Thyroid Labs

[Soror]

In a rush but I just had my latest follow-up. It looks like to me my t3 and t4 are too low but my TSH is already down, (reading papers now about interpretation I'm coming up empty on Stop the Thyroid Madness for my particular combo of results). I say the NP today, not impressed, trying to decide where to go from here, as of now she is running antibody tests for other auto-immune diseases and a complete metabolic profile and a few other tests to figure out why I'm still having issues- I was feeling absolutely fabulous then I had a crash(couldn't hardly sleep for a week) in Sep I think and have never recovered properly. 

 

Currently on Naturethroid and Cytomel

tsh- 0.62

t3 total- 85; 76-181

free t3 -2.7; 2.3-4.2

t3 uptake 30%; 22-35

t4 total 5.1; 4.5-12

free t4 1.5; 1.4-3.8

 

vitamin levels are good-even by STTM standards, except Bs, which aren't optimal but not horrible either

 

I've already been diagnosed Hashimotos so no surprise here but this is the first my tg antibody levels have been elevated. I've got growth on my thyroid but the last they were checked they were small enough not to be a concern- I'm way overdue for a re-check however.

tpo antibodies 550; range <9

tg antibodies 2; range <1

[Tiramisu]

I really don't know what to say except my dd has had below normal free T4 over multiple tests and low-ish total T4. Her TSH was higher than yours. All other tests of T3 were in the normal range. Antibodies were normal. The neuro-endocrinologist resident wanted to try her on some thyroid medication, but the main doctor was not in favor of it. It was really frustrating.

[Soror]

I really don't know what to say except my dd has had below normal free T4 over multiple tests and low-ish total T4. Her TSH was higher than yours. All other tests of T3 were in the normal range. Antibodies were normal. The neuro-endocrinologist resident wanted to try her on some thyroid medication, but the main doctor was not in favor of it. It was really frustrating.

Dr's are so incredibly frustrating when it comes to thyroid stuff :( My TSH is finally down but the not good part is that there has been no increase in my T3 and T4 levels, 

[HSmomof2]

Your TSH is a little low.....I would have 'hyper' symptoms at 0.62, but not everyone does. I also have Hashimotos and my hypo/hyper symptoms are similar. I feel best when my TSH is between 1.0-1.2, and free t3/free t4 in the middle of the range. I take cytomel and synthroid. The last time I was having symptoms, my thyroid was ok, but we found my ferritin was too low. (10) Adding an iron supplement has really helped my energy levels.

[Ellie]

In a rush but I just had my latest follow-up. It looks like to me my t3 and t4 are too low but my TSH is already down, (reading papers now about interpretation I'm coming up empty on Stop the Thyroid Madness for my particular combo of results). I say the NP today, not impressed, trying to decide where to go from here, as of now she is running antibody tests for other auto-immune diseases and a complete metabolic profile and a few other tests to figure out why I'm still having issues- I was feeling absolutely fabulous then I had a crash(couldn't hardly sleep for a week) in Sep I think and have never recovered properly. 

 

Currently on Naturethroid and Cytomel

tsh- 0.62

t3 total- 85; 76-181

free t3 -2.7; 2.3-4.2

t3 uptake 30%; 22-35

t4 total 5.1; 4.5-12

free t4 1.5; 1.4-3.8

 

vitamin levels are good-even by STTM standards, except Bs, which aren't optimal but not horrible either

 

I've already been diagnosed Hashimotos so no surprise here but this is the first my tg antibody levels have been elevated. I've got growth on my thyroid but the last they were checked they were small enough not to be a concern- I'm way overdue for a re-check however.

tpo antibodies 550; range <9

tg antibodies 2; range <1

 

Your FT3 is very low. FT4 is good, at the lower end of optimal.

 

How much NatureThroid are you taking? You don't need Cytomel if you're taking a high enough dosage of NDT.

 

I don't know about the antibodies. :-(

 

Are you (or have you heard of) the Autoimmune Protocol (AIP)? It's strongly recommended for Hashi's people.

[Ellie]

These are optimal levels for thyroid:

 

[Ellie]

Recommended lab work:

 

[melmichigan]

:bigear:

[gardenmom5]

:bigear:  ellie - I'll probably want to pick your brain.  we're doing more testing.  my tsh is 3 - but my thyroid is swollen. so, she's finally widening the panel.  this is the first time it has been swollen, and the lowest my tsh has been.  I've been having more voice problems too.  and I'm so darn tired - I don't get quaility sleep either.

