Elaine or anyone else - help in interpreting labs

[Guest guest]

Hi,

The only reliable tests you had were the FT4 and perhaps the TSH, although it

is often falsely decreased.

The fact that TSH is high, (new reference range 0.3-3.04) suggests that

you're moving into hypothryoidism. When the pituitary recognizes that you

don't have enough thyroid hormone for your body's needs, it secretes TSH in

an effort to help raise your thryoid hormone levels. So a high TSH is a sign

of hypothyroidism. Since TSH rises slowly if at all when on ATDs, many people

don't even secrete TSH until they become hypothyroid.

The other tests are obsolete and were once used to calculate what FT4

probably is. This is the FTI or index. Now that we have tests to measure FT4

directly, most labs no longer even run the other tests. If a doctor orders

them at the lab where I work, we just do an FT4.

Do you have any symptoms of hypo?

After one year on ATDs most everyone can be maintained on either 2.5-10.0 mg

Tapazole or 50-150 mg PTU. Take care, elaine

[Guest guest]

Hi Terry,

This is exactly what we do with the FT calc or index (FTI). In lab circles we

call this sort of test a guess-timate, based on probably how much of the

total T4 is protein and how much is probably free hormone. At one time, this

was the best we had.

But about a decade ago, we developed tests that accurately measure free T4.

Considering how different the calc is you can see why we called it a

guestimate and its use is no longer recommended. Take care, Elaine

[Guest guest]

Hi.

These are my latest lab results. I have been on Tapazole for a little

over a year.

T3 Uptake = 25.4 (27.8-40.7)

T4, Total = 11.8 (4.5-12.5)

T4,Free,Calculated = 3.0 (1.6-3.7)

T4, Free = 1.1 (0.8-1.8)

TSH = 3.24 (0.40-5.50)

Thanks.

C.

[Guest guest]

Hi ,

I want to add a question: Does FT4 'calculated' mean that they take the

uptake and total numbers and 'calculate' the FT4 from them? I find it

interesting that it differs so much from the FT4, being near the high end of

the range given, and the FT4 near the low end. My thought is that it is

totally meaningless, and I'd love some confirmation of that thought.

That said, I'm also curious what your current dose and symptoms are, .

If those were my numbers (the FT4 and TSH) I'd be looking to cut back on the

Tap and feeling hypO.

Terry

>

> Reply-To: graves_support

> Date: Tue, 06 May 2003 14:17:20 -0000

> To: graves_support

> Subject: Elaine or anyone else - help in interpreting labs

>

> Hi.

> These are my latest lab results. I have been on Tapazole for a little

> over a year.

>

> T3 Uptake = 25.4 (27.8-40.7)

> T4, Total = 11.8 (4.5-12.5)

> T4,Free,Calculated = 3.0 (1.6-3.7)

> T4, Free = 1.1 (0.8-1.8)

> TSH = 3.24 (0.40-5.50)

>

> Thanks.

> C.

>

>

>

>

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[Guest guest]

Hi ,

Most people achieve remission within 12-18 months on ATDs, although some

people achieve remission after a few weeks and for some people it takes years.

You might want to taper to 2.5 mg daily and then every other day before

stopping the meds. If you can get by without hyper symptoms after a month on

that dose, you should be ok. Or if you have a TSI test and it's around 2%

activity, you should be safe to stop ATDs. It's unlikely that you'd need

lifelong ATDs. With your TSH being up you may well have some hypothyroid

symptoms, like the sleep pattern you mentioned. Take care, Elaine

[Guest guest]

Terry & Elaine,

Thanks for the interpretation on my labs. The results of the FT4 has

been the same for the last 9 months. My TSH was 3.54 in December and

3.24 in April.

I'm currently on Tapazole, alternating between 5 mg and 2.5 mg per

day.

Ever since I've been diagnosed with Graves, I've been more tired and

able to sleep for 9-10 hours a day. I use to get really warm while I

slept and had more aches and joint pains. After I completed a month

of chinese herbal medication in March, I haven't been as warm and the

aches and pains subsided. The only symptoms I still seem to have is

that I really can sleep a lot and I do sometimes feel tired.

Any thoughts as to what will happen when I stop taking the Tapazole

in a few months? At the stage I am in, is it more likely I will have

to take it indefinitely or be okay off of it or everyone is different

and I'll just have to see what happens?

Thanks again for the input.

> Hi,

> The only reliable tests you had were the FT4 and perhaps the TSH,

although it

> is often falsely decreased.

> The fact that TSH is high, (new reference range 0.3-3.04) suggests

that

> you're moving into hypothryoidism. When the pituitary recognizes

that you

> don't have enough thyroid hormone for your body's needs, it

secretes TSH in

> an effort to help raise your thryoid hormone levels. So a high TSH

is a sign

> of hypothyroidism. Since TSH rises slowly if at all when on ATDs,

many people

> don't even secrete TSH until they become hypothyroid.

