Thyroid tests are normal?? Are you sure?

[nonstickpam107]

Yes, of course Bi est would have been more (more work in the compounding). The highest I paid for progesterone compound is 32 dollars a month (Rx. was 100mg/ML) and the lowest I paid was 24 dollars (but I liked the higher priced compound much better).

Pam

[Locarb4me]

I'm baaaaaack, with more lab results

Pam, when you get a minute, if you don't mind, can you take a look at these? I believe I misquoted my earlier results, but today got more clarification. And had a whack more bloodwork done last Saturday, also:

Free T4: 2.0 (range .80 - 1.80)
Free T3: 2.8 (range 2.3 - 4.2)
TSH: .25 (range .4 - 5.5)

My fasting blood sugar has gone up steadily over the past 6 months and is now 113. I'm sure you know, this is within pre-diabetes range now. (Diabetes starts at a FBS of 126)

However, my HBA1C is 6.0 which they say is good.

My TIBC is 456, (range 240-450 mcg/dl)
Ferritin is 68 (range 12-150 ng/mL)
Transferrin is 319 (range 198-360)

Any thoughts? I have another appt with my gastroenterologist on the 27th to review the FBS, and iron studies. I see my PCP on the 24th about thyroid, and of course she has all these reports too.

Oh and one more happy note, they found a kidney stone on my CAT scan last week. But they say it's small and may pass uneventfully. Lord, I hope so.

[nonstickpam107]

You aren't converting any of that huge amount of T4 into T3, first of all, and they are going to probably do an RAI uptake (my doc would) and your results look a LOT like my first ones!! FIVE doctors said "you're hyper" and they were ALL wrong...I was just having a hyper swing but had Hashimoto's. You need to have TSI and TPO antibodies done to rule out autoimmune and see whether it's Graves or Hashi's.

Pam

[HaleysNana]

Pam.....I may have finally found a good dr in Dallas from the link you've posted before. I saw him yesterday and he did my bloodwork - get the results Monday. However, based on my symptoms and his exam he said he felt my thyroid enlarged and my ankle reflexes were way off. Anyway he says he's reasonably confident that I have hypo and Hashimoto's. We'll see when I go back Monday what happens next.

In the meantime, I'm swearing off soy products. I'm also going to the bookstore at lunch to get The Thyroid Diet book - unless you suggest otherwise? I just need to learn once and for all how to eat to help my body!

[Locarb4me]

Originally Posted by nonstickpam107

You aren't converting any of that huge amount of T4 into T3, first of all, and they are going to probably do an RAI uptake (my doc would) and your results look a LOT like my first ones!! FIVE doctors said "you're hyper" and they were ALL wrong...I was just having a hyper swing but had Hashimoto's. You need to have TSI and TPO antibodies done to rule out autoimmune and see whether it's Graves or Hashi's.

Pam

Ok. I have a funny feeling it might be Hashimoto's after all. Thank you. (I just got back from a 4 day trip, so I'm catching up on posting).

[nonstickpam107]

Originally Posted by HaleysNana

Pam.....I may have finally found a good dr in Dallas from the link you've posted before. I saw him yesterday and he did my bloodwork - get the results Monday. However, based on my symptoms and his exam he said he felt my thyroid enlarged and my ankle reflexes were way off. Anyway he says he's reasonably confident that I have hypo and Hashimoto's. We'll see when I go back Monday what happens next.

In the meantime, I'm swearing off soy products. I'm also going to the bookstore at lunch to get The Thyroid Diet book - unless you suggest otherwise? I just need to learn once and for all how to eat to help my body!

I have The Thyroid Diet and wasted my money on it (well, maybe not, cuz I passed it along to someone who will NOT lowcarb or exercise). I think it's really important to eat well (and that means kicking sugar, wheat/gluten to the curb) and keep your calories tuned to your energy level. I really feel that going TOO low in cals/carbs just defeats the purpose for those with hypothyroidism. I feel that eating in moderation and exercising does more good.

Good luck..sounds like you are on the right path...this doctor obviously will have you on some thyroid hormone when the tests come back and then you will be able to heal.

Pam

[PalmTreeGal]

I am just beginning to look into this, totally coincidentally. I have a newish doctor due to switching insurance and she did tons of lab wok when I met her in April. Generally all was well, but I just happened to pull up my TSH online and I believe (at work now and can't check) 4.5, with the reference range 0.5-5. I remembered something about the reference values changing, so came here to scope it out.

