Thyroid tests are normal?? Are you sure? - Page 66

olsufka2 · 06-18-2008, 03:48 PM

Hey Pam thanks for replying to my thread. I understand the TSH levels can fluctuate daily but to drop 30 points in a month on the starting dose of levo.
My goodness when its bumped up to say 50 mcg will my TSH levels just continue to plumet? Isnt that indicative of a pituitary problem? One should have a moderate to high TSH when the T4 is low right??? I started out with a low TSH and although my T4 has risen slightly my TSH has taken a dive, I wouldnt be so concerned if my TSH would have started out on the high side and had room to drop 30 points in a month but starting out low and then dropping that much is a concern to me. What happens if ones TSH drops out of range exactly what does that mean???? It means there is a problem with the pituitary from everything I have read. Right???? Or am I misunderstanding all the information I am getting off the net????? Thanks

Lilgrnize · 06-18-2008, 03:57 PM

Your TSH will naturally drop when you start thyroid hormone, but at that point, like Pam said, the TSH is meaningless. No, a low TSH does not automatically mean you are hyper or have a pituitary problem. My TSH is <.001 and I'm far from hyper! You shouldn't even pay attention to the TSH after you have started thyroid hormone unless it is still high.

Have you had TPO antibodies checked? Often a low TSH with low free t's is a symptom of hashi's. That was the case with me.

olsufka2 · 06-18-2008, 04:40 PM

Thank you so much for your reply Niki. I guess when I first started researching all of this I was quite confused as to why my FT4 was low as well as my TSH. I know when the FT4 measures in at low the TSH should be at least at a moderately high number hence the pituitary kicking out Thyroid Stimulating Hormone, but mine was not high at all, it was actually borderline low, so that in itself was a little alarming to me. I do know that secondary hypothyroidism involves the pituitary and TSH as well as T4 are usually both low in these cases, since the pituitary is not working well it is unable to kick out the thyroid stimulating hormone, hence a low TSH. So, once thyroid medication is started one should just ignore the TSH levels???? They are really of importance no more????? It is just the T4 that I should focus on??
Well, I can say that has came up somewhat. I still feel like absolute CRAP
though!!!! I do see an internal med. doctor next week as my PCP also thought it was very strange that my TSH would drop so far on such a low dose of levo. in just a months time. This is all sooooo very confusing to me, you are all a little more seasoned in this than I so I do truly appreciate your patience and understanding with me. I'm learning. This thyroid stuff is a tricky business!!!!!!!!!!!!!

olsufka2 · 06-18-2008, 07:29 PM

OK I just ran across a site that said "Patients with a Free T4 of less than 0.9 mg/dl and a TSH of less than 1.0 mU/mL are likely to have central hypothyroidism. Hum, that pretty much sums up what I was thinking all along. My Free T4 was at 0.71 less that the 0.9 and my TSH was at 0.98 also less than the 1.0 Well, we'll see what my endo. says about all of this next week. I'll make sure to keep you all posted. Thanks much

nonstickpam107 · 06-19-2008, 01:53 AM

olsufka...that doesn't 'clarify' it. My TSH was LOWER and my FT4 about the same. I have Hashimoto's. That's about the most COMMON form of hypothyroidism to have. And that's determined by TPO antibodies. Not TSH and T4 (and you NEED T3 testing).

Pam

PalmTreeGal · 06-19-2008, 03:21 AM

I don't have all my labwork back but I sneaked a peek at my labs yesterday at work (sshhh, don't tell!) and my TSH was 5.1. The upper end of the range was 4.89. So there ya go. Looking forward to seeing my FTs and TPO.

olsufka2 · 06-19-2008, 06:02 AM

Thanks Pam. I realize it doesn't "clarify" it but if that is the case with secondary hypo. one should definately have more tests done. I am going to insist on an antibody test when I see my endo. next week, but I cant imagine he will overlook the possibility of having something going on with my pituitary. May I ask, since your labs were indicitive of a pituitary problem did you have all of the pituitary hormone tests run to absolutely rule out the possibility of something being wrong with it or did they just determine it to be Has. due to the antibody test?

nonstickpam107 · 06-19-2008, 11:54 AM

olsufka, no, I didn't 'get to' the pit tests...after getting my TPO back at ABOVE the 5,000 range. It was pretty evident. Why bother doing the rest of the tests? BTW...it's pit involvement if the TSH is UNDER the range, as well as both the FT4 and FT3. Most docs don't delve further if the TPO comes back high (cuz out of all the women who HAVE hypothyroidism, 98% have Hashimoto's). Now, if you are medicated for some time with both T4 and T3, and THEN your FT4 and FT3 BOTH fail to respond, your endoneurologist would do pit testing.

