Question about Timing for Med Ajustments

[Guest guest]

Hi, everyone,

My doc just changed me about 10 days ago from Synthroid (137 mcg) to Armor (90

mg) since

my energy level had dramatically decreased a couple of months ago. I have had a

couple of

good days but the rest pretty much the same, way too low energy (+ too cold,

constipated,

yadda yadda). I'd like to wait the necessary amount of time before requesting an

increase but

not longer since I'm sick of wasting so much time sleeping/resting. (Meanwhile

my GP is

testing adrenals, other reasons for fatigue).

I have an appt. w/ my endo to return for bloodwork in 6 wks., but I was

wondering: how long

does it take for you to feel the full effects of a med change? Will it take 6

wks., 2 wks. several

months, or a few days to notice a change? (I guess it takes 4-6 wks. to show up

in your TSH,

right?) I know T3 has a very short half life but when hormones are concerned

sometimes it

can take a while for things to balance out. If I call my endo and say it's not

working now

(have been on Armor about 2 wks.) and he says let's wait 6 wks., does anyone

have

studies/talking points for arguing for not waiting? Thanks!!

Glad the N. Texas meeting is now next Monday, maybe I'll be able to come!

Gail

[Guest guest]

You may need an increase in the Armour or the addition of some T4. Besides Free T3 and Free T4 tests after 6 to 8 weeks, I would ask the doc to order serum ferritin. Ferritin below about 50-100 can cause hypothyroid like symptoms.

If you have labs from the time you were switched, you might want to post them together with the reference ranges and the exact name of each test.

If your doc is adjusting your meds based on your TSH, you are doomed to be forever undermedicated and may require my favorite surgery: a radical doctorectomy.

Your GP is testing your adrenals? Which tests? Be aware that the 24 hour urine cortisol test is useless except for diagnosing Cushings.

>> Hi, everyone,> > My doc just changed me about 10 days ago from Synthroid (137 mcg) to Armor (90 mg) since > my energy level had dramatically decreased a couple of months ago. I have had a couple of > good days but the rest pretty much the same, way too low energy (+ too cold, constipated, > yadda yadda). I'd like to wait the necessary amount of time before requesting an increase but > not longer since I'm sick of wasting so much time sleeping/resting. (Meanwhile my GP is > testing adrenals, other reasons for fatigue). > > I have an appt. w/ my endo to return for bloodwork in 6 wks., but I was wondering: how long > does it take for you to feel the full effects of a med change? Will it take 6 wks., 2 wks. several > months, or a few days to notice a change? (I guess it takes 4-6 wks. to show up in your TSH, > right?) I know T3 has a very short half life but when hormones are concerned sometimes it > can take a while for things to balance out. If I call my endo and say it's not working now > (have been on Armor about 2 wks.) and he says let's wait 6 wks., does anyone have > studies/talking points for arguing for not waiting? Thanks!!> > Glad the N. Texas meeting is now next Monday, maybe I'll be able to come!> > Gail>

[Guest guest]

Thanks, Jan. So, in other words, even T3 needs 6-8 wks. to build up in your

blood and

make you feel its effects? Would a doctor who adjusted according to symptoms

wait the

full several weeks to make adjustments or do only docs who adjust primarily

according to

TSH do that? Does that make sense? As you can tell, I'm trying to figure out

about the

radical endocrinologectomy.

Yes, my GP is actually running serum ferritin and ordering a 24 hr. saliva kit

for cortisol,

which she said she likes to look at along with some bloodwork values (cortisol,

maybe) and

symptoms to evaluate adrenals. I've heard that is fairly reliable for

cortisol--yes?

Thanks so much!

What a crazy, dysfunctional little corner of Medicine. I'm glad we're talking

about doing

some advocacy; I'm on board.

Gail

>

>

> You may need an increase in the Armour or the addition of some T4.

> Besides Free T3 and Free T4 tests after 6 to 8 weeks, I would ask the

> doc to order serum ferritin. Ferritin below about 50-100 can cause

> hypothyroid like symptoms.

