Thyroid tests are normal?? Are you sure?

[nonstickpam107]

I was given T4 synthetic first also...yes, he most likely wants to see if you'll convert the T4 into a proper amount of T3. Takes patience to be a patient! But I still wouldn't want to come up that fast in dosage. If you don't feel 'right' when you raise the dose, then back off of it and give him a call (my doc was fine with that..if it didn't feel right, he was fine with me waiting for increases).

Pam

[Beth1121]

Cool. That sounds like what he told me. Thanks again! I will be on the lookout for any "off" feelings. The headache and other symptoms are mostly back to their normal levels (which still is blahhhhh!!!). It may have been something else altogether.

[Wolfpax24]

pam I posted this on the premenopausal too- but here is a repeat-hope I wrote them all down right.

FINALLY got some results back-
cortisol was 4.8 supposedly in normal range.
Free TS4 was .87
Free T3 uptake was greater than 50
TSH is 2.8

I am told this is all in normal range.
Then why do I feel so yuk?!

[nonstickpam107]

I answered you on the other thread. PM me if you need help.

Pam

[Rustyjack]

Pam,

What is going on with my thyroid. It looks like a roller coaster ride.

This is on 2 grains of Armour.

April 2006 my thyroid test was
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


March 2007

TSH 0.263 .350 - 5.500
T4 Free, Direct 0.77 0.61 - 1.76
Triliodothyronine, Free 2.6 2.3 - 4.2
Cortisol Am 15.9 4.3 - 22.4


July 2007 2 1/4 Grains
TSH 0.013 .350 - 5.500
T4 Free, Direct 0.87 0.61 - 1.76
Triliodothyronine, Free 3.1 2.3 - 4.2

This is on 2 grains of Armour as doctor said I had to lower my dose from the 2 1/4 then sent to endo who did this November test. Of course he said my thyroid was fine and stay on the 2grains of armour. I'm going to make an appointment with my pcp and I think she will up my Armour. But why the big swings?

November 2007

TSH 2.122 .350 - 5.500
T4 Free, Direct 0.99 0.61 - 1.76
Triliodothyronine, Free 3.0 2.3 - 4.2


Thanks Jackie

[nonstickpam107]

Jackie the 2.25 grains was about 'perfect'...obviously someone worships at the altar of TSH (docs who don't do a lot of Armour dosing look at the TSH and 'freak out')...and then, your thyroid 'liked and responded' to the 2.25 grains and when it was lowered, it decided to not do anything but play dead. Doc should have known this.

Pam

[Rustyjack]

Thanks Pam,

This where I feel the best
April 2006 on 2 grains my thyroid test was
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

I felt bad at 21/4. I knew my thyroid numbers had changed. I can feel it. I feel better now than at 21/4. Strange? but not as good as when I first started the 2 grains.


Jackie

[Pcola Girl]

I have been staying so sluggish and tired for many years now and my doctor said it could be my thyroid but everythime he has ran test it comes back ok. They can't find nothing wrong with me at all.
I know I don't feel like I do for no reason but none can be found.
I have already lost 100 pounds even though i still have 60 more I want to lose. Losing the weight has not even helped me feel better.
I do have asthama and stay short of breath alot and now my doctor is saying that may be the problem, but i use my Advair discus, my singular and my inhaler and my breathing seems ok to me. I even had my lungs checked out to to make sure I had nothing wrong with them.
I just feel tired all the time. I don't sleep good at night so I was thinking that may be the cause, am going in Jan. to get that checked out by having a sleep study.

I still feel like it may be my thyroid because I have two sisters who are on medication for theirs.

[SMP]

I've been there, and had thyroid tests come back negative as well. But one thing that happened to me 2 years ago was congestive heart failure after losing 80 pounds in 18 months. Heart was likely also damaged by uncontrollable environmental factors; and the damage is still there. Just had it tested at hospital a couple weeks ago. If your hemoglobin levels are normal (my anemic sister just had a mild heart attack due to lack of oxygen), then don't overlook a wonky heart. If it's OK, then keep looking at your thyroid.

