Re: Labs back - Finally!! TOPPER

January 15, 2006

Topper - I think you probably did not see my original posting

(below) so I am resending this. I would really appreciate your

input.

Sandy

>

> Okay, I need some help understanding these.

>

> I will start with a history of my TSH labs to give you a frame of

reference:

>

> December 5, 2005 TSH, high sensitivity 5.09H (range 0.45 - 4.50)

> October 14, 2005 TSH, high sensitivity 3.66 (range same and will

be unless

> noted otherwise)

> July 25, 2005 TSH, high sensitivity 4.38

> April 4, 2005 TSH, high sensitivity 3.47

> November 19, 2004, TSH high sensitivity 2.72

> December 2, 2003, TSH (this was my pre-op labs) 2.7

> January 3, 2006, TSH, high sensitivity 1.94 <---------- This

strikes me as

> very odd given my history and I can only assume a lab error. I

will say

> that it is the ONLY TSH lab listed that was non-fasting, but that

should not

> have affected the lab.

>

> The rest of the labs from January 3 are as follows:

>

> T4 Free Non-dialysis 1.0 (range 0.8 - 2.1)

> T3 Free Non-dialysis 2.1 (range 1.8 - 5.4)

> Microsomal TPO-Ab 17 (range <35) <------ This is what he ordered

to check

> for antibodies

> Selenium 150 (range 110-160)

> Copper 1198 (range 490-1840)

>

> My doctor just had his nurse mail this to me and there were no

> recommendations beyond what he had mentioned in his office the end

of

> December about trying me out on a low dose of thyroid meds to see

if we

> could get my thyroid going again. His thought was my large weight

loss via

> gastric bypass had confused my thyroid.

>

> Okay, my thought is that my thyroid is acting up; this TSH lab is

a fluke;

> and my history of fatigue, low energy, inability to hold down a job

> (resigned in 1995), fibromyalgia, Type II Diabetes, increase in

allergy

> symptoms over the past year are all indicators that my body is not

> functioning properly. Obviously my goal is to attempt to find a

doctor more

> familiar with thyroid and willing to think outside standard labs.

>

> I don't completely understand the labs yet, but if I remember from

other

> discussions on here correctly my Free T4 is way low and my Free T3

is on the

> low side. My doctor did not agree with my request to check the

Free T4 and

> the antibodies, but he did order them (although I am not sure the

Microsomal

> is the correct thing).

>

> So - HELP!!

>

> Thank you so very much for lending your experience to this attempt

on my

> part to understand this stuff.

>

> Sandy

> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

> slkscb@m... ~ Open RNY 12/8/03, 150 cm, Barix Clinics, 303/290 day

of

> surgery/195 current/ goal is to be HEALTHY. Emergency

appendectomy 11/1/04,

> Gallbladder 1/12/05. "Know your labs and track your trends." AZ

Grads join

> us at: http://health.groups.yahoo.com/group/AZGRADSOFWLS/

>

> Check out my gastric bypass journal at www.acdlady.com/WLS_1 for

many educational links. My OH profile is at

http://www.obesityhelp.com/morbidobesity/profile.phtml?

N=M1062876220 I am not affiliated with the medical profession

except as a proactive WLS post-op. "Trust your own instinct. Your

mistakes might as well be your own, instead of someone else's." –

Wilder

>

January 15, 2006

Topper - I think you probably did not see my original posting

(below) so I am resending this. I would really appreciate your

input.

Sandy

>

> Okay, I need some help understanding these.

>

> I will start with a history of my TSH labs to give you a frame of

reference:

>

> December 5, 2005 TSH, high sensitivity 5.09H (range 0.45 - 4.50)

> October 14, 2005 TSH, high sensitivity 3.66 (range same and will

be unless

> noted otherwise)

> July 25, 2005 TSH, high sensitivity 4.38

> April 4, 2005 TSH, high sensitivity 3.47

> November 19, 2004, TSH high sensitivity 2.72

> December 2, 2003, TSH (this was my pre-op labs) 2.7

> January 3, 2006, TSH, high sensitivity 1.94 <---------- This

strikes me as

> very odd given my history and I can only assume a lab error. I

will say

> that it is the ONLY TSH lab listed that was non-fasting, but that

should not

> have affected the lab.

