Now you need to put the exact lab parameters used that day by that lab (or say, lab ranges the same as last ones I posted) cuz labs differ one from the other and sometimes, even the ranges differ in teh SAME lab from on draw to the next.

That TSH would be WAY too high for ME, but perhaps YOUR lab's ranges start at just under what yours is....and mine starts at: .25-3.0 for instance.

Thanks.

Reference ranges are above...TIA

As you can see, your TSH is too high (but you're just starting? Or excuse me if you're not, but that FT4 would be too high for ME, personally..you see doc's who only give T4 get used to seeing it high in range in FT4 never realizing the person just isn't converting the incoming T4 into any 'usable energy T3'.

And, as you can see, you are NOT converting that incoming T4 into T3. Sigh.

What would I, personally want? (I'm not a doctor, therefore I cannot say what 'should' be done, but I'll try and give MY take):

I would want to drop down to about...oh, say...about 50mcg. of T4 and then have five mg. Cytomel in teh am, and five more about oh...when you need energy..I like my 'other split' about five hours after the first dose of T3 (I'm on Armour...and every grain has about 37MCG. of T4 and about 9mg of T3, and I take two grains a day, one in am, and one about five hours later and I feel well on that, and my FT4 is about midway of range or slightly lower, and my FT3 is between 2/3 and 3/4 of it's range. My TSH MUST MUST MUST be around 1 or slightly under for me to feel well).

But, we are all individuals...but I'm just saying WHAT I'd WANT to try.

OH, and just to add....then I'd 'maybe' want to increase to 10mg. cytomel in the am after my next tests, depending on HOW they looked...and then stay with the 5mg. in the afternoon...and then go from there.

Just had to add 'fuel to your fire' there, lol.

Have a GREAT holiday!

On the adrenal front... be aware that adrenal fatigue is considered by most docs to be a snakeoil diagnosis. As a fairly experienced adrenal patient, I tend to agree from what I've seen of the docs who treat adrenal fatigue. They're just as bad as the endos. The difference is the endos won't accept anything that isn't in a range they define so good luck getting good testing and the adrenal fatigue docs will take anyone on for adrenal fatigue.

An am cortisol would be a good place to start. If it's low (which there are multiple ranges used, some say less than 10, some less than 15--ask the doc, get someone who uses the lowest range) you would want an ACTH challenge.

I hope all you need to do is sort out the thyroid and that will be it.

F

I need to get hold of my last couple panels.

I finally started treatment for hypothyroid in December 2008 - so 3 years now.

I started 12/2008 on 50mcg levoxyl. It helped but didn't eliviate all the symptoms, so I was upped to 75mcg levoxyl.

This past spring, 03/2011 - I requested a change to Armour. Started at 1gram (60mcg). Felt HORRIBLE and without bloodwork, went back to what was working, the 75mcg levoxyl

I maintained a TSH of between 0.90 - 1.20 for almost 3 years on 75mcg levoxyl.

10/2011 - new panel shows a spike to total TSH and the T3/T4 #'s above.

I felt HORRIBLE again leading up to my October appointment - I knew my thyroid was not being treated properly. Anything much above 1.00 TSH and I am not feeling very well. The number was still surprising.

NPam - So googling Cytomel, I see it is a T3 med - and I trust your judgement. I go again for a panel the beginning of next month and will ask my pDoc to go over the results of the 10/2011 draw and try and educate myself to be able to talk to her about trying to get the meds to work together.

What about an Armour / Cytomel combo?

I'm sorry, I feel an 'am cortisol' would be a start for an animal, dog, etc.

But I'd be wanting a 4x in one day salivary cortisol (and you CAN get that ...pm me if you want to know where, I am NOT selling anything, it's a lab that will ship online...and then tell you where to send it too for results that come back to you, there are quite a few, you may already KNOW a few).

I have 22 YEARS experience in advocation with doctor's list who do well with thyroid..but also some for adrenal. WE (myself and another poster) who MUST take steroids ALL the time to sustain our lives...are 'different cases' and I was 'fortunate' to find a doctor who knows this (and even MORE fortunate to have had the research background to 'know the difference and stand toe to toe to 'argue' my point to a physician).

Also, have your ferritin and iron checked (if ferritin is LOW and they give you thyroid hormone, the low ferritin will have the same response as knackered adrenals)...ferritin under 60 is not good, and same for under 70 in iron. Also...lots of people in distress have a good 'morning cortisol' especially on a BLOOD DRAW...my next three salivary takes are HUGE ...all day, all night...who CARES what it looks like in the morning?? It doesn't to me.

If iron and ferritin are low, than an ACTH is going to ALSO be 'off'. It's like dominoes....a 'chain of endocrine' events.

Be aware, also, that if you are taking any sex hormones, they BIND the T4 to T3 conversion (so does black cohosh, evening primrose oil and soy that is not fermented...all can all but stop your incoming thyroid hormone depending on your body's response). That includes taking birth control.

Iron must be taken SIX hours away from thyroid incoming (T4) and calcium is four hours. Or it also 'binds it in the bloodstream'..so THAT is WHY you have the doc do FREE T's...they show what's actually usable...Total T4 and Total T3 only shows what's 'circulating around'.

If you take NO T3 before the test, then a FT3 test is not testing anything at all (except your ability to be able to afford that test). It's up to YOUR doctor..not ME, but MINE wants me to take HALF my daily dose of Armour (if I was taking 10mg. cytomel am he'd want me to take half that) and then he wants that blood drawn at PRECISELY the five hour after mark. Up to the doc.

No, you started at one GRAIN Armour (60mg.). And that should have been 'split' half and half most likely..I would have had heart palps, but, AGAIN, we don't know your adrenal status with a 4x sal. panel, don't know your iron, ferritin, progesterone, etc.

OH, I only 'suggested' Cytomel cuz most T4 huge amount giving docs won't Rx. it!!!

If it were ME??? I'd go back to 60mg. Armour and take half in am and half about five hours later and re test six weeks.

Pam

Update

Wow! Well, since my blood work in October, where I was hypothyroid & upped to 88mcg levoxyl, my latest blood panel are as follows:

TSH
0.372
range
0.450 - 4.500

T3 Free
2.8
range
2.0 - 4.4

T4
11.4 (this seems amazingly high?)
range
4.5 - 12.0

VitD
27.0
range
30.0 - 100.00 (low - wants me to up D3)

B12 / Folate
335 / 9.9
range
211 - 946 / >3.0 (wants me to supplement with some B12)

Ferritin
99
range
13 - 150

Also got a CBC with differential and comprehensive metabolic panel - I don't know what most of the stuff was, but it all fell in "normal" range. I am going to copy & paste results in my journal.

Anyway, pDoc is a little concerned about me falling into hyperthyroid range - although I feel fine Wants to retest in 6 weeks to see if things even out...

Also - suggesting switching from levoxyl to non-generic synthroid? Thoughts?