>

> If you have labs from the time you were switched, you might want to post

> them together with the reference ranges and the exact name of each test.

>

> If your doc is adjusting your meds based on your TSH, you are doomed to

> be forever undermedicated and may require my favorite surgery: a radical

> doctorectomy.

>

> Your GP is testing your adrenals? Which tests? Be aware that the 24 hour

> urine cortisol test is useless except for diagnosing Cushings.

>

>

[Guest guest]

You can actually get a valid Free T3 at 3 to 4 weeks. It is the Free T4 levels that take six or more weeks to stabilize. Both are important.

I have no experience with docs who adjust by symptoms alone. The best thyroid docs use Free T3, Free T4, symptoms, history, and their clinical experience. TSH is only important if it is too high. Testing is done at six to twelve weeks out until your levels are optimized.

Who is your GP? It sounds like she is on the right track.

> >> > > > You may need an increase in the Armour or the addition of some T4. > > Besides Free T3 and Free T4 tests after 6 to 8 weeks, I would ask the> > doc to order serum ferritin. Ferritin below about 50-100 can cause> > hypothyroid like symptoms.> > > > If you have labs from the time you were switched, you might want to post> > them together with the reference ranges and the exact name of each test.> > > > If your doc is adjusting your meds based on your TSH, you are doomed to> > be forever undermedicated and may require my favorite surgery: a radical> > doctorectomy.> > > > Your GP is testing your adrenals? Which tests? Be aware that the 24 hour> > urine cortisol test is useless except for diagnosing Cushings.> > > >>

[Guest guest]

Thanks; that helps. I guess I'll go ahead & give him a call just FYI my symptoms

& see

what he says.

I love my GP. I call her my GP, even though she's a CNP working under a GP, who

is also

quite good, I think. Her name is Sue & she works with at

Lakewood

Medical in Dallas. She's only with them one day a week and at a clinic in Plano

the other

days. I highly recommend them, especially Sue. She's very sharp, evidence-based,

but also

very open-minded to non-traditional approaches and good, I think, at knowing how

and

when to combine traditional w/ non-traditional and seems to really care.

Gail

>

>

> You can actually get a valid Free T3 at 3 to 4 weeks. It is the Free T4

> levels that take six or more weeks to stabilize. Both are important.

>

> I have no experience with docs who adjust by symptoms alone. The best

> thyroid docs use Free T3, Free T4, symptoms, history, and their clinical

> experience. TSH is only important if it is too high. Testing is done at

> six to twelve weeks out until your levels are optimized.

>

> Who is your GP? It sounds like she is on the right track.

>

[Guest guest]

Question, if you're having the full spectrum of tests every 6 weeks what is the significance of the T3, TOTAL measurement? If it doesn't move up with the FREE T4 levels, that still indicates a conversion problem, yes?

Dr. Zoirabi (at Dr. Pucillo's office) ran the last tests, then we talked about dosages. She wants (and I agree) me to stay at the 15 mg. Armour a day (a.m. and p.m.) and 10 mcg. T3 (5 mcg. a.m. / 2.5 lunch/2.5 dinner). So far 2 weeks in in TOLERATING the slightly increased Armour!!! This is the first time in 6 years I've been able to tolerate Armour at all! After the 2nd visit with her I liked her even more. She's attentive and seems thorough and is willing to definitely consider symptoms vs numbers. I have more tests in about a month, prior to the visit and then we'll consult again.

Here's some interesting things I noted. I asked her for the Lab Slip for QUEST so that I could do the tests BEFORE our next visit at my leisure and have the numbers already availble. She was more than fine with this. Last time I had the appointment, I did the blood tests right after then had to come back for another visit. The results are back in about 2-3 days but this saves me one extra doctor visit each time!

And, something else I noticed. Did you know that QUEST LABS has NOWHERE on the lab slip that lists a "FREE T3" test??!!! No WONDER docs don't put it on there. They have to hand write it in the empty space on the bottom of the test.

So, my test results. Remember I took NO Armour before the test but DID take the T3 2 hours before.