>

> The rest of the labs from January 3 are as follows:

>

> T4 Free Non-dialysis 1.0 (range 0.8 - 2.1)

> T3 Free Non-dialysis 2.1 (range 1.8 - 5.4)

> Microsomal TPO-Ab 17 (range <35) <------ This is what he ordered

to check

> for antibodies

> Selenium 150 (range 110-160)

> Copper 1198 (range 490-1840)

>

> My doctor just had his nurse mail this to me and there were no

> recommendations beyond what he had mentioned in his office the end

of

> December about trying me out on a low dose of thyroid meds to see

if we

> could get my thyroid going again. His thought was my large weight

loss via

> gastric bypass had confused my thyroid.

>

> Okay, my thought is that my thyroid is acting up; this TSH lab is

a fluke;

> and my history of fatigue, low energy, inability to hold down a job

> (resigned in 1995), fibromyalgia, Type II Diabetes, increase in

allergy

> symptoms over the past year are all indicators that my body is not

> functioning properly. Obviously my goal is to attempt to find a

doctor more

> familiar with thyroid and willing to think outside standard labs.

>

> I don't completely understand the labs yet, but if I remember from

other

> discussions on here correctly my Free T4 is way low and my Free T3

is on the

> low side. My doctor did not agree with my request to check the

Free T4 and

> the antibodies, but he did order them (although I am not sure the

Microsomal

> is the correct thing).

>

> So - HELP!!

>

> Thank you so very much for lending your experience to this attempt

on my

> part to understand this stuff.

>

> Sandy

> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

> slkscb@m... ~ Open RNY 12/8/03, 150 cm, Barix Clinics, 303/290 day

of

> surgery/195 current/ goal is to be HEALTHY. Emergency

appendectomy 11/1/04,

> Gallbladder 1/12/05. "Know your labs and track your trends." AZ

Grads join

> us at: http://health.groups.yahoo.com/group/AZGRADSOFWLS/

>

> Check out my gastric bypass journal at www.acdlady.com/WLS_1 for

many educational links. My OH profile is at

http://www.obesityhelp.com/morbidobesity/profile.phtml?

N=M1062876220 I am not affiliated with the medical profession

except as a proactive WLS post-op. "Trust your own instinct. Your

mistakes might as well be your own, instead of someone else's." –

Wilder

>

January 15, 2006

Hi Sandy....

These are your numbers 'condensed'

Date TSH FT4 FT3

01/03/06 1.94 1.0 (.8 - 2.1) 2.1 (1.8 - 5.4)

12/05/05 5.09 (range 0.45 - 4.50)

10/14/05 3.66

07/25/05 4.38

04/04/05 3.47

11/19/04 2.72

12/02/03 2.7 (this was my pre-op labs)

What we can see from the numbers is that you started out with a TSH that was higher than what a 'normal healthy' thyroid type person would have. After your bariatric surgery the TSH continued to increase. Not good. Is this because of a thyroid problem or from nutritional issues? Not sure yet. He's only tested the antibodies once, and they weren't abnormal at the time of testing. The lab ranges for TSH during this entire time of testing has been .3 to 3.0 you've been out of range since last April... and before that your levels were high enough to have warranted further testing to find out why....

You're comments about your Frees are right on... both Frees are too low. What we've learned by watching folks labs and symptoms, and the research, is that 'most folks' feel best with a Free T4 at mid range, or slightly higher, and a Free T3 at the top end of it's range

Date TSH FT4 FT3

01/03/06 1.94 1.0 (.8 - 2.1) 2.1 (1.8 - 5.4)

Mid range for your FT4 would be 1.45 [((2.1-.8)/2)+.8].... you're quite a bit below that, suggesting that your dose is too low to give you sufficient levels of storage hormone. The body needs the FT4 in storage, to be able to convert it to the Free T3 that it used for it's daily processes and activity. (I know... review for many, but new info to those new to all of this)

For the FT3.. obviously that is well below the top end of it's range... partly due to your body not having enough FT4 available for conversion... possibly in part cuz your body isn't converting right.... the first step in my humble brain's thought process is to increase your dose to get the Free T4 up to a level that will give you enough hormone to convert.

Once on hormone replacement.. that TSH should be 1.0 or less... *sigh* why can us 'medically uneducated masses' learn this stuff and the educated and intelligent and 'paid to know this stuff' docs not learn it?

Now... guess how I spent part of my morning? I watched a program on the Health channel for docs that are working on increasing their knowledge base on bariatric surgery... I know I have an attitude about it... but it sure sounded like a commercial... but I did learn more about the different types of surgeries.. that was interesting... they showed charts and diagrams that made it a little clearer to understand the different types of surgery. But what irritated me is that they still aren't answering a very serious question, for me, that you've already been facing, Sandy.... nutrition... Drastic reduction of intake as well as changes in nutrient absorption... how the heck do you survive after the weight is gone and you no longer have body fat stores to keep you alive? It just whooshes over the top of my head big time.....