Mandy, the new range for TSH is .30 to 3.0. Out of all the studies of TSH testing for women between the ages of 20 and 45, all the normal (NON thyroid disease affected) women had a TSH of around a 1. That is why you wouldn't want to be medicated JUST using TSH...if you are, then you run the chance of having a TSH of around 3, and STILL feeling terribly hypo with a 'TSH worshipping' doc saying "I don't know WHY you don't feel good, you're right in the 'middle' of the range". KWIM?

Pam

PalmTreeGal · 06-19-2008, 03:12 PM

My doc called today to start me on Synthroid. She told me my FTs were "normal" and told me what they were and the ranges, but she was going fast and I didn't catch them. She ordered a TPO but the lab didn't run it, so she reordered it. I am going by the office tomorrow to get a copy of my labs. I don't like it that the office doesn't automatically send me a copy.

So here's my plan: will get the values, and post them here for commentary. I will start the Synthroid as she prescribes it, and get cracking on finding a good thyroid doc within a couple hours drive. She wants to retest me (for TSH I assume) in August, but hopefully by then I'll be established with a thyroid doc.

I'm actually kind of excited about this - a treatment for my lack of energy and depression! I suppose a lot of thyroid sufferers have felt like this - elated to get a diagnosis at last.

inatic · 06-19-2008, 03:14 PM

how much synthroid did she give you?

PalmTreeGal · 06-19-2008, 03:16 PM

I don't know, I'll pick up the prescription tomorrow! Is there a usual starting dose?

olsufka2 · 06-19-2008, 05:29 PM

Thank you so much for all your information Pam. I guess I didnt realize if you dont respond to medication that has something to do with the pituitary. I guess I really dont understand that at all. Could you please explain. YOu have been soooo helpful!!!!!

PalmTreeGal · 06-20-2008, 06:40 AM

Okay, here are the long-awaited labs:

TSH 5.11 (0.46-4.98)
Free T3 2.7 (2.4-4.2)
Free T4 1.22 (0.71-1.85)
T3 Uptake 1.15 (0.8-1.3)
TPO 0.3 (0.0-3.9)
Antithyroglobulin AB 3.2 (0.0-14.4) (states anything under 14.4 is considered negative)

nonstickpam107 · 06-20-2008, 06:59 AM

Quote:

Originally Posted by olsufka2

Thank you so much for all your information Pam. I guess I didnt realize if you dont respond to medication that has something to do with the pituitary. I guess I really dont understand that at all. Could you please explain. YOu have been soooo helpful!!!!!

You may think that you would 'respond' right away? No. Most stay on a starting dosage of T4 (25mcg.) for about two, three months. Then re test. Go up to 50mcg. for two or three months, retest..and it's at that point you want to see a FT4, FT3 to determine if you are converting. If you are NOT converting them, a small dose of Cytomel (synthetic T3) might be added to your T4, OR be switched to Armour or Westhroid. Then you'll wait about three to SIX months to re check FT4, FT3 and see where you are.

Depending on how LONG you've been untreated, it can take up to three years to 'respond' with testing.

Pam

nonstickpam107 · 06-20-2008, 07:04 AM

Quote:

Originally Posted by PalmTreeGal

Okay, here are the long-awaited labs:

TSH 5.11 (0.46-4.98)
Free T3 2.7 (2.4-4.2)
Free T4 1.22 (0.71-1.85)
T3 Uptake 1.15 (0.8-1.3)
TPO 0.3 (0.0-3.9)
Antithyroglobulin AB 3.2 (0.0-14.4) (states anything under 14.4 is considered negative)

Now you need to rule out anything that may be causing your TSH to be high and your FT3 to be low (lack of conversion). You aren't testing 'yet' as Hashimoto's (my DD didn't test positive for about three years, then, all of a sudden, was HUGELY over the range...don't think this is the only test you should get, but wait at least a year or longer to re test).