T3 Total 106 (Range 97-219)

T3 Uptake 31 (Range 22-35)

T4 FREE 1.1 (Range 0.8 - 1.8)

T4 Total 7.7 (Range 4.5-12.5)

TSH, 3rd Generation (Whatever THAT means...) 1.55

T3 FREE 281 (Range 280-420)

I know my numbers are still very low, and I still feel pretty awful, but since my Free T4 has come up from .5 to 1.1 the chest pains have greatly subsided as well as a lot of the dizzy spells. I'm ENCOURAGED! So onward and upward.

Happy Holidays!

Steph S.

To: Texas_Thyroid_Groups From: texasthyroid@...Date: Tue, 9 Dec 2008 22:28:47 +0000Subject: Re: Question about Timing for Med Ajustments

You can actually get a valid Free T3 at 3 to 4 weeks. It is the Free T4 levels that take six or more weeks to stabilize. Both are important.

I have no experience with docs who adjust by symptoms alone. The best thyroid docs use Free T3, Free T4, symptoms, history, and their clinical experience. TSH is only important if it is too high. Testing is done at six to twelve weeks out until your levels are optimized.

Who is your GP? It sounds like she is on the right track.

> >> > > > You may need an increase in the Armour or the addition of some T4. > > Besides Free T3 and Free T4 tests after 6 to 8 weeks, I would ask the> > doc to order serum ferritin. Ferritin below about 50-100 can cause> > hypothyroid like symptoms.> > > > If you have labs from the time you were switched, you might want to post> > them together with the reference ranges and the exact name of each test.> > > > If your doc is adjusting your meds based on your TSH, you are doomed to> > be forever undermedicated and may require my favorite surgery: a radical> > doctorectomy.> > > > Your GP is testing your adrenals? Which tests? Be aware that the 24 hour> > urine cortisol test is useless except for diagnosing Cushings.> > > >>Suspicious message? There’s an alert for that. Get your Hotmail® account now.

[Guest guest]

Hi ,

I have not necessarily noticed a correlation with Total T3 moving or

not with the Free T4. I think that's absolutely true when you're

also taking any amount of T3 since the half lives are entirely

different.

I too find doing the labs just before an appt can be helpful. That

does work fine for the thyroid labs, but based on recent

experiences, some of the tests like Vitamin D take longer.

I also noticed the same thing about Quest wrt the Free T3 not being

standard on the form nor in the customized part of either of my

doctors forms. It's the same for Labcorp. If the doc doesn't write

in the codes for the Free T3 test, I do it myself. You can look them

up on the Quest and Labcorp websites. The docs don't seem to mind,

as usually it's the nurse that misses these despite the docs saying

they should be run.

If you took the T3 two hours before your test, you are still

miserably low in T3 dosing, but I think you know that already and

that's likely a very big part of you're still feeling " awful " .

B.

>

>

> Question, if you're having the full spectrum of tests every 6

weeks what is the significance of the T3, TOTAL measurement? If it

doesn't move up with the FREE T4 levels, that still indicates a

conversion problem, yes?

>

> Dr. Zoirabi (at Dr. Pucillo's office) ran the last tests, then we

talked about dosages. She wants (and I agree) me to stay at the 15

mg. Armour a day (a.m. and p.m.) and 10 mcg. T3 (5 mcg. a.m. / 2.5

lunch/2.5 dinner). So far 2 weeks in in TOLERATING the slightly

increased Armour!!! This is the first time in 6 years I've been able

to tolerate Armour at all! After the 2nd visit with her I liked her

even more. She's attentive and seems thorough and is willing to

definitely consider symptoms vs numbers. I have more tests in about

a month, prior to the visit and then we'll consult again.

>

> Here's some interesting things I noted. I asked her for the Lab

Slip for QUEST so that I could do the tests BEFORE our next visit at

my leisure and have the numbers already availble. She was more than

fine with this. Last time I had the appointment, I did the blood

tests right after then had to come back for another visit. The

results are back in about 2-3 days but this saves me one extra

doctor visit each time!

