Private labs showing high levels need advice

[jeanie245]

Hello, everyone, I need help with figuring my med adjustment. I am on thyroid meds for last 2 years.

I just had some lab work done on my own, and wanted to test my free T3, TSH, and T4 privately. (without it showing on my medical records.) I got the tests done 12 hours after last dose of levo (88mcg) and 3 hours after last dose of T3 -- Cytomel (10 mcg), because I wanted to see the numbers differently

I normally take 88 mcg levo and 10 mcg of T3 --cytomel at 2:30 am, and then 10 mcg of cytomel at 10:30 am.

My labs showed the following:

TSH - third generation <0.010

Range being 0.400 - 4.100 UIU/ML

T-UPTAKE 36.1 ---- with range at 24.3 to 39.0 / %

T4 (THYROXINE) 6.2 ----- with range at 4.5-10.5 / UG/DL

CORRECTED T4 (FTI) 6.9 ----- with range at 4.2-11.6 / UG/DL

FREE T3 [H] 5.5 ----- with range at 2.2-4.2 / PG/ML

I go to the doctor in 3 weeks and she will run my tests for the medical record for T3 T4, TSH, and B12, Ferritin, Iron, etc. My last labs showed very very high B12, normal iron and ferritin.

I still am tired, fatigue, sleep well, but not very much energy, constant headaches all the time, and irritable. I dont really feel very well. I think my T3 is too high, so should I cut it down to 15 mcg for the next 3 weeks, or cut down my levo? I take Unithroid, or cut down both?

When I get the lab work done from the Doctor,in 3 weeks, I will do the testing 24 hour after my levo and 8-12 hours after last dose of cytomel. I dont want the endo to cut back my meds too much if it shows high results. He is not that informed about what the levels of the hormones should be, but he does give me T3 -- cytomel.

Please share your thoughts with me. Thank you

Jeanie

[greygoose]

The only test of any use in that lot is:

FREE T3 [H] 5.5 ----- with range at 2.2-4.2 / PG/ML

And, of course that's going to be high if you took your T3 three hours before the blood draw. It was at its peak. But, that peak isn't going to last. The reason we say to have the blood draw 8 to 12 hours after your last dose is that it will show the usual circulating level of T3 in the blood, the level you have for the longest time in the day. Having a high peak doesn't mean you should reduce your dose, because that would mean that for most of the time, you would be under-medicated.

The T4 tested are out-moded tests that give you little information. What you need is the FT4.

As for the TSH, depends what time of day you took the blood. And you don't tell us that. But the fact that it's suppressed is not, on its own, a good reason to reduce your dose.

[jeanie245 in reply to greygoose]

Thanks so much greygoose !!

I did take the tests at 2 pm. When I go for my doctors testing in 3 weeks I will wait the 12 hours for cytomel and 24 hours for levo.

Anything else I should get tested? Free T3. FreeT4. What about reverse T3 ??

Thank you

[greygoose in reply to jeanie245]

OK, so that's why your TSH is so low. Before 9 am it would have been higher.

No point in testing rT3, it doesn't give you any information that you can't get from testing FT4 and FT3. For example, if your FT4 is high, then your rT3 is going to be high, too. That's the way it works.

However, there are many, many reasons for high rT3 that have nothing to do with thyroid. So, the test will tell you if it's high, but won't tell you why.

Have you ever had your antibodies tested: TPO antibodies and Tg antibodies, If not, it's a good idea to get them done.

My last labs showed very very high B12, normal iron and ferritin.

What do you call 'normal' iron and ferritin? Just being somewhere within the range doesn't mean they're optimal. And optimal is what you need.

Have you been supplementing B12?

How about vit D and folate?

[jeanie245 in reply to greygoose]

Oh okay. So I should continue with folate and iron and B12. On 8/21 my B 12 was 1461 --- range is

High pg/mL 232-1245

My Ferritin, Serum was 63 with range at

ng/mL 15-150

My Vitamin D, 25-Hydroxy was 34.5 with range of

ng/mL 30.0-100.0

Do you suggest I continue with B12 and iron and folate? Thanks so much Greygoose.

[greygoose in reply to jeanie245]

So I should continue with folate

I don't know, you haven't said what your level was.

On 8/21 my B 12 was 1461 --- range is

High pg/mL 232-1245

Yes, that is high. How much are you taking? Are you taking a b complex with it?

My Ferritin, Serum was 63 with range at

ng/mL 15-150

That is low, yes, but have you had your iron tested?

My Vitamin D, 25-Hydroxy was 34.5 with range of

ng/mL 30.0-100.0

Good lord! Your doctor should be giving you loading doses!

[jeanie245]

Thank you greygoose!! I really appreciate your feedback ! I will get all the tests in 3 weeks and folate iron ferritin b12 I really appreciate you ! 😀