Just wondering if anyone can see anything wrong with these labs

[marchm2016]

Glucose, Serum92 65-99mg/dL

Thyroxine (T4) Free, Direct, S

T4,Free(Direct)1.32 0.82-1.77ng/dL

Cortisol 6.6 ug/dL

Tsh0.537 0.450-4.500uIU/mL

Triiodothyronine,Free,Serum2.9 2.0-4.4pg/mL

Vitamin D, 25-Hydroxy44.6 30.0-100.0ng/mL

[puncturedbicycle]

It looks like you're not converting very well and your d is too low. Are you on levo?

On the whole this result is unusual because your tsh is low but so is your t3 and your t4, while not utterly low, is not high enough. I think this kind of result can also indicate a pituitary issue but I'm out of my depth on pituitary matters.

Not informed enough to comment on the glucose or cortisol, sorry, but I'm sure someone who knows more will be along to have a look.

[marchm2016 in reply to puncturedbicycle]

I am on Synthroid 100mcg. Was in 112 mcg. On vit d - 5000 iu's. i cannot seem to loose weight. I had my A1c tested but no results yet. I have to take a dexamethizone suppression test. I just got the pill for that test tonight. Supoose to have sleet and icy roads tomorrow morning so I have to wait to get that test done. I also have to go back and have an the ACTH test re-done. They didnt use a frozen/cold tube for that test. Oh. And I was fasting and was told I may be insulin resistant and was diagnosed with Hashimoto's last April

[puncturedbicycle in reply to marchm2016]

Let me guess, was your Synthroid reduced because your tsh was too low? Just addressing your tsh is not helping you if your t3 is so low. You need to stay on top of your folate, iron, ferritin, b12 and d in the hope that your conversion will improve. You may need to take a bit more d3 to get it at a better level.

[greygoose]

Are you on any thyroid hormone replacement? If so, the TSH is irrelevant, and you could do with an increase. Your conversion isn't brilliant, but not drastic.

If you're not on any thyroid hormone replacement, then your results are inconclusive. TSH a bit on the low side, given that your FT4 is just mid-range and your FT3 slightly below. But too soon to think of pituitary. Labs would need to be done again in a few months time, to see how things have evolved.

[marchm2016 in reply to greygoose]

Thank you greygoose. I am on Synthroid 100mcg. Was in 112 mcg. On vit d - 5000 iu's. i cannot seem to loose weight. I had my A1c tested but no results yet. I have to take a dexamethizone suppression test. I just got the pill for that test tonight. Supoose to have sleet and icy roads tomorrow morning so I have to wait to get that test done. I also have to go back and have an the ACTH test re-done. They didnt use a frozen/cold tube for that test. Oh. And I was fasting and was told I may be insulin resistant and was diagnosed Hashimoto's last April

[greygoose in reply to marchm2016]

Why did you come down from 112 mcg? You really do need an increase, now, and I would suggest an increase of 25 mcg. 100 mcg really is a low dose.

Your FT3 is far too low for you to lose weight. And, all attempts to lose it will probably make things worse.

[marchm2016 in reply to greygoose]

My joints were killing me. And -My TSH labs in October .79 uIU/mL. So she decreased sythroid - My joints feel better -- Woukd Cytomel help.

[greygoose in reply to marchm2016]

It might. It could be that synthroid doesn't suit you. And, as I said, your conversion isn't brilliant.

But, have you had your vit D, vit B12, folate and ferritin tested? Aching joints can sometimes be down to nutritional deficiencies.

[marchm2016 in reply to greygoose]

Vit D was .19. Now up to .44. My ferritin was tested 9 moths ago and it was "normal". (Hate to use that word). No B12 and No folate. I think I need to find a video on the conversion to better understand this thyroid. I just dont know how it all works.

[greygoose in reply to marchm2016]

0.19? Or 19? That point, there, is a little confusing. But, even if it's up to 44, that's still much too low, and will cause aches and pains.

Do you not have the actual number for the ferritin? 'Normal' is meaningless.

It would be a very good idea to get your B12 and folate tested. If B12 is low, it will cause all sorts of symptoms.

I don't know of a video that explains conversion. I don't think a video is even necessary, there's nothing to see. Simply put, it's not that complicated :

- The thyroid gland, basically, produces two hormones : T4 and T3.