>

> And, something else I noticed. Did you know that QUEST LABS has

NOWHERE on the lab slip that lists a " FREE T3 " test??!!! No WONDER

docs don't put it on there. They have to hand write it in the empty

space on the bottom of the test.

>

> So, my test results. Remember I took NO Armour before the test but

DID take the T3 2 hours before.

>

> T3 Total 106 (Range 97-219)

> T3 Uptake 31 (Range 22-35)

> T4 FREE 1.1 (Range 0.8 - 1.8)

> T4 Total 7.7 (Range 4.5-12.5)

> TSH, 3rd Generation (Whatever THAT means...) 1.55

> T3 FREE 281 (Range 280-420)

>

> I know my numbers are still very low, and I still feel pretty

awful, but since my Free T4 has come up from .5 to 1.1 the chest

pains have greatly subsided as well as a lot of the dizzy spells.

I'm ENCOURAGED! So onward and upward.

>

>

> Happy Holidays!

> Steph S.

>

>

>

>

[Guest guest]

Glad to hear that you are doing better. Slow and steady wins the race! Also glad to see more reviews of Dr Pucillo's office for the Houstonians that aren't able to travel. It's encouraging.

-

To: texas_thyroid_groups From: slstultz622@...Date: Wed, 10 Dec 2008 16:39:26 +0000Subject: RE: Re: Question about Timing for Med Ajustments

Question, if you're having the full spectrum of tests every 6 weeks what is the significance of the T3, TOTAL measurement? If it doesn't move up with the FREE T4 levels, that still indicates a conversion problem, yes? Dr. Zoirabi (at Dr. Pucillo's office) ran the last tests, then we talked about dosages. She wants (and I agree) me to stay at the 15 mg. Armour a day (a.m. and p.m.) and 10 mcg. T3 (5 mcg. a.m. / 2.5 lunch/2.5 dinner). So far 2 weeks in in TOLERATING the slightly increased Armour!!! This is the first time in 6 years I've been able to tolerate Armour at all! After the 2nd visit with her I liked her even more. She's attentive and seems thorough and is willing to definitely consider symptoms vs numbers. I have more tests in about a month, prior to the visit and then we'll consult again. Here's some interesting things I noted. I asked her for the Lab Slip for QUEST so that I could do the tests BEFORE our next visit at my leisure and have the numbers already availble. She was more than fine with this. Last time I had the appointment, I did the blood tests right after then had to come back for another visit. The results are back in about 2-3 days but this saves me one extra doctor visit each time! And, something else I noticed. Did you know that QUEST LABS has NOWHERE on the lab slip that lists a "FREE T3" test??!!! No WONDER docs don't put it on there. They have to hand write it in the empty space on the bottom of the test. So, my test results. Remember I took NO Armour before the test but DID take the T3 2 hours before. T3 Total 106 (Range 97-219)T3 Uptake 31 (Range 22-35)T4 FREE 1.1 (Range 0.8 - 1.8)T4 Total 7.7 (Range 4.5-12.5)TSH, 3rd Generation (Whatever THAT means...) 1.55T3 FREE 281 (Range 280-420) I know my numbers are still very low, and I still feel pretty awful, but since my Free T4 has come up from .5 to 1.1 the chest pains have greatly subsided as well as a lot of the dizzy spells. I'm ENCOURAGED! So onward and upward. Happy Holidays!Steph S.

To: Texas_Thyroid_Groups From: texasthyroid@...Date: Tue, 9 Dec 2008 22:28:47 +0000Subject: Re: Question about Timing for Med Ajustments

