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Thyroid - High Free T4?

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Posted 3/2/2017 1:46 PM (GMT 0)
I just got some blood work results back, and trying to research what this means... high Free T4 with low TSH.
Unfortunately my Free T3 wasn't tested.

Perhaps I'm on a bit too much Natural Dessicated Thyroid?

TSH <0.01 Range: 0.32 - 4.00

Free T4 21 Range 9 - 19

Any ideas?
Posted 3/2/2017 3:42 PM (GMT 0)
Anyone taking T3-containing Natural Desiccated Thyroid really needs Free T3 testing as part of every thyroid check.

Desiccated Thyroid is made from porcine thyroid that has a different proportion of T3/T4 than human thyroid with the proportion favoring T3.

People taking desiccated thyroid usually have Free T3 levels that are proportionately higher in the range than their Free T4 levels.

And, people taking optimal doses of desiccated thyroid will have suppressed (below-range) TSH.

All of that said, your TSH isn't of concern but your Free T4 level is. If it's over-range, I can't imagine how over-range your Free T3 level is.

How much time was there between your last intake of meds and the blood draw? If you took your meds shortly before the blood draw, that alone could explain the results.

If you didn't take your meds shortly before the blood draw *and* you are feeling good, you might be one of "those people" who needs over-range Free T3/T4 levels to function properly.

The infection process wreaks havoc with thyroid function and Lyme is known to block thyroid hormone receptors....and hormone will accumulate in the blood (as yours is).

Truly, if you are feeling OK, I'd be inclined to leave things are they are. However, if your heart rate is consistently elevated (well over 100) or you're feeling overly irritable, or have the runs frequently, etc., you might want to consider a dose decrease.

What does your doctor have to say? And, how *are* you feeling?
Posted 3/2/2017 4:56 PM (GMT 0)
Most people have higher T3 than T4 on natural pig thyroid, (its the pig ratio) so like CD mentioned, theres a good chance your t3 is soaring.

BUT.....you didnt mention feeling hyper at all. So I guess you arent? Fell good?

For lab comparison, its best to have labs the same time of day, spaced the same from thyr meds.

I take thy labs about 18 hrs from last pig thyroid med. Because since T3 levels are short lived (can temporarily spike, then lower), it will appear at the top, or over the range otherwise if tested too soon, and will freak out the Dr.

Having a low TSH is enough to freak him out LOL. But thats where I feel best on pig thyroid.

Post Edited (astroman) : 3/2/2017 1:41:23 PM (GMT-7)

Posted 3/2/2017 8:36 PM (GMT 0)
My last dose of NDT was about 18 hours before blood draw.

My doctor hasn't gotten back to me yet, but I'm sure she'll have me decrease the dose.

My heart rate has been elevated lately after a period of being normal, but it was also elevated when I was hypo, so I'm not sure how much it's related.

Other than that my symptoms haven't changed much lately.
Posted 3/2/2017 8:43 PM (GMT 0)
So your prob at the "pre - hyper" range, but it would be good to see what your T3 is just to confirm.
Posted 3/2/2017 11:01 PM (GMT 0)
Should I cut my dose down, or stop it all together?
Posted 3/3/2017 2:37 AM (GMT 0)
What dose are you taking?

When did you last have thyroid labs done and what were the results? Would you also please share the dose you were taking back then?

I'd be inclined to reduce the dose somewhat but a Free T3 test is really important. I know LabCorp keeps blood for at least one week - is it possible for you to ask your doctor to see if the Free T3 test can be run?

If you start to feel more symptoms, it wouldn't be overly horrible to not take your thyroid meds for a day or two and then resume on a slightly lower dose.
Posted 3/3/2017 2:29 PM (GMT 0)
I'm on 150mg per day, split into 2 doses.

Back in January, I was on 120mg and my TSH was 0.78 and my FT4 was not measured for some reason.

I've stopped the medication for now, and will see if my heart rate comes down.

I might actually stay off it for a month until my next bloodwork depending on how I feel, or I might bring it back in at like half the dose in a week or two.
Posted 3/3/2017 2:53 PM (GMT 0)
Thanks for sharing the finer details.

I'm sorry to say that I find it a bit scary that only your TSH was tested last time. TSH is a pituitary hormone and looking at its level to judge thyroid status is like looking at the odometer when you want to know how much gas is in your tank.

I'm guessing your doctor knows that people taking T3-containing meds are expected to have suppressed (below-range) TSH if they are taking optimal doses and that's why your dose was increased after your January labs.

Your experience is testament to the fact that TSH should not be used for dosing purposes.

If you've been taking 150mg, it's clear to me that you need to be on some type of thyroid hormone replacement.

While it's prudent to hold off on thyroid hormone until your heart rate comes down, I wouldn't stay off it for a month. You'd have to start all over with the titration.

Why not consider going back to 120mg in a few days and stay at the dose for a full 4 wks. before labs?

And, be sure to get a FT3 test every time moving forward.

Good luck!
Posted 3/3/2017 4:32 PM (GMT 0)
Mustard Seed- At 150mg per day going off for days is not recomemded , as CD noted.

Doing so can put your body into a downward spiral whirlwind. You will have wished you didnt do it. Hormones are very prone to body drastic changes symptom wise.

However, going off it for a day can reset the body with out "shocking it", then resume dose. People have done that and also resumed dose a little lower afterward with good results.

Your Dr does not manage your thyroid very well, or maybe too far between appts? as previously noted, one needs all three tests done on dessicated thy meds - emphasis on free t3/t4.
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