Guest guest Posted November 14, 2006 Report Share Posted November 14, 2006 Hollis - would you share what you make of these numbers. Hi, Dusty. I've interspersed my comments with yours below. my latest thyroid tests (10.10.06) taken 32 hours without any thyroid meds - T4 Direct, Free 0.96ng/dl Norm 0.61 to 1.76 T3 Free, Serum 2.9pg/ml 2.3 to 4.2 TSH 0.16uiu/ml .350 to 5.50 Doc says I'm "fine". Of course he did. . . Obviously, your Free T3 and Free T4 are very low, though technically "normal." Now, I adhered to the advice of not taking meds prior to blood test, but test was at 4 in afternoon, so I'm thinking this test is not more valid/indicative of my blood levels than if I had taken meds and shown a sudden spike. Can't win for losing!!! I think it probably doesn't make sense to not take meds on the day of our blood draw, because if it is late, as mine was - it's even more inaccurate than if you took the meds at the usual time and in the usual manner - giving a more accurate picture of daily blood levels of the drugs. Again, This test was 32 hours after my last dose of Cytomel and Synthroid. What do you think - next time should I just take my meds so I can get the picture with the meds in my system? I take 100 mcg Synthroid and 12 1/2 mcg Cytomel. The Cytomel has a short half life and probably is the culprit in letting these numbers drop down like this after the 32 hours. Since i take neither Cytomel nor Synthroid, i'm probably not the best position to give advice on your particular situation, but. . . . From everything i've read, i do think it makes good sense (and thyroid docs like mine require it) to hold off taking a first morning dose, so as to avoid the transient spike in blood levels when the hormone peak a few hours later. But that being said, i think this works best when the blood draw is done first thing in the morning -- say 8 or 8:30 after having taken a last dose perhaps the afternoon before, so there's at least a 16 hour lag time. I agree that having the blood drawn 32 hours later may give you a less helpful look at what's what. But i WOULD point out that, unlike the T3, the T4 has a much longer half life -- and, given that, your freeT4 is still quite low. And the very low free T3 says to me that there's not a whole lot of T4 to T3 conversion going on. . . . . If i figured this right, you took your last dose at 8 am the morning before the draw, right? What is your dosing schedule? When would you have normally taken your other doses the day before? If it's, say, 3x/day, i'd just skip the last dose and get your bloodwork done the following morning, rather than late afternoon. That way you'd avoid the two extremes (drawn during peaking/drawn during more of a "fast") I know you're not a morning person (low thyroid symptom! low thyroid symptom! lol), but that would be my advice, for what it's worth. I've been meaning to ask you, how are you faring V wise now that you have added your estrogen patch? Are you considering increasing the dosage in yo ur patch? Thanks for asking, Dusty. Well, so far i can't say i've had a miracle recovery - or anything even approximating it, unfortunately. But i'm still hopeful, since my last serum test still showed my estradiol to be way too low (63, i think). I'm actually just now in the process of switching over to compounded estradiol drops, made up by Pete Hausemann at Bellevue. Over time my skin has started to react to my Climara patches: i have redness and, sometimes, itchiness under and around the patch. And i can clearly see where my former patches have been, since the area stays red more than a week after its removal! Not good. The idea of those adhesive chemicals does not thrill me. (I wonder if your Vivelle Dot would be different. . . .) So, i'll see how the sublingual drops go. I'm going to have them put in emu oil, which for me has less of a burn than olive oil does to my ridiculously sensitive oral tissues. I like the idea of dose flexibility that i'll have with the drops and the avoidance of the adhesives. . . but the patch is sure nice for being able to forget about it and, if its working properly, the constant absorption rate. After i got my last blood work done, i started adding a second 0.0375 mg. patch. I'll be getting blood work done fairly soon and will see what that did for my levels. Pete told me that a 0.05 mg. patch (pretty much what i'm getting with my two 0.0375 ones) equals 1 mg./day oral. So i'll be getting a 30 ml (1 oz.) bottle with ..25 mg. per drop and taking four drops a day to start. I had always thought, much to my consternation, that i had no baseline hormone levels