You can actually get a valid Free T3 at 3 to 4 weeks. It is the Free T4 levels that take six or more weeks to stabilize. Both are important.I have no experience with docs who adjust by symptoms alone. The best thyroid docs use Free T3, Free T4, symptoms, history, and their clinical experience. TSH is only important if it is too high. Testing is done at six to twelve weeks out until your levels are optimized.Who is your GP? It sounds like she is on the right track. > >> > > > You may need an increase in the Armour or the addition of some T4. > > Besides Free T3 and Free T4 tests after 6 to 8 weeks, I would ask the> > doc to order serum ferritin. Ferritin below about 50-100 can cause> > hypothyroid like symptoms.> > > > If you have labs from the time you were switched, you might want to post> > them together with the reference ranges and the exact name of each test.> > > > If your doc is adjusting your meds based on your TSH, you are doomed to> > be forever undermedicated and may require my favorite surgery: a radical> > doctorectomy.> > > > Your GP is testing your adrenals? Which tests? Be aware that the 24 hour> > urine cortisol test is useless except for diagnosing Cushings.> > > >>

Suspicious message? There’s an alert for that. Get your Hotmail® account now. Send e-mail anywhere. No map, no compass. Get your Hotmail® account now.

[Guest guest]

I called Dr. Pucillo’s office to get my thyroid

checked. I asked for both Free T3 and Free T4.

I also asked for the antibodies to be checked.

I just spoke with the person who answers the phone to leave a

message for Barbie (Dr. P’s nurse)

When I got there to have my blood drawn I asked again that the

antibodies be drawn.

When I got the results, no Free T3 or antibodies were drawn.

Makes me mad that I wasted my time and didn’t get the

correct tests done.

Next time I will make sure I talk with the nurse directly.

Goes to show that they don’t routinely check the Free T3

(in my case).

Lynn

From: Texas_Thyroid_Groups

[mailto:Texas_Thyroid_Groups ] On Behalf Of

Caldwell

Sent: Wednesday, December 10, 2008 1:29 PM

To: Texas Thyroid Yahoo Group

Subject: RE: Re: Question about Timing for Med Ajustments

Glad to hear that you are doing

better. Slow and steady wins the race! Also glad to see more reviews of

Dr Pucillo's office for the Houstonians that aren't able to travel. It's

encouraging.

-

To: texas_thyroid_groups

From: slstultz622@...

Date: Wed, 10 Dec 2008 16:39:26 +0000

Subject: RE: Re: Question about Timing for Med

Ajustments

Question, if you're

having the full spectrum of tests every 6 weeks what is the significance of the

T3, TOTAL measurement? If it doesn't move up with the FREE T4 levels, that

still indicates a conversion problem, yes?

Dr. Zoirabi (at Dr. Pucillo's office) ran the last tests, then we talked about

dosages. She wants (and I agree) me to stay at the 15 mg. Armour a day (a.m.

and p.m.) and 10 mcg.

T3 (5 mcg. a.m. / 2.5 lunch/2.5 dinner). So far 2 weeks in in

TOLERATING the slightly increased Armour!!! This is the first time in 6 years

I've been able to tolerate Armour at all! After the 2nd visit with her I liked

her even more. She's attentive and seems thorough and is willing to definitely

consider symptoms vs numbers. I have more tests in about a month, prior to the

visit and then we'll consult again.

Here's some interesting things I noted. I

asked her for the Lab Slip for QUEST so that I could do the tests BEFORE our

next visit at my leisure and have the numbers already availble. She was more

than fine with this. Last time I had the appointment, I did the blood tests right

after then had to come back for another visit. The results are back in

about 2-3 days but this saves me one extra doctor visit each time!

And, something else I

noticed. Did you know that QUEST LABS has NOWHERE on the lab slip that lists a

" FREE T3 " test??!!! No WONDER docs don't put it on there. They have

to hand write it in the empty space on the bottom of the test.

So, my test results. Remember I took NO Armour before the test but DID take the

T3 2 hours before.

T3 Total 106 (Range 97-219)

T3 Uptake 31 (Range 22-35)

T4 FREE 1.1 (Range 0.8 - 1.8)

T4 Total 7.7 (Range 4.5-12.5)

TSH, 3rd Generation (Whatever THAT means...) 1.55

T3 FREE 281 (Range 280-420)

I know my numbers are still very low, and I still feel pretty awful, but since

my Free T4 has come up from .5 to 1.1 the chest pains have greatly subsided as

well as a lot of the dizzy spells. I'm ENCOURAGED! So onward and upward.

