Wife's lab results - expert guidance needed?

[Mustang&]

Dear forum,


My wife is on the way to optimize her hormone levels after long period of inaccurate Levythyroxin medication and the possible damage it did (it went on for few years before she learned about the topic and found a doc that would prescribe Armour). Looking for expert thoughts on the results/development and the potential next steps before seeing any docs (and spending more $$$). She could also get some more tests done but would need to know what to look for first?


After Jan/18 tests Levythyroxine was changed to Armour 90mg + Progesterone 120mg was added. All the lab tests have been taken at the same time of the cycle and in May/18 progesterone was not taken in the morning before testing but Armour was taken. (wasn't sure if she should take progesterone before labs or not?). Estradiol with ELCIA method and range is from Stop the tyroid maddness site (as is Progesterone). Happy to take your opinions on those.


31y female, bodybuilding lifestyle with daily exercise (mainly weightlifting and cardio)

Our thoughts:
-T3 Free was flagged in May/18 as high but that's OK as I'm on Armour, right?
-T3 Rev unfortunately I have no historical results (bad doctors) but should I be worried of the high-ish number?
-Progesterone should be higher - but is this due to not taking the dose before tests?
-Estradiol could be lower (and support in fat lost?) Would dosing up the Progesterone help?
-TT and Free have both greatly increased but we're thinking there is too little Free T still - could be linked to high Estradiol levels and therefore large amount of the TT being in SHBG (not measured unfortunately) form?


Nov/17 --Jan/18 --May/18 -- (Range)
Lab: Quest -- Labcorp -- Labcorp ...
TSH: 0.230 -- 0.703 -- 0.718 -- (0.450-4.500 / labcorp)
T4: NA -- NA -- 7.00 -- (4.5-12.0 / labcorp)
T4, Free: 1.00 -- 1.73---1.10- - (0.82-1.77 / labcorp)
T3, Free: NA -- 2.8 -- 4.6 -- (2.0-4.4 / labcorp)
T3 Rev: NA -- NA -- 18.7 -- (9.2-24.1 /labcorp)
TT: -- NA--29 -- 38 -- (8-48/labcorp)
T, Free: NA -- 1.3 -- 2.2 -- (0-4.2/labcorp)
DHEA: NA -- 211.5 -- 260.2 -- (84.8-378.0/labcorp)
Estradiol: NA -- 126.8--122.7 -- (44-211/Labcorp ; 80-100/STTM as optimal)
Progest: NA -- 7.6 -- 7.0 -- (8-10/labcorp)
Estrone, Serum: 77 -- NA -- NA -- (50-114 / Quest)
FSH: 3.4-- NA -- NA -- (1.8-5.1) / Quest mid-Luteal)
Prolactin: 8.1 -- NA - NA -- (2.3-26.7/quest)

Apologies for the formatting! It has three test results + range listed divided by --.



Updated other labs by Quest on Nov/17 (if relevant to the topic in any way)

Component -- Your Value -- Standard Range
SODIUM -- 140 mEq/L -- 133-146 mEq/L
POTASSIUM -- 4.3 mEq/L-- 3.5-5.1 mEq/L
CHLORIDE -- 102 mEq/L -- 98-109 mEq/L
BICARBONATE-- 32 mEq/L -- 21-31 mEq/L
CALCIUM -- 9.8 mg/dL -- 8.3-10.5 mg/dL
ALBUMIN -- 4.5 g/dL -- 3.5-5.7 g/dL
BLOOD UREA NITROGEN -- 25 mg/dL -- 2-25 mg/dL
CREATININE -- 0.97 mg/dL -- 0.60-1.30 mg/dL
GLUCOSE -- 82 mg/dL -- 65-100 mg/dL
PROTEIN, TOTAL -- 7.3 g/dL -- 6.4-8.9 g/dL
ALT (SGPT) -- 32 Unit/L -- 0-52 Unit/L
ALKALINE PHOSPHATASE-- 62 Unit/L -- 34-104 Unit/L
AST (SGOT) -- 37 Unit/L -- 0-39 Unit/L
BILIRUBIN,TOTAL -- 0.5 mg/dL -- 0.0-1.0 mg/dL
GFR(African American,Est) >60 mL/min/1.73m2 >=60 mL/min/1.73m2
GFR(non-African Amer,Est) >60 mL/min/1.73m2 >=60 mL/min/1.73m2

Component -- Your Value -- Standard Range
WHITE CELL COUNT -- 5.9 K/UL -- 3.5-10.5 K/UL
RED CELL COUNT -- 4.58 M/UL -- 3.80-5.20 M/UL
HEMOGLOBIN -- 14.1 g/dL -- 11.6-15.4 g/dL
HEMATOCRIT -- 43.6 % -- 34.0-45.0 %
MCV -- 95 FL -- 80-99 FL
MCH -- 30.8 pg -- 27.0-34.0 pg
MCHC -- 32.3 % -- 32.0-35.5 %
RDW -- 12.9 % -- 11.0-15.0 %
PLATELET COUNT -- 225 K/UL -- 140-390 K/UL
DIFF TYPE Auto
Rflx Morphology No

Component Your Value
CHOLESTEROL 230 mg/dL
TRIGLYCERIDE 63 mg/dL
HDL CHOLESTEROL 97 mg/dL
LDL CHOL (CALC) 120 mg/dL
Non-HDL Cholesterol 133 mg/dL

Component Your Value Standard Range
SEG 59 %
LYMPHOCYTES 31 %
MONOCYTE 8 %
EOSINOPHIL 2 %
BASOPHIL 0 %
ABSOLUTE NEUTROPHILS 3.5 K/UL 1.5-8.0 K/UL
ABSOLUTE LYMPHOCYTES 1.8 K/UL 1.0-4.0 K/UL
ABSOLUTE MONOCYTE 0.5 K/UL 0.2-1.0 K/UL
ABSOLUTE EOSINOPHILS 0.1 K/UL 0.0-0.6 K/UL
ABSOLUTE BASOPHILS 0.0 K/UL 0.0-0.3 K/UL

Thank you!