[Soror]

re: Iron- yes my levels are good, even by STTM standards, after I crashed in August I started supplementing again

 

re: Auto-Immune diet- I started it when I was diagnosed, last April. I added some things back in this summer(nightshades-some dairy) but have pulled them back out.

 

On the plus side I've been sleeping better but despite sleeping at night I can't make it through the day without a nap, my hair has thinned(I noticed this when I got a haircut last month but didn't think much of it as my hair is so thick to begin with I was just happy to not to need to have it thinned). 

 

I just made a chart with all my lab results, so the problem is my TSH is low enough I'm afraid to increase my dose but T3 and T4 levels still aren't optimal and I feel just as hypo as I did when I was diagnosed. Unfortunately I don't have any tests from times that I've really felt good but since my dosage increase in Aug my TSH has gone down 2+ pts but my Free T3 has only increased one tenth. 

 

The NP I saw yesterday said my thyroid was great and there was no problem there, unfortunately I hadn't pre-viewed my tests and didn't see them myself until after the visit. It certainly won't hurt to test for other auto-immune diseases but I'm not sure as to what to do with the thyroid stuff and I keep coming across info that says to look at the pituitary when TSH is low with low thyroid numbers and this one thinks my thyroid is perfectly fine.

 

On the plus side my A1C lowered to 5.5, from a 5.6 so I'm not skirting quite as close to the pre-diabetic line, although that is still waaaaayyyy more close than I want to be and I continue to have issues with fasting levels. This NP said however that pre-diabetes doesn't even exist and the ADA puts out numbers that are too low to get people to go on medication to make money for big pharma. So I have a follow-up scheduled for 2 wks, which I really don't think is even worth my time, perhaps I'll just wait until the labs come back and then try the functional med dr again- although I was trying the local lady as he was less than responsive after the initial visit. 

 

I noticed charting my results that my platelets have came back low and my MPV and MONO high every single CMP that I've had done, I'll be interested to see how my new one comes back since it has been right at 1 yr since the last one. The one and only hormone tests that I've had done 1.5 yrs ago showed sky high testosterone and high estrogen but that hasn't been followed up on either as we've been trying to get the thyroid done.

 

Thanks for the chart, I'd been comparing against the info on STTM but this is an easier to read format. A friend sent me an info graph from STTM that show that low range T4 with T3 below the upper quarter as hypo on natural+t3.

These are optimal levels for thyroid:

 

 

Edited December 1, 2015 by soror

[HSmomof2]

Is there a good endocrinologist in your area that you could see? This made all the difference for me. After 20 years of being mis/under-diagnosed, I was able to get in to see my endocrinologist who specializes in thyroid.

[Laurie4b]

Your FT3 is very low. FT4 is good, at the lower end of optimal.

 

How much NatureThroid are you taking? You don't need Cytomel if you're taking a high enough dosage of NDT.

 

I don't know about the antibodies. :-(

 

Are you (or have you heard of) the Autoimmune Protocol (AIP)? It's strongly recommended for Hashi's people.

 

Are you doing AIP? Or do you know anyone with Hashimoto's who is? What kind of results are expected?  What kind of results are actually happening?

 

 I have Hashi's but no symptoms so am not being treated yet.  Are people doing it aiming for remission or aiming for reduced symptoms? I have zero desire to do that protocol since I am not feeling bad and that protocol is tough but am in the stage of "considering data" even if anecdotal. 

[Soror]

Are you doing AIP? Or do you know anyone with Hashimoto's who is? What kind of results are expected?  What kind of results are actually happening?

 

 I have Hashi's but no symptoms so am not being treated yet.  Are people doing it aiming for remission or aiming for reduced symptoms? I have zero desire to do that protocol since I am not feeling bad and that protocol is tough but am in the stage of "considering data" even if anecdotal. 

