Labs fluctuating so much. Confusing.

[DiamondH2020]

I really enjoy this board and appreciate the feedback. I have had a Hashimoto's diagnosed since 2019 with High TgAb antibodies and low t3. Finally found a good doc who put me on 25mcg of Sythroid and 5mcg of Liothyronine. Many of the symptoms disappeared. My Ft3 has still stayed on the lowest end of the scale so we changed to 10mcg and then 12.5 mcg of Liothyronine in January 2021. In early May 2021 I got Covid (mild case). Since then my labs have been crazy. At the end of May my FT3 was 2.06 pg/mL R-2.020-4.430, FT4 0.62 ng/dL R-0.93-1.70, TSH 1.40 uIU/mL R-0.250-4.200 . Dr was concerned with my low Ft4, so upped the Synthroid to 75mcg. Liothyronine stayed at 12.5. At the end of July I had more labs and came back high, but I did take the meds that morning with a late afternoon blood draw. FT3 4.82pg/mL R-2.020-4.430, FT4 1.60 ng/dL R-0.93-1.70, TSH <0.005 R- 0.250-4.200 . Was scheduled to have an appt in August but Dr had to cancel and push back to mid October. So, on my own, I cut the Synthroid in half to 35mcg, as I was worried about the high results. I just had my regular GP run labs and now it shows T3 Uptake 21 Flagged Low. Range 24-39. T4 8.3 range 4.5- 12.0, T4 Index 1.7 range 1.2-4.9, TSH 0.281 range 0.450-4.500 flagged low. Meds taken 24hrs before.

So, it is confusing to have the flagged low TSH and low T3 still after the high reading in July. Can anyone have any feedback?

[greygoose]

I think one of the problems here is that you're not always doing your blood draw at the same time of day. That is very important if you want to be able to compare them, as levels change throughout the day.

May - dose: 25 mcg levo; 12.5 mcg T3

FT3 2.06 pg/mL (2.020-4.430)

FT4 0.62 ng/dL (0.93-1.70)

TSH 1.40 uIU/mL (0.250-4.200)

July (took levo too close to blood draw, but possibly ok for T3, but you don't give the actual times) 75 mcg levo; 12.5 mcg T3

FT3 4.82pg/mL (2.020-4.430)

FT4 1.60 ng/dL (0.93-1.70) False high

TSH <0.005 (0.250-4.200)

on my own, I cut the Synthroid in half to 35mcg, as I was worried about the high results

I don't understand why you did that, because not only was your FT4 well in-range, but you took your levo too close to the blood draw, so got a false 'high' FT4.

I just had my regular GP run labs and now it shows:

T3 Uptake 21 Flagged Low. (24-39) Useless test, doesn't give you any helpful information.

T4 8.3 (4.5- 12.0)

T4 Index 1.7 (2-4.9) Another useless test.

TSH 0.281 (0.450-4.500) flagged low. Unimportant.

Pretty useless labs, actually, because there's no FT4 or FT3, so you really can't compare them.

Meds taken 24hrs before.

But, if you took your T3 24 hours before the blood draw, you would have a false low FT3. You should only leave 8-12 hours.

It's bound to be confusing if you do bloods in that haphazard way, because there's no way you can compare them. So, if I were you, I'd reinstate the 75 mcg levo, wait six weeks and then retest in the recommended way:

* early morning blood draw - before 9 am

* fast over-night

* leave 24 hours between your last dose of levo and the blood draw

* leave 8 to 12 hours between your last dose of T3 and the blood draw.

See what you have in the way of results then.

.

[DiamondH2020 in reply to greygoose]

Thanks for the info. I had just read where you needed to delay the dosing. In all n previous labs I always took the normal dose in the AM, regardless of lab timing. May labs were taken around 10AM, after normal meds. I was not aware that is is 24hrs for Levo and just 8-12 for Lio. The July labs, meds were taken 3 hours before. No Dr ever told me to delay, so glad to learn it now. Not sure why my GP does those labs, she was the one to find the antibodies, so grateful to finally have a diagnosis. I sure appreciate the information. Thank you!

[greygoose in reply to DiamondH2020]

You're very welcome. Doctors just don't understand how it all works well enough to explain how to do things properly. You have to live with it for years, and actually do some research, to get a grip on all that.