Re: Lab results that I need some help understanding

[Guest guest]

Hi Jeff

First time posting to the forum although I have

been following the topics for a while. At the suggestion of someone on the list

I have had labs performed and the results posted below. Since these labs were

taken I have switched from 90mg of ND Pig Thyroid to 120 mg of Armour and

started taking 2000 mg of B12 sublingually daily along with 2000 mg of Vit. C

and 1000 mg of Vit. B5 Pantothenic Acid. Half the dosage in the morning and the

other half in the evening. My temperature has averaged 96.5 degrees over the

past two weeks that I have been taking it. If someone could please comment on

the results and offer some direction and advice I would be grateful.

TSH 26.220 as of 12/30.

- I don't understand this reading or

reference range.

Free T4 0.47 Ref. range

0.93-1.70 - this is low

Free T3 3.7 Ref. Range

2.0-4.4 For somebody taking Thyroid extract,

I would have expected the free T3 to be near to the top of the range. Did you

take your thyroid meds on the morning you had your blood drawn or had you

stopped it for 24 hours before?

RT3 (Reverse T3) 88 Ref. Range 90-350

Ferritin Iron reserve -

very IMPORTANT) 348 Ref. Range 30-400 The

range for ferritin for men is usually around 30 to 300

Iron Serum Not taken for some reason unless it is written as something else on

the lab results that I am not familiar with.

Anti-TP 72 REf. Range 0-34 - This is positive for antibodies

TgAb (Thyroid Antibodies) 2,023 Ref. Range 0-40 I may have this reading wrong.

I used the Thyroid Antithyroglobulin Abs result. Correct? This is a very high level of antibodies. The antibodies see your

thyroid gland as public enemy number one and set about its gradual destruction

so the time will come when there will be no thyroid gland left to secrete any

thyroid hormone.

Adrenal Cortisol levels 6.3 Ref. Range 2.3-12.3 Doesn't mean a thing - this is

just a snapshot of what your cortisol level was at that particular time of day.

You should consider getting the 24 hour salivary adrenal profile done at four

specific times of the day and night which Genova Diagnostics can do. Go to our

FILES section accessible from the Home Page of this forum. Scroll down the list

to 'Discouonts on Supplements and Tests' and click on 'Genova Diagnostics'

B-12 462 Ref. Range 211.0-946 - This is too low. B12 is one test

that should be at the top of the reference range. You could boost this yourself

by buying B12 1000mcgs sublingual tablets.

Folate 12.7 Ref. Range 4.6-34.8 - This is a bit on the low side

Magnesium 2.1 Ref. Range 1.70-2.55

Potassium 4.7 Ref. Range 3.5-5.5

Vitamin D3 Wasn't tested unless another name was used

Copper(serum) 80 Ref. Range 90-1.55 WOW - did your GP ignore this.

You are right outside the bottom of the reference range. This is BAD. Go to

your Health Food store and tell them your results and be advised by their

recommendation. I would point this out to your doctor and tell him you are

amazed he let this go without taking any action.

Zinc 117 Ref. Range 70-150 - This is OKish,

but might benefit from being a little higher. You can take 15mgs zinc daily to

help boost this level. If you can get your hands on a zinc tablet, put it in

your mouth and crunch it up, if it taste strongly of copper, this is a sign

your zinc level is low and needs supplementing. If, on the other hand, it

tastes of nothing but chalk, this is a sign your zinc level is fine.

Aldosterone (serum) 3.7 Ref. Range 0-30 - This is also too low.

Thanks in advance,

Jeff

[Guest guest]

Hi Jeff,

So you have a tsh of 26 with a range of .27 - 4.2? Not good. You're aiming

to take enough meds to bring your tsh down to 1 or under and your Free t3 and

Free t4 to the top end of their ranges.

Iron, I think, shows up as mcv, mean corpuscular volume which is the cell size.

If it is small is shows lack of iron and if it is large, lack of B12. Not

sure what happens if you have low iron and low B12.... perhaps they cancel each

other out so your results look fine but you feel terrible (this would not be

a surprise).

Lack of copper means that the cells fail to make use of iron even if it is

there, so you can have anemia but normal readings.... yours is low.

Folate could be higher...

Fastest way to increase B12 is injections, (I don't use the ones based on

cyanide..) one injection is supposed to be equal to a months worth of 1000

mcg taken once a day.... Your B12 needs to be higher

You have Hasimotos disease as evidenced by the high antibodies. This will not

go away until your thyroid is destroyed and the best thing to do is replace the

meds which the thyroid is no longer able to produce.

What is your doctor doing about all this?

