Thyroid tests are normal?? Are you sure?

[Cruzcrzy]

Originally Posted by inatic

She sent a text message to me early this am.

It said.

"boring here. they had me up and walking."

Good sign . Thanks so much for keeping us updated.


Marie

[MAMZELLE]

With so much positive energy from so many, and love, Pam, you can't miss. That's what it's all about in life. You're getting back what you've always given to everyone. No mystery there! You've earned it.

[clarke]

Hello ladies,
Unfortunately, I will probably be joining your ranks soon. I had a thyroid nodule found by my ob/gyn the other day and had an ultrasound done on it. From that report, I Just heard today that I have a multi-nodular goiter -- a couple of 1.5 cm nodules on one side and a smaller one on the other side. I had blood test done on Saturday ( nothing back yet) and a visit to the surgeon for a possible aspiration next week. So, I am just guessing here, but I think that I might be hypothyroid, (most serious symptom is I am always VERY cold).
Do you have any side affects from medication you are prescribed for this? Will supplements like Fish Oil, Flush free niacin and red yeast rice have any effect on thyroid medications? Any helpful hints anyone would like to share?
I probably won't get any final info until at least the last week of April since I will be out of town easter week, but I guess I am just trying to get some info on what I have possibly coming up.

Thanks

[decodiana]

Mamzelle,

Thanks for your comments. As far as my TPO, I don't know what that is because the GP didn't test for it....

The good news is I have an appointment on Wednesday, 4/12 with one of the Top Docs who has many, many positive patient comments on the Thyroid web site. I called Saturday and left a message that I would like an appointment and the doctor himself called me SUNDAY NIGHT to schedule me!!!!!

Linda, thanks for your comments....my weight loss has taken four years due to the Hashi's being diagnosed right in the middle of it. For the last year, it's been extremely difficult to lose, but I want to lose about 20-25 pounds more. I'm sure this wonderful doctor knows his stuff and will test me for everything that's necessary. I haven't been tested for the antibodies since I was put on the meds three years ago, because I believed that my GP with the annual testing was covering it. Now I know better and know what to look for.

This thread is so informative and you ladies are just wonderful. I'll let you know what developes.

Just wanted to say that I just found this thread, but like to many of you admire Pam for all she has contributed. Wishing her well....

Diana

[clarke]

Hello ladies,
I have 3 thyroid nodules and an appt with a surgeon for fine needle aspiration. My family doc ordered blood tests. Over the phone I was told the TSH was 1.89 and the T4 was 1.2. Am I correct in reading this that the TSH is ok, but the T4 is low? Is there another test that I should have get more info? My biggest symptom of hypo is I am always cold. Other than that, nothing else is a major symptom. I have been having some pre-meno symptoms, but have noticed that some of these are the same as hypo. I also have high cholestrol and Raynaulds syndrome ( white finger in the cold). Any suggestions on how to approach my next doc appt?
Thanks
P.S. I am a 47 yo female.

[inatic]

always get a hard copy of your labs in your hand.. AND you need to post labranges with the #'s.

[clarke]

Thank you, I probably won't have a hard copy of that info until the end of April. My followup will be after the surgeon visit and vacation. I will post then .

[clarke]

Ok, I am impatient and drove over to the doc's office and got a hard copy...

T-4 Free 1.2 ng/dl range 0.8 - 1.8
TSH 1.89 MIU/L range 0.30-4.50

They look within range, so normal? Should I pursue any other tests?

[MAMZELLE]

Yes, Clarke... nobimbo will explain much better than I ever could.... you need TPO and Free T3. I'm having same problem right now for almost 2 months trying to get / find another dr who will take FT3 which I'm told I need because my TPO [antibodies] is high. My Endo told me everything is normal with my TPO sticking out there like a sore thumb as 574 ""Hi"" [normal is 100] right on the report which I only knew about after sent to me in mail, and he never told me that could be a problem, then when I confronted him about it by phone, he STILL said I have no problem and shouldn't worry, and that's what this thread is all about and the hi TPO is why I'm convinced further testing is needed.

[nobimbo]

Your FT4 is at a decent level. Your TSH is ok, but that number can fluctuate as much as 3 points throughout the day and it's not a good indicator of thyroid function (although most docs will tell you it is).

Recommended tests to get a full picture of what's going on:

Free T3
TPO antibodies (to rule out Hashimoto's Thyroiditis); your thyroid nodules may be a sign of that so you definitely should see if you have antibodies. Antibodies can skew the other thyroid tests, btw.

ferritin (iron stores, not the same as iron test or RBC's): low ferritin can cause hypothyroid-like symptoms, including feeling cold

estrogen/progesterone: there needs to be a good balance of these for optimum thyroid function; imbalances can also mimic thyroid problems

Eating a very low carb (or low calorie) diet can also make you feel cold.

Hypothyroidism often causes high cholesterol.