I am a an RN and nurse anesthesia student and fairly health-care savvy, although thyroid disease is way out of my realm of expertise. The main symptom I have is fatigue. I have had depression most of my life and I know when it is or isn't well-treated. Right now I have a lot of anxiety about major life changes (graduating, new job, moving) but I don't feel depressed. But I am SO TIRED. No other symptoms off the list (constipation pre-Atkins, but no more). Losing weight okay. I've gained a lot over the past two years but probably related to sedentary lifestyle and stress eating while in grad school. Do regular docs take the basal temp thing seriously? I haven't tried it but it's an easy thing to do.

Oh, and my heart rate is HIGH. around 80 resting, I get up to move across the room and it goes to 115. I thought it was antidepressants (Wellbutrin and Effexor) but I'm only on Lamictil now. Gave up coffee and no change. I need to talk to the doc about that too, but it kind of contradicts the potential diagnosis of hypothyroid, eh?

I'm not sure what to do. I don't know this doc very well, she seems nice and took me seriously, but it was just a "nice to meet you" visit. Also she won't be my doc for much longer as we'll almost certainly be moving around the end of the year. Although we have very good insurance now and it seems like a good time to get all my physical affairs in order. I don't feel really bad. Just not really good. Everything I do takes so much energy.

[PalmTreeGal]

Oh, and I have an aunt with Grave's disease. I have no idea how relevant that is.

[nonstickpam107]

Originally Posted by PalmTreeGal

Oh, and I have an aunt with Grave's disease. I have no idea how relevant that is.

I would've quoted the first post but it was longer, TSH isn't a test of the thryoid anyway...so you need the whole panel. I suggest you just go through Online Lab Tests: blood work, blood testing and laboratory tests and order Thyroid Panel II. You pay less than 90 dollars (way less in some states), they send you to a lab near YOU, and they report back to you.

You aren't going to know if it's thyroid until you get tested, and that means a Free T3, Free T4 and TSH. If my TSH goes over a 1.5, I'm miserably sick...I've always been that way, and most women like a TSH near or slightly over/under a 1 WITH FT's of at least halfway of their ranges. (So...just doing TSH isn't giving you the whole story).

Most cases are autoimmune (Hashimoto's)...and you don't want to go through life with autoimmune disease unchecked/untreated...as a nurse you certainly know having one autoimmune disease predisposes you to having more..like me...no one would treat my Hashi's, and now I'm disabled with Sjogrens, HIE, PAN, etc. I didn't have to have all this...but I do.

You just need correct testing (and it's not easy getting treatment in CA...depending on just where you are) and a baseline testing of Free T3 (NOT T3 uptake..they are not the same tests), Free T4 and TSH with TPO antibodies for a start. If you work as a nurse, perhaps you can get a lab 'friend' to run them.

Pam

[HaleysNana]

Originally Posted by nonstickpam107

I have The Thyroid Diet and wasted my money on it (well, maybe not, cuz I passed it along to someone who will NOT lowcarb or exercise). I think it's really important to eat well (and that means kicking sugar, wheat/gluten to the curb) and keep your calories tuned to your energy level. I really feel that going TOO low in cals/carbs just defeats the purpose for those with hypothyroidism. I feel that eating in moderation and exercising does more good.

Good luck..sounds like you are on the right path...this doctor obviously will have you on some thyroid hormone when the tests come back and then you will be able to heal.

Pam

I sure hope so....its been a really long journey and I'm just tired!! Constantly tired and ready to try to get back to having normal amounts of energy again.

So, you think getting off sugar completely, no gluten and eating lower carb (I assume low GI carbs) is the best approach? I'm just trying to decide if I need to keep whole grains and fruits in or limit those too? I know you'll understand better than anyone, but I'm frankly tired of "trying" things...I want to know once and for all what's best for my body while dealing with these thyroid/auto-immune issues.

Thanks again Pam...you're a gem!!

[nonstickpam107]

If you don't have Celiac, and can have whole grains like oats (steel cut or rolled) and flax, that's good. And fruit is ok depending on 'when' you eat it. Exercise is vital to good energy, of course, and especially important to those of us with thyroid disease.

Depends on you...I know on days I lift pretty heavily (I gave up cardio, heh heh, my lungs can't withstand it for long, and lifting weights without a lot of 'recovery' time does the same thing for me) I can eat all the way up to and including about 110 gms. carb, and about 1900 cals. Days I don't lift, I walk a lot and get up to about 70 gms. carb and around 1600 cals.

Pam

[HaleysNana]

As far as I know I don't have celiac, but I think I'll do a strict induction just to get past the carb cravings and then slowly start adding them back in so I can tell what's going to work and what isn't. I do know exercise isn't going to be an option and I've already had the treadmill moved out of the garage and into the house so I can at least do incline walking while watching tv at night - so no more excuses! lol

[Carolina Rose]

Pam ~ First of all, let me say THANK YOU for the valuable information you share so generously here. However, I've tried reading through this thread and I get so confused! So many terms and procedures I don't understand.

