Re: Results are in (m)

[Guest guest]

Hi Clair,

Your results look great. T4 and T3 are your thyroid hormones. Measurements of

free (not bound to protein) thyroid hormone, that is, FT4 and FT3 are the

most accurate.

So your thyroid hormone levels have come down nicely.

TSH is a pituitary hormone that helps regulate thyroid hormone levels. When

the pituitary sees that you have more than enough thyroid hormone, it stops

releasing TSH. So TSH is always low in hyperthyroidism. And it continues to

stay suppressed for quite some time. So it can be misleading since many

people only start secreting TSH when they're hypothyroid. It helps gauge

what's going on and in some people it does rise faster and helps predict

hypoT. But its use is not recommended for patients on ATDs.

The T3 uptake is an old-fashioned test used to tell if you have adequate

binding proteins. Using this result and the total T4, we calculate a Free T4

index or calculation. In many labs this test is obsolete because a direct

measurement of FT4 is much more accurate.

100-150 mg PTU is the usual maintenance dose for PTU. By maintenance dose, I

mean the level that will keep your thyroid hormone levels in the normal

range. Your levels should still be decreasing so continuing on this dose and

being re-checked in 4 weeks is a good move. Take care, Elaine

[Guest guest]

Clair Baca wrote:

>

> And I notice

> my TSH Serum has stayed the same. What does that mean?

TSH does that!

Don't let it bother you as it will come back in it's own time,

and don't let then use TSH to judge dose of PTU or you'll be fed

too much PTU.

The TSH will come back a few weeks or months after the fT4 and

fT3 (hmm where was it) get back in range.

[Guest guest]

>>>fT4 and fT3 (hmm where was it)<<<

Was I missing a test, Simon? Free T3??

Thanks,

Clair

> >

> > And I notice

> > my TSH Serum has stayed the same. What does that mean?

>

> TSH does that!

>

> Don't let it bother you as it will come back in it's own time,

> and don't let then use TSH to judge dose of PTU or you'll be fed

> too much PTU.

>

> The TSH will come back a few weeks or months after the fT4 and

> fT3 (hmm where was it) get back in range.

[Guest guest]

Clair Baca wrote:

>

> >>>fT4 and fT3 (hmm where was it)<<<

>

> Was I missing a test, Simon? Free T3??

Well I think it is implied from the rest, you weren't

undertested, more differently tested.

Just the serum free thyroid hormones seem to be the easiest

indicators to interpret when we are otherwise just a normal case

of Graves'. TSH may be accurate, or maybe lower than it would be

in a healthy person with the same amount of thyroid hormone

circulating.

My TSH remained suppressed for a long time after my fT4 went

normal.

TSH made an appearance when I went massively hypo, and

disappeared for months when I dropped the Carbimazole dose to

something that allowed me to function in a vaguely normal

fashion.

The usual idea with TSH remaining low is that it is either

pituitary response to TSI, or hypothalmus/pituitary systems

giving up on making TRH for a bit.

In my case I think it is possible the reason my TSH remained

suppressed was in part I seem to tend to a disproportionately

high ratio of fT3 to fT4. fT3 being more active, even if fT4 is

normal, the TSH could be suppressed by high fT3.

Since then I've been pushing for fT3 testing (and paying for it

if necessary), although all I've discovered so far is my fT3

seems to go the opposite way to TSH (which is normal) and the

also the opposite way to my fT4 (which is odd). Presumably at

some point it must stop going the opposite way to the fT4?!

Still at least I now know why a normal TSH and a normal fT4

still leave me feeling very out of sorts at times.

Probably you only wanted the first sentence of that reply...

Simon