Re: my labs

[Guest guest]

Regarding rose11141 post: My doctor(Fibromyalgia and Fatique Clinic), just started adding T3 to my resume. HA!. I am taking .125 of levoxyl which worked well the first 3 months but seemed to actually quit helping me at all. I am up to 50 mcg which I can really begin to tell a big difference again. She said as we go up on the T3, we will probably need to cut back the dosage of levoxyl.

my labs

I went to the walk-in clinic instead of calling for the results of my labs, and the doctor decided he wanted to see me.I asked the receptionist for a copy of my labs and she kinda looked at me funny and told me I would have to ask the doctor for that.(Strange isn't that??I mean they ARE mine)I was on 0.1 mg of eltroxin and he told me that was too much so he lowered it to 0.088 here they are: THYROTROPIN (SENSITIVE TSH) <0.05 REF RANGE 0.35-5.00 FREE THYROXINE (FREE T4) 28 REF RANGE 9-23My question is,if my T4 is too high and my TSH too low its obviously not converting,right?So instead of just lowering my script shouldn't he have given me something that included T3?That would be the reason I'm so tired all the time and I've gained 40LBS in a year??Also,I picked up some brazil nuts because they are an excellent source of selenium and will help with the conversion, and I plan to munch one a day.Also,don't I need to include iodine in my diet as well? I have an appointment with a new doctor on Monday morning so what are the most important things to ask??When I asked the clinic doc for a copy of my labs he looked at me strangely too and said "PARDON?"So...........I asked again in a louder voice. HEHE

[Guest guest]

To answer your question about conversion, there is no way to know whether

you're converting or not, since the Free T3 test was not run at all. This

is how you know you are converting. High amts of T4 can suppressed your

TSH. Some people's TSH is suppressed by smaller amts of T4. As a matter of

fact, the TSH can vary by as much as 4 points in one day, so TSH is rather

a moot point for so many of us, except for a healthy thyroid system, with no

problems at all. Hypo people are a different matter altogether. You won't

know til that FREE T3 test is run, and then you won't know whether your

cellular receptors for it are working, except by the way you FEEL, and that

is if all problems are thyroid related.

my labs

> I went to the walk-in clinic instead of calling for the results of

> my labs, and the doctor decided he wanted to see me.I asked the

> receptionist for a copy of my labs and she kinda looked at me funny

> and told me I would have to ask the doctor for that.(Strange isn't

> that??I mean they ARE mine)I was on 0.1 mg of eltroxin and he told

> me that was too much so he lowered it to 0.088 here

> they are: THYROTROPIN (SENSITIVE TSH) <0.05

> REF RANGE 0.35-5.00

>

> FREE THYROXINE (FREE T4) 28

> REF RANGE 9-23

>

> My question is,if my T4 is too high and my TSH too low its

> obviously not converting,right?So instead of just lowering my script

> shouldn't he have given me something that included T3?That would be

> the reason I'm so tired all the time and I've gained 40LBS in a

> year??Also,I picked up some brazil nuts because they are an

> excellent source of selenium and will help with the conversion, and

> I plan to munch one a day.Also,don't I need to include iodine in my

> diet as well?

> I have an appointment with a new doctor on Monday morning so what

> are the most important things to ask??When I asked the clinic doc

> for a copy of my labs he looked at me strangely too and

> said " PARDON? " So...........I asked again in a louder voice. HEHE

[Guest guest]

>

> I went to the walk-in clinic instead of calling for the results

of

> my labs, and the doctor decided he wanted to see me.I asked the

> receptionist for a copy of my labs and she kinda looked at me

funny

> and told me I would have to ask the doctor for that.(Strange isn't

> that??I mean they ARE mine)I was on 0.1 mg of eltroxin and he

told

> me that was too much so he lowered it to 0.088 here

> they are: THYROTROPIN (SENSITIVE TSH) <0.05

> REF RANGE 0.35-5.00

>

> FREE THYROXINE (FREE T4) 28

> REF RANGE 9-23

>

> My question is,if my T4 is too high and my TSH too low its

> obviously not converting,right?So instead of just lowering my

script

> shouldn't he have given me something that included T3?That would

be

> the reason I'm so tired all the time and I've gained 40LBS in a

> year??Also,I picked up some brazil nuts because they are an

> excellent source of selenium and will help with the conversion,

and

> I plan to munch one a day.Also,don't I need to include iodine in

my

> diet as well?

