Blood results with ranges

[soupybp]

I cannot figure out how to get back to my original post, so I am sorry that this is disconnected from the background. At that time, I didn't have the ranges to go along with my daughters numbers. I have those now. For the most recent draws:

TSH - 6.81 (0.3-3.8)

Free T4 - 0.91 (0.8-1.8)

T3 - 102 (80-200)

Free T3 - 2.71 (2.3-3.8)

Reverse T3 - 9 (8-25)

TPO - 11.4 (0-31)

Tg - <10 (0-60)

Vitamin D 25 hydr. - 25 (30-100)

After receiving the final component of these numbers, the ob/gyn stated that her "T3 was borderline" - prescribed 30mg Armour and 5000IU Vitamin D. She commenced the medicine on 10/18. Unfortunately, she is currently in hospital - we were trying to make it to the first appointment with the new psychiatrist (after over 2 months with no psych care as we were waiting), but the suicidal thoughts turned too far into intentions with her last menstrual cycle.

I would most appreciate thoughts on these numbers from all you well-versed people as I am still learning...and knowledge is power!

[SlowDragon Administrator]

Her TSH is above range, so this confirms she's hypothyroid

Her antibodies are negative, however EDS is linked to having autoimmune diseases.

Has she had an ultrasound of her thyroid?

This can confirm if Hashimoto's is present, despite negative antibodies

When hypothyroid we tend to have low stomach acid and then vitamins drop

Obviously her vitamin D was very low and now being supplemented.

Has she had B12 and folate tested? Or ferritin?

Low FT3 is linked to severe depression and it's good she has been started on Armour as this contains T3 and T4

[soupybp in reply to SlowDragon]

There has not been an ultrasound at this point. I have it on my list of things to discuss at our next appointment.

She has not been tested for the B12, folate, or ferritin. I have those on a list. She is slated to have blood drawn in the near future for sex hormone levels after ovulation. I intend to get orders in place to have those items drawn at the same time to minimize the number of draws for her.

Here and some other good sites I see that some of her symptoms could definitely be from thyroid. The OB/GYN was of that same thought. And the fact that we see more symptoms in the "psychosis" type range manifest 3-4 days before menstruation and the first few days, he expects to find an issue in those hormones as well.

Since she is in a mental health hospital for a few days, it is disrupting her tracking her cycle to schedule the blood work appropriately. They have graciously allowed her to have her Creighton charting materials with her and give her supervised, brief access to a pen to make her notes. They are not, however, accommodating of her basal body temperature monitoring. I am hoping she is released soon enough for us to pick that back up while still useful.

I also have on my list to discuss adrenal testing with the doctor when we see him.

What is the minimum amount of time I should wait from her starting the Armour to conducting the retest of thyroid attributes? I don't want to "leave her hanging" any longer than I have to if the dose needs increased.

[greygoose]

Your posts are here:

healthunlocked.com/user/sou...

So sorry to hear about your daughter. x

[soupybp in reply to greygoose]

THANK YOU!!

[soupybp]

Good appointment with new psychiatrist. He did not make any changes pending his reviewing C/T scan from last fall, review of thyroid labs, lithium level check, and EEG. We liked him - He and his physician assistant spent 2.5 hours talking to us.

Also, seems we have a winner with the ob/gyn that we are working with on the thyroid/hormone side. Daughter was in hospital the last full week of October with destabilized mood - ob/gyn called me to check on her and evaluate the role the thyroid medication may have had in that. He was so upset to think he may have caused it (he didn't - other factors in play).

Got gp to give us an order for some additional testing too:

folate - 17.3 (>4.5)

B12 - 820 (200-900)

ferritin - 38.1 (20-324)

lithium - 0.4 trough (0.5-1.5 therapeutic range)

Lithium is low. She had been riding right at the low end of the range when tested 1 and 2 weeks after starting the medication. That would be a definite contributor to her recent complete lack of appetite. We also believe that the lithium has sent her eczema into an absolute tizzy (based on timing...).

Looks to me like the folate and ferritin aren't quite where they need to be.

Note that she started Armour thyroid 30mg on October 18 and vitamin D3 5000IU/day on October 15. Thyroid panel scheduled for first week of December (that is just over 6 weeks after starting thyroid med), but no retest on vitamin D3 scheduled yet. Checking D3 again at first of December would be about 6-7 weeks which doesn't seem like quite long enough.

Interesting note:

I saw in her test history in her online portal that there were limited thyroid tests run in November of 2015 (along with CBC/Comprehensive panel/mono screen - all normal):

TSH - 2.89 (.3-3.8)

fT4 - 1.06 (.8-1.8)

Called the gp we were with at that time because I didn't have notes about why we did those tests...and I just couldn't remember. Doc's notes indicate that she was sleeping 12-14 hours a day, not eating, and extremely fatigued. It obviously resolved some time following that because there was not follow up testing or appointment.

Also interesting:

Using Creighton fertility monitoring and basal body temps to identify timing of hormone tests for estradiol/progesterone. I didn't know she was having heavy cervical mucus her entire cycle - would soak a medium flow menstrual pad each day. (Can be related to a hormonal imbalance or thyroid dysfunction.) Also low basal body temps in first half of cycle (96.7-97.1) - possibly indicative of thyroid dysfunction. Yesterday we did first draw in a series to evaluate the estradiol/progesterone levels. Anyone know much about those kind of tests and the results thereof?