I started the Auto-Immune protocol last April and I felt better even before I started meds however I tend to feel better and worse so it is hard to attribute it to diet. I added back in nuts, seeds and nightshade spices easily without issue. This summer I worked on adding back eggs, occasional dairy and nightshade veggies but I seem to do better without them so as of now I strictly limit them. No way would I start without symptoms, it is tough. Some people say they have a reduction of antibody levels on AIP my antibody levels have only slightly moved, they did max out the test at the point that I added back eggs, nightshades etc (they were above 900 then and that was as high as was tested) and now on this last one my levels are back down to 500s but then again I was diagnosed at levels of 300 before I even started AIP so I really don't see a correlation for myself. Also, although some see a connection between how they feel and their antibody levels I have not myself. I'm not convinced as to the science of it all but I just go by how I feel at this point. There is an auto-immune diet FB page that I'm a part of but the big thing I see for a lot of people is that you have people coming from a SAD diet feeling so much better but not necessarily with those already following a whole foods diet, with the exception of gluten- as I believe that numbers are at least 25% of Hashimoto's patients have Celiac's disease

[Soror]

Is there a good endocrinologist in your area that you could see? This made all the difference for me. After 20 years of being mis/under-diagnosed, I was able to get in to see my endocrinologist who specializes in thyroid.

I'd like to find one but I haven't yet. I found a functional medicine dr in the city that I went to based on all these rave reviews but he has only been so-so. The one endo that I seen referenced had a huge wait time and I keep on going back and forth on whether it would be worth it or if they would blow me off too as my levels are in range.

[TranquilMind]

Your FT3 is very low. FT4 is good, at the lower end of optimal.

 

How much NatureThroid are you taking? You don't need Cytomel if you're taking a high enough dosage of NDT.

 

I don't know about the antibodies. :-(

 

Are you (or have you heard of) the Autoimmune Protocol (AIP)? It's strongly recommended for Hashi's people.

Yeah, sounds like you need to boost the NatureThroid to me.   You should not need both. 

[Laurie4b]

I started the Auto-Immune protocol last April and I felt better even before I started meds however I tend to feel better and worse so it is hard to attribute it to diet. I added back in nuts, seeds and nightshade spices easily without issue. This summer I worked on adding back eggs, occasional dairy and nightshade veggies but I seem to do better without them so as of now I strictly limit them. No way would I start without symptoms, it is tough. Some people say they have a reduction of antibody levels on AIP my antibody levels have only slightly moved, they did max out the test at the point that I added back eggs, nightshades etc (they were above 900 then and that was as high as was tested) and now on this last one my levels are back down to 500s but then again I was diagnosed at levels of 300 before I even started AIP so I really don't see a correlation for myself. Also, although some see a connection between how they feel and their antibody levels I have not myself. I'm not convinced as to the science of it all but I just go by how I feel at this point. There is an auto-immune diet FB page that I'm a part of but the big thing I see for a lot of people is that you have people coming from a SAD diet feeling so much better but not necessarily with those already following a whole foods diet, with the exception of gluten- as I believe that numbers are at least 25% of Hashimoto's patients have Celiac's disease

 

Thanks for sharing. I appreciate it as I consider things. 

 

Yeah, I already eat a very healthy diet, not the SAD. I can see your point totally about going from SAD to AIP and feeling better just from healthier food. OTOH,  I have a friend who *has* to be on AIP (she gets anaphylactic reactions to foods despite negative allergy tests to them!) and it is really, really rough. Frankly, I don't even want to go off gluten unless it's truly necessary. I don't eat a lot of it but still, I like what I do eat! 

[Soror]

:bigear:  ellie - I'll probably want to pick your brain.  we're doing more testing.  my tsh is 3 - but my thyroid is swollen. so, she's finally widening the panel.  this is the first time it has been swollen, and the lowest my tsh has been.  I've been having more voice problems too.  and I'm so darn tired - I don't get quaility sleep either.

(hugs) that is ridiculous, how are your other numbers? Have they done an ultrasound of your thyroid yet, surely they have that scheduled. My very normal GP scheduled an ultrasound for me after my test (which he didn't order) came back as Hashi's and he palpated some spots. It is maddening trying to get dr's to listen to you as a patient. We aren't seeking meds we just want to feel better!

[gardenmom5]

(hugs) that is ridiculous, how are your other numbers? Have they done an ultrasound of your thyroid yet, surely they have that scheduled. My very normal GP scheduled an ultrasound for me after my test (which he didn't order) came back as Hashi's and he palpated some spots. It is maddening trying to get dr's to listen to you as a patient. We aren't seeking meds we just want to feel better!