> I have an appointment with a new doctor on Monday morning so

what

> are the most important things to ask??When I asked the clinic doc

> for a copy of my labs he looked at me strangely too and

> said " PARDON? " So...........I asked again in a louder voice. HEHE

>

According to your labs you are hyper..for someone not on replacement

hormones..according to your symptoms you are hypo..so something is

obviously not right..with these labs though you would have a hard

time convincing a doc to give you more thyroid hormones with out a

reason..

You need to have a Free T3 test run.. and a TBG test done..It is a

good thing you got copies of your labs but did you ask the doctor

why if you were so hyper that you felt so hypo?

Kats3boys

[Guest guest]

> >

> > I went to the walk-in clinic instead of calling for the results

> of

> > my labs, and the doctor decided he wanted to see me.I asked the

> > receptionist for a copy of my labs and she kinda looked at me

> funny

> > and told me I would have to ask the doctor for that.(Strange

isn't

> > that??I mean they ARE mine)I was on 0.1 mg of eltroxin and he

> told

> > me that was too much so he lowered it to 0.088 here

> > they are: THYROTROPIN (SENSITIVE TSH) <0.05

> > REF RANGE 0.35-5.00

> >

> > FREE THYROXINE (FREE T4) 28

> > REF RANGE 9-23

> >

> > My question is,if my T4 is too high and my TSH too low its

> > obviously not converting,right?So instead of just lowering my

> script

> > shouldn't he have given me something that included T3?That would

> be

> > the reason I'm so tired all the time and I've gained 40LBS in a

> > year??Also,I picked up some brazil nuts because they are an

> > excellent source of selenium and will help with the conversion,

> and

> > I plan to munch one a day.Also,don't I need to include iodine in

> my

> > diet as well?

> > I have an appointment with a new doctor on Monday morning so

> what

> > are the most important things to ask??When I asked the clinic

doc

> > for a copy of my labs he looked at me strangely too and

> > said " PARDON? " So...........I asked again in a louder voice. HEHE

> >

> According to your labs you are hyper..for someone not on

replacement

> hormones..according to your symptoms you are hypo..so something is

> obviously not right..with these labs though you would have a hard

> time convincing a doc to give you more thyroid hormones with out a

> reason..

> You need to have a Free T3 test run.. and a TBG test done..It is a

> good thing you got copies of your labs but did you ask the doctor

> why if you were so hyper that you felt so hypo?

>

> Kats3boys

>

[Guest guest]

Hi Amber,

I am on .100 mcg levoxyl and just started two weeks ago on 10 mcg T3 cytomel — what dose did you start at and how often did you increase? I don’t get labs for 4 more weeks and was wondering if I should call in and ask for dose to be upped or wait the full month more ? I feel the t3 working a bit in that my hands are warm but that’s about it so far...

My last labs had my t4 high end range and my t3 just 10 about the 230 to 420 range so I know I need it, just don’t know how much and 10 mcg seems low...

Sue

Regarding rose11141 post: My doctor(Fibromyalgia and Fatique Clinic), just started adding T3 to my resume. HA!. I am taking .125 of levoxyl which worked well the first 3 months but seemed to actually quit helping me at all. I am up to 50 mcg which I can really begin to tell a big difference again. She said as we go up on the T3, we will probably need to cut back the dosage of levoxyl.

[Guest guest]

>could I be REALLY anemic??

> I went to the walk-in clinic instead of calling for the results

of

> my labs, and the doctor decided he wanted to see me.I asked the

> receptionist for a copy of my labs and she kinda looked at me

funny

> and told me I would have to ask the doctor for that.(Strange isn't

> that??I mean they ARE mine)I was on 0.1 mg of eltroxin and he

told

> me that was too much so he lowered it to 0.088 here

> they are: THYROTROPIN (SENSITIVE TSH) <0.05

> REF RANGE 0.35-5.00

>

> FREE THYROXINE (FREE T4) 28

> REF RANGE 9-23

>

> My question is,if my T4 is too high and my TSH too low its

> obviously not converting,right?So instead of just lowering my

script

> shouldn't he have given me something that included T3?That would

be

> the reason I'm so tired all the time and I've gained 40LBS in a

> year??Also,I picked up some brazil nuts because they are an

> excellent source of selenium and will help with the conversion,

and

> I plan to munch one a day.Also,don't I need to include iodine in

my

> diet as well?