Happy Holidays!

Steph S.

To: Texas_Thyroid_Groups

From: texasthyroid@...

Date: Tue, 9 Dec 2008 22:28:47 +0000

Subject: Re: Question about Timing for Med Ajustments

You

can actually get a valid Free T3 at 3 to 4 weeks. It is the Free T4 levels that

take six or more weeks to stabilize. Both are important.

I

have no experience with docs who adjust by symptoms alone. The best thyroid

docs use Free T3, Free T4, symptoms, history, and their clinical experience.

TSH is only important if it is too high. Testing is done at six to twelve weeks

out until your levels are optimized.

Who

is your GP? It sounds like she is on the right track.

---

In Texas_Thyroid_Groups , " malcolmsaidso "

wrote:

>

> Thanks, Jan. So, in other words, even T3 needs 6-8 wks. to build up in

your blood and

> make you feel its effects? Would a doctor who adjusted according to

symptoms wait the

> full several weeks to make adjustments or do only docs who adjust

primarily according to

> TSH do that? Does that make sense? As you can tell, I'm trying to figure

out about the

> radical endocrinologectomy.

>

> Yes, my GP is actually running serum ferritin and ordering a 24 hr. saliva

kit for cortisol,

> which she said she likes to look at along with some bloodwork values

(cortisol, maybe) and

> symptoms to evaluate adrenals. I've heard that is fairly reliable for

cortisol--yes?

>

> Thanks so much!

>

> What a crazy, dysfunctional little corner of Medicine. I'm glad we're

talking about doing

> some advocacy; I'm on board.

>

> Gail

>

>

> >

> >

> > You may need an increase in the Armour or the addition of some T4.

> > Besides Free T3 and Free T4 tests after 6 to 8 weeks, I would ask the

> > doc to order serum ferritin. Ferritin below about 50-100 can cause

> > hypothyroid like symptoms.

> >

> > If you have labs from the time you were switched, you might want to

post

> > them together with the reference ranges and the exact name of each

test.

> >

> > If your doc is adjusting your meds based on your TSH, you are doomed

to

> > be forever undermedicated and may require my favorite surgery: a

radical

> > doctorectomy.

> >

> > Your GP is testing your adrenals? Which tests? Be aware that the 24

hour

> > urine cortisol test is useless except for diagnosing Cushings.

> >

> >

>

Suspicious message? There’s an alert for that. Get

your Hotmail® account now.

Send

e-mail anywhere. No map, no compass. Get your Hotmail® account now.

No virus

found in this incoming message.

Checked by AVG - http://www.avg.com

Version: 8.0.176 / Virus Database: 270.9.16/1841 - Release Date: 12/10/2008

9:30 AM

[Guest guest]

Even with Dr. Z. in Dr. Pucillo's office, I had to ask her to check Free T3 on the first visit, which she readily agreed I needed and then I had to remind her on the second visit to write it on the lab slip. In my case, we have AETNA HMO and she mentioned that they couldn't do the blood draw in their office, I had to have it done at Quest. It must be some contract issues with HMO's although my old PCP did all the blood work right in their office. Confusing so I'll have to ask Dr. Z. what gives. As suggested in her post, I will double check each lab slip when she gives it to me. If they do your blood work in their office you can always double check with the person drawing the blood exactly what the doctor ordered. It's frustrating, isn't it, to have to be the 'watchdog' during all this!!!!????

Steph S.

To: Texas_Thyroid_Groups From: lbonacci39@...Date: Wed, 10 Dec 2008 14:34:18 -0600Subject: RE: Re: Question about Timing for Med Ajustments

I called Dr. Pucillo’s office to get my thyroid checked. I asked for both Free T3 and Free T4.

I also asked for the antibodies to be checked.

I just spoke with the person who answers the phone to leave a message for Barbie (Dr. P’s nurse)

When I got there to have my blood drawn I asked again that the antibodies be drawn.

When I got the results, no Free T3 or antibodies were drawn.

Makes me mad that I wasted my time and didn’t get the correct tests done.