>

> TSH 26.220 as of 12/30. Was not retested with the latest labs Ref.

range is 0.27-4.20

> Thanks in advance,

>

> Jeff

>

[Guest guest]

Thank you Shiela and Galathea for the comments and feedback. I greatly

appreciate it. Some more background. I was diagnosed with Hypothyroidism a few

years ago and started with synthroid, switched to Sythroid and Cytomel and then

to Pig tyhroid when the others still were not helping with symptoms of fatigue,

low metabolism, etc. Thanks to your forum and the help of one individual in

particular I began to feel better but the TSH levels actually went down at my

last visit to the Dr.. He wanted me back on Synthroid which I refused to do so

he prescribed 120mg of Armour which I began on 01/31/11. He is patient and is

willing to do what I ask but he thinks its all mumbo jumbo and you can't believe

what the internet tells you. I know that I am not feeling better on his meds

alone and that the underlying issues must be addressed. The proof for me was

your interpretation of the lab results and his failure to think that the low

copper results is an issue. He made no reference to it in his notes to me along

with the labs. He basically justified his position. Still he is willing to

allow me my opinions and works with me which from what I have been reading here

is better than most.

I will head to the store today to check out the supplement for the low copper

readings as well as begin the process of the adrenal swab test ehich I will post

here when I get the results. Oh, I also bought Zinc yesterday and bit into one

of the tablets and it definitely tasted like chalk so I am assuming my zinc

levels are OK. Thanks again.

[Guest guest]

Hi Jeff,

Wrong way round.... If the zinc tablet tastes like chalk you are short of

zinc... If it tastes terrible you are ok.

Zinc and copper work together, Best to take both. You can buy zinc and copper

together in oone tablet from holland and barret.

.

> I will head to the store today to check out the supplement for the low copper

readings as well as begin the process of the adrenal swab test ehich I will post

here when I get the results. Oh, I also bought Zinc yesterday and bit into one

of the tablets and it definitely tasted like chalk so I am assuming my zinc

levels are OK. Thanks again.

>

[Guest guest]

TSH 26.220 as of 12/30. Was not retested with the latest labs Ref. rangeis 0.27-4.20Free T4 0.47 Ref. range 0.93-1.70Free T3 3.7 Ref. Range 2.0-4.4RT3 (Reverse T3) 88 Ref. Range 90-350Ferritin Iron reserve - very IMPORTANT) 348 Ref. Range 30-400

Anti-TP 72 REf. Range 0-34TgAb (Thyroid Antibodies) 2,023 Ref. Range 0-40 I may have this readingwrong. I used the Thyroid Antithyroglobulin Abs result. Correct? (-yes, that is correct)

Some more background. I was diagnosed with Hypothyroidism a fewyears ago and started with synthroid, switched to Sythroid and Cytomel and thento Pig tyhroid when the others still were not helping with symptoms of fatigue,low metabolism, etc. Thanks to your forum and the help of one individual inparticular I began to feel better but the TSH levels actually went down at mylast visit to the Dr.. He wanted me back on Synthroid which I refused to do sohe prescribed 120mg of Armour which I began on 01/31/11. He is patient and iswilling to do what I ask but he thinks its all mumbo jumbo and you can't believewhat the internet tells you. I know that I am not feeling better on his medsalone and that the underlying issues must be addressed.

Hello Jeff,

I am very confused reading the above.... You say you had been diagnosed a few years ago with hypothyroidism, had been on a combination of Synthroid and Cytomel (which is a combination of T4 and T3), then you switched to pig thyroid and now to Armour.....- since `Pig thyroid' and `Armour' are the same thing (both are natural desiccated thyroid), which other `pig thyroid' have you been taking before you were prescribed Armour?

But the most important question is – why is your TSH still 26.22 after years on thyroid medication (particularly since taking natural thyroid medication ????? ) This does not make sense at all. If those figures above are correct, then something is very seriously wrong. After only a few months on any kind of thyroid medication your TSH should have gone down to at least 1 or below, in particular since you have nearly always taken a combination of T4 and T3 .... those figures just do not add up.

You also mention that your TSH levels actually went down.... as if you were expecting the TSH to go up. This is not what you should be expecting. On medication your TSH should go down and your FT's (FT3 and FT4) should go up and on the correct level of medication your TSH should be between 0 – 1, or even below 0, your FT4 and FT3 should be in the upper third of the ref range...... your figures seem to show a reversed picture.

If a TSH is still high after several months -or, as in your case, years – of thyroid supplementation, then that would indicate that thyroid hormone is not getting inside the cells, where it is needed.

