As TSH has risen, I have returned to hypo symptoms. Bit confused on % of Ft4 to Ft3 and ratios of % to understand where I am with medication levels. Not sure what the increase from 75mg to 130mg will do to my readings.
BP has risen and cholestrol so doubled my meds.
My doctor was away so saw doctor that takes his patients, he did the increase. He told me all the numbers are for monitoring purposes and the important factor was 'how do you feel'. The answer was I felt awful, leg aches, brain fog, anxieties, must sleep between 3-4pm etc.
I am coeliac and have DH, diabetic.
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bonnyaus
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The doctor you consulted certainly seems to know about how thyroid hormones work especially when :-
"He told me all the numbers are for monitoring purposes and the important factor was 'how do you feel'. "
That's a revelation as most doctors would not make that statement.
The problem with blood test results is they were introduced along with levothyroxine which is T4 only.
When NDT alone was prescribed (since 1892 with no blood tests) - only diagnosed on symptoms and given a trial. Then we had small gradual increases until symptoms were relieved.
If taking NDT, which consists of T3, T4, T2, T1 and calcitonin your doctor is correct that the emphasis is on 'how the patient feels'. This is a more holistic way to treat. The following doctor only took one initial blood test and then all concentration was upon relief of symptoms.
I think many doctors nowadays are unaware of how fatigued we are when trying to get increases in a dose or the addition of T3 to T4. Hopefully they will begin to add T3 to T4 at the very least.
I am fortunate to still have 10 mcgsT3 added to my Levo,( prescribed by my Endo ) I would be very worried if it was taken away.I have considered trying Armour again .I think I would need 2grains to roughly equal my 100/75 Levo + 10mcgs T3, but the pharmacy I could send to for it in my county stipulates needing a prescription.If I were to buy it myself,why would that be?
The doctors in this surgery all treat holistically and a compound chemist is part of the surgery. Of course they do not bulk bill on our Medicare system but so worth the extra.
Click on the tab "hormony tarczycy" for thyroid results.
Put your FT4 result into the box beside FT4, then the figure for bottom of range goes into the box after norma od and the figure for top of range goes into the box after do
Click on oblicz and it will calculate the percentage.
Repeat for your FT3 result.
To get a ratio of FT4:FT3, providing the units of measurement are the same you divide the FT4 figure by the FT3 figure, eg FT4 = 21 and FT3 - 4.5, the ratio would be 21/4.5 = 4.66 : 1
For any other tests click on the tab inne and repeat the process putting the result in the box next to wynik and the figures for the range as above.
So your thyroid results mentioned above give you:
18/4/19
Ft4: 11.4 (10.0-22.0) = 11.67%
Ft3: 3.6 (2.5-6.5) = 27.5%
6/7/19
FT4: 11 (10.0-20) = 10%
FT3: 4.1 (2.8-6.8) = 32.5%
Last test 24/9/19 fasting 8am
Ft4: 12.1 (10.0-20.0) = 21%
Ft3: 3.9 (2.3-5.7) = 47.06%
You can only compare results accurately if all tests are done under exactly the same conditions and it's important to follow the timing for the last dose of thyroid meds before test.
When doing thyroid tests, we advise:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (both Medichecks and Blue Horizon advise to leave Biotin/B Complex off).
These are patient to patient tips which we don't discuss with doctors or phlebotomists.
All tests are done fasting and around 8am. It seems I am leaving too long a gap after day before meds. I did not realise the gap was not 24 hours for NDT. So my blood results read low when they actual are not which explains the hypo symptoms. Is that correct? Just a bit confused.
Also I have read where you talk about where in the range is optimum, the quadrant range. How do you calculate that?
I do have good medical care but I need to understand as I see my primary care doctor about once a year as we are travelling around Australia. Need my ducks in a row if I have to see other doctors on our travels.
So my blood results read low when they actual are not which explains the hypo symptoms.Is that correct?
Just because your results are incorrectly reading lower due to too long between last dose of NDT and blood draw, that doesn't mean you have hypo symptoms. Hypo symptoms are caused when actual result of TSH is higher and FT4/FT3 lower.
The last dose of NDT should be 8-12 hours before blood draw. If you are leaving 24 hours then your FT4/FT3 will be showing false lows and your normal circulating hormone will be higher than the result of that test shows.
Take your latest result:
Ft4: 12.1 (10.0-20.0) = 21%
Ft3: 3.9 (2.3-5.7) = 47.06%
So if you left 24 hours those results are showing low. It's said that you add 20% to your result if you leave too long a gap and that would give a result nearer to your normal circulating hormone level, and if my maths is correct that would give:
FT4: 14.52
FT3: 4.68
Adding 20% is a guestimate, it is not guaranteed to be the actual correct difference so we can only talk approximations where that is concerned.
Also I have read where you talk about where in the range is optimum, the quadrant range. How do you calculate that?
Everyone has their own individual place where they are optimally medicated. As a general thing it's said that when on Levo only most people feel best when TSH is 1 or below with FT4/FT3 in the upper part of the range. When taking NDT it tends to lower, even suppress TSH, and it also tends to lower FT4, so it's FT3 that is the most important test. Only you can know where you need your FT3 to feel optimally medicated although for most people that may be in the upper part of the range.
Thank you. I have another test in 6 weeks so I will adjust the time when I take my NDT to reflect the 8-12 hours before the draw. I usually take the capsule between 6am-7am so will move it to 8pm. I think it is at least 2 hours after eating.
Also I will stop all the supplements I take for a couple of days before.
If you take Biotin or a B Complex containing Biotin (B7), leave that off for 7 days. If Biotin is used in the testing procedure (which many labs do) then results may be false.
If you take B12 then you should also take a B Complex to balance all the B vitamins.
The Biotin in a B Complex will affect some blood tests and give false results if Biotin is used in the testing procedure, which is why it's recommended to leave it off for 7 days. Continuing with our B12 will not affect any other test results, your B12 test result will reflect the B12 that you are taking.
I forgot to say thst all the tests are by the same company but in different parts of Queensland because we ate travelling. So the ranges differ a little. Really not sure why if the same company.
If you are travelling round then even though it's the same company they will very likely be using a local lab rather than send them all to the same lab. Therefore, each lab will have it's own range.
Makes sense so I will ask where the tests will be done next time. Next test will be done in the same lab as not travelling in the next couple of months.
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