[nonstickpam107]

Originally Posted by Pcola Girl

I have been staying so sluggish and tired for many years now and my doctor said it could be my thyroid but everythime he has ran test it comes back ok. They can't find nothing wrong with me at all.
I know I don't feel like I do for no reason but none can be found.
I have already lost 100 pounds even though i still have 60 more I want to lose. Losing the weight has not even helped me feel better.
I do have asthama and stay short of breath alot and now my doctor is saying that may be the problem, but i use my Advair discus, my singular and my inhaler and my breathing seems ok to me. I even had my lungs checked out to to make sure I had nothing wrong with them.
I just feel tired all the time. I don't sleep good at night so I was thinking that may be the cause, am going in Jan. to get that checked out by having a sleep study.

I still feel like it may be my thyroid because I have two sisters who are on medication for theirs.

I'd like to see your Free T4, Free T3 and TSH (with the actual lab ranges used by the lab)....and your anti TPO antibodies as well if they did them. If all the docs are doing is a simple TSH and/or T4 you'll NEVER know. I have brittle asthma and HIE and it gets SO much worse when my thyroid isn't medicated properly. And YES, they did the 'it'ssomethingelsedoasleepstudyeverythingisnormal' stint with ME too, for years...it IS my thyroid and I just needed a good doctor.

Pam

[DebM]

Pam,

In April I had a uptake scan and was found to be hyper. I had had a major panic/anxiety attack which sent me to the hospital in Nov of 06 where my symptoms were rapid pulse and I was weak and was thinking I was going to black out. At that time at the hospital they said that my potassium was critically low which I was taking hydrochol (water pill) for high bp. The blood work also indicated that my tsh was .27. I left there thinking potasium issues. Fast forward to Feb/March 07. I had had about 3 episodes of panic attacks which scared the crap out of me and had bloodwork taken again and my regular doc sent me to the endocronolgist.
I was T4 5.5
TU 33
TSH .31
I then had the uptake scan which indicated hyper and not thyroiditis.
Sooooo, started a 6 month treatment with tapazole and then when I became hypo, added levoxyl. In October 07, the plan then became to go off all meds and see if it was in remission.
Bloodwork last week was: TSH .9 T3 106 and T4 6.4

Sorry this is so long but my question(s) are this: Since last November I've gained about 9 lbs. I didn't lose being hyper, I gained as I was so wired that I ate and ate. I CANNOT LOSE THIS 9 lbs!!! and have tried the Atkins plan which helped me lose the 9# about 4 years ago. I am 5'4" and feel the best at 125#. I cannot wear my wedding rings which drives me crazy too.

Any suggestions on carbs - 20? 30? Fat fast? I don't want to give in because I'm afraid I'll continue to gain and I exercise about 4-5 days/wk and always have. I also wonder if I should have them check for diabetes. I have to pee alot (mostly in a.m.) and thirsty alot....

[nonstickpam107]

Ok, first of all, you giving me lab results with NO lab ranges doesn't 'compute' (all labs have 'different lab ranges'), so please REPOST with the lab ranges that were used for YOUR tests.

2. Most of us with autoimmune HYPOthyroidism present with a hyPER TSH FIRST...Hashiimoto's hyPOthyroidism is autoimmune and is called the 'rollercoaster disease'...meaning we 'swing' from one point to the other until the antibodies KILL off the thyroid. People with hyPER (for sure hyper...and they did TSI antibodies and anti TPO to find that out...uptakes don't mean squat unless they do the antibody/autoimmune testing) so, get those test results (copies of labs) out too. If you don't HAVE copies, call the doc and get them! The FT3, or TT3 is what determines how 'hyper' you are, not the uptake (and your uptake isn't pointing to 'hyper'...mine was much higher and I have Hashimoto's autoimmune hyPOthyroidism). You are telling me the docs did one T3 hormones test (and it's a TOTAL T3)..big mistake.

3. Hyper people DO gain weight, but until they kill off the thyroid with radiation (RAI) they don't TAKE Levoxyl (in other words, you never WERE actually 'hyper'...you had a 'swing').

4. You should be worried about gaining knowledge of thyroid disease and finding out if you have autoimmune thyroid disease...which leads to heart, lung, muscle, joint problems and OTHER autoimmune diseases...nine pounds to lose kind of takes a 'backseat' to that I would think. I'm not being unsympathetic..but you ARE now 4 years older than last time you lost the weight...right? And if you are perimenopausal, than the progesterone that is 'draining away' can cause all kinds of thyroid problems. One of the MAJOR reasons why so many of us have thyroid problems in our 30's is because the thyroid tries to 'speed up' and take over for our lack of progesterone...causing it to become damaged.

