Would like input re lab values

Hi all, as I posted, have been feeling awful and dealing with a disinterested, recalcitrant PCP/GP for several years. Finally had my appt with a new endo last fri. 3/13/18. Went well; here are labs and visit highlights: Current values 4/13/18 12noon. NPO missed dose thurs and fri am. 1. TG antibodies: <1.0 IU/mL Range(0.0-0.9) (Beckman Coulter Methodology) 2. TSH: 4.090uIU/mL (0.450-4.500) Past results done by GP (grudgingly!) 3/19/18 2.62 12/5/17 1.57 10/23/17 6.10 Raised dose from 100mcg/day to 125 after begging! PCP wanted to wait til TSH reached 12 !!! 5/16/17 5.42 4. Vit D, 25. Hydroxy 4/13/18 16.7ng/mL (30.0-100ng/mL 5. Vit B12: 452pg/mL (232-1245) 6. Cortisol: 5.3ug/mL AM 6.2-19.4 PM 2.3-11.9 7. DHEA-SO4 102.3ug/dL (20.4-186.6ug/dL) 8. Ferritin 106ng/mL (15-150) * Past results 1/8/18 48ng/mL 10/23/17 48ng/mL 5/16/17 62ng/mL * Been eating 8 oz liver weekly since level was 48. 9. T4 Free 1.49ng/dL (0.82-1.77) Past results (GP) 3/19/18 1.6 12/5/17 1.5 10/23/17 1.4 5/16/17 1.4 10. T3 Free 2.4pg/mL (2.0-4.4) 11. Iron 100mcg/dL (45-160) TIBC 392 mng/dL (250-450) Iron Sat 26% (11-50%) *These 3 done 10/23/17 12. Total Bilirubin 0.3mg/dL (0.0-1.2) Don't know why-no alcohol. Current test done Fri 4/13/2018. Nexr appt/ tests for June 6th. Was NPO and skipped levo Thurs and Fri. Rolate accidentally left out. Will do June 6th. Meanwhile will start folate supplements now. What are best supplements and dosages? New Rx: Star1.ting tomorrow: 1. Synthroid brand (no more generics) 125mcg/daily 2. Liothyronine (generic) 5mng/daily 3. Rx Vit D 50,000IU one weekly for 8 weeks Thanks for evaluating and input. Want to have good info for next visit. Also what is a good B12 supplement? And the $64,000 question when will I start to feel better?? Thanks everyone. And please excuse terrible typing. Good nurse, horrile computer skills!

[Jazzw]

Hi Irina1975 - I confess to really struggling to read that. So, here’s my attempt to reformat!

Current values April 13 2018 at 12noon

TG antibodies: <1.0 IU/mL (0.0-0.9)

TSH: 4.090uIU/mL (0.450-4.500)

T4 Free 1.49ng/dL (0.82-1.77)

T3 Free 2.4pg/mL (2.0-4.4)

Vit D 16.7ng/mL (30.0-100ng/mL)

Vit B12: 452pg/mL (232-1245) (folate not done - accidentally left out)

Cortisol: 5.3ug/mL (AM 6.2-19.4, PM 2.3-11.9)

DHEA-SO4 102.3ug/dL (20.4-186.6ug/dL)

Ferritin 106ng/mL (15-150)

Results from 23 October 2017:

Iron 100mcg/dL (45-160)

TIBC 392 mng/dL (250-450)

Iron Sat 26% (11-50%)

Total Bilirubin 0.3mg/dL (0.0-1.2)

Next appt/ tests for June 6th.

Folate accidentally left out. Will do June 6th. Meanwhile will start folate supplements now. What are best supplements and dosages?

New Rx: Starting tomorrow

Synthroid brand (no more generics!) 125mcg/daily

Liothyronine (generic) 5 mcg/daily

Rx Vit D 50,000IU one weekly for 8 weeks

Thanks for evaluating and input. Want to have good info for next visit. Also what is a good B12 supplement? And the $64,000 question when will I start to feel better??