Topper ()Yahoo IM: toppertwoSkype: topperlinda

On Sun, 15 Jan 2006 08:19:23 -0700 " and Steve" writes:

Topper - I think you probably did not see my original posting

(below) so I am resending this. I would really appreciate your

input.

Sandy

>

> Okay, I need some help understanding these.

>

> I will start with a history of my TSH labs to give you a frame of

reference:

>

> December 5, 2005 TSH, high sensitivity 5.09H (range 0.45 - 4.50)

> October 14, 2005 TSH, high sensitivity 3.66 (range same and will

be unless

> noted otherwise)

> July 25, 2005 TSH, high sensitivity 4.38

> April 4, 2005 TSH, high sensitivity 3.47

> November 19, 2004, TSH high sensitivity 2.72

> December 2, 2003, TSH (this was my pre-op labs) 2.7

> January 3, 2006, TSH, high sensitivity 1.94 <---------- This

strikes me as

> very odd given my history and I can only assume a lab error. I

will say

> that it is the ONLY TSH lab listed that was non-fasting, but that

should not

> have affected the lab.

>

> The rest of the labs from January 3 are as follows:

>

> T4 Free Non-dialysis 1.0 (range 0.8 - 2.1)

> T3 Free Non-dialysis 2.1 (range 1.8 - 5.4)

> Microsomal TPO-Ab 17 (range <35) <------ This is what he ordered

to check

> for antibodies

> Selenium 150 (range 110-160)

> Copper 1198 (range 490-1840)

>

> My doctor just had his nurse mail this to me and there were no

> recommendations beyond what he had mentioned in his office the end

of

> December about trying me out on a low dose of thyroid meds to see

if we

> could get my thyroid going again. His thought was my large weight

loss via

> gastric bypass had confused my thyroid.

>

> Okay, my thought is that my thyroid is acting up; this TSH lab is

a fluke;

> and my history of fatigue, low energy, inability to hold down a job

> (resigned in 1995), fibromyalgia, Type II Diabetes, increase in

allergy

> symptoms over the past year are all indicators that my body is not

> functioning properly. Obviously my goal is to attempt to find a

doctor more

> familiar with thyroid and willing to think outside standard labs.

>

> I don't completely understand the labs yet, but if I remember from

other

> discussions on here correctly my Free T4 is way low and my Free T3

is on the

> low side. My doctor did not agree with my request to check the

Free T4 and

> the antibodies, but he did order them (although I am not sure the

Microsomal

> is the correct thing).

>

> So - HELP!!

>

> Thank you so very much for lending your experience to this attempt

on my

> part to understand this stuff.

>

> Sandy

> slkscb@m... ~ Open RNY 12/8/03, 150 cm, Barix Clinics, 303/290 day

of

> surgery/195 current/ goal is to be HEALTHY. Emergency

appendectomy 11/1/04,

> Gallbladder 1/12/05. "Know your labs and track your trends."

January 15, 2006

Hi Sandy....

These are your numbers 'condensed'

Date TSH FT4 FT3

01/03/06 1.94 1.0 (.8 - 2.1) 2.1 (1.8 - 5.4)

12/05/05 5.09 (range 0.45 - 4.50)

10/14/05 3.66

07/25/05 4.38

04/04/05 3.47

11/19/04 2.72

12/02/03 2.7 (this was my pre-op labs)

What we can see from the numbers is that you started out with a TSH that was higher than what a 'normal healthy' thyroid type person would have. After your bariatric surgery the TSH continued to increase. Not good. Is this because of a thyroid problem or from nutritional issues? Not sure yet. He's only tested the antibodies once, and they weren't abnormal at the time of testing. The lab ranges for TSH during this entire time of testing has been .3 to 3.0 you've been out of range since last April... and before that your levels were high enough to have warranted further testing to find out why....