5. When you get the test results WITH lab ranges, also put the NEWEST labs (your doc should be checking your FT3 (Free T3), FT4 (Free T4), TSH, TSI, anti TPO...not uptakes and totals...and Levoxyl is a T4 ONLY hormone (most of us need both T4 and T3 replacement to live well). If you go back through this WHOLE thread (yes, I KNOW it's long, but your questions have already been answered in the thread) than you will find out about T4, T3, T2, T1 hormones, autoimmune thyroid diseases, that most docs who aren't well versed in thyroid disease (endo's are good at diabetes, not all of them at thyroid) will 'mistake' a low TSH as being hyPER..when TSH is actually a test of the pituitary, and that's precisely WHY we need FREE T testing.

And here's a website explaining WHY endo's may not be the 'best doctors' for thyroid patients and WHY we NEED T3:

Stop The Thyroid Madness Index Page

Pam

[DebM]

Sorry about not putting the ref ranges. I should have known....

March 07
T4 5.5 4.0-11.0
TU 33 25-39
FT1 1.82 1.0-4.2
TSH .31 .50-2.25
T3 UPTAKE 1.04 (don't see the range)

May 07
T4 4.4 4.0-11.0
TU 31 25-38
FTI 1.36 1.0-4.2
TSH 2.92 .50-2.25
T3 93 94-170

July 07 Sept 07
T4 4.9 5.6 4.0-11
TU 31 33 25-38
FTI 1.52 1.85 1.0-4.2
TSH 4.19 3.48 .50-6.00

Oct. 07
T4 5.3 5.0-11.0
T4 Uptake 1.12 .70-1.20
FTI 4.7 6.0-11.0
TSH 3.990 .400-5.500

These results were over the phone, doctor sick Dec 07
TSH .9 .5-6.000
T3 106 (didn't say)
T4 6.4 (didn't say)
I should be able to get a copy and will. Normally they post it on "MyChart", cleveland clinic but it's not there yet
I was called at work so I only heard to recheck in 6 weeks.


I am on no meds other than elavil .25 mg and atenolol .25 mg. I do take progesterone cream which my pharmacist compounded per saliva testing. Needs updated. 52 years old now and no period since March 07.

I will read all the posts and have to admit that I am clueless on most of this. I know I need to research better for myself. I've got the "Thyroid Solution" but I am still confused.

Thanks for all your help.

[nonstickpam107]

Ok, look at your tests and range....If you were HYPER your T3 would have been top of range or OVER (it's barely IN the range...and a T3 Uptake is NOT a T3 measurement...it is a binding T4 test, very old fashioned and most docs no longer do it).

You are clearly hyPO and you need an anti TPO antibodies test (for Hashimoto's). See the wild 'swing' of your TSH? Atenelol will help with the 'heebie jeebies' but women who have very low estrogen (menopause) will also have panic attacks.

Rule of thumb is: 'Normal' T4 and T3 are in about midlevel of range, under that is usually hypo, over range is hyPER. And you are taking progesterone, therefore you need Free T4 and Free T3...progesterone, estrogen, testosterone and soy all bind the USABLE thyroid hormones in the bloodstream..therefore T4 and T3 will show what's 'floatin' around' and Free's will show what's actually usable (you may have NO thyroid hormone at all!).

If you need help finding a good thyroid doc, pm me with your location (state/any state lines nearby by two hour drive). I went through the SAME thing you are with FIVE endo's...not a ONE diagnosed me...until I went to a doctor who is a thyroidologist...all said I was 'hyper'....I'm not, never was. I'm kind of 'shocked' though that you haven't had any autoimmune testing, no TSI (which would have proven Graves hyper) and no anti TPO (which would have proven Hashimoto's). Doctors calling a low TSH 'hyper' and doing no tests to prove isn't a good thing.

Pam

[DebM]

Pam,

I'm on page 8.....

I'm waiting on a call from my endo to set up my next 6 week appt and plan to ask them about adding the antibodies test, ferrilon, iron, estrogen and progesterone to my bloodwork. I'll also ask about the Hashimtotos.

