1. #1

    Blindsided by TSH labs

    As the title states,I am stunned at my recent labs.

    Been on TRT and treatment for Hashi/ Hypo thyroid for 5 years. Protocol has been pretty solid with very minor adjustments along the way as needed.

    Current #s are concerning.

    TSH - 20.470 (.45-4.5)
    Free T4 - .47 (.82- 1.77)
    Free T3 - 2.3 ( 2.0-4.4)



    SHBG - 16.2 (16.5-55.9)
    AST - 61 (0-40)
    ALT - 82 (0-44) Non-Drinker here

    TT- 998
    Free T - 34.2 (6.8 - 21.5)
    E2 - 48.3

    Protocol is NDT 2 grains upon rising and 1.5 grains in afternoon.
    100mg Test cyp twice a week, with 500 iu HCG twice a week, with .25mg Anastrazole.

    Test level is high this time for some unknown reason, but has been in the 700 range for year+ on this protocol.

    But more concerning is the Thyroid, any input greatly appreciated.
    Just looking for some input before my follow up appointment next week with Defy.
    Thank you

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  3. #2
    Im unclear on NDT but have you used T3 and/or T4 by themselves? Or what is it...levothyroxine?

  4. #3
    1 grain NDT contains approx. 9mcg T3 and 35mcg T4

  5. #4
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    NDT is Natural Descicated Thyroid. A common brand is Armour..
    I get a compounded version, not certain if they altered the ratios, I dont recall that ever being mentioned.

  6. #5
    Where did TSH sit in the most recent lab work prior to this?
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

  7. #6
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    I was typically around 2.5-3 on TSH prior. Have been at this dosage for 2.5 yrs with pretty much minimal fluctuation.

  8. #7
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    My first thought is maybe I have a bad batch of meds. My labs seem like Im not taking anything.

  9. #8
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    Quote Originally Posted by Ab037 View Post
    My first thought is maybe I have a bad batch of meds. My labs seem like Im not taking anything.
    Also have you considered the tech running your blood test samples was on a hangover from the holidays? Have you considered have the test redone?
    If these are not your normal numbers do you feel any different? I would think if the numbers were real you would feel something.
    Best of luck I hope you will keep us informed as to how it is going.

  10. #9
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    I agree with feelinglost I would rerun your Labs just to make sure they are right. That is a huge jump in a short amount of time.
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  11. #10
    Member Sean Mosher's Avatar
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    I've read that iodine can give TSH results that are through the roof.
    Have you added that recently or are you taking supplemental iodine of any sort?

  12. #11
    Moderator Vince's Avatar
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    That's a good point about iodine. I supplement with 325mcg of iodine a day, but when I tried a high dose of iodine it through my TSH levels way off
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  13. #12
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    No supplementation, other than D3, selenium, DHEA, and a Multi.
    As far as the Lab Tech, anything ispossible.
    I have been very tired the past few weeks and cold. Im fully expecting to be doing some follow up labs.

  14. #13
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    Another thing I was kicking around, I usually order about 90 days worth when I refill. Last time, was when the Hurricane tore up Houston, which happens to be where one of the compounding labs for Defy is, and I had a big delay so they shipped from another faciltity out of Fl. Well, ofc I ended up receiving both. Probably amounts to nothing but, perhaps 6 months is too long a shelf life for compounded NDT, or one of the Batches was bad.. what do I know.

  15. #14
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    looks to me like you are hypothyroid

    I would repeat the thyroid labs and add some more thyroid tests (including TBG) to make sure the finding is real. TSH is the first number to increase in hypothyroidism. This is because the thyroid is slowing down and not producing enough thyroid hormone and the body responds by producing more TSH to try to 'wake up' the thyroid gland (Hashimoto's often produces hypothyroidism as an end result). Your thyroid gland is probably slowing down now from the Hasimoto's, requiring an upward medication adjustment. Your SHBG is OK . Your estrogen is a little high for my liking, but not terrible. I might go to anastrozole .50 every other week with the HCG.