> I have an appointment with a new doctor on Monday morning so

what

> are the most important things to ask??When I asked the clinic doc

> for a copy of my labs he looked at me strangely too and

> said " PARDON? " So...........I asked again in a louder voice. HEHE

>

[Guest guest]

rose11141 wrote: >could I be REALLY anemic??> I went to the walk-in clinic instead of calling for the results of > my labs, and the doctor decided he wanted to see me.I asked the > receptionist for a copy of my labs and she kinda looked at me funny > and told me I would have to ask the doctor for that.(Strange isn't > that??I mean they ARE mine)I was on 0.1 mg of eltroxin and he told > me that was too much so he lowered it to 0.088 here > they are: THYROTROPIN (SENSITIVE TSH) <0.05> REF

RANGE 0.35-5.00> > FREE THYROXINE (FREE T4) 28> REF RANGE 9-23> > My question is,if my T4 is too high and my TSH too low its > obviously not converting,right?So instead of just lowering my script > shouldn't he have given me something that included T3?That would be > the reason I'm so tired all the time and I've gained 40LBS in a > year??Also,I picked up some brazil nuts because they are an > excellent source of selenium and will help with the conversion, and > I plan to munch one a day.Also,don't I need to include iodine in my > diet as well?> I

have an appointment with a new doctor on Monday morning so what > are the most important things to ask??When I asked the clinic doc > for a copy of my labs he looked at me strangely too and > said "PARDON?"So...........I asked again in a louder voice. HEHE>_________________________________________A new doc, labs that include t3 and a protocol that includes t3 would probably be your best bet. I think you are on the right track! ~E:) ~EG Connecticut Total-T 2 years ago / 60 mg Synthetic/150mg Armour

Yahoo! Mail Use Photomail to share photos without annoying attachments.

[Guest guest]

> >could I be REALLY anemic??

>

> > I went to the walk-in clinic instead of calling for the results

> of

> > my labs, and the doctor decided he wanted to see me.I asked the

> > receptionist for a copy of my labs and she kinda looked at me

> funny

> > and told me I would have to ask the doctor for that.(Strange

isn't

> > that??I mean they ARE mine)I was on 0.1 mg of eltroxin and he

> told

> > me that was too much so he lowered it to 0.088 here

> > they are: THYROTROPIN (SENSITIVE TSH) <0.05

> > REF RANGE 0.35-5.00

> >

> > FREE THYROXINE (FREE T4) 28

> > REF RANGE 9-23

> >

> > My question is,if my T4 is too high and my TSH too low its

> > obviously not converting,right?So instead of just lowering my

> script

> > shouldn't he have given me something that included T3?That would

> be

> > the reason I'm so tired all the time and I've gained 40LBS in a

> > year??Also,I picked up some brazil nuts because they are an

> > excellent source of selenium and will help with the conversion,

> and

> > I plan to munch one a day.Also,don't I need to include iodine in

> my

> > diet as well?

> > I have an appointment with a new doctor on Monday morning so

> what

> > are the most important things to ask??When I asked the clinic

doc

> > for a copy of my labs he looked at me strangely too and

> > said " PARDON? " So...........I asked again in a louder voice. HEHE

> >

> _________________________________________

> A new doc, labs that include t3 and a protocol that includes t3

would probably be your best bet. I think you are on the right track!

> ~E:)

>

>

>

>

>

>

[Guest guest]

Here is some info from the Merck manual..

About 20% of the circulating T3 is produced by the thyroid. The

remaining 80% is produced by monodeiodination of the outer ring of

T4 (5´D-I), mainly in the liver. Monodeiodination of the inner ring

of T4 (5-deiodinase [5D-III]) also occurs in hepatic and

extrahepatic sites to yield 3,3´,5´-T3 (reverse T3 or rT3). This

iodothyronine has minimal metabolic activity but is present in

normal human serum and in insignificant amounts in thyroglobulin.

About 99% of the circulating rT3 is generated by inner ring

deiodination of T4 in peripheral tissues. rT3 levels increase in

many instances in which serum T3 levels fall because of decreased

activity of outer ring 5´D-I (eg, chronic liver and renal disease,

acute and chronic illness, starvation, and carbohydrate-deficient

diets). This increase in rT3 occurs primarily because of decreased

outer ring (5´D-I) activity, which markedly decreases the clearance

of rT3. These states of chronic illness, therefore, result in

decreased production of the active hormone, T3, and in increased

serum rT3 levels due to decreased rT3 clearance. The decreased

production of T3 might be an adaptive response to illness.

This is also from the Merck Manual and explains why your Free T4 may

not be a true free and the roll of TBG..

Indirect estimation of free T4: These measurements are readily

available, are simpler, and compare extremely well with the methods

for measuring direct free T4 mentioned above. Index methods require

two independent tests, one measuring total serum T4 and the other

measuring thyroid hormone-binding ratio or T3 resin uptake. The free

T4 index is then calculated using the total T4 and the TBG level,

the thyroid hormone-binding ratio, or T3 resin uptake. The index is

directly proportional to the free T4 level. Immunoassay methods are

standardized against a direct measurement of free T4 by equilibrium

dialysis, thus results are reported in absolute units (ng/dL or

pmol/L). The two most commonly used methods are a two-step and a one-

step immunoassay method using a T4 analog. These assays are not

completely free of the influence of binding proteins or substances

in serum that may result in false increases or decreases in the free

T4 levels.