Your FT4 is good. Your conversion is nonexistant. Some of the things that cause that are: low iron, low ferritin, low progesterone (peri meno/meno), eating soy, TOO LOW CARBS AND CALORIES FOR TOO LONG. So, you need to rule out things first..(cuz no one wants to have to take thyroid hormone for the rest of their life without knowing if something else is 'causing' the tests to be low thyroid). Once you start on thyroid hormone, the thyroid 'senses it' and starts to shut down...and that's why you rule out all other possibilities for low tests.

The range for iron in women is commonly like: 10-210..so if your doc thinks 'anywhere in range' is 'ok'..most women with a result of under 70 or so will exhibit high TSH and low FT3. Upon getting the iron up where it should be, the lab results may change.

ETA: Obviously your FT4 is fine. And so..um..your doctor gave you more. You need T3 brought up if anything after you rule out the above. On your next labs, if your FT4 is even HIGHER but your FT3 hasn't come up to just under midway of it's range...you are not converting any T4 (even the incoming) into T3...and might want to discuss why the doc is giving more T4 when it's T3 you need.

Pam

Lilgrnize · 06-20-2008, 07:05 AM

For most women, the ft4 should fall around 50% on the range and the ft3 should be around 75% to feel good. Of course this varies with each individual.

Your ft4 is at 45% of the range, and the ft3 is at 17%! That ft3 is really low...here's hoping you convert, or the $ynthroid alone isn't going to help you alot. I was lucky and started on Armour from the beginning.

That low ft3 will definitely cause the fatigue and depression.

olsufka2 · 06-20-2008, 10:59 AM

Oh, your such a blessing Pam. Thank you so much for answering my questions. I am learning more and more every day. I am going to demand an FT3 and antibody test be done next week. I just dont understand why Dr's dont think an FT3 is important in all of this. On a side note, when I was going through all of my records the other day to take to my endo. I was reading one of my EEg reports from a year and a half ago that stated I have polyneuropathy, multiple nereve entrapments. My Dr. said in his notes that this is usually caused by chronic illnesses such as thyroid diseases, diabetes...
I am starting to wonder if my thyroid may have something to do with this. At the time of this test both my TSH and FT4 were on the low side and have been for the last 3 years but he has always told me my thyroid was fine. SHEESH!!!!

nonstickpam107 · 06-20-2008, 01:00 PM

I had 'frozen' shoulder (nerve entrapment) and carpal tunnel until I was treated optimally. I don't have EITHER now. And I almost let a surgeon cut me for the carpal tunnel....good thing I waited it out.

The pituitary involvement I 'think' you may be talking about is the TSH test. TSH means 'Thyroid stimulating hormone'...meaning that it tests the pituitary's action UPON the thyroid. That's why it's less important to go by TSH than it is to go by the actual hormone levels (T4, T3, FT4, FT3).

Pam

PalmTreeGal · 06-20-2008, 01:12 PM

On the phone I asked my doctor if she medicated to TSH or to FT3/FT4. She said "Your FT3 is normal." So obviously, she doesn't "get" it and won't have the privilege of managing my thyroid hormones!

Pam - I get a lot of dietary iron, but have no idea what my iron stores look like. My periods are light and short from being on the pill so many years. Should I have iron/ferritin tested?

I eat a little soy, in the form of about 1 Atkins bar a week. Would that be enough to have an effect?

I am not perimenopausal (age 31) and am on BCPs so I think I'm getting all my female hormones.

I don't eat terribly low carbs or calories - carbs are 20-35, usually toward the high end, and cals are almost never under 1600. My TSH was also high a year ago and I had not been dieting or low carbing in any way at that point, so I'm thinking that isn't the problem.

I am heading out the door to go visit my in-laws in Boston - FIL has had pancreatic cancer for 2 years now and seems to be reaching the end of the road. We make it up to MA a lot so maybe I will look for a doc up there, if there are some good ones? Or I will keep checking out the ones in MD/VA/PA. Thanks so much, Pam and Niki for your input!

nonstickpam107 · 06-20-2008, 02:45 PM

Mandy, prayers for you, and inlaws/family...my MIL has been in hospital for two days now...she just bottomed out (pulse and heart failure) during her dialysis a couple days ago.

AH HA..you take BCP's!! It's even MORE important to go by FT's. Total T's show what's in the blood...and Free T's show what's USABLE. And BCP'S bind up conversion and FT3 in the bloodstream.

Um, yeah, your doctor 'doesn't get it'.