    Tell your doctor to put you on Armour thyroid. Its much better than other types.

    Please note: any suggestions I provide are not medical recommendations and are just my opinion. Please consult with your physician on any matters concerning your health.

    Quote Originally Posted by Ab037 View Post
    As the title states,I am stunned at my recent labs.

    Been on TRT and treatment for Hashi/ Hypo thyroid for 5 years. Protocol has been pretty solid with very minor adjustments along the way as needed.

    Current #s are concerning.

    TSH - 20.470 (.45-4.5)
    Free T4 - .47 (.82- 1.77)
    Free T3 - 2.3 ( 2.0-4.4)

    SHBG - 16.2 (16.5-55.9)
    AST - 61 (0-40)
    ALT - 82 (0-44) Non-Drinker here

    TT- 998
    Free T - 34.2 (6.8 - 21.5)
    E2 - 48.3

    Protocol is NDT 2 grains upon rising and 1.5 grains in afternoon.
    100mg Test cyp twice a week, with 500 iu HCG twice a week, with .25mg Anastrazole.

    Test level is high this time for some unknown reason, but has been in the 700 range for year+ on this protocol.

    But more concerning is the Thyroid, any input greatly appreciated.
    Just looking for some input before my follow up appointment next week with Defy.
    Thank you
    Last edited by abrms; 01-17-2018 at 10:22 AM.

  16. #15
    Quote Originally Posted by Ab037 View Post
    As the title states,I am stunned at my recent labs.

    Been on TRT and treatment for Hashi/ Hypo thyroid for 5 years. Protocol has been pretty solid with very minor adjustments along the way as needed.

    Current #s are concerning.

    TSH - 20.470 (.45-4.5)
    Free T4 - .47 (.82- 1.77)
    Free T3 - 2.3 ( 2.0-4.4)

    SHBG - 16.2 (16.5-55.9)
    AST - 61 (0-40)
    ALT - 82 (0-44) Non-Drinker here

    TT- 998
    Free T - 34.2 (6.8 - 21.5)
    E2 - 48.3

    Protocol is NDT 2 grains upon rising and 1.5 grains in afternoon.
    100mg Test cyp twice a week, with 500 iu HCG twice a week, with .25mg Anastrazole.

    Test level is high this time for some unknown reason, but has been in the 700 range for year+ on this protocol.

    But more concerning is the Thyroid, any input greatly appreciated.
    Just looking for some input before my follow up appointment next week with Defy.
    Thank you
    I am also a defy patient. I recently had to stop the ndt due to my thyroid being off... Not as bad as yours.

    The t3:t4 ratios in NDT are really not known and cannot be guaranteed by the raw material supplier; therefore, it may work or may not work for someone. For this reason, I had to go on synthetic t4 and t3 where the exact amount of t3 and t4 is KNOWN AND GUARANTEED.

    I was told that defy medical does not write prescriptions....so the chances of you getting script for synthroid and cytomel are non existent.

    UNFORTUNATELY, for these reasons, you should get your thyroid treated by your primary physician.

  17. #16
    I don't know but wouldn't you be looking at the pituitary gland for a tumor. Your on thyroid meds and the TSH is through the roof. Your thyroid levels are low but the TSH of 20 is something. I know of one other person a week ago with a TSH close to 50 and is on 200mcg T4 and they are upping the dose more. This don't sound right to me but I and not a doctor.

  18. #17
    Quote Originally Posted by captain View Post
    I don't know but wouldn't you be looking at the pituitary gland for a tumor. Your on thyroid meds and the TSH is through the roof. Your thyroid levels are low but the TSH of 20 is something. I know of one other person a week ago with a TSH close to 50 and is on 200mcg T4 and they are upping the dose more. This don't sound right to me but I and not a doctor.
    Or thyroid tumors...

