Elaine and all TSH 3.09 FT4 1.1 Normal ???

October 16, 2003

Hi Elaine,

TSH 3.09 range 0.40-5.50 FT4 1.1 range 0.8-1.8

I see the endo Friday pm. My present dose of PTU is 75 daily. (Boy

am I glad I reduced it from 100 daily to 75 daily 2 1/2 weeks ago!)

I win the nickel from the endo for the higher TSH. I thought my

Free T4 had risen more. I am shocked at 1.1! What would you expect

the Free T3 to be? (I'l e-mail her and see if she can run FT3.)

What dosage of PTU should I be taking know?

Is it must be time to add some synthroid? Does my endo need to have

experience with that protocol to make it work?

My Catacholamine results were all in the " normal " range except there

was not enough epinephrine to report. (How can that happen?) CBC

all " normal " . Prolactin and Cortisol also " normal "

(I will send exact results with ranges if they are useful to you.

Let me know.)

Ever hopeful,

Alice

October 16, 2003

Hi Alice,

Although the testing lab you used hasn't bothered to change their ranges, the

AACE recommended that TSH ranges be changed to 0.3-3.04 nearly a year ago.

Normal people rarely have TSH levels above 1.0, and on meds it's recommended

that TSH be kept between 0.3-1.0.

You'd either want to reduce your PTU to 50 mg daily or leave it at 75 and add

Synthroid or Armour in block and replace. It's best if a doctor has

experience with B & R. If not, he or she just has to be careful not to allow you

to

become hypo. Sometimes docs worry about causing hyperT with B & R and go to the

opposite extreme.

Plasma catecholamine levels measure epinephrine, norepinephrine and dopamine.

The normal or reference range for epinephrine is <50 for supine patients

(laying down when drawn) and <95 when upright. This is because you have more

norepinephrine relative to epinephrine and are only looking for high epinephrine

levels. When there are problems epinephrine is generally high. There's no

significance or reason to measure very low epinephrine levels since a level of

10

wouldn't be significantly different than a level of say 45.

Take care, Elaine

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