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Discussion Starter · #1 ·
Hello. I started taking 25 mcg levothyroxine two years ago when I felt lethargic and my TSH came back 9.8, 0.45-4.5 being normal. At least three people in my family have thyroid issues also. As it built up in my body, I felt immediately better. However, I never went for follow up blood tests because I have vasovagal syncope and dread having them done as a result. I just go with how I feel, and since it's a lowest dosage and I feel fine, I'm assuming there is no need to adjust. In the first few weeks, I actually felt I had too much in my system because I had trouble falling asleep and had similar hyperthyroid symptoms. As a result, I've been skipping a dose on Sunday for months now. Am I causing problems down the line doing this?
 

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Discussion Starter · #4 ·
I had two blood tests, one in 2011 when the TSH (Ultra Sen 3rd gen) was 5.88, and one in 2015 the TSH (not sure which test) was 9.81. Since then I didn't have one.
 

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Discussion Starter · #10 ·
I will have them done soon then. It's just the last two times I had a blood test I passed out and I try to avoid it at all cost, but it seems like there is no way around it. What test do I ask for to "dial in"?
 

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Discussion Starter · #14 ·
How are you receiving prescription refills without lab's? Very odd - most doctors require lab's at least annually if not more.
I read a lot so he listens to me, I usually tell him what to prescribe whenever I have a problem. So because of that he trusts me enough to keep prescribing it without labs. Although I have no data, I feel better than before the medication, and I also take the lowest dose possible and at the same time I'm not exhibiting hyperthyroid symptoms so I'm assuming my levels are fine. But I will do the test as it is the only way to be sure.

When I had my blood tested for the first time ever was 5 years ago when my thyroid became diseased.
I almost passed out. So the next time I had blood drawn I told the Phlebotomist that I almost passed out the last time.
She drew my attention away from what she was doing by sparking up a conversation with me.
Before I knew it, it was over and I didn't even feel anything.
Tell the person who draws your blood that you have a tendency to pass out.
After the first couple of blood draws you will get used to it.

Like the previous members told you , you must have blood tests when treating thyroid disease.
Drawing my attention away won't prevent me from passing out. It is not seeing it or feeling it that causes it. It's just my body automatically reacting to it. The last two times I didn't look at the needle and didn't feel it, yet both times after 30 seconds to a minute I passed out, like clockwork. I'm gonna try getting it drawn from my hand, lifting my feet up, and tensing all my other body parts. I read they could help to prevent this type of fainting.
 

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Discussion Starter · #15 ·
I can imagine passing out during blood tests is unpleasant at best, but...its required for thyroid meds.

You need TSH, free t4 and free t3.
Ok so I finally had the blood test done after 2 years and 3 months and without fainting once I followed the aforementioned techniques. My TSH is 3.98 (0.450-4.5), free T4 is 1.68 (0.82-1.77), and T3 is 111 (71-180). How do those numbers look?
 

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Discussion Starter · #17 ·
Congrats on not fainting!

Your results are a little odd. Usually when we see a high-ish TSH we see a low FT3 and FT4. Is that T3 result a Free T3? Have they ever run thyroid antibodies?
Thanks! :) It just says T3 on the report, so maybe Total T3? Whereas for the T4 it says Free T4. I don't think I've done the antibodies yet.
 

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Discussion Starter · #20 ·
If you could, I would do TPOAb and TSI or TRAb (the hyper ones). That way you get a more complete picture.
Ok. Testing for TRAb antibodies is done with a TSI/TSAb test which are practically the same thing, correct?
 

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TSI and TRAb are different antibody tests, but sometimes insurance pushes back on TSI so if that happens, TRAb is an okay substitute.
Okay. You mentioned earlier in the thread that usually a highish TSH is accompanied by low FT3/FT4. Is that the case even if you're already taking synthroid?

EDIT: I am asking because those results would occur before starting synthroid. But those were my results after taking it for a while - high TSH and FT4, but both within range. Does that mean I might need a higher dose, to bring TSH closer to optimal range? But then FT4 might rise above the range.
 

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Discussion Starter · #24 ·
When did you take your Synthroid in relation to your lab draw?

Do you have lab's drawn around the same time ?

