Posted 24 August 2013 - 05:50 PM
I have (yet another) question. I thought I understood the 4-6 week blood delay thing as every health professional I've seen has gone on about it, but I've realised now that I just don't get it.
All along, I've been told that there must be a 4-6 week minimum wait between dose changes before blood testing, however, I can feel a difference in my health/symptoms after only a week or two sometimes, and have asked for slightly earlier tests when I feel like I've gone hypER after a dose drop or hypO as per my last high dose - and this has been reflected in my blood results there and then.
Also, now that I am hypo, my endo wants to test my blood in a week's time to see if my levels are back within range before restarting carb, but how will this be apparent in a week's time? She even re-iterated the blood test 4/6 wk wait time yesterday, then said we'll check them next week first. So have I missed something or am I just being hypo-stoopid?
Is it even possible to feel hypO or hypER but it not yet be reflected in blood tests? My experience so far is that my blood tests reflect my symptoms at that moment rather than where I was 4/6 weeks ago, especially as I have been so up and down so quickly, so I just don't understand it anymore.
Any info welcome!
Thanks again folks,
Posted 24 August 2013 - 10:50 PM
For me I need the four to six weeks (sometimes it's only three weeks) from the dose change when I get labs to make sure I am where I am at. If I do it too soon then I am all over the place (yo yoing) with my lab results and not where I need for them to be at.
Elaine Moore has an article on this for how long it takes:
Posted 25 August 2013 - 06:43 PM
From my experiences , with study backing this up, here's my short list.
First treatment with ATDs, it takes time for stored thyroid hormones to be processed by the body. At this phase the dose of ATD is meant to block all thyroid hormone from being produced.
After our FT4 comes into range, the dose is lowered to start working towards a dose that maintains thyroid levels ( NOT TSH ) at a good place for the individual. When first adjusting this early dose, testing at two weeks up to four weeks, gets us closer to right with fewer errors.
Two weeks shows the trend.
Four weeks shows what that dose will do.
Adding thyroid hormone in pill form is a much slower process. Testing at six weeks shows a trend, and eight weeks shows what that dose will do. Then it takes more time for the bodies cells to start the healing process.
For me, ATDs were more like steering a little sports car. While adding T4 was more like steering an ocean liner. Takes time to turn one of those.
Posted 26 August 2013 - 03:29 AM
Thanks Pam . That makes more sense to me. :-) I've read around a bit and all I could find is that it is the TSH changes which take at least 6 weeks to show in labs (confirmed via a Q&A on Elaine Moore's site) but that T4 changes show sooner once treatment is established.
I think it's really important to push for labs at least every 4 weeks, as I have had to do, and not be fobbed off by endos with this 6 weekly test and check up regime too soon. If I had followed that protocol I would in a far worse condition than I am now (if that's possible?!). My endo moved me to 6 week check ups almost immediately and it was just too long between dose changes for me - I knew that because I could feel latter dose change differences pretty quickly. It may be less important if you're taking a softly, softly approach, but my former endo has made somewhat dramatic changes to my dosing for the last 6 months. *sigh*
However, as you say, when I first started ATD it took longer as I had all that excess hormone floating around. But without the labs, it is tempting to be led by your symptoms and start tweaking doses.
See - I have learnt the first rule of Graves Club already Pam!
Please, please do correct me if I have got this horribly wrong though.
Posted 26 August 2013 - 12:44 PM
You have things wonderfully right, Mel
And, you have grasped one of our mantras: symptoms can be confusing, labs don't lie.
That's why labs are such a valuable tool on our path to healing.
Best of luck to you moving forward! You'll heal from this blasted disease in spite of the doctors
as long as you continue to be willing to learn and be proactive with your care.