Labs confusion- TSH went up

Katty

Member
Joined
Jan 3, 2013
Messages
396
Received my recent lab results and I'm a little confused. T3/T4 stayed the same, TSH went up.
After being on 1.25 grains of Nature-throid for a while (maybe a year or so?), here were my labs result on 6/6/14:
TSH: .54 (0.30-5.00 mcIU/mL)
Free T3 2.6 (2.0-4.4 pg/mL)
Free T4 0.76 (0.80-1.80 ng/dL)

After these results, I went on synthetic T3 and T4 (both generic) - started with 56mcg of T4 and 12.5mcg of T3. Eventually lowered to 46mcg of T4 for about 4 weeks and 10mcg of T3. Then had the following labs done on 8/13/14:
TSH 1.90 (0.30-5.00 mcIU/mL)
Free T3 2.7 (2.0-4.4 pg/mL)
Free T4 0.74 (0.80-1.80 ng/dL)

I didn't take my meds the day of the lab. T3 and T4 are essentially the same, but TSH jumped up quite a bit. What gives? When TSH goes up, does this mean my T4 supplementation is too low?

Also, when I originally went on natural desiccated thyroid (maybe about 2.5 yrs ago), my labs were actually all in range. Why is my T4 low now? Is it because the thyroid meds temporarily suppress the thyroid, and that if I went off the meds altogether, my thyroid would jump back up to speed in a couple days?
 
OP
K

Katty

Member
Joined
Jan 3, 2013
Messages
396
narouz said:
katty-
What brand of synthetic did you use?
A generic brand given to me by pharmacy. The T4 is manufactured by Lannett, the T3 by Sigma.
 

narouz

Member
Joined
Jul 22, 2012
Messages
4,429
I took dessicated natural for a year or two.
Switched to Cynoplus because I thought it might be more reliable.
Cynoplus is synthetic T4/T3, and "Peat approved."

Seemed to work well for about half a year.
Then...seemed to change...or I changed.
At any rate, I wasn't doing well on it.

So, because many here like Thiroyd, a different natural dessicated thyroid
from what I had taken earlier,
I tried it.
It seems decidedly stronger than the synthetic.
Had to pretty drastically back down my dosage...still working on it.

Peat has said that Armour, when it was well made,
was actually more reliable and consistent than many synthetics.

All this is just to suggest
that you might want to try the Thiroyd brand.
 
OP
K

Katty

Member
Joined
Jan 3, 2013
Messages
396
narouz said:
I took dessicated natural for a year or two.
Switched to Cynoplus because I thought it might be more reliable.
Cynoplus is synthetic T4/T3, and "Peat approved."

Seemed to work well for about half a year.
Then...seemed to change...or I changed.
At any rate, I wasn't doing well on it.

So, because many here like Thiroyd, a different natural dessicated thyroid
from what I had taken earlier,
I tried it.
It seems decidedly stronger than the synthetic.
Had to pretty drastically back down my dosage...still working on it.

Peat has said that Armour, when it was well made,
was actually more reliable and consistent than many synthetics.

All this is just to suggest
that you might want to try the Thiroyd brand.
Thanks Narouz. I've been thinking about that. I kind of want to stick with this for a little while to see how I do. I've been messing with the doses a bit, so I'll stay on the dose my Dr gave me for about 6 weeks and then see where I'm at.
I also prefer to get my Rx from my Dr as opposed to ordering online. I ordered cynomel recently-- it all went fine, but a pain to wait such a long time for it, and difficult to work with the small pills. And I felt horrible on it.

Still a bit confusing for me why my T3 and T4 would stay the same but my TSH would rise.
 

BingDing

Member
Joined
Nov 20, 2012
Messages
976
Location
Tennessee, USA
Katty

I posted a link to an article here that said TSH can vary a lot over 24 hours. One case was 0.3 to 2.0 and the other 1.0 to 5.0. Can't think of anything more.
 

Peata

Member
Joined
Jun 12, 2013
Messages
3,402
Katty I really don't know anything about this, so I'm just throwing something out there, but I've read someone said on the fb pg that TSH can change even throughout the day. It will be lower in the morning because adrenaline suppresses it. Did you happen to get your blood drawn later in the day for these tests? Or eat or drink before the tests?
 
OP
K

Katty

Member
Joined
Jan 3, 2013
Messages
396
BingDing said:
Katty

I posted a link to an article here that said TSH can vary a lot over 24 hours. One case was 0.3 to 2.0 and the other 1.0 to 5.0. Can't think of anything more.

Peata said:
Katty I really don't know anything about this, so I'm just throwing something out there, but I've read someone said on the fb pg that TSH can change even throughout the day. It will be lower in the morning because adrenaline suppresses it. Did you happen to get your blood drawn later in the day for these tests? Or eat or drink before the tests?

Thanks guys. Good to know. Blood was taken around 11am, and I had eaten breakfast already. So I guess it could mean that not much changed really from the last blood draw.

