Optimal Lab Values
Below are examples of ideal lab values and what patients have learned to look for.
THYROID:
*TSH: When patients are optimal on their desiccated thyroid, they find themselves with a TSH lab result FAR below range, such as .009 or .004. But we have learned never to dose by the TSH, ever. This is just to let you know that if you find yourself that low while feeling wonderful on desiccated thyroid, don’t sweat it and do NOT let your doc freak out and lower your meds.
*FREE T3: When patients are optimal on their desiccated thyroid…AND IN THE PRESENCE OF PLENTY OF CORTISOL whether from strong adrenals or adequate cortisol supplementation…they will tend to have a free T3 at the top of the range, if not over for some. If your free T3 is high or over the range with continuing hypo, that is your clue of adrenal fatigue, or not being on enough HC (hydrocortisone).
*FREE T4: Generally, patients who have the above with the free T3 will also have a mid-range T4, but it’s individual.
*T7, TOTAL T3, TOTAL T4, UPTAKE, or any other thyroid labs: useless
*anti-TPO and TgAb (thyroid antibodies labs for Hashimotos): Generally, if these are above the range, you’ve got the autoimmune thyroid disease Hashimotos. If they are anywhere below the “less than” mark, or in the range provided, you are fine. Note that one can be normal and the other high. That’s why you need both.
ADRENALS:
*SALIVA RESULTS: If your adrenals are healthy and unchallenged, you will generally have:
* morning 8 am result at the top of the range or slightly above
* 11-noon in the upper fourth
* 4-5 pm around the middle
* 11-midnight at the bottom of the range (i.e. 1 if the range is 1-4).
A DHEA above midrange is good, but 8 can mean the adrenals are compensating for a problem.
If your saliva results do not match the healthy results above, find out which of the 7 stages of adrenal fatigue you are in here: http://www.chronicfatigue.org/ASI%203.html Note that the first three stages represent climbing cortisol levels, and Stage Four is the beginning of the decline, with some results still high, others now low.
ALDOSTERONE: If you are mid-or-below in the range, which is often 4.0 - 31.0 ng/dl , there is reason to be suspicious that your adrenals aren’t producing enough, since healthy adrenals will generally put you in the upper range. This is best tested in the morning and with no salt intake for 24 hours. Women need to do it in the first week after their period, since rising progesterone can also raise your aldosterone. Center of this range is 17.5.
RENIN: If renin is high in the range along with a low aldosterone, you have an adrenal cause. If both hormones are low in the range, you have a pituitary problem. Always tested along with Aldosterone to see if your problem is due to the adrenals (primary adrenal insufficiency) or your pituitary (secondary adrenal insufficiency).
FERRITIN: If your Ferritin result is less than 50, your levels are too low and can be causing problems…as well as leading you into anemia as you fall lower, which will give you symptoms similar to hypo, such as depression, achiness, fatigue. If you are in the 50’s, you are scooting by. Optimally, patients shoot for 70-90 at the minimum. If your ferritin is much higher, you could have hemochromatosis, a genetic disease in which too much iron is absorbed, or it could be caused by an on-going inflammation, liver disease, alcoholism, diabetes, asthma, or some types of cancer. Or it may be normal for YOU. Men are generally higher than women without having the above problems.
It may also be helpful to have the following labs: Serum Iron, Transferrin Saturation (also called iron saturation or % Saturation), and TIBC (Total Iron Binding Capacity), which will help rule out other problems such as thalassemia, an inherited blood disorder. A low ferritin with a high transferrin saturation could have hemochromatosis. But don’t worry–most thyroid patients have simple low ferritin.
B-12: Most hypothyroid patients have no issue with their B-12. But if you do get yours checked, know that it is NOT optimal to simply be “in range”. If your range is similar to 180-900, a healthy level is 800 or higher. In the 500-800 range, you can benefit from taking B12 lozenges, specifically Methylcobalamin. It has been shown in studies that patients with labs under 350 are likely to have symptoms, which means the deficiency is very serious and has gone on for a few years undetected. Lab ranges are much too low for B12…in Japan the bottom of the range is 500.
Also add the urine test Urinary Methylmalonic Acid , also called the UMMA, which is a very sensitive detection and if high, will reveal a true B12 deficiency.
This bible of hypothyroid treatment contains most everything you will find on this site, plus a whole lot more, including a chapter on T3, an explosive doctor chapter, historical information on desiccated thyroid as well as T4, an entire chapter on the TSH (Thyroid Stimulating Hooey), how to interpret your cortisol labs, extra details in two adrenal chapters, and more!
You can order the book from the publishing website here:
www.laughinggrapepublishing.com
