BellaOnline Forums Health and Fitness Thyroid Health New: Help with Labs, Possible Conversion Problem?

Hey everyone well it turns out that after going hypo between Apr-May, I have now gone hyper. Besides my hair falling out and feeling a bit hot, my fibro pain has greatly diminished. I can handle fatigue and hair loss but I cannot handle pain. Anyways I think the pain my have dramatically diminished and my mood improved because my ft3 went up to mid level for the first time in a year and half! It has always been low - mid low. My ft4 went way up too. I still think though that even though I went hyper and ft4 went way up ft3 was low, ratio wise. I hope I am explaining my self correctly. So now I'm down to 224 from 250, unfortunately I figured this out after I went to my doctors app and compared my past labs with my current ones. Now, I have to wait two months for my blood work, and I'm sure my ft3 will come down to low and I will feel bad again. But at least know and I can prove it. My ferritin also went up, I also think that helped me feel better. Even My atibodies went down!
My ft4 is alway optimal mid-level to high even when my tsh goes up, know I just have to be patient. Maybe I do have a conversion problem? Here are my lab results your help is highly appreciated!

April
TSH- 1.31 (.40-4.50) High mine has to be below 1.0
ft4- 1.3 (0.8-1.8) optimal!
ft3- 234 ( 230-420) doc agreed it was lower that would like but thought it would improve with optimal tsh.
Ferritin 8 ( 10- 154) Low
Antibodies >1000 high ( <35)

June
TSH- 0.02 (.40-4.5) low
ft4- 2.1 (0.8-1.8) high
ft3 364 (230-420) normal ?
Ferritin 15 ( 10-154) normal but could use improvement
Antibodies 784 High (<35) but they came down!!!

TOB,

Your TSH alone would seem to indicate over-treatment and I'm sure from your post, that you're on thyroid hormone therapy. I also take from your info, that you're on a T-4 only replacement medication.
Looking at just your Free T-4 & T-3, you don't look terribly over-treated but could use a slight dose decrease in my opinion (such as 12mcg) but I'm hoping your Dr. doesn't overeact and cut the dose by half or a third because if he does so, your joint/fibro pain may return.
I can say from personal experience that I suffered joint/muscle aches from being uner-treated and mine near-completely resolved when my dose was increased to adequate level. I'm also the type patient whose TSH does not properly reflect my thyroid dose level. My TSH was 0.01, even lower than yours but my Free T-4 was at mid-range and Free T-3 at just slightly above mid-range.
Some Dr.s over-react to a low or undetectable TSH, when the Free T-4 & T-3 are the more important indicator in some patients. This is especially true in those whose TSh levels have proven to be unreliable (rare but happens).
Your labs do seem to indicate a slightly slow conversion of T-4 to T-3 but I'm not sure it's pronouced enought to change your medication brand. I feel in your case I would monitor symptoms after a slight dose increase and if they return, discuss a change to a T-4/T-3 combination medication. I also personally do better of natural T-4/T-3 (Armour) and had unsatisfactory results on Thyrolar the synthetic version but may not be true of all patients. Both are made by the same company. Another option, would be for your Dr. to lower your T-4 dose slightly and simply add a little T-3 to your dose (Cytomel).
These are just some ideas to think about and discuss with your Doc. I also feel your ferritin levels needs improved because some people claim to experience some symptoms of low iron even at the level you are at. A reading of near mid-range would be a better goal and at least up to about a 50.

Make sure to see my post about my free audio, you can click and listen to via the link I provide. I actually go into T-4 to T-3 conversion in it somewhat, among a number of other things.

Jimlow,
Thanks for the response, it makes sense what you say about tsh, no matter how optimal my tsh is I still feel I am missing something. I am hoping that by going down from 250 to 224 I will not feel bad again. I am looking foward to my next set of labs and see the improvement and to talk to my doctor about adding some t3 cytomel, if things do not improve. Armour would me my last hope, just because of the difficulty of finding a good experienced doctor who prescribes it. But it is exciting to know that I may just need to tweak my med a little for alot of relief! Now if only the doctors would get it!!