Yep, get that iron test (and NO, a hemoglobin is NOT the 'same thing'...watch in amazement when it comes back and your doctor says you're 'normal' if it's a range of 10-210 and it comes back, say 11'ish...I hear that all the time..oh, so normal..NOT).

If you want to hear a hypothyroid story/coupled with low iron...ask inatic! She went through that...and finally got her iron levels up so she could get her FT's up (with T4/T3 at first, and now Armour, but her iron had to be brought up...it took about a year for her).

Pam

mrshelenmarie · 06-21-2008, 09:07 AM

[b]Results are in....

--------------------------------------------------------------------------------

Hi Pam,
I had the blood work done at the lab you recommended. Could you please tell me what you think???? I have an appt in June with Dr RM Harrell, of Ft Lauderdale. Although he's on my insurance plan, I'm not sure he's the one. I broke down on the phone when they told me his first available appointment was October; seems the receptionist had some empathy and SQUEEZED me in. The reason I want to stick within my plan is the goiter issue. I feel so tight in the neck, makes me think it's grown. I've been so dizzy and utterly confused; my focus is so off, it's almost as if I can feel the disconnect in my head. Let me know what you think of the tests. Thanks so much!!!!! Helen

Thyroid Peroxidase (TPO) Ab <10 0-34 IU/mL

Antithyroglobulin Ab <20 0-40 IU/mL
Siemens (DPC) ICMA Methodology

TSH 1.643 0.350-5.500 uIU/mL
Adult TSH concentrations below 5.5 uIU/mL do not
rule out the presence of subclinical hypothyroidism.

Triiodothyronine,Free,Serum 2.8 2.3-4.2 pg/mL
T4,Free(Direct) 1.11 0.61-1.76 ng/dL

Well, you don't have Hashimoto's at this point, no antibodies are showing. Your conversion from FT4 to FT3 is..um..not even there. That could be from something you're eating/taking...from low iron to perimeno/meno...to birth control, to eating too few carbs/calories, to eating soy and suppressing.

You really need to have an ultrasound/and then follow up testing if there are nodules/cysts on the thyroid. There's a patient recommend on that doctor, but .. um..that he'll add T3 to T4 (meaning synthetic, but that's ok..) and that he ultrasounds, and is very attentive. So, that's a good place to start, I'm glad they could fit you in. Oh, and that doctor is also supportive of lowcarb eating, so that's a plus. Let me know how it all turns out..anytime a goiter is growing, you need to find out why.

Pam
__________________
So many fireworks. So little time.

Pam..........I thank God for you and the others that offer information to those of us with many symptoms and no reason..........

Dr Harrell did an ultrasound, ruled out cancer and informed me I had a few more nodes on my thyroid. He told me my symptoms were not endocrine related, were depression and I was perimenopausal. He didn't suggest estrogen for me, it may cause clots; gave me paperwork on the South Beach diet, and told me to go to the gym and work out with a trainer. All this was done BEFORE he looked at my blood test results, which of course were normal to him.

I walked out of there feeling awful, lost and more depressed than ever. I had hopes that I would finally feel better and that I wasn't crazy. Today, as I read some new pages in this thread, I TRULY understood the pain of all those in search of help. Helen

nonstickpam107 · 06-21-2008, 01:26 PM

Helen, you need to find a better doctor than that. So, he didn't Rx. any progesterone (cuz just low T3 would benefit from progesterone).

If he was only going to give your horse urine estrogen.. and didn't..then you are lucky he was such an asshat.

There ARE other doctors, unfortunately for many, you will have to look for someone not on your insurance (I don't know too many women who find a good thyroid doctor who takes THEIR insurance...but there are many who will let your PCP do the blood work, and then let you file the insurance yourself to get some of it back).

Ok, don't give up! First, go to the ArmourThyroid and look for the 'docfinder' feature. It uses zipcodes, so give zips up to a radius and about an hour's drive one WAY (most of us have to travel to get a good doc...it's worth it). Secondly, start calling the pharmacies around you...ask "Do you carry Armour Thyroid?" and if they say 'yes', tell them that you've just moved to the area, and need to find a doctor who Rx's that Armour Thyroid, to stay 'within your plan' (the reason I'm suggesting this is because most docs's who Rx. Armour also do the correct tests and know bioidentical hormones well...two birds with one stone).