What is the TSI - I did have a "scan" with the iodine in April to see if I was hyper or thyroiditis and that's where he "determined" that I was hyper?????

When I figure out the PM'ing I'll give you my location. I've tried to click on the websites that you've mentioned in pgs 1-8 but don't get a list.

[nonstickpam107]

Your scan didn't show 'hyper' either. Sigh. Listen, about one out of every 75 endos are 'good at thyroid' the rest are good at diabetes. On this site alone, more than 20 women have been diagnosed and treated as 'hyper' when they've been hypo. TSI antibodies show 'Graves' disease (autoimmune hyPERthyroidism) and TPO antibodies show Hashimoto's autoimmune (out of all the women who HAVE hypothyroidism, 98% have this type). Usually if you 'ask' or 'argue' with the endo he will 'fire' you as a patient...so tread softly. The more you read through this thread, the more you will see what's 'happening' across the US. What state are you in? (and 'thyroiditis' is Hashimoto's...it's not determined by an RA uptake scan, sorry, it's determined by antibodies).

I was fired by two endos just for asking about taking Armour Thyroid! Here's a site for you: Stop The Thyroid Madness Index Page and another is Thyroid Disease - Hypothyroidism - Hyperthyroidism - Cancer - Autoimmune Disease both are great, join the forum at the about.com site to gain more info too. I have lists of 'top thyroid docs in every state, some foreign countries, but I think many have found a good doc who used Armour Thyroid at this site (the docfinder uses zipcode, most of us well treated are travelling up to two hours driving time ONE WAY, so put in zips from a two hour driving radius around you) Armour Thyroid Official Site

Pam

[DebM]

Pam,

I PM'd you with where i live.

IF my endo isn't in or on your state list do you think if they work with you that they are okay or should you just up and go to someone on the list you have? I'm afraid that it's true that with mine, he's probably more diabetic than thyroid.......

I mean basically he's ready to do the RAI with my okay.......

Deb

[nonstickpam107]

OMG..no..don't do RAI!! OMG...I'm pretty sure I KNOW who you are going to..there are three docs in OH who will ablate thyroids right and left just going by TSH alone! (I know I lived there for years). You have a PM....get the list in your area by zipcodes from the Armour site, then PM me back (copy and paste who you are interested in) and I'll look it over.

Anyone reading this who lives in OH (near Cleveland/NE/Columbus) who has a doc who does FT's and gives Armour, please be so kind as to post the particulars.

Pam

[carrielyn]

Hope everyone is doing well on this Monday.

Got my results back from being on 75 mcg Synthroid and 5 Cytomel now for 2 months.

TSH 1.86 (.40 - 4.50)
T3 uptake 33 (22 - 35)
T4 Total 8.5 (4.5 - 12.5)
FT4 2.8 (1.4 - 3.8)
FT3 341 (230 - 420)

Seems to be in pretty good order. Not going to rock the boat for a couple of months and then I'm going to request the other tests Pam suggests just to make sure I'm doing well in those areas which can also affect thyroid and how we feel.

My endo has an assistant now whom I would like to throw out the window but maybe I can get her 'trained' a little so the next patient who gets the misfortune of the assistant won't have to fuss so much for all of the tests. You would think we are asking for the moon and not just a couple of tests.

[Pcola Girl]

My body temp always registers 97.3. It never is 98.6 which is normal. Its either real high with a fever or below 98.
My doctor said 97.3 must be normal for me because its always that. He has never mention that it might be due to thyroism.

[nonstickpam107]

Carrilyn, if they will 'let ya'...you might want to go up 5mg. in Cytomel...depending on how YOU feel...if you feel good, lose weight well on your woe, have good skin, hair, no aches, pains, no depression, then stay where ya are, otherwise, your FT3 could use a boost (IMHO...my FT3 needs to be where your FT4 is and my FT4 doesn't mean a whole lot).

Pam

[nonstickpam107]

Pcola Girl, I am well treated for my hypothyroidism, but my temp rarely gets above 97...I have several autoimmune processes going on though, so that's the culprit.

It's also indicative of low iron, low ferritin, low progesterone, low estrogen (the list could go on). Without having FT's and anti TPO testing, you aren't going to know for sure. And if you feel it IS hypothyroidism (probably mixed with other low hormones), you might want to search out a naturopath, or look at the docfinder at Armour Thyroid Official Site

Pam

[Abbott]

I am taking Nature-Throid 1 grain and I stopped 7 days ago taking all slow release T3 (52.5mcg SR twice a day).