[Hidden in reply to Jazzw]

Jazz, Than you so much for reformatting my post. I'm sorry to cause difficulties. I came late to computers and really only know the basics. I don't like using them but it-s the way of the world now. I really tried to type it in an organized fashion. If I never had to use a computer again I'd be relieved. Again, thank you for helping me with this. I-m really not stupid just have a hard time with today's technology. Don't use 1/2 the functions on my smartphone and happily don't tweet or have a facebook account. irina

[Jazzw in reply to Hidden]

It was no problem - was happy to do it xx

[TSH110 in reply to Hidden]

Hand typing results and ranges is a real challenge! I had a friend who was very well paid as a typist because she did horrible stuff like seemingly meaningless lists of numbers and she never made a mistake!

I usually take a photo instead and upload that but it can have details you don’t want appearing in the shot or it may not display clearly if it contains a lot of info.

Pity TUK don’t devise a template where you could just bung the numbers into relevant boxes

[Hidden in reply to TSH110]

Hi TSH, That's a very good idea except I don't even use the camera on my smart phone. The only computers I used until after retirement were in hospitals as a nurse. But they were programmed so well, one didn't have to think; just use the programs as we were taught and it was virtually impossible to make a mistake. Didn't even own a computer til recently. Thought I could make it through this life without all the fancy technology but finally broke down and joined the crowd. I get frustrated easily with the computer. I really think I have 2 right brains. LOL. Am 74 and I have family and friends with 3 year olds that can run the electronics in their house. Amazing! ( I can't even cut and paste!). I have had brain fog from being so thyroid undermedicated for so long. Maybe with my new meds and doc this will clear up and I can make sense of some of my computer instructions. My main book is "CHROMEBOOK FOR DUMMIES" and even that's hard right now. Take care. irina

[TSH110 in reply to Hidden]

Get a child to show you if you can - I have found them to be excellent teachers! I got my nephew to show me tele txt about which I was clueless - I had it in a trice with his guidance. The trouble with computers are that they are stupid so you have to tell them everything in the right order which is not really human we make lots of assumptions and jumps in logic not that pedestrian computer stuff. Keep at it tho because they are very useful. Have a go with the camera they are quite fun and can also be useful too. On the iPhone you just hit the camera icon and you’re away just compose and click.

[Hidden in reply to TSH110]

I really love having access to so much info. That's a good idea re kids as teachers. I've also bought children's books to learn from as they are written clearly and simple. The authors aren't trying to impress you with their writing ability. I think some of my frustration really is because of being so hypo for so long and my mental fog will get better. Sometimes computer language I think makes things harder because what something is called to my mind doesn't fit its function. But that' s probably me. Anyway, will keep trying and suggestions offered when I goof will be graciously accepted. 🐹

[TSH110 in reply to Hidden]

Not you - they are not intuitive things we are not pure logic - thank goodness!

[Jazzw]

And now for a spot of interpreting.

Good to introduce liothyronine I think as your TSH is much too high for someone taking thyroid hormone replacement. Glad your doctor resisted the urge to lower your levothyroxine dose. I’d say in due course you’ll need more than 5mcg of liothyronine though.

Your Vit D levels were woeful! Good that you’ve been put on a weekly big dose but I think 50,000iu is on the conservative side (can’t remember how high a loading dose should be). That low Vit D is probably a good part of the reason for you feeling under the weather so hopefully when that’s addressed you’ll feel better.

Your B12 levels aren’t as bad but over 500 would be better. If you start supplementing B12 and folate now though your June results will read artificially high. It’s a judgement call - it can’t hurt to supplement both now as any excess B vits taken are excreted via urine.

Ferritin is good but I’m no expert on the other iron levels so can’t comment on the overall picture.

[SeasideSusie Remembering in reply to Jazzw]

Jazz

Vit D loading doses total 300,000iu over a number of weeks here in the UK, not sure about US where Irina is.

Well done on reformatting, I couldn't have done it, it hurt my eyes!!

[Hidden in reply to SeasideSusie]

I'm taking 50,000 IU of D weekly for 8 weeks so- a total of 400,000 IU. I'm sure my endo will do more labs and reassess. I just want to feel better. One of my worries is that I live in senior living and they are always keeping a sharp eye out to see if anyone should be bumped up to assisted living. In the US assisted living and nursing homes are a fate worse than death to me. So I don't want to appear like I have problems that I am not on top of. I don't like senior living but was encouraged to move here. I wish I hadn't done it. Thanks for listening.

[Hidden in reply to SeasideSusie]

With these med changes can I expect to feel worse before starting to feel better. That would be fine, just want to know what to expect. Thanks.