Before going on any thyroid meds, my numbers were always normal (maybe on the low side, but always in range). I'm somewhat concerned that my numbers are lower than range now... maybe the hormones would start up on themselves again if I stopped the meds for several days.
 

ilovethesea

Member
Joined
Feb 9, 2013
Messages
1,115
I have found there is a lot of variation in potency from brand to brand of thyroid, even when you're taking the exact same dose on the label. I would be concerned that your rising TSH indicates you're not getting as potent of a dose as before. I don't tend to pay too much attention to the free T3 and free T4 numbers as they have never correlated well to my actual symptoms. (For ex - they were deemed "perfect" by my doctors when I now realize I was very hypothyroid.) I understand about wanting to go the doctor prescription route, in some ways it is easier. Is your doctor open to increasing dose on the generic to see if TSH goes down? Most importantly - how are symptoms?
 
OP
K

Katty

Member
Joined
Jan 3, 2013
Messages
396
ilovethesea said:
I have found there is a lot of variation in potency from brand to brand of thyroid, even when you're taking the exact same dose on the label. I would be concerned that your rising TSH indicates you're not getting as potent of a dose as before. I don't tend to pay too much attention to the free T3 and free T4 numbers as they have never correlated well to my actual symptoms. (For ex - they were deemed "perfect" by my doctors when I now realize I was very hypothyroid.) I understand about wanting to go the doctor prescription route, in some ways it is easier. Is your doctor open to increasing dose on the generic to see if TSH goes down? Most importantly - how are symptoms?
Thanks for your response! Feeling not good. Part of it is my fault. I took a lower dose of T4 than Dr recommended- I was trying to stick to the Peat recommended 1:4 ratio of T3:T4. I thought I felt better the first 1.5 weeks or so on the synthetic as opposed to on the NDT. But maybe the synthetics hadn't had enough time to kick in yet at that point. Since then I dealt with depression, hair loss, and body odor.
So... Dr wants me on 75mcg of T4- I'll try that for 6 weeks and see. Though I do think my body doesn't like the generic T4 (causing body odor), so maybe I'll see if I can get the brand Synthroid.
TSH went up and I'm feeling worse, so that makes sense.

It's all kind of a bummer. I was making some progress until the switch and now I feel like I regressed. :cry:
 

ilovethesea

Member
Joined
Feb 9, 2013
Messages
1,115
Ah I see. I reached the end of my rope with doctors and the way they "treat" hypothyroidism... I just use them for tests and prescriptions now! It's like talking to a brick wall, they don't hear me.

Have you listened to the Rainmaking interview where Ray talks about the woman whose doctors kept giving more and more T4 (as she wasn't responding to meds) and then she ended up in a coma? They had to give T3 to revive her in the hospital.

I wrote to him asking about ratios and he said most people feel best between 2:1 and 4:1. That has been my experience too... I think T4 can make people feel "ok" initially but long-term can be harmful. I was AMAZED by the dramatic improvements I experienced from simply changing my dose from 11:1 (what my ND had me on) to 4:1. (Now I notice even more on 1:1 but I know that's not exactly what Ray suggests.)

Are you in the US? Could you order from Mexico? I don't think Synthroid would be any different to what you're on now, to be honest. Or maybe you could see if you can find an alternative doctor who'd be open to NDT for you?
 
OP
K

Katty

Member
Joined
Jan 3, 2013
Messages
396
ilovethesea said:
Ah I see. I reached the end of my rope with doctors and the way they "treat" hypothyroidism... I just use them for tests and prescriptions now! It's like talking to a brick wall, they don't hear me.

Have you listened to the Rainmaking interview where Ray talks about the woman whose doctors kept giving more and more T4 (as she wasn't responding to meds) and then she ended up in a coma? They had to give T3 to revive her in the hospital.

I wrote to him asking about ratios and he said most people feel best between 2:1 and 4:1. That has been my experience too... I think T4 can make people feel "ok" initially but long-term can be harmful. I was AMAZED by the dramatic improvements I experienced from simply changing my dose from 11:1 (what my ND had me on) to 4:1. (Now I notice even more on 1:1 but I know that's not exactly what Ray suggests.)

Are you in the US? Could you order from Mexico? I don't think Synthroid would be any different to what you're on now, to be honest. Or maybe you could see if you can find an alternative doctor who'd be open to NDT for you?

Mt Dr is open to NDT. I was on that and then switched to synthetic 8 weeks ago. I felt ok on it, but just felt like I wasn't optimal. And lots of suggestions on the forum for me to switch to synthetic. So that's what I tried. Of course my Dr isn't into the Ray Peat T4/T3 ratio, so I tried that on my own (about 4:1), but apparently that wasn't my optimal dose. T4 is still low. So it doesn't make a lot of sense to me to keep lowering my T4 dose. I could have increased T3, but I kind of felt like it was pushing me too hard--- and I couldn't take more than my Dr prescribed anyway or I would have run out before the end of the month.

I ordered cynomel... tried it for 3 days (same dose as the synthetic T3 I was on so thought it wouldn't make a difference). But i felt horrible on it. Really tight, painful muscles and kind of loopy. Maybe it was just too potent. The dose is hard to work with-- the smallest dose offered was 25mcg and they're tiny so taking, say, 10mcg, is really hard and you never know if you're getting the same dose because you have to bite or cut it. I didn't order any cynoplus because I wanted to see how just one worked. Maybe cynoplus is easier to work with, but after my reaction with the cynomel, in addition to the pain or ordering and waiting for the stuff, I'm not that excited about trying it out.
 

Similar threads

Back
Top Bottom