TMI

H Shaunna - thanks so much for sharing with me! It really helps so much. It's so hard to explain how the hypo messes with your head. Wish I had a little warning about that. I was basically euthyroid prior to my surgery.Thanks again

Hi Sherry - thanks for your kind words. BTW - i like your avatar as my "sign" is Cancer! Cheryl

Hi Sherry, When you're feeling better do you mind if I ask you a question as an endocrinologist? My most recent TSH level was 1.4, the doctor told me she usually looks for values in the 0-1 range but I read online that anything under 2 is considered "ok". I am on 0.05 mg of Synthroid and have been for over a year, but I still get hypo sympotoms sometimes. I thought that if you were just under a TSH of 2 but still had symptoms, then you should have your T3 and T4 tested, but my doctor says no, she only goes by TSH level. I thought this was why my primary care wanted me to see an endorcrine specialist in the first place!! Does this seem normal to you? Thanks so much, and if you don't want to answer or aren't feeling up to it after your surgery, that's ok. Shaunna

Thanks Cheryl! I really appreciate you sharing what you've learned. I willl ask her to do the free T3 and free T4 tests and if she refuses, I'll see someone ask or ask my PCP to do it. When you say most people feel better in the mid to upper 1/3 of the normal range, do you mean TSH values closer to 0 or closer to 2? Or were you refering to T3 and T4 numbers?? Thanks again!

Shaunna - sorry - I was referring to the free T3 levels. Again I want to clarify that everyone is different, and that is why it is so important to know what is your normal range. Most women are "happiest" with a TSH around 1. You should start keeping track of your labs and the normal ranges. Example - my lab uses a range of 240 -420 for the "normal" range of Free T3. That is a range of 180 points - you better believe that people are going to feel symptomatic at either end of that range, and yet there are docs out there that will say - your problems are not from your thyroid if you fall "anywhere" in the normal range. Your thyroid gland puts out about 80% T4 and 20% T3, another reason to know what your free T3 levels are. The rest of your T3 comes from converting T4 as Sherry said. That has been my problem. My free T3 levels have been steadily dropping since surgery. I think I may be one of those people who are more dependant on that 20% T3 output that I no longer have. However, since I have been feeling better lately, I'm hopeful that my body has learned to adapt and is doing a better job of converting that T4 to T3. Keep your fingers crossed for me! I encourage you to be proactive about this as at your age, it would not be unreasonable to expect changes in your doses from time to time. Women are 10x more likely than men to become hypothyroid, and many have this happen during the perimenopausal years. I really think all women should have a screening TSH,and Free T3 and T4 in their late 30's to early 40's, just to establish a baseline. Good luck, and keep me posted! Sherry - I was a CCRN for 10 years before I stayed home to raise DS - the medical background really helps when doing research!

Shaunna - I was feeling a little embarrassed about "sharing" so much of my story, but if I have helped you in any way, then I am really glad I did!

You still check FreeT4 as plain T4 includes hormone that is protein bound and not a very helpful number. If you have a thyroid, a TSH is more important as it's hard to predict exactly what your own thyroid is producing, but it should never be the only value used. Synthroid is T4 - but it has a long half-life - I found it could take as long as 2 weeks to notice the effects of dose change - but as much as 4-6 weeks for doses to take full effect. That said, I used to feel a "flush" about the time the pill would be absorbed, and it is possible to have a false high FT4 value if you take it too close to the time of your lab draw. It wouldn't effect either the TSH or the FT3 level. My endo always goes by TSH and FT4, but was willing to monitor FT3 levels as well when I asked for them. If you are on Armour or Cytomel + Synthroid, those combos will depress TSH rendering that value basically useless, and prescribing is done with FT4 and FT3. I don't take my daily synthroid dose until after my labs are drawn, and I make sure that I have them drawn at the same time of day under similar conditions. Had my labs drawn this morning and am anxiously waiting for the new results! Here's a couple of links http://thyroid.about.com/cs/hypothyroidism/a/undertreated.htm http://www.thyroidmanager.org/index.html