I've finally made an appointment with a new family doctor to see about these symptoms I've been having. I looked at Dr. Rind's matrix you posted and I have several of the symptoms in both the adrenal and the low thyroid lists.

Anyway, long story short .... I don't know where to begin! I haven't been to anyone but my gyno in, gosh, over 10 years probably (I'm 46 now). This new doctor will run tests and will refer me to an endocrinologist if necessary, but what exactly do I need to ask for? If you could just spell it out, what tests I need to ask him to run. As I said, medical terms, etc. are like a foreign language to me. I'd like to bring him a list and be able to say, "here, check this."

I have pretty good insurance but I'm willing to pay that online site for more tests if need be. I'm usually very timid when visiting the doctor (one reason I avoid them!) but in this case, I want to start right off the bat being assertive about my health.

Thanks again, Pam. I really appreciate all the input you give and I will keep reading, hoping to figure all this out.

[nonstickpam107]

Carolina Rose, you're very welcome. I'm 'assuming' you're in one of the 'Carolina's', lol. Depending on which symptoms you had on the DrRind site, when one is female, over 40, and have both symptoms, then menopause and unbalanced hormones are also included in the diagnosis.

In my opinion, if you were me, I'd start by getting TSH, FT4, FT3, TPO antibodies (offered also by that site), estradiol, progesterone, ferritin, iron and go from there. If you are going to approach your physician about it, then make sure he/she will not do 'T3 Uptake' in place of Free T3. Free T3 sometimes has to be 'written in' the notes portion by the doc/requesting source and so does FT4 (Free T4) sometimes. Some labs only offer T4, T3 (Totals).

Once you get that copy of those results in hand, then you go from there. PM me (I get forgetful in my 'old age' lately) and we'll find a doctor as close to you as we can (lucky you with good insurance. Sadly, many don't have that).

I was amazed at how much better I felt once I was being treated with bio identical hormones and natural thyroid.

Pam

[Wolfpax24]

I showed my doc. some info on what thyroid issues can do, and my own probs. and asked if he would order a whole thyroid panel and he did, so will be interesting to see the results!

[nonstickpam107]

Doctors who were in school several years ago are so busy in their practices that is is difficult for them to research changes in thyroid treatments and practices. Doctors of Osteopathy seem to know the most/willing to change.

The mark of a very good doctor is one who works WITH the patient, Wolfpax24, and who is willing to listen to the patient and see the patient's research. I'm really glad your doctor is so willing to help and do the correct tests. Too many physicians think a 'thyroid panel' is just a TSH and a T4. It's not.

Pam

[Carolina Rose]

Thank you so much, Pam! I will print this out and tell the doc on Wednesday what tests I'd like to have done.

I'm about 90 miles SE of Charlotte, NC and about 90 miles NE of Columbia, SC, so between the two, surely I can find a good doctor who will work with me. There's an endocrinologist about 45 minutes from me that has been recommended to me by two different women, so maybe I'll start with him?

And, truth be told, I gave up my Diet Dr. Pepper a week ago and several of my "symptoms" seem to have vanished or greatly diminished. So I'm wondering if a lot of this was caused by aspartame poisoning? I've read that it can mimic certain ailments.

I thought about using that reasoning to cancel my doctor's appointment (I hate going to the doctor!) but I've decided I'm going in anyway and at least getting the tests done. I need to know what's going on and I'm not going to chicken out!

Thanks again, Pam! You're so generous with your time and knowledge. I surely do appreciate it.

[nonstickpam107]

Well, get the tests first..no sense relying on expensive endos (and endo's aren't usually 'great' thyroid docs anyway...most are good diabetes docs) before you even know you need one. Usually, most of us travel up to two hours radius one way to a great doctor (cuz once you get 'stabilized' you only go once or twice a year).

Pam

[HaleysNana]

Pam - here are my labs:

TSH 1.287 (range says 0.350-5.500 but my dr said he uses 0.2-2.0)
T4 10.5 (range 4.5 - 12.0)
T3 Uptake 24 (range 24 - 39)
Free Thyroxine Index 2.5 (range 1.2 - 4.9)
T3 159 (85 - 205)
Thyroid Peroxidase <10 (0 - 34)
Antithyroglobulin 26 (0 - 40)

Can you put that in plain english for me? I love this dr, but he has such a heavy Dutch accent its difficult to get everything he's saying - not to mention today is one of the worst "fog" days I've had and I feel like the whole world is in slow motion around me.