You're comments about your Frees are right on... both Frees are too low. What we've learned by watching folks labs and symptoms, and the research, is that 'most folks' feel best with a Free T4 at mid range, or slightly higher, and a Free T3 at the top end of it's range

Date TSH FT4 FT3

01/03/06 1.94 1.0 (.8 - 2.1) 2.1 (1.8 - 5.4)

Mid range for your FT4 would be 1.45 [((2.1-.8)/2)+.8].... you're quite a bit below that, suggesting that your dose is too low to give you sufficient levels of storage hormone. The body needs the FT4 in storage, to be able to convert it to the Free T3 that it used for it's daily processes and activity. (I know... review for many, but new info to those new to all of this)

For the FT3.. obviously that is well below the top end of it's range... partly due to your body not having enough FT4 available for conversion... possibly in part cuz your body isn't converting right.... the first step in my humble brain's thought process is to increase your dose to get the Free T4 up to a level that will give you enough hormone to convert.

Once on hormone replacement.. that TSH should be 1.0 or less... *sigh* why can us 'medically uneducated masses' learn this stuff and the educated and intelligent and 'paid to know this stuff' docs not learn it?

Now... guess how I spent part of my morning? I watched a program on the Health channel for docs that are working on increasing their knowledge base on bariatric surgery... I know I have an attitude about it... but it sure sounded like a commercial... but I did learn more about the different types of surgeries.. that was interesting... they showed charts and diagrams that made it a little clearer to understand the different types of surgery. But what irritated me is that they still aren't answering a very serious question, for me, that you've already been facing, Sandy.... nutrition... Drastic reduction of intake as well as changes in nutrient absorption... how the heck do you survive after the weight is gone and you no longer have body fat stores to keep you alive? It just whooshes over the top of my head big time.....

Topper ()Yahoo IM: toppertwoSkype: topperlinda

On Sun, 15 Jan 2006 08:19:23 -0700 " and Steve" writes:

Topper - I think you probably did not see my original posting

(below) so I am resending this. I would really appreciate your

input.

Sandy

>

> Okay, I need some help understanding these.

>

> I will start with a history of my TSH labs to give you a frame of

reference:

>

> December 5, 2005 TSH, high sensitivity 5.09H (range 0.45 - 4.50)

> October 14, 2005 TSH, high sensitivity 3.66 (range same and will

be unless

> noted otherwise)

> July 25, 2005 TSH, high sensitivity 4.38

> April 4, 2005 TSH, high sensitivity 3.47

> November 19, 2004, TSH high sensitivity 2.72

> December 2, 2003, TSH (this was my pre-op labs) 2.7

> January 3, 2006, TSH, high sensitivity 1.94 <---------- This

strikes me as

> very odd given my history and I can only assume a lab error. I

will say

> that it is the ONLY TSH lab listed that was non-fasting, but that

should not

> have affected the lab.

>

> The rest of the labs from January 3 are as follows:

>

> T4 Free Non-dialysis 1.0 (range 0.8 - 2.1)

> T3 Free Non-dialysis 2.1 (range 1.8 - 5.4)

> Microsomal TPO-Ab 17 (range <35) <------ This is what he ordered

to check

> for antibodies

> Selenium 150 (range 110-160)

> Copper 1198 (range 490-1840)

>

> My doctor just had his nurse mail this to me and there were no

> recommendations beyond what he had mentioned in his office the end

of

> December about trying me out on a low dose of thyroid meds to see

if we

> could get my thyroid going again. His thought was my large weight

loss via

> gastric bypass had confused my thyroid.

>

> Okay, my thought is that my thyroid is acting up; this TSH lab is

a fluke;

> and my history of fatigue, low energy, inability to hold down a job

> (resigned in 1995), fibromyalgia, Type II Diabetes, increase in

allergy

> symptoms over the past year are all indicators that my body is not

> functioning properly. Obviously my goal is to attempt to find a

doctor more

> familiar with thyroid and willing to think outside standard labs.

>

> I don't completely understand the labs yet, but if I remember from

other

> discussions on here correctly my Free T4 is way low and my Free T3

is on the

> low side. My doctor did not agree with my request to check the

Free T4 and

> the antibodies, but he did order them (although I am not sure the

Microsomal

> is the correct thing).

>

> So - HELP!!

>

> Thank you so very much for lending your experience to this attempt

on my

> part to understand this stuff.

>

> Sandy

> slkscb@m... ~ Open RNY 12/8/03, 150 cm, Barix Clinics, 303/290 day

of

> surgery/195 current/ goal is to be HEALTHY. Emergency

appendectomy 11/1/04,

> Gallbladder 1/12/05. "Know your labs and track your trends."

January 15, 2006

Thank you Topper. I will be better prepared for the doctor when I

see one. Would you start with the natural or a synthetic with my

labs? I do plan on taking the saliva tests that is offered via

www.canaryclub.com as part of my analysis of what is happening with

my body now.