- T4 is composed of Tyrosine with four atoms of iodine.

- The gland produces mainly T4, a storage hormone, which can be converted into T3 as and when needed.

- T3 is produced in small quantities by the gland, but the bulk of it comes from conversion of T4.

- To convert T4 to T3, one atom of iodine is removed.

Exactly how the atom of iodine is removed is too complicated to explain here - don't think I could even do it - but it's not necessary to know.

- The problem is that we hypos aren't always very good at conversion.

- There can be various reasons for that : low nutrients, low/high cortisol, high antibodies... But, often, we don't even know why. It just is that way. And, we need to take T3 along with our T4; or change to NDT; or even just take T3 only.

It sounds as if your doctor doesn't know very much about thyroid, and is just looking at the TSH - which is good, but irrelevant - and doesn't know that your FT3 is too low for you to be well. And, I don't know what you can do about that.

[marchm2016 in reply to greygoose]

Greygoose- thank you so much. I so appreciate you explaining this to me. I feel like they look at me like I am crazy or something. I live in such a small town. Maybe its time to look further away. When I see her on March 6th I will address all of this To her. She is very young. I think she is trying to diagnose me with Cushings disease. I will keep you posted..... Thank you, you give me some hope 🙃

[greygoose in reply to marchm2016]

Why on earth would she want( to diagnose you with Cushing's? I doubt she'd know how to treat that, either.

[marchm2016 in reply to greygoose]

I know. I know. I am thinking i need to just find another doctor. Out picks on docs here are thin. Very thin. I just cant stand it. She is new. Young and is Ukranian. I wish I could order my own and fix myself

[greygoose in reply to marchm2016]

Well, you can buy your own levo/T3/NDT and 'fix' yourself.

[marchm2016 in reply to greygoose]

Can you Private message me on where I can do this I am thinking this may be my route. And I think there is a site I can order my labs as well

[greygoose in reply to marchm2016]

I'm sorry, I don't have any up-to-date contacts. It would be better if you posted a new question, asking just that.

You'll find details of private testing on the main page of ThyroidUK.

[marchm2016 in reply to greygoose]

Hey there. Got my last lab. It was suppose to be an A1c. Turns out they ran an insulin test instead.

Insulin 18.8. Ref 2.6-24.9 uIU/ml.

Doc office called me. They are not wanting to increase my synthroid. Ask if she would reconsider. I see her in March. By then the dexamethizone suppression test will be back and she will have everything infront of her. Greygoose. Did you do your dosage and testing all on your own? I so appreciate your knowledge and Thank You. I may ask to try Tirosint. I tried Armour Thyroid a few years back and it took me into a complete anxiety level -- it was a nightmare.

[greygoose in reply to marchm2016]

I self-treat, yes. For years I fought with doctors who had no idea what they were doing, and just made me worse and worse. I finally decided that I knew more about it than they did, and decided I couldn't make a worse job of my treatment than them. So, I stopped going to the doctors, found where to buy my own hormone, and now dose myself by how I feel - I know my body pretty well, by now, which is something doctors can never know.

In 2013, for various reasons, I was forced into the arms of doctors again. But, the doctor I ended up with was so abysmally ignorant, about so many things - not just thyroid - that I swore I would never see another one as long as I lived. I probably won't be able to stick to that, but I'll do my best! lol

[Ruthi]

Blood glucose is towards the top of the range. Were you fasting when the test was done?

Hba1c is a better measure of long term glucose levels.

[marchm2016 in reply to Ruthi]

I was fasting. And I am still waiting on my A1c -- I was told I may be insulin resistant

[marchm2016 in reply to Ruthi]

Het there. Got that last lab back-- it was suppose to be an A1c. They ran an insulin test instead

Insulin 18.8. Ref 2.6-24.9 uIU/ml.

I probably over induldged in the Holidays. Labs were on 1/7/17. I havent had any sugar and on a better healthier meal plan now. Still get light headed.

[Ruthi]

Well at least it's in range, but I don't know enough about insulin. I do know it varies through the day, and with food intake.

If you think you might be diabetic maybe get a blood glucose meter.

[marchm2016 in reply to Ruthi]

I will do that. Just seems like a roller coaster at times. Thank you