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What Does This Thyroid Test Result Indicate?

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Posted on Sat, 28 Mar 2015
Question: What does the following test results mean and am I following the right course of action?
TSH of 0.11 (Taken 1-20-15)
TSH of 0.718 (taken 10-31-14)
T4 Total of
T3 Uptake Ration of 23
Free Thyroxine Index of <.1>
doctor
Answered by Dr. Binu Parameswaran Pillai (23 minutes later)
Brief Answer:
Need dose reduction

Detailed Answer:
Good day,
Noted your concern.
The last TSH was 0.11 while on 120 mg Armour thyroid. That means that you are over replaced and dose need to be reduced.

By looking at your blood profile pattern from 2010 onwrds, i can see that your blood works looks good ( especially most of 2012) while on 50 mcg Synthroid. ( but i understand that you were not feeling well). I have a suspicion that you are being treated by a non endocrinologist now.

Most endocrinologists do not prefer Armour Thyroid as it is a crude animal preperation and diffcult to titrate. Occasional patient may not feel well while just being on Synthroid (t4) and we may have to add little bit of Cytomel ( t3). But this practice is discouraged by endocrinologists including myself. Our aim would be to keep your TSH between 1 to 3 while on Synthroid.

May i know what symptoms did you have while on Synthroid? And what was the TSH at that time?
This would throw some light and i may be able to help you further.

However, just based on your latest blood works, i can surely say that we need to reduce the current dose of Armour Thyroid,

Regards
Binu


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (16 hours later)
Thank you, Dr. XXXXXXX The only test results I have through the years are what I sent you. I have always been on Cytomel (since I was diagnosed) but Synthroid was added back in 2010. That is when I started to feel very tired/exhausted; had problems sleeping; gaining weight (despite no changes in diet/exercise/lifestyle); hair was thinning and I was extremely cold all the time. All these things were very typical of under-treated hypothyroidism. I was feeling pretty well (despite my lower levels) until the Synthroid was added...and that is when I started to feel bad. This feeling pretty much continued until I got off of it in 2013. An endocrinologist took me off of it and bumped up the Cytomel a bit. Another doctor (Gynecologist) agreed to let me try the Armour and that is when I started feeling better. I know the levels are all off but I definitely feel better. I added CLA to the supplements I currently take and have finally been able to loose 6-7 pounds (which is what I put on initially and couldn't take off - no matter what). So the bottom line is I don't like or feel well while on Synthroid and feel much better while on Armour. So why do I feel so much better but my blood test results are still off?
doctor
Answered by Dr. Binu Parameswaran Pillai (4 hours later)
Brief Answer:
Armour has both T4 and T3

Detailed Answer:
You must understand the difference between Cytomel and Synthroid. We do have 2 thyroid hormones, T4 and T3. Cytomel contains only T3 where as Synthroid has only T4. T3 is the active hormone and T4 will have to be converted to T3 for it's actions.

Some people will have diffiulty converting T4 to T3 and hence they continue to experience symptoms despite being a normal T4. In those patients, we may need to add Cytomel to Synthroid.

Armour thyroid has both T3 and T4 in it. You may have a defect in converting T4 to T3. It must be the reason that you are feeling better on Armour ( combination of T4 and T3).

However, the TSH shows that you are overreplaced and hence it is not good for your heart and bones. You need to reduce Armour dose a bit. I must confess that most endocriologsts will not have experience adjusting the dose of Aromour thyroid, simply because they dont use it.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Does This Thyroid Test Result Indicate?

Brief Answer: Need dose reduction Detailed Answer: Good day, Noted your concern. The last TSH was 0.11 while on 120 mg Armour thyroid. That means that you are over replaced and dose need to be reduced. By looking at your blood profile pattern from 2010 onwrds, i can see that your blood works looks good ( especially most of 2012) while on 50 mcg Synthroid. ( but i understand that you were not feeling well). I have a suspicion that you are being treated by a non endocrinologist now. Most endocrinologists do not prefer Armour Thyroid as it is a crude animal preperation and diffcult to titrate. Occasional patient may not feel well while just being on Synthroid (t4) and we may have to add little bit of Cytomel ( t3). But this practice is discouraged by endocrinologists including myself. Our aim would be to keep your TSH between 1 to 3 while on Synthroid. May i know what symptoms did you have while on Synthroid? And what was the TSH at that time? This would throw some light and i may be able to help you further. However, just based on your latest blood works, i can surely say that we need to reduce the current dose of Armour Thyroid, Regards Binu