Measurement of total serum T3 and free T3: Since T3 is tightly bound

to TBG (although 10 times less than T4) but not to transthyretin,

total serum T3 levels measured by the same methods described above

for total T4 will be influenced by alterations in the serum TBG

level and by drugs that affect binding to TBG. Free T3 levels in the

serum are measured by the same direct and indirect methods described

above for T4.

Diagnosis

It is important to differentiate secondary from primary

hypothyroidism; while secondary hypothyroidism is uncommon, it often

involves other endocrine organs affected by the hypothalamic-

pituitary axis. In a woman with known hypothyroidism, the clues to

secondary hypothyroidism are a history of amenorrhea rather than

menorrhagia and some suggestive differences on physical examination.

In secondary hypothyroidism, the skin and hair are dry but not as

coarse; skin depigmentation is often noted; macroglossia is not as

prominent; breasts are atrophic; the heart is small without

accumulation of the serous effusions in the pericardial sac; BP is

low; and hypoglycemia is often found because of concomitant adrenal

insufficiency or growth hormone deficiency.

Laboratory evaluation demonstrates a low level of circulating TSH in

secondary hypothyroidism (although serum TSH may be normal by

immunoassay but with decreased bioactivity), whereas in primary

hypothyroidism there is no feedback inhibition of the intact

pituitary, and serum TSH levels are elevated. The serum TSH is the

simplest and most sensitive test for the diagnosis of primary

hypothyroidism. Serum cholesterol is usually high in primary

hypothyroidism but less so in secondary hypothyroidism. Other

pituitary hormones and their corresponding target tissue hormones

may be low in secondary hypothyroidism.

The TRH test (see Laboratory Testing of Thyroid Function, above) may

be useful in distinguishing between hypothyroidism secondary to

pituitary failure and hypothyroidism caused by hypothalamic failure.

In the latter, TSH is released in response to TRH.

The determination of total serum T3 levels in hypothyroidism

deserves mention. In addition to primary and secondary

hypothyroidism, other conditions are characterized by decreased

circulating levels of total T3; these include decreased serum TBG,

the effects of some drugs (see above), and the euthyroid sick

syndrome due to acute and chronic illness, starvation, and low

carbohydrate diets (see above for discussion of euthryroid sick

syndrome).

The diagnostic dilemma is whether the patient has hypothyroidism or

the euthyroid sick syndrome. The most sensitive indication of

hypothyroidism due to primary thyroid gland failure is a marked

elevation of serum TSH. In contrast, patients with the euthyroid

sick syndrome have suppressed, normal, or slightly elevated levels

of serum TSH depending on the course of the illness. Coexistent

hypothyroidism in the patient with an acute or chronic systemic

illness is also suggested by a low or low-normal serum reverse T3

level. A more difficult differential diagnosis is central

hypothyroidism. Serum cortisol levels may aid diagnosis because they

will be elevated in patients with euthyroid sick syndrome and low or

low-normal in patients with pituitary-hypothalamic disease.

A lot of medical mubble jubble, I know..everything I copied and

pasted is from the Merck Manual for physicians.. if your doctor

questions any of this tell him to go to section 2, chapter 8 of the

merck manual..

What you want..

A free T3

A reverse T3

A TBG

A serum cortisol ..

and if these blood tests do not show the doctor what is going on

then you need to ask the doctor more questions.

T3 is responsible for so much,

Effects of Thyroid Hormones

Thyroid hormones have two major physiologic effects: (1) They

increase protein synthesis in virtually every body tissue. (T3 and

T4 enter cells, where T3, which is derived from the circulation and

from conversion of T4 to T3 within the cell, binds to discrete

nuclear receptors and influences the formation of mRNA.) (2) T3

increases O2 consumption by increasing the activity of the Na+, K+-

ATPase (Na pump), primarily in tissues responsible for basal O2

consumption (ie, liver, kidney, heart, and skeletal muscle). The

increased activity of Na+, K+-ATPase is secondary to increased

synthesis of this enzyme; therefore, the increased O2 consumption is

also probably related to the nuclear binding of thyroid hormones.

However, a direct effect of T3 on the mitochondrion has not been

ruled out. T3 is believed to be the active thyroid hormone, although

T4 itself may be biologically active.

Kats3boys