Your FT3 appears to be high – indicating that the cells are getting thyroid hormones. Also, your rT3 figure is below the ref range, which I take to mean that rT3 is not an issue here. Your FT4 is low, but for a patient on natural thyroid hormone this would not be unusual.

However – and this is a big `however' – you have tested positive for both types of thyroid autoantibodies – TPO and TgAB and whilst your TPO are moderately elevated, your TgAB are massively high. This could mean that your FT figures might not be what they seem, as high autoantibodies can erroneously alter the thyroid figures. AA's attack the thyroid gland and after an attack loads of extra thyroid hormones get pushed out into the bloodstream, artificially pushing up the blood figures.

Whatever the answers to this riddle – to my mind, if the above figures are truly the results and you have not accidentally muddled up any figures, you need to find yourself a really good endo who will take you under his or her wing. (If you email Sheila privately, she will send you a list with endo's known to be sympathetic to combination therapy of T4 and T3 or to Armour). I assume that you are currently just under the care of a GP (?) (although it is rare that a GP prescribes Armour on NHS, so I wonder)..... If, however you are already in the care of an endo, then I cannot comprehend why he is not investigating further, given those results and circumstances. Has a scan of your thyroid gland ever been suggested? - or any other attempt been made to get to the bottom of what is going on here ? You need some answers, Jeff. To have a TSH of 26.22 after years on thyroid medication and for an endo to do nothing about it is just not on.

With best wishes,

[Guest guest]

>> > TSH 26.220 as of 12/30. Was not retested with the latest labs Ref. range> is 0.27-4.20> Free T4 0.47 Ref. range 0.93-1.70> Free T3 3.7 Ref. Range 2.0-4.4> RT3 (Reverse T3) 88 Ref. Range 90-350> Ferritin Iron reserve - very IMPORTANT) 348 Ref. Range 30-400> > > > Anti-TP 72 REf. Range 0-34> TgAb (Thyroid Antibodies) 2,023 Ref. Range 0-40 I may have this reading> wrong. I used the Thyroid Antithyroglobulin Abs result. Correct? > (-yes, that is correct)> > > > Some more background. I was diagnosed with Hypothyroidism a few> years ago and started with synthroid, switched to Sythroid and Cytomel> and then> to Pig tyhroid when the others still were not helping with symptoms of> fatigue,> low metabolism, etc. Thanks to your forum and the help of one individual> in> particular I began to feel better but the TSH levels actually went down> at my> last visit to the Dr.. He wanted me back on Synthroid which I refused to> do so> he prescribed 120mg of Armour which I began on 01/31/11. He is patient> and is> willing to do what I ask but he thinks its all mumbo jumbo and you can't> believe> what the internet tells you. I know that I am not feeling better on his> meds> alone and that the underlying issues must be addressed.> > > > Hello Jeff,> > I am very confused reading the above.... You say you had been diagnosed> a few years ago with hypothyroidism, had been on a combination of> Synthroid and Cytomel (which is a combination of T4 and T3), then you> switched to pig thyroid and now to Armour.....- since `Pig> thyroid' and `Armour' are the same thing (both are natural> desic cated thyroid), which other `pig thyroid' have you been> taking before you were prescribed Armour?

I ordered Thiroid from Greater Pharma in Thailand when I switched from Synthroid because at the time I wanted to switch Armour was in short supply and had some back order issues so I decided to go with a non prescription thiroid. After these last tests my Dr. recommended going with Synthroid again which I refused so he suggested Armour. Because of my elevated TSH readings compared to the last test with him over a year ago he believed that the thiroid I was using was ineffective. I went with the Armour because its covered by my insurance and easier to get. > > But the most important question is – why is your TSH still 26.22> after years on thyroid medication (particularly since taking natural> thyroid medication ????? ) This does not make sense at all. If those> figures above are correct, then something is very seriously wrong. > After only a few months on any kind of thyroid medication your TSH> should have gone down to at least 1 or below, in particular since you> have nearly always taken a combination of T4 and T3 .... those figures> just do not add up.

I wish I had an answer for you but I can't explain it either unless the undrlying issues of adrenal fatigue, low copper and zinc levels, etc. have had an adverse affect on the thiroid or as my Dr. suggests the pig thiroid from Thailand was not good. Of course my Dr. argued that the synthetic thyroid was working as my levels were lower when on it. > > You also mention that your TSH levels actually went down.... as if you> were expecting the TSH to go up. This is not what you should be> expecting. On medication your TSH should go down and your FT's (FT3> and FT4) should go up and on the correct level of medication your TSH> should be between 0 – 1, or even below 0, your FT4 and FT3 should be> in the upper third of the ref range...... your figures seem to show a> reversed picture.