[Jazzw in reply to Hidden]

I think the Vit D addition should help more than you might expect. Low Vit D can be the culprit for all sorts, from feeling blue to lowering gut absorption (so that your B12/folate/iron levels fall).

Hopefully the T3 will make a difference too. Sometimes, the addition of a small amount of T3 seems to encourage the body to convert more levothyroxine to T3 as well.

Hope you do start to feel better soon xx

[Hidden in reply to Jazzw]

Thanks, Jazz. I picked up my new scripts yesterday and took my first Vit D (50,000 U) before I even left the pharmacy. I was feeling my usual daily muscle and joint pains. And when I woke up this morning I have so much less morning pain. Esp knees. Probably all in my mind as I don't expect anything to work that fast but my mood is already better with less pain. Also took my 1st liothyronine this am. Maybe I feel better because I'm getting closer to the light at the end of the tunnel. I've had surgery and illnesses over the years and have always handled them (I think) matter of factly and well. Nursing has taught me illness is part of life, no one escapes 100%, so just handle it as well as we can. But I honestly can't remember ever feeling as chronically bad as I have this past year as my thyroid situation was heading south with no appropriate care from my (ex) PCP. I tried to get tests ordered, and appropriate treatment started but to no avail. Can't believe I put up with her for so long. Won't happen again. Angry at myself but also really p%#$@& at her too. Have a lead on a new Primary and will set up an appt. Again, thanks for your help. If you were in Atlanta I would pay you to come over and explain the computer to me! (LOL). The computer is my friend. The computer is my friend.......

[TSH110 in reply to Hidden]

It won’t be in your mind I felt truly dreadful when I had a severe vitD deficiency could not think straight, aches and pains all over, mind and body glacially slow, depression ++. It was awful and vitD supplements helped a lot. Your dose is much higher so ought to be a lot more rapid and effective. I am a super fast reactor to medications according to 23&me gene analysis and I always thought this was the case. Perhaps you are the same. Good luck with the improvements ☘️🍀☘️

[Hidden in reply to TSH110]

Thank you. You've described exactly how I've felt for most of the past year. Took my first Vit D Thursday and I swear I'm beginning to feel less aches and pains. Very hopeful. I react to meds quickly too-both good and bad. Take care. PS Love the 4 leaf clover emojis. If you know how I can access the emoji's on my Chromebook I would love that. Can't find it in my instruction books.

[TSH110 in reply to Hidden]

Sorry I have an iPhone and iPad so not sure how you do it on chrome book it may come up if you google it

Oh I just did and found this:

To insert emoji into documents, emails and chat sessions:

Open your Chromebook's on-screen keyboard.

In the lower-left corner, tap or click More .

Tap or click Emoji.

Tap or click the emoji or graphic that you want to insert.

Hope it works 🍀☘️🍀😎

[Jose651 in reply to TSH110]

☘️👍☘️

[Hidden in reply to TSH110]

Thank you. Will write down instructions and do right after dinner.

[Hidden in reply to TSH110]

Did it but there is no emoji icon. willtry again later probably take me a couple of tries!

[Hidden in reply to TSH110]

found it (3 vertical dots)😊😀😂😈😇 THANK YOU.

[TSH110 in reply to Hidden]

👍🏽😉👍🏽

You can change the skin colour on the iPhone by holding on the emoji for options 👍👍🏿👍🏼

[helvella Administrator Thyroid UK in reply to TSH110]

Which I can fully understand - but wasn't that one of the reasons for garish yellow being so widely used? It is good visually and absolutely no-one has skin of that colour - hence it can be taken as universal.

[TSH110 in reply to helvella]

What about the Simpsons?

👍😎😂👍

[Hidden in reply to TSH110]

🐱

[Hidden in reply to TSH110]

Thanks. I may conquer this computer thing yet. LOL

[Hidden in reply to Jazzw]

I think your comment re the B12 and folate is good advice. I will hold off on starting supplements-though would like advice on the best supplements. I don't want my labs on the 6th to look too good as this doctor will still be learning about me and I want to feel better more than anything. I feel so fatigued and generally bad on a daily basis I want the doc not to be afraid to give me needed meds. I never felt this bad when I began my a-fib journey. I am also angry with myself for sticking with this PCP for so long. I had a wonderful Primary for years but about 4 years ago he retired and she took his place. I thought I would give her a chance and in the beginning she was fine. I didn't have these thyroid problems then. Thanks again. irina