 

 

it was my appt. last week where she said it felt swollen. it was the first time any dr has said it felt swollen. (it's only been a few months that I've noticed more trouble with my voice.)  that's when she ordered another tsh,  the free t3 and t4, etc. (along with more liver numbers.) the results aren't back yet.   I don't remember everything ordered - there were nine in total.  

 

my last tsh was 3, but I'm more symptomatic than when I was at 4.  I've been on levo for about five years.  I did ask about swtiching to armour. (we'll know more when we review the labs.)

 

she's actually been far more concenred about my liver numbers. this is the first time my thyroid has concerned her.  last year this time - they were really good.  last summer, not so much.

Edited December 3, 2015 by gardenmom5

[Susan C.]

These are optimal levels for thyroid:

 

 

The chart recommends very high free T3....  For some, that would be "can't peel me off the ceiling hyped." And on natural thyroid, that number fluctuates drastically, depending on the last dose timing. Also, natural thyroid doesn't "last" as long as synthetic, so splitting the dose might be necessary. That might explain getting tired mid-day.

[Ellie]

:bigear:  ellie - I'll probably want to pick your brain.  we're doing more testing.  my tsh is 3 - but my thyroid is swollen. so, she's finally widening the panel.  this is the first time it has been swollen, and the lowest my tsh has been.  I've been having more voice problems too.  and I'm so darn tired - I don't get quaility sleep either.

 

((((gardenmom5)))))

 

Your TSH *should* be low, if you are being treated properly. Sadly, most doctors do not. They don't order the proper labs, they treat according to TSH and not symptoms or Free T3 and Free T4, they somehow have missed the memo that many, if not most, thyroid issues are actually Hashimoto's--an autoimmune disease--and not just a thyroid condition. :crying:

 

Have you heard of the Autoimmune Protocol (AIP)? It's an elimination diet highly recommended for people with autoimmune diseases (and really, we should assume that's what you have, until proven otherwise), sort of like paleo on steroids, lol. All grains are to be avoided--all grains, not just gluten--and in the beginning, all dairy, nightshades, legumes, seeds, most nuts, and eggs are avoided. After a month you can begin adding in some foods to see how you feel, but glutens are always avoided, because they are inflammatory.

[Soror]

You might want to switch to something other than Armour like Naturethroid.  Armour seems to have been reformulated and a lot of people are having problems on it after doing really well for years.   In fact, so many people are switching from Armour to another NDT that there have been shortages in some areas. 

I'm actually taking Nature-throid now, I've always used it and Cytomel. 

[Soror]

it was my appt. last week where she said it felt swollen. it was the first time any dr has said it felt swollen. (it's only been a few months that I've noticed more trouble with my voice.)  that's when she ordered another tsh,  the free t3 and t4, etc. (along with more liver numbers.) the results aren't back yet.   I don't remember everything ordered - there were nine in total.  

 

my last tsh was 3, but I'm more symptomatic than when I was at 4.  I've been on levo for about five years.  I did ask about swtiching to armour. (we'll know more when we review the labs.)

 

she's actually been far more concenred about my liver numbers. this is the first time my thyroid has concerned her.  last year this time - they were really good.  last summer, not so much.

Hopefully she will finally look at it more in depth. Susan mentioned about an issue with the formulation with Armour, which I wasn't aware of as I don't use it but I know from a friend that does that the cost has significantly gone up and she has switched to Nature-throid(which is crazy cheap here-at least from the pharmacy- the FM dr I was seeing charged an arm and a leg for it) due to that. I know nothing about the liver, hopefully that is addressed soon.

 

That's the issue with the TSH is that it doesn't tell you much, which I'm seeing right now. My tsh is as low as it's ever been but my t3 is the same as when my TSH was 2, my best t3 numbers were when my TSH was 3 something. 

[Soror]

The chart recommends very high free T3....  For some, that would be "can't peel me off the ceiling hyped." And on natural thyroid, that number fluctuates drastically, depending on the last dose timing. Also, natural thyroid doesn't "last" as long as synthetic, so splitting the dose might be necessary. That might explain getting tired mid-day.