He did say I have Hashimotos and started me on Synthroid so I'm praying that I start feeling better soon. This has been a long, hard, discouraging journey...something has to change, right?

[Locarb4me]

Pam, she (my PCP) put me on Armour, 90 grains, once a day. How does that sound? Retest in 6 weeks.

In response to my question about Hashimotos: She said she *would* test me for Hashimoto's, but that it wouldn't make any difference in how she's treating me.

She also told me today "don't get too hung up on all these numbers...that's all they are, numbers."

Another comment, she said sometimes when you're overmedicated (hyperthyroid), you feel the same as when you are undermedicated (hypo). She has a term for it, something like idiosyncratic hypothyroidsim or something. Whatever.

According to everything I've read, I'm slap dab in metabolic syndrome. The only symptom I do not currently have is HPB and I actually did a couple months ago before I began low carbing.

She didn't seem to care at all about the possibility of iron-deficiency anemia or the high fasting blood sugar.

I came away feeling like I'm a hypochondriac.

[Locarb4me]

Another note.

I know you'll gasp but it is worth noting, that since I began upping my Synthroid by taking one half tablet more every third day, I feel so much better. I have been doing this for about 2-3 weeks.

I mean, seriously better.

Now please!!!! I AM NOT RECOMMENDING this to anyone else, this is just a side note since I seem to have a particularly stick-in-the-mud doctor who totally does not *get* thyroid disease nor metabolic syndrome.

Thyroid.org does have 2 endos in my area that are supposedly recommended by patients to have treated their thyroid problems to their satisfaction. Maybe I should just suck it up and get a referral???

[Locarb4me]

Originally Posted by nonstickpam107

You aren't converting any of that huge amount of T4 into T3, first of all, and they are going to probably do an RAI uptake (my doc would) and your results look a LOT like my first ones!! FIVE doctors said "you're hyper" and they were ALL wrong...I was just having a hyper swing but had Hashimoto's. You need to have TSI and TPO antibodies done to rule out autoimmune and see whether it's Graves or Hashi's.

Pam

I asked about this. She said I AM converting my T4 to T3. In her opinion.
RAI--that would be a hassle since I watch my granddaughter 3 days a week and there is not a good option for a substitute.

How long do you need to be quarantined for after that?

[Wolfpax24]

Originally Posted by nonstickpam107

Doctors who were in school several years ago are so busy in their practices that is is difficult for them to research changes in thyroid treatments and practices. Doctors of Osteopathy seem to know the most/willing to change.

The mark of a very good doctor is one who works WITH the patient, Wolfpax24, and who is willing to listen to the patient and see the patient's research. I'm really glad your doctor is so willing to help and do the correct tests. Too many physicians think a 'thyroid panel' is just a TSH and a T4. It's not.

Pam

I will make sure that it includes all of the tests before I take it. As soon as I am over the horrid sinus infection, and getting my voice back, I will go in for the tests. I can barely hear right now. My daughter also needs some bloodwork done, and is so much easier for her, if she sees mommy get stuck first~
thanks for your expertise pam.

[nonstickpam107]

Originally Posted by HaleysNana

Pam - here are my labs:

TSH 1.287 (range says 0.350-5.500 but my dr said he uses 0.2-2.0)
T4 10.5 (range 4.5 - 12.0)
T3 Uptake 24 (range 24 - 39)
Free Thyroxine Index 2.5 (range 1.2 - 4.9)
T3 159 (85 - 205)
Thyroid Peroxidase <10 (0 - 34)
Antithyroglobulin 26 (0 - 40)

Can you put that in plain english for me? I love this dr, but he has such a heavy Dutch accent its difficult to get everything he's saying - not to mention today is one of the worst "fog" days I've had and I feel like the whole world is in slow motion around me.

He did say I have Hashimotos and started me on Synthroid so I'm praying that I start feeling better soon. This has been a long, hard, discouraging journey...something has to change, right?

Well those tests do not confirm Hashimoto's. You're really good on both T4 and T3 (he didn't DO a FT3 test to see where that was). I would NOT take any thyroid hormone if this was my result before starting meds. I do not agree with the doctor at all.

May I see your: estradiol, progesterone, free testostorone, ferritin, iron tests results please? (You can PM those).

I don't agree with giving a patient thyroid hormone when their blood panel is that good and your antibodies tests are just fine and dandy...there are no antibodies present as per that test. JMHO, I've seen a lot of patient get medicated with thyroid hormone who do NOT need it. There may be another reason why you feel as you do...and I'd be looking at the other hormones (especially progesterone, if you're peri/meno/post you'll have those symptoms if your progesterone runs low, as it always does in perimeno..the thyroid wants/needs progesterone to aid it) and ferritin and iron.

Pam