Pam is the real thyroid expert here (everything I know I've learned from her), but I'm not sure if she's up to contributing her usual words of wisdom right now so thought I'd give it a try.

HTH,
Linda

[clarke]

Thank you both for your responses.. I go for a followup the end of April and will inquire about those test too. In 2004, I had a TSH test and it was 2.89 or thereabout, will have to look it up. This is all so confusing !! Thanks again

[MAMZELLE]

Let us know his attitude of even GIVING you those additional tests... I'm curious.

[nonstickpam107]

Linda...YOU RAWK!!!! Couldn't have done it better myself. Carry on.

Pam

[MAMZELLE]

W E L C O M E back, Pam!!!! I assume you're not completely 'back' lol, but nice of you to quickly check in, if that's the case. So happy everything went well!

[ew1]

Pam, sounds like the teacher has a few good students on the board!

OK, spoke to the Doc and he said to cut back on the 25gm Cytomel to a half tablet to start or less if that's what I am comfortable on-I was getting a low grade headache.At least he listens!
Does this med act like a diuretic on anyone else? Boy, I am peeing like every 40 min. I take enough potassium between food and multivitamins to offset it.

Elaine

[inatic]

I was going to say.. 25gm is a lot to start.. Is that mcg? I'd definitely start slower. (he should have told ya that

When i started with cytomel, i started with 5mcg, and when the doses were upped, i divded ea new dose in half for a few days till i got used to it.. It often gave me the rapid heart beat if i increased to fast.

[nonstickpam107]

It's in mg's. Most start with 5mg twice a day, to three times a day to START. Yes, it will act like a diuretic if you had a lot of edema, but it can also speed the system up. Your head ache may get worse before better...you're gonna have to do 'creative Cytomel Cutting 101'.

[ew1]

Thank you ladies, I will start with the way smaller dose. The Doc does not have a problem with me adjusting it. You are the best, and thank you Pam for jumping on the PC!

[Rustyjack]

Hi Pam,

Hope you are feeling better.

This was my test after 8 weeks of 1 1/2 grains of Armour.

TSH 1.562 uIU/mL 0.350 - 5.500
T4, Free Direct 0.97 ng/dL 0.61 - 1.76 T
Triliodothyronine, Free 2.8 pg?mL 2.3 - 4.2

She then add another 1/2 grain of Armour and I guess I failed to get another test, as I when in for an unrelated problem and saw her PA. She upped me another 1/2 grain and I got another test ran before the increase. This is my test on 2 grains of Armour for about the last 18 months.

TSH 0.363 uIU/mL 0.350 - 5.500
T4, Free Direct 1.06 ng/dL 0.61 - 1.76
Triliodothyronine, Free 3.8 pg?mL 2.3 - 4.2

Now I will be on 2 1/2 grains. I'm thinking she will reduce it.

I was in a medication study with a doctor that does thyroid and hormones and at the end of the study he gave me a physical and said I was low on T3. That was in March 2006 while I was on the 2 grains. The study med had nothing to do with thyroid or hormones.

What'a think? I still have no energy and freeze when everyone else is burning up, dry skin, bumps down side of tongue and almost no reflexes, memory is getting worse by the day.

[nonstickpam107]

I think you are getting there. And it's GREAT to see ya Rusty, I'm kind of trying to take it easy...big incision and I can't sit for very long without pooping out. Yes, your FT3 CAN go higher...you are almost there...it can go all the way to the top of that range (and some docs will allow it to go a teeny bit OVER if the patient is feeling well). Remember, too, that MOST women are taking 3 grains to 5 grains at their 'goal' optimized.

As long as you are NOT getting any 'heebie jeebies', heart palps, diarhea or many loose stools per day don't even LOOK at your TSH, ok?? It's just not useful with Armour and being optimized...but the FT's tell the 'story'.

Ya know, you don't go by person's size with hormones...to tritrate them. Take me, for instance....I'm 5'1.5" and (well right NOW) 99 pounds...I take 3.5 grains winter and 3 grains summer. LOTS of us take more in winter, and that may just be the difference for YOU too...once you are in summer, you may do just right on 2.5 grains, but NEED 3 in the winter. Be on the lookout for this phenomenon. And if YOU are feeling good...and know you have room to go up a bit in Armour...and the doc says a lab is 'too high' or whatever, tell her/him "I'm a patient, I'm a real person and I appreciate that you recognize that fact, therefore I want to stay at this because it's about how I feel and my quality of life, not your lab values on a piece of paper".

There ya go...you are now 'armed and dangerous'.

Pam

[Peggi_L]

Just got back the results of my annual blood work for hypothyroid meds......

Thyroxine (T4) Free, Direct, T4, Free (direct) 1.38 ng/dl .61-1.76

TSH 2.197 uIU/mL .35-5.5

Triiodothyronine, Free, Serum 2.6 pg/mL 2.3-4.2

Last year my Doc raised my dosage of (generic) synthroid from .75 mg to 100 to try to get my TSH around 1.0. I am waiting for a call from him to discuss possibly raising it more? Don't know what these other tests are or what the results should be. Any help is appreciated!!