I've always split my doses and I don't take them before the tests. The highest I have tested of free t3 was 3.2 and I honestly was pretty tired at that level too, I've had a couple of periods where I felt like I was hyper but I've never tested during those times to see my numbers. I've also never tested when I've felt really good- I wish I had those numbers now because I'd like to know what optimal looks like for me, I guess I'll have to find out again. I started my vitamins again, my iron is decent but could be a smidge higher and my b's could be as well. I have to watch though as I tend to rev easily, last time after I started back on iron and b's is when I had my wired time- not sure if it was connected but it makes me leary as it seems to occur together. The lady I am consulting with says that frequently when you are hypo that you have difficulty with the B's. As of now she is looking at my previous test results and coming up with rec's. She also thinks that my bg issues are just a result of my thyroid and I need to up my carbs a bit. I had read that going too low carb can cause thyroid issues- which is why I went to the Perfect Health Diet for awhile but that didn't end up working well at all, except for putting 20lbs on me. Anyway, I'm backing off focusing on my bg so heavily, it isn't at critical levels so perhaps if we do focus on the thyroid it will line out.

Edited December 3, 2015 by soror

[Pawz4me]

it was my appt. last week where she said it felt swollen. it was the first time any dr has said it felt swollen. (it's only been a few months that I've noticed more trouble with my voice.)  that's when she ordered another tsh,  the free t3 and t4, etc. (along with more liver numbers.) the results aren't back yet.   I don't remember everything ordered - there were nine in total.  

 

my last tsh was 3, but I'm more symptomatic than when I was at 4.  I've been on levo for about five years.  I did ask about swtiching to armour. (we'll know more when we review the labs.)

 

she's actually been far more concenred about my liver numbers. this is the first time my thyroid has concerned her.  last year this time - they were really good.  last summer, not so much.

 

FWIW -- When I was diagnosed with hypothyroidism several of my liver enzymes were high.  After being on levothyroxine for six weeks or so my liver numbers were back down in the normal range.

Edited December 3, 2015 by Pawz4me

[jg_puppy]

Have you heard of the Autoimmune Protocol (AIP)? It's an elimination diet highly recommended for people with autoimmune diseases (and really, we should assume that's what you have, until proven otherwise), sort of like paleo on steroids, lol. All grains are to be avoided--all grains, not just gluten--and in the beginning, all dairy, nightshades, legumes, seeds, most nuts, and eggs are avoided. After a month you can begin adding in some foods to see how you feel, but glutens are always avoided, because they are inflammatory.

 

Do you have a book or website that you can recommend to learn more information about the Autoimmune Protocol? My daughter was diagnosed with Hashimoto Thyroiditis almost 5 months ago. I think she is finally ready to start discussing dietary changes to see if we can make more progress on getting her healthy. 

 

[Soror]

 

Do you have a book or website that you can recommend to learn more information about the Autoimmune Protocol? My daughter was diagnosed with Hashimoto Thyroiditis almost 5 months ago. I think she is finally ready to start discussing dietary changes to see if we can make more progress on getting her healthy. 

 

 

The Paleo Mom is the go to source:

http://www.thepaleomom.com/

 

Her book is The Paleo Approach: REversing Auto-Immune Disease and Heal your Body

[Soror]

 

I have been on the AIP diet twice now.  I dropped 10 lbs fast and I'm thin so I was surprised.  My stomach is now flat and I feel better as far as digestion goes, no bloating, gas, etc.  I went off of it briefly and added back in things way too fast and bloated right back up and gained 5lbs within a week.  Went back on, bloat and weight came off. 

 

My antibodies were off the charts and are now halved but I haven't been AIP again long enough to claim that's what did it.  I, like a PP, am skeptical about the claims of gluten always being the root cause of Hashi's and the science.  I will keep myself grain free at least for the long haul because I look and feel so much better.  It is hard.

Yep, it is hard. I wouldn't go into it expecting a miracle. IMO there a lot more theory than proof, from what I've seen the only official trial has been Wahl's trial, which was not specifically with Hashi's patients but MS(another auto-immune disease). I get really tired of these people claiming that the paleo cures hashis. I was paleo long before being diagnosed. I've done the auto-immune protocol, strictly for many many months. It is still there and I'm still on meds. Yes, I feel better on a paleo diet but it doesn't/hasn't made my anti-body levels disappear- 7 months of strictly following it and I cut 60 pts off and my other numbers were not any better at all.