TSH is usually higher in the morning - it's wise to lab in the morning and before you take your thyroid hormone replacement
I only had one blood test since I started taking Synthroid in April of 2015, and I took the pill maybe 2 hours before the lab. I'm going again Thursday, and won't be taking it before. But that means my TSH is even higher naturally. Something doesn't add up, I need the FT3 also and the antibodies done to find out what's going on.
 

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Due to the long 1/2 life - you may be surprised, it may only be a tiny bit higher.

It's always good to lab without taking hormone replacement though.

It's criminal that you have not had a lab since beginning hormone replacement in April of 2015. You should lab 6 weeks after beginning and every 6 weeks until you reach acceptable levels. If you change your dose be sure to lab in 6 weeks and make sure you do Free T-4 and Free T-3 along with TSH.
I meant I had one since starting, in 2017. That's when the TSH was 3.98 and the FT4 1.68. I figured it wasn't a big deal since I was only borderline hypo as my TSH was 9.8 in 2015 before starting Synthroid, and I am taking the lowest dose.
 

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Discussion Starter · #27 ·
Ok I took the test, unfortunately passed out again since it took longer than last time as my blood was coming out slow :p Results are:

TSH 4.8 (.45-4.5) - went up since last time, although I took the med before test last time, and this time I didn't

FT4 1.65 (.82-1.77)

TRAb .56 (0-1.75)

T3 uptake 32 (24-39)

TT3 107 (71-180)

TPOAb 90 (0-34) - Hashimoto's?

They forgot the FT3. The doctor said she will contact the lab. They can still check FT3 without having to do another draw, correct?
 

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Discussion Starter · #29 ·
As long as they drew enough blood, they should be able to do the FT3 test without having to draw again. How long was it between your last dose of meds and the test? You've got some funky results--a high TSH and a high-ish FT4, so it looks like your TRAb and TPOAb antibodies are to blame.
I took it the day before at 9 am. The test was at 930 am. Do you think I should increase the dose to try to be in the 1-1.5 TSH range? Or try to find the cause of hashimotos and fix it? Most likely that's what I have since the TRAb is fine.
 

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Discussion Starter · #33 ·
I think if you feel there is merit to those kinds of articles, go for it! I'm completely supportive of people taking control of their health.

There is so little concrete scientific evidence that any of those issues listed are "really" the cause of Hashi's that I chose to focus on keeping my labs in a good place. But that works for me and this thread isn't about me. :)
There is nothing wrong with that, and I will try to get my labs in a good place too, but I want to find out more. It's confirmed an autoimmune disorder is causing my thyroid problem, and supplementing thyroid only solves that part, but the underlying disorder remains and can cause other problems. So I want to prevent them. There has been a sudden rise in autoimmune disorders lately, which I suspect is environment/food related and not genetic.
 

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Discussion Starter · #35 ·
Just a note, your TRAb isn't fine; fine would mean it's at zero. You've got a smidge going on but it's still a positive antibody test.
So I have Hashimotos and slight Graves? By the way I didn't mention it but I work out pretty hard at the gym 4 days a week for the past 2 years now. I read it can mess with the thyroid.
 

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I did a blood spot test recently through ZRT labs. Results were:

FT4 1.1 (0.7-2.5 ng/dL)

FT3 3.6 (2.4-4.2 pg/mL)

TSH 2.5 (0.5-3.0 uU/mL)

TPOaB 108 (0.150 IU/mL, 70-150 borderline)

I've been taking 25 mcg Levothyroxine daily at the same time consistently, eliminated everything that can make hypothyroidism worse from my diet (besides coffee), and didn't take the pill before this test. These numbers are good now, correct?
 

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Discussion Starter · #39 ·
Labs look a bit hypo to me on your FT-4 but have to say your FT-3 has recovered quite nicely. I have edited in bold the 1/2-3/4 of your range next to your actual range.

How do you feel?
This is actually the first time they did FT3 for me. My TSH improved though. Are those ranges the ideal ones? I feel ok but seem to sleep more than I should.
 

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Discussion Starter · #41 ·
Goal is to have both FT-4 and FT-3 to fall somewhere between 1/2-3/4 of the ranges.

Alot of people report a TSH of 1 is optimal. I for one do not run TSH due to stimulating antibodies.

If your FT-4 or FT-3 is too high - most people would report higher TSH.

If you get your FT-4 a tad higher your TSH will likely fall.
I see. So I'd need FT4 to be slightly higher and my TSH to be around 1. Should I increase dosage to 50 mcg?
 
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