to compare my recent ones to. But a few days ago, while digging through storage boxes holding my (literally) pounds and pounds of old medical records, i came across some old test i had totally forgotten about having done. Turns out that my 34 year-old estradiol level on Day 4 was 99. This was so exciting a discovery for me! I wasn't exactly that healthy even at that age -- and had a lot of menstrual irregularities then -- but this jives with my sense of where i want my levels to be: somewhere around 100 or a little over. VV wise, things have not been great lately -- more irriation and soreness lately, even with my diligent application of topical E in emu oil twice a day. I need to think about adding in the T, which i haven't done yet. And i'm hoping that getting my systemic levels up will help matters. We'll see. . . . . Hollis P.S. When i saw my thyroid doctor two weeks ago, he felt that i would benefit from adding in some extra T3 (I'm at 4 grains/day and he thinks my sweet spot will be around 5 grains.) I'm a little relunctant, given my awful reaction to Cytomel a few years ago at a very low dose, but he argued that, now i'm in better shape thyroid level-wise, it won't be a problem. He's not pushing me about it, but does suggest it. I'm going to go up a little higher on my porcine thyroid before i try it. Things are going so smoothly, now i've gotten past that scary palp stage in September, and i hate to think of it starting up again. . . . Regards Dusty Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 14, 2006 Report Share Posted November 14, 2006 Hollis - would you share what you make of these numbers. Hi, Dusty. I've interspersed my comments with yours below. my latest thyroid tests (10.10.06) taken 32 hours without any thyroid meds - T4 Direct, Free 0.96ng/dl Norm 0.61 to 1.76 T3 Free, Serum 2.9pg/ml 2.3 to 4.2 TSH 0.16uiu/ml .350 to 5.50 Doc says I'm "fine". Of course he did. . . Obviously, your Free T3 and Free T4 are very low, though technically "normal." Now, I adhered to the advice of not taking meds prior to blood test, but test was at 4 in afternoon, so I'm thinking this test is not more valid/indicative of my blood levels than if I had taken meds and shown a sudden spike. Can't win for losing!!! I think it probably doesn't make sense to not take meds on the day of our blood draw, because if it is late, as mine was - it's even more inaccurate than if you took the meds at the usual time and in the usual manner - giving a more accurate picture of daily blood levels of the drugs. Again, This test was 32 hours after my last dose of Cytomel and Synthroid. What do you think - next time should I just take my meds so I can get the picture with the meds in my system? I take 100 mcg Synthroid and 12 1/2 mcg Cytomel. The Cytomel has a short half life and probably is the culprit in letting these numbers drop down like this after the 32 hours. Since i take neither Cytomel nor Synthroid, i'm probably not the best position to give advice on your particular situation, but. . . . From everything i've read, i do think it makes good sense (and thyroid docs like mine require it) to hold off taking a first morning dose, so as to avoid the transient spike in blood levels when the hormone peak a few hours later. But that being said, i think this works best when the blood draw is done first thing in the morning -- say 8 or 8:30 after having taken a last dose perhaps the afternoon before, so there's at least a 16 hour lag time. I agree that having the blood drawn 32 hours later may give you a less helpful look at what's what. But i WOULD point out that, unlike the T3, the T4 has a much longer half life -- and, given that, your freeT4 is still quite low. And the very low free T3 says to me that there's not a whole lot of T4 to T3 conversion going on. . . . . If i figured this right, you took your last dose at 8 am the morning before the draw, right? What is your dosing schedule? When would you have normally taken your other doses the day before? If it's, say, 3x/day, i'd just skip the last dose and get your bloodwork done the following morning, rather than late afternoon. That way you'd avoid the two extremes (drawn during peaking/drawn during more of a "fast") I know you're not a morning person (low thyroid symptom! low thyroid symptom! lol), but that would be my advice, for what it's worth. I've been meaning to ask you, how are you faring V wise now that you have added your estrogen patch? Are you considering increasing the dosage in yo ur patch? Thanks for asking, Dusty. Well, so far i can't say i've had a miracle recovery - or anything even