Edited December 3, 2015 by soror

[gardenmom5]

((((gardenmom5)))))

 

Your TSH *should* be low, if you are being treated properly. Sadly, most doctors do not. They don't order the proper labs, they treat according to TSH and not symptoms or Free T3 and Free T4, they somehow have missed the memo that many, if not most, thyroid issues are actually Hashimoto's--an autoimmune disease--and not just a thyroid condition. :crying:

 

Have you heard of the Autoimmune Protocol (AIP)? It's an elimination diet highly recommended for people with autoimmune diseases (and really, we should assume that's what you have, until proven otherwise), sort of like paleo on steroids, lol. All grains are to be avoided--all grains, not just gluten--and in the beginning, all dairy, nightshades, legumes, seeds, most nuts, and eggs are avoided. After a month you can begin adding in some foods to see how you feel, but glutens are always avoided, because they are inflammatory.

 

thanks - I have more motivation to do the elimination diet. and the specifics to look up.

 

I knew the tsh was supposed to be low - and when I started, they had just lowered the threshold to 4.  so the dr then was skeptical - but started me on thyroid meds anyway.  I'd been symptomatic for years - but it was never connected to my thyroid.  until my symptoms started to disappear. . . . .

 

this is the first time I remembered to ask to run the free t3/t4 numbers.  so, I'm eager to hear about them.   but it's also the first time I've ever had a dr. say it was swollen.

 

I do have a high inflamation level . . . .years ago, I was eating almost no grain (I ate oatmeal, and pasta. no bread.)  no dairy. did use butter.  also no sugar - it took a month, but I felt great . . . . it is very hard to keep it up.  most of my kids have moved out, so I am working back into it (until last week . . . . )

[gardenmom5]

ok - I think my labs used a different scale.

 

My tsh is 1.28 - the lowest they have ever been.  (I added in emerald labs thyroid, which contained natural bovine dessicated thyroid from NZ.)

 

T4 - total (not sure if she did free)  10.1

T3 - total (don't think she did free)  102

I asked for the free numbers . . . . 

 

everything is listed as "in range".  she was much more obsessed with my liver panel.  but, cutting out sugar and getting back to yoga is helping.  so, my numbers are good enough - she didn't have the nurse call and tell me to get in to the office.  but I'm so darn tired . . . .and don't sleep very well.

 

I think that is a signal to me to go ahead, change my PP (so insurance will pay for it.) and go to a ND who specializes in my genetic mutation . . . . 

[Soror]

gardenmom- I agree you need to find a new dr- and get the right tests, it is sooo very frustrating to ask for specific tests and not have them run them. As it is said unfortunately the TSH tells you nothing about the thyroid, truly putting my numbers into a chart helped bring that home as there was no connection between my thyroid numbers and my TSH levels. 

[gardenmom5]

 I plan on switching my PP to a ND who also specializes in my homozygous genetic mutation.  on monday - didn't have time this afternoon.  I expect much more thorough labs.

 

I can also have my dd help me go over the labs.  but yeah - I asked for "Free", and it's particular irritating that wasn't what was ordered.  (especially since the dr's assistant - can't draw blood.  I ended up going TO the lab for the blood draw. that was a huge hassle - and I was supposed to be fasting. it was 2pm before my blood was finally drawn, and even later before I could eat!)

[Soror]

 I plan on switching my PP to a ND who also specializes in my homozygous genetic mutation.  on monday - didn't have time this afternoon.  I expect much more thorough labs.

 

I can also have my dd help me go over the labs.  but yeah - I asked for "Free", and it's particular irritating that wasn't what was ordered.  (especially since the dr's assistant - can't draw blood.  I ended up going TO the lab for the blood draw. that was a huge hassle - and I was supposed to be fasting. it was 2pm before my blood was finally drawn, and even later before I could eat!)

Fasting until 2pm, what a pain! I'll be interested to hear how it goes with the new ND, keep us updated. I'm seeing the NP of the Func. Med Dr. Tuesday, I've not seen her before. I'll be asking for a full iron panel- my last was just ferritin but I want to see all the numbers to make sure I'm good- in the meantime I've added iron back as I always take it on my period anyway and I have room to go up. I'm also asking about RT3 numbers, saliva cortisol- we've assumed my adrenals were less than optimal for awhile but now we are going to see. I'm going to see as well if they can order a specific iodine loading test.