I cannot take any slow release medications.
I would like to go on Armour to allow under the tongue absorbtion.

I have already symptoms of low T3. Crying for no reason, very tired, need extra sleep, low-low temperature.

Plan is to test the first of January and see what the test results are without the T3.

Questions:
Are there any other T3 options?
Is 1 grain of Nature-Throid the same as 1 grain of Armour?
How much T3 in one grain of Armour?
How low can you TSH go when you are on Armour with out harm?

Any help will be so appreciated!

[nonstickpam107]

1. You could use Cytomel, which is synthetic T3 (but I wouldn't want to.
2. One grain of Naturethroid is the same as 1 grain Armour (it just costs a lot more for Naturethroid and Naturethroid is 'said to be' a little more 'washed of fillers'...there is no 'proof of that').
3. Both Naturethroid (and Westhroid) and Armour have the SAME amount of T4 and T3: Approximately 37mcg. T4 and 9mg. of T3 per grain.
4. A good doctor well versed in thyroid treatment NEVER looks at just TSH...and mine uses FT's to measure my T4 and T3. My TSH can go as low as .009 (and has) without doing any 'harm' (what do you mean harm????? TSH is a measure of pituitary, not thyroid hormones). BUT...you don't want your FT3 over range, most patients on Westhroid, Naturethroid OR Armour have a FT4 of around midway of lab range or lower, and a FT3 of midway of lab range or HIGHER...you go by your Free T4, Free T3 (if you'd like to show yours, or pm me, that's fine, make SURE you have the lab ranges from the copy of your labs though, all labs have different lab range).

SR compounded Armour was used on me at the start of my treatment....it is quite harmful to be getting TOO MUCH T3...I can tolerate about 3 grains of Armour without my FT3 going over range. The amount of T3 you were taking would have been 'too much' for me. My heartrate would have been too fast, muscles would have been weak, my emotions would have been all over the place, etc. No good to go 'hyper'. That's WHY doctors do FT's...to determine dosage, and NOT YOUR TSH.

Your symptoms of 'low T3' are MY symptoms of also having TOO MUCH. I can't tell until my FT's are back from the docs' lab.

Pam

[Abbott]

Thank you Pam.

I'm treated by a Naturopath for my thyroid. No insurance to cover this, but he does the correct blood tests (I have to pay for the tests and the Dr. visits).
My primary Dr. does not like this and keeps monitoring my TSH only. When it goes to low she gets really upset..... She just doesn't get it. Discussions with her do not help. She has given us good care in other areas.

[nonstickpam107]

I have a PCP who is an internist...and I've let him 'take over' the Rx'ing for my pulmonary and cardiac medications (although he stays in touch with my cardiologist and my pulmonologist and my immunologist...it's just that we've found what works and why keep paying these specialists to have the same thing over and over again, sigh). He keeps trying to send me for a TSH only and I've talked to him till I'm blue in the face and he still doesn't 'get it' sometimes.

HyPER is determined by your FT's...and if your FT3 is ABOVE range (mine would be with that whopping amount of incoming T3, that's for sure) than you are doing a misservice to the body. No amount of T3 will raise my temperature, and many a naturopath has made me very hyper trying to raise temp alone (so not all naturopathics 'get it' either). I have autoimmune disease, my 'thermometer' is permanently 'damaged' and I'm gonna be 97.0 body temp no matter WHAT they do. My thyroidologist 'gets it'.

So, like you, I keep my internist/PCP cuz he's GREAT with most of the other autoimmune diseases I have and for other care....but I'm still going to see my thyroidologist for my thyroid/hormone care. As long as SOMEONE is getting your Free T's (and you are getting the copies of all the lab reports to monitor yourself) than all is well.

ETA: Check out how much you are paying for your TSH, Free T4, Free T3...cuz you can get it through Online Lab Tests: blood work, blood testing and laboratory tests (you order Thyroid panel II online, they send you to a lab near you and then report back to you) for under 90 dollars out of pocket, then take the report to your doc. Just wanted to make sure you knew that. Most docs/patients are being charged up to 300 dollars for that panel when they are sent to the lab by the doc.

Pam