr. Elmore was conservative, I oould manage with her. Any thoughts? Please feel free to be very blunt with me...If you think I'm whining and should be happy with these numbers, say so. If you think I'm needing to go through the data base and find someone else to help, say it plainly, because I am pretty brain foggy. If you think begging will help, I'll try that, too, in person...and since my progesterone is non-existant (October labs) maybe adding that in would help?I need your 2 cents, please!Thank you in advance. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2011 Report Share Posted January 27, 2011 Wanted to report on my follow up with Dr. Elmore regarding my recent lab work. It went a lot better face to face with her than I anticipated. If you remember, my labs were way below optimal range, and a phone call from staff person said no adjustment to my Armour dose. However, in person, after listening to my symptoms, she thinks that I need to try Westhroid or Nature-throid, and upped me to 2 grains. She says if this doesn't work in two weeks, to call her and we will try something else. She is willing to compound for me, because she thinks there is something in the reformulated Armour that isn't working for me. She says symptoms are important to her, too. I was prepared for the worst, but was surprised she felt this way. (I think this is where talking to a staff person over the phone about labs and adjusting medication is doing the patient a disservice.) My heart was thumping, I was freezing cold, I was calm but she could tell I wasn't feeling well...if I hadn't written things down in advance to talk about the brain fog would have made the meeting less productive. Obviously, in this case, making a follow up appointment was the right thing to do. Also, she is finally addressing the progesterone issue...she admitted we should have done it sooner. I'm very relieved she is trying something...and when I mentioned ERFA, she is open to it, although she cannot help me specifically, she understands that some patients do that, and since I seem to be having problems with reformulated Armour, this could be an option. Her role is the write the prescription, it is up to me where to fill it. Anyway, I'll try the Nature-throid...I have not done any research on this at all, so if anyone has any advice or caution, I'm grateful. I realize I still have a long way to go, but at least I have another chance and we will see how it goes from here. Thanks to everyone who responded to me...it really meant a lot to me that you took the time to help. K Quote Link to comment Share on other sites More sharing options...
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