  19. #18
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    I wanted to update the thread.
    Re ran labs with exact same protocol/medication of 2 grains NDT in the AM followed by 1.5 grains NDT in afternoon.
    Results were
    TSH 11.18
    Free T4 .85
    Free T3 2.3

    As explained before I believe something with these particular bottles of meds are off.. They came from APS pharmacy where as I usually get it from Empower.. it is a conpounded version.
    I was given the option to get name brand Armour but at twice the cost.. i reordered my script for a short supply from empower.. and Ill probably retest again here shortly to see if it was in fact a bad batch of meds.. if not then ill bite the bullet and get some armour and test again..
    Most previous test over the past few yrs my TSH has been 1.5 ish..
    Any other input appreciated.
    Thank you

  20. #19
    Looks like those NDT pills are not working. We see this all the time. Try a different brand or go synthethic with cytomel and synthroid. That works real well too.

  21. #20
    Quote Originally Posted by Ab037 View Post
    I wanted to update the thread.
    Re ran labs with exact same protocol/medication of 2 grains NDT in the AM followed by 1.5 grains NDT in afternoon.
    Results were
    TSH 11.18
    Free T4 .85
    Free T3 2.3

    As explained before I believe something with these particular bottles of meds are off.. They came from APS pharmacy where as I usually get it from Empower.. it is a conpounded version.
    I was given the option to get name brand Armour but at twice the cost.. i reordered my script for a short supply from empower.. and Ill probably retest again here shortly to see if it was in fact a bad batch of meds.. if not then ill bite the bullet and get some armour and test again..
    Most previous test over the past few yrs my TSH has been 1.5 ish..
    Any other input appreciated.
    Thank you

    Other than Armour you can try to get NP Thyroid by Acella, WP Thyroid, or Naturethroid. There have been some shortages reported for some of these meds so you would have to call your pharmacy to find out what is available.

  22. #21
    Quote Originally Posted by Ab037 View Post
    I wanted to update the thread.
    Re ran labs with exact same protocol/medication of 2 grains NDT in the AM followed by 1.5 grains NDT in afternoon.
    Results were
    TSH 11.18
    Free T4 .85
    Free T3 2.3

    As explained before I believe something with these particular bottles of meds are off.. They came from APS pharmacy where as I usually get it from Empower.. it is a conpounded version.
    I was given the option to get name brand Armour but at twice the cost.. i reordered my script for a short supply from empower.. and Ill probably retest again here shortly to see if it was in fact a bad batch of meds.. if not then ill bite the bullet and get some armour and test again..
    Most previous test over the past few yrs my TSH has been 1.5 ish..
    Any other input appreciated.
    Thank you
    I don't think it has anything to do with APS. The problem is that when dealing with NDT, the T3:T4 RATIOS ARE UNKNOWN AND VARY FROM LOT TO LOT!

    Do yourself a favor and get on t3 and t4 synthetics where you know exactly how much of each you're getting.

  23. #22
    Quote Originally Posted by a_crossfitter View Post
    I don't think it has anything to do with APS. The problem is that when dealing with NDT, the T3:T4 RATIOS ARE UNKNOWN AND VARY FROM LOT TO LOT!
    The manufacturer's websites I've read say that they all test the T4 and T3 content of each batch of NDT to insure consistency.

  24. #23
    Then why has every major brand of NDT failed for all sorts of reasons?

    Quote Originally Posted by HarryCat View Post
    The manufacturer's websites I've read say that they all test the T4 and T3 content of each batch of NDT to insure consistency.

  25. #24
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    This is contrary to what Ive read.
    Do you have any links/research you could share?
    If read that synthroid/levo was around since 1955 or so and wasnt approved by FDA until like 2002 due to failures.
    Armour has been around 100 years and only failed by the FDA once in 2005 after losimg potency below levels after 2 years.

    At any rate I seen a local endo specialist and agreed to try a run of synthroid.
    Will update
    Thx

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