approximating it, unfortunately. But i'm still hopeful, since my last serum test still showed my estradiol to be way too low (63, i think). I'm actually just now in the process of switching over to compounded estradiol drops, made up by Pete Hausemann at Bellevue. Over time my skin has started to react to my Climara patches: i have redness and, sometimes, itchiness under and around the patch. And i can clearly see where my former patches have been, since the area stays red more than a week after its removal! Not good. The idea of those adhesive chemicals does not thrill me. (I wonder if your Vivelle Dot would be different. . . .) So, i'll see how the sublingual drops go. I'm going to have them put in emu oil, which for me has less of a burn than olive oil does to my ridiculously sensitive oral tissues. I like the idea of dose flexibility that i'll have with the drops and the avoidance of the adhesives. . . but the patch is sure nice for being able to forget about it and, if its working properly, the constant absorption rate. After i got my last blood work done, i started adding a second 0.0375 mg. patch. I'll be getting blood work done fairly soon and will see what that did for my levels. Pete told me that a 0.05 mg. patch (pretty much what i'm getting with my two 0.0375 ones) equals 1 mg./day oral. So i'll be getting a 30 ml (1 oz.) bottle with ..25 mg. per drop and taking four drops a day to start. I had always thought, much to my consternation, that i had no baseline hormone levels to compare my recent ones to. But a few days ago, while digging through storage boxes holding my (literally) pounds and pounds of old medical records, i came across some old test i had totally forgotten about having done. Turns out that my 34 year-old estradiol level on Day 4 was 99. This was so exciting a discovery for me! I wasn't exactly that healthy even at that age -- and had a lot of menstrual irregularities then -- but this jives with my sense of where i want my levels to be: somewhere around 100 or a little over. VV wise, things have not been great lately -- more irriation and soreness lately, even with my diligent application of topical E in emu oil twice a day. I need to think about adding in the T, which i haven't done yet. And i'm hoping that getting my systemic levels up will help matters. We'll see. . . . . Hollis P.S. When i saw my thyroid doctor two weeks ago, he felt that i would benefit from adding in some extra T3 (I'm at 4 grains/day and he thinks my sweet spot will be around 5 grains.) I'm a little relunctant, given my awful reaction to Cytomel a few years ago at a very low dose, but he argued that, now i'm in better shape thyroid level-wise, it won't be a problem. He's not pushing me about it, but does suggest it. I'm going to go up a little higher on my porcine thyroid before i try it. Things are going so smoothly, now i've gotten past that scary palp stage in September, and i hate to think of it starting up again. . . . Regards Dusty Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 14, 2006 Report Share Posted November 14, 2006 Hollis - would you share what you make of these numbers. Hi, Dusty. I've interspersed my comments with yours below. my latest thyroid tests (10.10.06) taken 32 hours without any thyroid meds - T4 Direct, Free 0.96ng/dl Norm 0.61 to 1.76 T3 Free, Serum 2.9pg/ml 2.3 to 4.2 TSH 0.16uiu/ml .350 to 5.50 Doc says I'm "fine". Of course he did. . . Obviously, your Free T3 and Free T4 are very low, though technically "normal." Now, I adhered to the advice of not taking meds prior to blood test, but test was at 4 in afternoon, so I'm thinking this test is not more valid/indicative of my blood levels than if I had taken meds and shown a sudden spike. Can't win for losing!!! I think it probably doesn't make sense to not take meds on the day of our blood draw, because if it is late, as mine was - it's even more inaccurate than if you took the meds at the usual time and in the usual manner - giving a more accurate picture of daily blood levels of the drugs. Again, This test was 32 hours after my last dose of Cytomel and Synthroid. What do you think - next time should I just take my meds so I can get the picture with the meds in my system? I take 100 mcg Synthroid and 12 1/2 mcg Cytomel. The Cytomel has a short half life and probably is the culprit in letting these numbers drop down like this after the 32 hours. Since i take neither Cytomel nor Synthroid, i'm probably not the best position to give advice on your particular situation, but. . . . From everything i've read, i do think it makes good sense (and thyroid docs