Lab interpretation please? Help. Thks

Lab interpretation please? I am adding my last 3 labs so you can get an idea and contrast from dosages plus numbers.

Labs 02/17/2017 8:30 am Last dose was 12 hours before the lab. I was on 1/2 grain + 1/4 of NDT + 75 mg (levoythyroxine) ...

Testosterone 109 Low 250-827 ng/dL

TSH 0.01 Low 0.40-4.50 mIU/L

FT3 = 2.1 Low 2.3-4.2 pg/mL

FT4 = 1.0 0.8-1.8 ng/dL

FSH= 2.1 1.6-8.0 mIU/mL

LH = 6.0 1.5-9.3 mIU/mL

PROLACTIN= 3.0 2.0-18.0 ng/mL

Labs 11/21/2016 8:45 am my last dose was taking 24 hs before the lab. I was on 1 1/2 grain of NDT + T4 (levothyroxine) 75mg

TSH: 0.0 0.40-4.50 mIU/L

FT4= 1.4 0.8-1.8 ng/dL

FT3= 4.4 2.3-4.2 pg/mL

Vit D= 28 30-100 ng/mL

TESTOSTERONE= 310 250-827 ng/dL

Labs 08/29/2016 9:12 am My last dose was taking 24 hs before the Lab. I was on 1 grain of NDT + 12.5mg T3 + T4 (levothyroxine) 50 mg

TSH: 0.01 0.40-4.50 mIU/L

FT4= 0.9 0.8-1.8 ng/dL

FT3= 3.5 2.3-4.2 pg/mL

Cortisol (bloodwork)= 10.4 mcg/dL

8.10 am 4.6-20.6 mcg/dL

4-6 pm 1.8-13.6 mcg/dL

PROLACTINE: 5.2 2.0-18.0 ng/mL

Notes:

If you notice this time on my last Labs I took the test within 12 hs not 24 hs (ppl say 12 hs is the most accurate test), and my FT3 is low, but my FT4 shows kind of good range.

Questions:

1) Do you think I should raise my current NDT to 1 grain + 1/4 instead of that 1/2 + 1/4? or probably even more to raise my T3? Take into account that when I was on 1 grain and 1/2 ndt my FT3 was hight, even though the lab test was taken 24 hs not 12 hs like this time.. What do you think?

2) Why the FT4 although in range it dropped a bit in despite my same 75 mg levo? Could it be due to the 12 hs factor vs 24 hs from my latter lab tests?

3) I've been showing consistently low testosterone. But now I know it is because my Lyme disease could make hormones trouble. Do you think I still consider a pituitary problem or just fix the lyme first to decide?

Thank you

5 Replies

oldestnewest
  • Your labs are complicated because you seem to have a pituitary problem, which is affecting your thyroid results. Your TSH level in particular is very low but can probably be ignored, especially since you are taking NDT.

    In answer to (2) your FT4 probably dropped because you were taking less. NDT contains some T3 and some T4, so although your Levothyroxine (T4 only) dose stayed the same, you took less NDT so your total dose of T4 dropped.

    In answer to (3) I think you do have a pituitary problem because when your FT3 is below range (02/17/2017) your pituitary should be producing TSH to make your thyroid work harder, however your TSH was very low.

    In answer to (1) How do you feel - what symptoms do you have? With your labs being so complicated it is probably best to listen to your body and adjust your dose by how you feel.

  • Xanderusa,

    You are under medicated because FT3 is below range. Try 1 to 1.25 grains NDT + 75mcg T4.

  • if someone does have a lacking pituitary like I do...is the treatment any different?

  • Jacrjacr,

    No, treatment is replacement thyroid hormone but dose should be guided by FT4 and FT3 levels because TSH reslts will be invalid due to pituitary dysfunction. If the lack of pituitary causes other deficiencies in sex and growth hormones they will also need addressing.

  • thank you...I think that is my problem....I am low in other hormones and dr is giving me things for them but my thyroid test tsh ft4 ft3 do not match up...showing too low tsh and low normal ft3 ft4....and I have been diagnosed like this for years.....staying low on just t4 meds or ndt but once in a while my ft3 level will show correctly mid range so...I am so confused....and so far drs have been no help really.....

You may also like...