>

> The other tests are obsolete and were once used to calculate what

FT4

> probably is. This is the FTI or index. Now that we have tests to

measure FT4

> directly, most labs no longer even run the other tests. If a doctor

orders

> them at the lab where I work, we just do an FT4.

> Do you have any symptoms of hypo?

> After one year on ATDs most everyone can be maintained on either

2.5-10.0 mg

> Tapazole or 50-150 mg PTU. Take care, elaine

>

>

>

[Guest guest]

,

I can only tell you my experience, which is that a gradual decrease in med

levels and keeping the dosage as *even* throughout every day as possible, is

the best thing I've done. Alternating between 5 & 2.5 a day is NOT a good

idea, as you are then on a dosage roller coaster and your body simply

doesn't know what to do.

I have found that splitting the Tap pills into quarters, and then shaving

off a bit of each is what I need to do now--I take two of these a day, down

from three. My levels started getting better when I went to taking my meds

at approximately 8 hour intervals. At that time, I was taking 12.5 mg. a

day. Over the last 6 months or so I've decreased the dose slowly, but always

dividing it up. I took it in three parts until the dose got so small I

couldn't physically split it into three, and then went to two. Now I may be

ready to drop to one, I'll know when I get my labs done next week.

I also am very, very observant of how I feel and monitor my pulse and my

blood pressure several times daily. I find that the more towards hypo I am,

the slower my pulse (down to 60 bpm for instance) and the higher my BP. I

know I am feeling best when my pulse is 68-74, and my BP is my usual

sub-normal. For instance, when I was feeling hypo, my BP went up from my

norm of about 110/70 to 126/88. When I feel hypo, I also get foggy thinking.

I suspect I'm there now--I've been pretty down lately because my work

situation is falling apart, and have lapsed into a depression I can see but

can't seem to rise from, although I think things are getting clearer

finally. I attribute some of that to the situation, and some to the changes

in my thyroid levels.

So, to me if you are taking 7.5 mg. every two days, you should be taking it

differently. I'd suggest taking three quarter-pills a day, starting when you

get up in the morning, ending when you go to bed, and putting the third as

close to the middle of your day as possible. I'm betting you will start

being able to interpret how you feel much better if you do that, and that

you will slowly be able to decrease your dose, as I have done. BTW, I also

take Chinese herbs on a routine basis, I do feel that they help make the

course of GD a lot more tolerable than without them.

My hope, with the course of action I outlined above, is that I go into

remission and STAY there. I hope the same for you, too.

Terry

>

> Reply-To: graves_support

> Date: Thu, 08 May 2003 13:53:16 -0000

> To: graves_support

> Subject: Re: Elaine or anyone else - help in interpreting

> labs

>

> Terry & Elaine,

>

> Thanks for the interpretation on my labs. The results of the FT4 has

> been the same for the last 9 months. My TSH was 3.54 in December and

> 3.24 in April.

>

> I'm currently on Tapazole, alternating between 5 mg and 2.5 mg per

> day.

>

> Ever since I've been diagnosed with Graves, I've been more tired and

> able to sleep for 9-10 hours a day. I use to get really warm while I

> slept and had more aches and joint pains. After I completed a month

> of chinese herbal medication in March, I haven't been as warm and the

> aches and pains subsided. The only symptoms I still seem to have is

> that I really can sleep a lot and I do sometimes feel tired.

>

> Any thoughts as to what will happen when I stop taking the Tapazole

> in a few months? At the stage I am in, is it more likely I will have

> to take it indefinitely or be okay off of it or everyone is different

> and I'll just have to see what happens?

>

> Thanks again for the input.

>

>

>

>

>

>

>> Hi,

>> The only reliable tests you had were the FT4 and perhaps the TSH,

> although it

>> is often falsely decreased.

>> The fact that TSH is high, (new reference range 0.3-3.04) suggests

> that

>> you're moving into hypothryoidism. When the pituitary recognizes

> that you

>> don't have enough thyroid hormone for your body's needs, it

> secretes TSH in

>> an effort to help raise your thryoid hormone levels. So a high TSH

> is a sign

>> of hypothyroidism. Since TSH rises slowly if at all when on ATDs,

> many people

>> don't even secrete TSH until they become hypothyroid.

>>

>> The other tests are obsolete and were once used to calculate what

> FT4

>> probably is. This is the FTI or index. Now that we have tests to

> measure FT4

>> directly, most labs no longer even run the other tests. If a doctor

> orders

>> them at the lab where I work, we just do an FT4.

>> Do you have any symptoms of hypo?

>> After one year on ATDs most everyone can be maintained on either

> 2.5-10.0 mg

>> Tapazole or 50-150 mg PTU. Take care, elaine

>>

>>

>>