My mistake. The levels were elevated not suppressed. > > If a TSH is still high after several months -or, as in your case, years> – of thyroid supplementation, then that would indicate that thyroid> hormone is not getting inside the cells, where it is needed.> > Your FT3 appears to be high – indicating that the cells are getting> thyroid hormones. Also, your rT3 figure is below the ref range, which I> take to mean that rT3 is not an issue here. Your FT4 is low, but for a> patient on natural thyroid hormone this would not be unusual.> > However – and this is a big `however' – you have tested> positive for both types of thyroid autoantibodies – TPO and TgAB and> whilst your TPO are moderately elevated, your TgAB are massively high.> This could mean that your FT figures might not be what they seem, as> high autoantibodies can erroneously alter the thyroid figures. AA's> attack the thyroid gland and after an attack loads of extra thyroid> hormones get pushed out into the bloodstream, artificially pushing up> the blood figures.> > > > Whatever the answers to this riddle – to my mind, if the above> figures are truly the results and you have not accidentally muddled up> any figures, you need to find yourself a really good endo who will take> you under his or her wing. (If you email Sheila privately, she will send> you a list with endo's known to be sympathetic to combination> therapy of T4 and T3 or to Armour). I assume that you are currently> just under the care of a GP (?) (although it is rare that a GP> prescribes Armour on NHS, so I wonder)..... If, however you are already> in the care of an endo, then I cannot comprehend why he is not> investigating further, given those results and circumstances. Has a scan> of your thyroid gland ever been suggested? - or any other attempt been> made to get to the bottom of what is going on here ? You need some> answers, Jeff. To have a TSH of 26.22 after years on thyroid medication> and for an endo to do nothing about it is just not on.> > I live in the States so that might explain the fact that my Dr. prescribes Armour. He is not an endo. but he states its an interest of his but I can't explain why he doesn't take an interest in my total lab results just the ones that support his decisions. I am grateful that he at least will work with me. He has suggested that I see a more holistic co-worker of his and I am going to schedule an appointment with her to see if she is more willing to address these issues. In any case I at least have taken charge of my own recovery and feel more in control at this point. > > With best wishes,> > >

[Guest guest]

>> > Hi Jeff,> 120mg Armour isn't really a large dose- many folk need 180mg or more. If you are adequately medicates that TSh is a poor indicator- often it will be >0.01 which does not matter a jot -it's the Ft4 and most importantly Ft3 levels that matter.> you've got it backwards about the zinc- chalky means low levels and a sharp metaiilc taste means levels are OK- supplement for a month and try sucking it agian and you'll see the difference!> >Got it! I will supplement for a month and see what happens!

> > thyroid treatment@...> > From: jeff2051@...> > Date: Sun, 6 Feb 2011 10:38:18 +0000> > Subject: Re: Lab results that I need some help understanding> > > > > > > > > > > > Thank you Shiela and Galathea for the comments and feedback. I greatly appreciate it. Some more background. I was diagnosed with Hypothyroidism a few years ago and started with synthroid, switched to Sythroid and Cytomel and then to Pig tyhroid when the others still were not helping with symptoms of fatigue, low metabolism, etc. Thanks to your forum and the help of one individual in particular I began to feel better but the TSH levels actually went down at my last visit to the Dr.. He wanted me back on Synthroid which I refused to do so he prescribed 120mg of Armour which I began on 01/31/11. He is patient and is willing to do what I ask but he thinks its all mumbo jumbo and you can't believe what the internet tells you. I know that I am not feeling better on his meds alone and that the underlying issues must be addressed. The proof for me was your interpretation of the lab results and his failure to think that the low copper results is an issue. He made no reference to it in his notes to me along with the labs. He basically justified his position. Still he is willing to allow me my opinions and works with me which from what I have been reading here is better than most. > > > > I will head to the store today to check out the supplement for the low copper readings as well as begin the process of the adrenal swab test ehich I will post here when I get the results. Oh, I also bought Zinc yesterday and bit into one of the tablets and it definitely tasted like chalk so I am assuming my zinc levels are OK. Thanks again. > > > > > > > > > > ------------------------------------> > > > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> > > >

[Guest guest]

and Jeff:

, you mentioned that Jeff got it wrong with the taste of zinc. However,

Sheila posted the following in her response to Jeff on February 4, 2011:

" If you can get your hands on a zinc tablet, put it in your mouth and crunch it

up, if it taste strongly of copper, this is a sign your zinc level is low and

needs supplementing. If, on the other hand, it tastes of nothing but chalk, this

is a sign your zinc level is fine.

So, chalky means fine, coppery means need. Clarification may be in order.

Onward!