I have been on an aggressive vitamin/mineral supplementation program

from the very beginning as a post-op. I have also been very

proactive with getting in enough protein shakes to keep my lab

protein numbers up there. If you are interested I can actually

provide you with an excel spreadsheet of all my numbers beginning

with my pre-op numbers (which by the way have a Free T4 BELOW normal

at 0.64). I am so unimpressed with the medical community right

about now.

Believe it or not, but there are many who have gastric bypass and

who DO NOT take adequate supplements. This is partly because the

surgeons can't agree on what is needed. So as people get into

serious caca and tests discover new deficiencies some surgeons are

realizing that there are more issues involved than first thought. I

do not have a serious problem with memory as many post-ops do

because I have been aggressive with my Vitamin B supplements. This

surgery takes commitment and perseverence and is NOT the quick fix

to losing pounds that so many poor souls think it is. It most

certainly is not the easy way out. Many simply cannot afford the

amount of supplements required to keep their bodies healthy after

this surgery.

I was reading about some deficiencies that could contribute to

thyroid issues (magnesium, iron, and Vitamin A) and guess what? I

had all three as a pre-op or early post-op. All went undiagnosed

until I insisted on tests as a post-op and diagnosed myself based

upon labs. I have successfully raised all my levels.

I do wonder what would have happened with my surgery decision (last

chance desperation that I was willing to DIE for) had I been

properly diagnosed before going under the knife. Well, I can't cry

about spilled milk now and have to make the best health that I can

with what is left.

Thank you again for your help in understanding the tests.

Sandy

> >

> > Okay, I need some help understanding these.

> >

> > I will start with a history of my TSH labs to give you a frame of

> reference:

> >

> > December 5, 2005 TSH, high sensitivity 5.09H (range 0.45 -

4.50)

> > October 14, 2005 TSH, high sensitivity 3.66 (range same and will

> be unless

> > noted otherwise)

> > July 25, 2005 TSH, high sensitivity 4.38

> > April 4, 2005 TSH, high sensitivity 3.47

> > November 19, 2004, TSH high sensitivity 2.72

> > December 2, 2003, TSH (this was my pre-op labs) 2.7

> > January 3, 2006, TSH, high sensitivity 1.94 <---------- This

> strikes me as

> > very odd given my history and I can only assume a lab error. I

> will say

> > that it is the ONLY TSH lab listed that was non-fasting, but that

> should not

> > have affected the lab.

> >

> > The rest of the labs from January 3 are as follows:

> >

> > T4 Free Non-dialysis 1.0 (range 0.8 - 2.1)

> > T3 Free Non-dialysis 2.1 (range 1.8 - 5.4)

> > Microsomal TPO-Ab 17 (range <35) <------ This is what he ordered

> to check

> > for antibodies

> > Selenium 150 (range 110-160)

> > Copper 1198 (range 490-1840)

> >

> > My doctor just had his nurse mail this to me and there were no

> > recommendations beyond what he had mentioned in his office the

end

> of

> > December about trying me out on a low dose of thyroid meds to see

> if we

> > could get my thyroid going again. His thought was my large

weight

> loss via

> > gastric bypass had confused my thyroid.

> >

> > Okay, my thought is that my thyroid is acting up; this TSH lab is

> a fluke;

> > and my history of fatigue, low energy, inability to hold down a

job

> > (resigned in 1995), fibromyalgia, Type II Diabetes, increase in

> allergy

> > symptoms over the past year are all indicators that my body is

not

> > functioning properly. Obviously my goal is to attempt to find a

> doctor more

> > familiar with thyroid and willing to think outside standard labs.

> >

> > I don't completely understand the labs yet, but if I remember

from

> other

> > discussions on here correctly my Free T4 is way low and my Free

T3

> is on the

> > low side. My doctor did not agree with my request to check the

> Free T4 and

> > the antibodies, but he did order them (although I am not sure the

> Microsomal

> > is the correct thing).

> >

> > So - HELP!!

> >

> > Thank you so very much for lending your experience to this

attempt

> on my

> > part to understand this stuff.

> >

> > Sandy

> > slkscb@m... ~ Open RNY 12/8/03, 150 cm, Barix Clinics, 303/290

day

> of

> > surgery/195 current/ goal is to be HEALTHY. Emergency

> appendectomy 11/1/04,

> > Gallbladder 1/12/05. " Know your labs and track your trends. "

>

January 15, 2006