Next time I will make sure I talk with the nurse directly.

Goes to show that they don’t routinely check the Free T3 (in my case).

Lynn

From: Texas_Thyroid_Groups [mailto:Texas_Thyroid_Groups ] On Behalf Of CaldwellSent: Wednesday, December 10, 2008 1:29 PMTo: Texas Thyroid Yahoo GroupSubject: RE: Re: Question about Timing for Med Ajustments

Glad to hear that you are doing better. Slow and steady wins the race! Also glad to see more reviews of Dr Pucillo's office for the Houstonians that aren't able to travel. It's encouraging. -

To: texas_thyroid_groups From: slstultz622@...Date: Wed, 10 Dec 2008 16:39:26 +0000Subject: RE: Re: Question about Timing for Med AjustmentsQuestion, if you're having the full spectrum of tests every 6 weeks what is the significance of the T3, TOTAL measurement? If it doesn't move up with the FREE T4 levels, that still indicates a conversion problem, yes? Dr. Zoirabi (at Dr. Pucillo's office) ran the last tests, then we talked about dosages. She wants (and I agree) me to stay at the 15 mg. Armour a day (a.m. and p.m.) and 10 mcg. T3 (5 mcg. a.m. / 2.5 lunch/2.5 dinner). So far 2 weeks in in TOLERATING the slightly increased Armour!!! This is the first time in 6 years I've been able to tolerate Armour at all! After the 2nd visit with her I liked her even more. She's attentive and seems thorough and is willing to definitely consider symptoms vs numbers. I have more tests in about a month, prior to the visit and then we'll consult again. Here's some interesting things I noted. I asked her for the Lab Slip for QUEST so that I could do the tests BEFORE our next visit at my leisure and have the numbers already availble. She was more than fine with this. Last time I had the appointment, I did the blood tests right after then had to come back for another visit. The results are back in about 2-3 days but this saves me one extra doctor visit each time! And, something else I noticed. Did you know that QUEST LABS has NOWHERE on the lab slip that lists a "FREE T3" test??!!! No WONDER docs don't put it on there. They have to hand write it in the empty space on the bottom of the test. So, my test results. Remember I took NO Armour before the test but DID take the T3 2 hours before. T3 Total 106 (Range 97-219)T3 Uptake 31 (Range 22-35)T4 FREE 1.1 (Range 0.8 - 1.8)T4 Total 7.7 (Range 4.5-12.5)TSH, 3rd Generation (Whatever THAT means...) 1.55T3 FREE 281 (Range 280-420) I know my numbers are still very low, and I still feel pretty awful, but since my Free T4 has come up from .5 to 1.1 the chest pains have greatly subsided as well as a lot of the dizzy spells. I'm ENCOURAGED! So onward and upward. Happy Holidays!Steph S.

To: Texas_Thyroid_Groups From: texasthyroid@...Date: Tue, 9 Dec 2008 22:28:47 +0000Subject: Re: Question about Timing for Med AjustmentsYou can actually get a valid Free T3 at 3 to 4 weeks. It is the Free T4 levels that take six or more weeks to stabilize. Both are important.I have no experience with docs who adjust by symptoms alone. The best thyroid docs use Free T3, Free T4, symptoms, history, and their clinical experience. TSH is only important if it is too high. Testing is done at six to twelve weeks out until your levels are optimized.Who is your GP? It sounds like she is on the right track. > >> > > > You may need an increase in the Armour or the addition of some T4. > > Besides Free T3 and Free T4 tests after 6 to 8 weeks, I would ask the> > doc to order serum ferritin. Ferritin below about 50-100 can cause> > hypothyroid like symptoms.> > > > If you have labs from the time you were switched, you might want to post> > them together with the reference ranges and the exact name of each test.> > > > If your doc is adjusting your meds based on your TSH, you are doomed to> > be forever undermedicated and may require my favorite surgery: a radical> > doctorectomy.> > > > Your GP is testing your adrenals? Which tests? Be aware that the 24 hour> > urine cortisol test is useless except for diagnosing Cushings.> > > >>

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