like mine require it) to hold off taking a first morning dose, so as to avoid the transient spike in blood levels when the hormone peak a few hours later. But that being said, i think this works best when the blood draw is done first thing in the morning -- say 8 or 8:30 after having taken a last dose perhaps the afternoon before, so there's at least a 16 hour lag time. I agree that having the blood drawn 32 hours later may give you a less helpful look at what's what. But i WOULD point out that, unlike the T3, the T4 has a much longer half life -- and, given that, your freeT4 is still quite low. And the very low free T3 says to me that there's not a whole lot of T4 to T3 conversion going on. . . . . If i figured this right, you took your last dose at 8 am the morning before the draw, right? What is your dosing schedule? When would you have normally taken your other doses the day before? If it's, say, 3x/day, i'd just skip the last dose and get your bloodwork done the following morning, rather than late afternoon. That way you'd avoid the two extremes (drawn during peaking/drawn during more of a "fast") I know you're not a morning person (low thyroid symptom! low thyroid symptom! lol), but that would be my advice, for what it's worth. I've been meaning to ask you, how are you faring V wise now that you have added your estrogen patch? Are you considering increasing the dosage in yo ur patch? Thanks for asking, Dusty. Well, so far i can't say i've had a miracle recovery - or anything even approximating it, unfortunately. But i'm still hopeful, since my last serum test still showed my estradiol to be way too low (63, i think). I'm actually just now in the process of switching over to compounded estradiol drops, made up by Pete Hausemann at Bellevue. Over time my skin has started to react to my Climara patches: i have redness and, sometimes, itchiness under and around the patch. And i can clearly see where my former patches have been, since the area stays red more than a week after its removal! Not good. The idea of those adhesive chemicals does not thrill me. (I wonder if your Vivelle Dot would be different. . . .) So, i'll see how the sublingual drops go. I'm going to have them put in emu oil, which for me has less of a burn than olive oil does to my ridiculously sensitive oral tissues. I like the idea of dose flexibility that i'll have with the drops and the avoidance of the adhesives. . . but the patch is sure nice for being able to forget about it and, if its working properly, the constant absorption rate. After i got my last blood work done, i started adding a second 0.0375 mg. patch. I'll be getting blood work done fairly soon and will see what that did for my levels. Pete told me that a 0.05 mg. patch (pretty much what i'm getting with my two 0.0375 ones) equals 1 mg./day oral. So i'll be getting a 30 ml (1 oz.) bottle with ..25 mg. per drop and taking four drops a day to start. I had always thought, much to my consternation, that i had no baseline hormone levels to compare my recent ones to. But a few days ago, while digging through storage boxes holding my (literally) pounds and pounds of old medical records, i came across some old test i had totally forgotten about having done. Turns out that my 34 year-old estradiol level on Day 4 was 99. This was so exciting a discovery for me! I wasn't exactly that healthy even at that age -- and had a lot of menstrual irregularities then -- but this jives with my sense of where i want my levels to be: somewhere around 100 or a little over. VV wise, things have not been great lately -- more irriation and soreness lately, even with my diligent application of topical E in emu oil twice a day. I need to think about adding in the T, which i haven't done yet. And i'm hoping that getting my systemic levels up will help matters. We'll see. . . . . Hollis P.S. When i saw my thyroid doctor two weeks ago, he felt that i would benefit from adding in some extra T3 (I'm at 4 grains/day and he thinks my sweet spot will be around 5 grains.) I'm a little relunctant, given my awful reaction to Cytomel a few years ago at a very low dose, but he argued that, now i'm in better shape thyroid level-wise, it won't be a problem. He's not pushing me about it, but does suggest it. I'm going to go up a little higher on my porcine thyroid before i try it. Things are going so smoothly, now i've gotten past that scary palp stage in September, and i hate to think of it starting up again. . . . Regards Dusty Quote Link to comment Share on other sites More sharing options...
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