(Do bumps around the edge of the tongue have something to do with the thyroid? I've noticed this for the past few years!)

[nonstickpam107]

If your doctor is a TSH worshipper...then there's not much you can do...except get a doc who isn't! You are like me (and thousands of others)you can take synthetic T4 till the COWS COME HOME and still not have energy....why?? Cuz if part of that T4 isn't converted into T3...then you have none of the energy/weightloss part of the hormone (that's T3).

If your doc watches your TSH (why is he so interested in your PITUITARY?? you're medicated already...so the TSH will fall ANYWAY...so what????????????? ) you'll never feel any better.

MOST normal human women need a TSH of below 1 ( in me...wayyyy below, mine is .033). It doesn't mean ANYTHING...it's the actual measurements of the thyroid hormone levels you want (those are Free T4 and Free T3). FT4 should be about midway of range or higher (see yours? It's fine, like most you have T4 ok). FT3 should be HIGHER than FT4 (see yours??? It's in the toilet, meaning your doc keeps giving you T4 ONLY and it's not converting and he only cares about your TSH...that's pretty sad, but very lucrative for the doc since he's getting paid no matter if he has any knowledge about this OR NOT).

Yes, scalloped tongue is a dead giveaway to not having any T3. The REASON Dr. ATkins gave his thyroid patients either Armour Thyroid (has T1, T2, T3, T4 just like OUR OWN THYROIDS) or he put Cytomel (synthetic T3) WITH synthetic T4 is because he was very smart and KNEW that most women do not make T3 out of T4, so giving you loads of T4 won't ever get you to a place where you feel 'normal' cuz your NORMAL thyroid, before it was diseased, made both T4 AND T3.

Pam

[warmfuzzy]

Hope someone can advise me......
I'm recently (5 months) diagnosed w/Hashis. I was started on Levoxyl, then added tiny amount of cytomel, then changed doctors...three times. Finally found one who was willing to give me Armour. I'm 4 weeks into taking Armour and scheduled to go for more blood work in two weeks.
Question......does it matter what time of day this blood work is done? I'd like to go in the afternoon, since that's when my energy goes way down. I feel the doctor might get a good idea of what's in my system by the afternoon and be better able to judge if my dose needs to be increased. Is the morning or afternoon better for blood work?
Thanks in advance for any help

[nonstickpam107]

warmfuzzy, first of all, most of us split our Armour dosage...I split mine 1.5 grain am, and 1.5 grain 3pm. T3 is most 'active' about two hours after taking, so my doc wants me to take it at 5am and then test at 9am to 2pm.

Feeling fatigued doesn't have anything to do with the hormone testing....T4 has a half life of 2 WEEKS, so the T4 you got today isn't active till about 1.5 weeks from now, and T3 has a half life of 4 HOURS so, the T3 you took at 6am is about out of system at 11am...but will look high in blood levels all DAY.

So, you MUST do a TSH, Free T4 and Free T3 to get accurate results, just doing TSH and T4 won't 'cut it' when taking Armour or Cytomel.

The difference between Total T4/T3 and Free T4/T3 is this: Totals tell what's circulatin in the blood, but not what's usable to YOU. Free's tell you how much you are ACTUALLY using (and is much better predictor). In most women, FT4 at about midway of lab range and FT3 3/4 to highest in lab range is about normal. Armour Thyroid DUMPS the TSH right away, so my doc doesn't use TSH once the patient is on Armour/Cytomel, he uses FT's to gauge. Doctors who 'freak' at TSH (TSH worshippers) rarely let a patient get to feeling 'normal' on Armour cuz the immediately lower the dosage to bring the TSH UP instead of using Free T's. If you are on HRT, or birth control pills, they bind the thyroid hormone in the blood, and FT's are used to tell the doc EXACTLY what's not being bound. Hope this helps.

Pam

[MAMZELLE]

Gee Peggi, I remember VERY long ago.... so long that I don't even remember when, but I noticed what looked like bite marks around the very edges of both sides of my tongue, and I just figured my teeth always clamped down on my tongue when I slept and thought nothing of it! It's not there now [just checked when reading that above]. I don't remember if it was always that my tongue was that way, or sometimes, or even just ONCE, but your post triggered my memory of thinking back then.... how weird it was. Or maybe my teeth DID make that indentation. I don't know. What do you think, Pam. Possible that teeth can do that overnight?

[SMP]

And I always considered my frequently-scalloped tongue a sign of allergy; as it, fatigue, and swollen eyes and nasal tissue all occurred simultaneously or near the same time. Hmmm. What say you, Pam? Sandra

[nonstickpam107]

Scalloped tongue and missing the outer thirds of the eyebrows are very often seen in those with Hashimoto's autoimmune hypothyroidism. So is swollen tongue and inability to form words.

Pam