New labs came back and MD appt this week

[Goldenrescuemom]

Hi! I’m from the states and having been reading your blog to get good info which I appreciate. Also have a shortage of endos in my area and they focus on DM. Can someone look at my labs and give feedback? I am still having a lot of muscle joint pain and fatigue. I have been taking b12 shots now on drops, d3 and mag 800mg.for at least a yr. My weight won’t budge and my stomach is huge.

4/24 labs:

B12. 971 (200-1,100)

Folate 11.1 ( low <3.4)

Vit d 55 ( 50-100)

Tsh 4.82 (.4-4.5)

T4 free 1.2 (.8-1.8)

Started Levo50mcg 4/24

now labs 7-24

T3 96 (76-181)

Tsh 2.19 (.4-4.5)

T4 free 1.4 (.8-1.8)

I followed advice here about testing before meds before 9 am

Any thoughts?

Thanks!

[SlowDragon Administrator]

push for next increase in dose ….initially 50mcg and 75mcg on alternate days

Retest again in another 8 weeks

No iron or ferritin results

Or thyroid antibodies

Test TPO and TG antibodies at next test

[Goldenrescuemom in reply to SlowDragon]

Thank you!

My doctor did say I did not have Hashimotos based on previous labs. I looked back and found tests done 3/23

Vit d 27(30-100) so this has come up

Tyhroglobulin antibodies<1

Thyroid peroxide 1

Tran 1.6 (

Can the antibodies change?

Thank you !

[SlowDragon Administrator in reply to Goldenrescuemom]

Antibodies can change

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Gluten intolerance is often a hidden issue too.

Request coeliac blood test BEFORE considering trial on strictly gluten free diet

[FallingInReverse in reply to Goldenrescuemom]

What is the range of those tests.

And what is “Tran”? Was there more info or a range on that?

So likely your AB test was “negative” - but also whether it was or not, treatment is the same (ie, Levo).

A negative is an indicator, but actually inconclusive. Antibodies do fluctuate, and all you need is one positive to confirm an autoimmune cause.

That being said - it’s relatively less important to your treatment since you are already on Levo.

[FallingInReverse]

Hello from the US!

Agree with SD - you definitely and simply need to increase from 50 to 75 daily Levo.

I’m also going to guess that’s TOTAL T3 and not FREE T3.

Since you’re in the US, let us know what kind of insurance you have (private? Medicare?) as you need to start getting the right set of blood tests each time you go.

In the US it’s hit or miss if you get the right “thyroid panel”, and outdated or useless tests are often included.

You should be able to just ask for these, you might want to call your insurance and ask if they cover them and how frequently (mine has no cap).

Here is what I get every time:

1) TSH

2) Free T3

3) Free T4

Plus these vitamins

4) ferritin

5) folate

6) B12

7)Vit D3

These should be tested at least once:

1) TRab

2) TSI

3) TPOab

4) TGab

But if it’s all the same, you can get the TPO and the TGab every time.

[Goldenrescuemom in reply to FallingInReverse]

Thank you!

I found a few more labs like antibodies so I posted them. I will ask for the iron /ferritin as I don’t see that one.

I was afraid that my MD will say these are now normal so she won’t increase the Levo.

Thanks so much!

[FallingInReverse in reply to Goldenrescuemom]

There are many doctors who know nothing about the thyroid.

Hard to believe, but very true.

Yours might be awesome and informed! In which case - no problem!

But if your doctor included total T3 and not Free T3, I’d wonder what she was thinking . If she looks at your results, while on 50 mcgs, and hears your symptoms - and doesn’t agree you need an increase to 75 for the next 2 months and then a full blood test done, then you should consider she might not fully understand.

In that case - regroup and plan your strategy! You (usually) can’t teach a doctor about something they think they know about. You just have to educate yourself and find ways to ask and get what you need.

In any event - you are now on the journey to educating yourself… so you can confidently ask for exactly what you need. It’s a process.

.

50 mcgs Levo is a starter dose. General (directional) dosing guidelines are 1.6 mcg per kg of body weight. That means that on average you will see “most/many” people settle somewhere around 100 give or take. If on Levo only, it can be. 100-125-ish.

Don’t expect your doctor to know this, but great if she does.

What many doctors might/do understand if anything is that we generally look for TSH to be around 1. So if you make your case and she says “all normal” because they are “in range”, then she at the very least she might understand the TSH target of 1. Which requires an increas in Levo.

Being “in range” is no more than saying your shoe size falls somewhere between 5 and 10. But if you are a size 8, and you have a size 5 shoe on, who cares if it’s “normal” - it’s not optimal for you.

We are all different though. So it’s through your own understanding of your blood work along with your symptoms that you will be able to advocate for yourself and move towards feeling better.

Keep us posted.

[FallingInReverse]

Also - this: mag 800mg

What is the exact kind of magnesium, and exactly what ingredient is labeled at 800 mg?

[Goldenrescuemom in reply to FallingInReverse]

it’s Nature Made Magnesium oxide. 400mg and I take 2. This is primarily for constipation and I take it at bedtime. It works and I don’t notice a problem.

[FallingInReverse in reply to Goldenrescuemom]

Magnesium is practically impossible to test for, although likely all of us need it, hard to test if we are taking too much.

That amount is probably a little high or as much as double … but also possible the magnesium part is less than 400 and the rest is made up by the oxide part??

Check out this article for good info:

healthline.com/nutrition/ma...

[helvella Administrator Thyroid UK in reply to FallingInReverse]

Also magnesium oxide is very poorly absorbed!