 

[ratbag]

Not sure her FT3 needs to be over range as it is. This means you could cut back on the Armour some. Being over range on this is not desireable unless she feels better than being slightly under range

Her FT4 is low in fact it's not close to 50% of range. It should be ideally at approx. 2/3rds of range.

This is what happens when you take T3 in any form... it drives down your FT4 numbers (not everyone but it's a common situation). So I think a slight reduction on armour is in order and you'll probably have to take some Levythyroxin to get your FT4 higher.

 

[Vettester Chris]

Thanks for posting ... Couple questions .. I know your wife is real young, but is she experiencing any pre/peri menopausal symptoms? Any irregularity in her cycles?

On the labs, at what phase of her cycle did she run labs (follicular, ovulatory, luteal)? The E2 range might suggest it was Follicular(?), but no reference range on her E1?

As the case with many women, iron and calcium can tend to be deficient. For thyroid purposes, Iron & Ferritin can't be stressed enough, this will be crucial with any talking points on a thyroid treatment protocol.

There's been a lot of scuttle with Armour over the past few years, many people seeing a difference in its effectiveness since Forest Labs sold to Activas.

 

[ratbag]

There's been a lot of scuttle with Armour over the past few years, many people seeing a difference in its effectiveness since Forest Labs sold to Activas.

I was thinking exactly the same but her FT3 is above range. I think that says it's working.

The other question I had was.. was she on Levythyroxin when the 1st labs were taken on Jan/18? it looks like that as her FT4 was higher.

 

[Mustang&]

Chris, ratbag - thank you for your time, it's really appreciated. We're both new to the world or hormones and taking a crash course via web resources to catch up with everything.

All of the tests were taken on the 21st day of her cycle (Luteal phase). I took the reference from here https://stopthethyroidmadness.com/lab-values/ and do realize it does not mention the cycle at all. Labcop says 44-211 as the range (will update that to original post as well). Range for Estrone for Quest was 50-114 (will update to orginal post).

In the first Quest tests, the doc ordered a lot of stuff that we thought was not relevant (will update to the original post), including Calsium (9.8 (range 8.3-10.5)) but perhaps not Iron/Ferritin. Take a look at the other values and let me know if they tell you anything. No pre/peri menopausal symptoms or irregularity in her cycles.

FT3, FT4 - good notes and yes, she does feel a lot better than before - but hard to tell if she'd feel any worse/better if the Armour dose was lower (60mg). Will draw one set of bloods before making any changes.

Any thoughts on the Progesterone/Estradiol/Free T comments?

 

[Mustang&]

I was thinking exactly the same but her FT3 is above range. I think that says it's working.

The other question I had was.. was she on Levythyroxin when the 1st labs were taken on Jan/18? it looks like that as her FT4 was higher.

Correct. The Armour Thyroid + Progesterone compound was taken into use after those labs as advised by a doctor due to T3 being so low (there wasn't really any other reasoning besides the symptoms and low T3). She has been feeling a lot better after using Armour and it's now less of 'curing a disease' but trying to find the optimal way forward to support the bodybyilding lifestyle she has chosen to take.

 

[MarkM]

Mustang&,

There was a question in the original post about the Reverse T3 and it being high-ish. 8.7 is a little below the range of 9.2 - 24.1. You want this below 15 and you want your ratio of Free T3:Reverse T3 to be greater than 20 (>20). Your ratio is almost 53. The Armour might be driving down the Reverse T3 some and that is why it may be below range but your ratio is real good. Maybe Chris Vettester, ratbag, or one of the many other knowledgeable forum members on thyroid will look at that for you.

 

[Mustang&]

Mustang&,

There was a question in the original post about the Reverse T3 and it being high-ish. 8.7 is a little below the range of 9.2 - 24.1. You want this below 15 and you want your ratio of Free T3:Reverse T3 to be greater than 20 (>20). Your ratio is almost 53. The Armour might be driving down the Reverse T3 some and that is why it may be below range but your ratio is real good. Maybe Chris Vettester, ratbag, or one of the many other knowledgeable forum members on thyroid will look at that for you.

Original and correct number is 18.7, the 1 got deleted while i copy/paste/edited it. Apologies.

 

[MarkM]

Well, while 18.7 is over what many feel like is optimal at 15, your ratio is still over 20 coming in at almost 25. Your T3 may be pooling because of the higher Reverse T3. Have you checked iron and ferritin levels? Low ferritin can really impact how well the thyroid functions.

 

[Mustang&]

Will definitely test that next time- now working on finding a doc in network that could order all the labs we need + figuring out what all should be tested. Thank you for bringing this to our attention!

Question from my wife: how would lowering the dose/driving down the T3 (and RT3 with it ideally) effect on her?

 

[Seronne]

Hello! It is admirable that you are taking your wife's health so seriously. I have found out that hormones are in fact more important than what we usually might think. Especially when it comes to women, low estrogen and progesterone can lead to several health issues. Therefore, it is fundamental to reintegrate the quantity of horomone. Fot instance on xcellr8.health you can read about bio-identical hormone replacement therapy. This one appears to be less harmful than taking usual synthetic hormones.