Mari

[Guest guest]

Hello Jeff,

I ordered Thiroid from Greater Pharma in Thailand when I switched from Synthroid because at the time I wanted to switch Armour was in short supply and had some back order issues so I decided to go with a non prescription thiroid. After these last tests my Dr. recommended going with Synthroid again which I refused so he suggested Armour. Because of my elevated TSH readings compared to the last test with him over a year ago he believed that the thiroid I was using was ineffective. I went with the Armour because its covered by my insurance and easier to get

Ah right, thanks for the explanation.... it's all beginning to make sense now. However, although it is the obvious choice for you to get a prescription for Armour (now that it is available again), it is nonetheless highly unlikely that – as your doctor suspects – the Thiroyd is to blame for your increase in TSH..... very unlikely indeed! I have been taking the same Thiroyd continuously for nearly the past 2 years now and it is working wonderfully. My thyroid parameters are all where they should be – my TSH has consistently been at <0.03 and the FT4 and FT3 both correspond optimally with my dosage of 2 grains/day. Many of our members take Thiroyd and if any of the batches had led to a significant increase in TSH, I am sure we would have heard about it. My own doctor does the same thing as yours, btw, – whenever I have some unusual (non-thyroidal) blood results, his first reaction is to blame "those pills from Thailand" <g>....

I wish I had an answer for you but I can't explain it either unless the underlying issues of adrenal fatigue, low copper and zinc levels, etc. have had an adverse affect on the thiroid or as my Dr. suggests the pig thiroid from Thailand was not good. Of course my Dr. argued that the synthetic thyroid was working as my levels were lower when on it. I am sure that you can rule out the possibility of the Thiroyd from Thailand not working properly. Other underlying issues – yes. Adrenal fatigue, if you suffered from that badly, could well be an issue. Do you know your adrenal profile results? Have you been tested? Do you take adrenal support?

Low Copper and Zinc ... hmmm, they would have an influence, yes, but I cannot believe that alone would be enough to push up or keep up a TSH level of above 26; there is more to it. Your TSH level at present – after years on thyroid medication – is currently higher than mine or that of most our members has ever been... and that is to be taken seriously. All other thyroid figures (TT4, FT4, TT3, FT3) can be influenced by all sorts of things, but - to the best of my knowledge – not the TSH. This is why doctors pay kudos to the TSH and think it's the absolute gold standard for managing thyroid treatment..... well, they got that one wrong – once a patient is on treatment, the TSH's role is to go down and stay down. If the TSH despite thyroid treatment climbs up to a count of 26, then the only explanations I have is that for some reason either your cells are not receiving any of the thyroid hormones that you are taking, or (and that is the more likely scenario) that there is a problem with your hypothalamic-pituitary axis. I have copied a comment from the below medscape website – please see:

http://www.medscape.com/viewarticle/705879

Markedly elevated TSH levels without low or at least low-normal thyroid hormones suggests other diagnoses or reasons for the discrepant dose requirements such as heterophilic antibody interference with TSH measurements, TSH secreting pituitary tumours, or thyroid hormone resistance syndromes. If the thyroid hormone levels are not low, more investigation and establishing the correct diagnosis are essential.

Just for interest... do you have any previous TSH figures from the time when you were taking Synthroid? How high did your TSH start off with before treatment, and what was the lowest figure you ever reached?

I live in the States so that might explain the fact that my Dr. prescribes Armour. He is not an endo. but he states its an interest of his but I can't explain why he doesn't take an interest in my total lab results just the ones that support his decisions. I am grateful that he at least will work with me. He has suggested that I see a more holistic co-worker of his and I am going to schedule an appointment with her to see if she is more willing to address these issues. In any case I at least have taken charge of my own recovery and feel more in control at this point. I agree, it is necessary for you to see somebody else. Commendable as your doctor's interest in thyroid matters is, an interest alone is not enough .... not with your results – you need someone with thyroid knowledge. I believe that there is more to it than meets the eye, and I reckon it would be a good idea to have a thyroid specialist take a look, perhaps do a needle biopsy of the thyroid, or a thyroid scan to look for any abnormalities, perhaps a CT brain scan to check the pituitary function – I don't know what in particular, nor do I know of all the available options, but something is clearly not working as it should, and it needs investigating. According to your TSH your cells are saying loud and clear that they are not getting any thyroid hormones despite the fact that your FT3 says the opposite and there does not appear to be an rT3 issue which might explain this discrepancy. So either `something' is making your pituitary gland malfunction and send out the wrong signal, or your FT3 figure is not what it appears to be..... or there is something else going on. You do need a specialist to look at you, Jeff.

Please keep us posted of any progress.

With best wishes,