If that fails, then I'll give you a list of 'patient recommended' docs (although that one DID have ONE teeny recommendation...since you were geared to see someone on your insurance, I didn't suggest any others, but will if you want the list).

Don't lose hope! When you don't feel well, you need to be listened to, and work things out until you DO feel well. It may very well be a problem with sex hormones and balancing...but first you need to find a doctor who works WITH the patient, not AGAINST you. Hang in there dear! We've been down this road before!

Pam

mrshelenmarie · 06-21-2008, 03:05 PM

Quote:

Originally Posted by nonstickpam107

Helen, you need to find a better doctor than that. So, he didn't Rx. any progesterone (cuz just low T3 would benefit from progesterone).

If he was only going to give your horse urine estrogen.. and didn't..then you are lucky he was such an asshat.

There ARE other doctors, unfortunately for many, you will have to look for someone not on your insurance (I don't know too many women who find a good thyroid doctor who takes THEIR insurance...but there are many who will let your PCP do the blood work, and then let you file the insurance yourself to get some of it back).

Ok, don't give up! First, go to the ArmourThyroid and look for the 'docfinder' feature. It uses zipcodes, so give zips up to a radius and about an hour's drive one WAY (most of us have to travel to get a good doc...it's worth it). Secondly, start calling the pharmacies around you...ask "Do you carry Armour Thyroid?" and if they say 'yes', tell them that you've just moved to the area, and need to find a doctor who Rx's that Armour Thyroid, to stay 'within your plan' (the reason I'm suggesting this is because most docs's who Rx. Armour also do the correct tests and know bioidentical hormones well...two birds with one stone).

If that fails, then I'll give you a list of 'patient recommended' docs (although that one DID have ONE teeny recommendation...since you were geared to see someone on your insurance, I didn't suggest any others, but will if you want the list).

Don't lose hope! When you don't feel well, you need to be listened to, and work things out until you DO feel well. It may very well be a problem with sex hormones and balancing...but first you need to find a doctor who works WITH the patient, not AGAINST you. Hang in there dear! We've been down this road before!

Pam

Thanks Pam, I'm hanging and really do appreciate your words of wisdom!! I just thought of something.........since I'm 48 and peri, I don't cycle often, usually only 2x year; however, I got my (.) on Monday, do you think I should get a hormone panel done?? And if so, when in the cycle is the right time??? I've been using USP progesterone cream for years so maybe my hormones are at play here. I haven't been able to access the Armour website, even after I lowered all my security. Is it me??? I went back to the list of Docs you did suggest, one was 7 hrs away, 2 were 5 hrs away, one is 3 hrs away, the Boca one isn't affordable and he won't work with any tests already taken. Florida is long and narrow and I'm in the southeastern area, near Ft lauderdale and 20 miles north of Miami. Perhaps there are a few more you can suggest, I'm in need.......I will start making phone calls to pharmacies to see if that gets me anywhere as well. Whew..............

nonstickpam107 · 06-22-2008, 04:11 AM

Helen...it's gonna be rough. But here's the name of one doctor (he seems to like to give iodine for thyroid though (I don't approve of this...) and if he's gonna take your money, you have to right to say "I'm just here for BHRT if I need it, and Armour Thyroid, let's set up a workable plan for those things".

Doctor Maiquez Anti-aging Age Management Physician Miami

The following is a compounding pharmacy (and they will know which docs are Rx'ing Armour Thyroid, as well as be able to get you tested for the rest of the hormones).

8301 Florida Dr
Pembroke Pines, FL 33025
(954) 241-0175‎

Pam

lisabinil · 06-22-2008, 07:55 AM

Hey Pam

My tests results from the endo came back-all my hormones are low not just the thyroid and I am low on Vitamin D. He has prescribed 50 mg of synthroid and Vitamin D to hopefully start me feeling better. He wants to go slow and see how the synthroid does-of course he is checking again in 2 months and if things are not changed he will being pituitary testing. I called for a copy of my labs to be mailed to me. So I am hoping the synthroid will at least start to make me feel better along with the Vitamin D and further testing will get to the root of my problems.

pennylovesdarren · 06-22-2008, 05:30 PM

Forgive me if this has been answered somewhere else but what's the deal with Walgreen's saying they won't be carrying armour thyroid anymore? I picked up my prescription yesterday and was telling the pharmacy tech how fabulous it is etc., etc., and she said they can't get it anymore. WHAT?

I live in Oregon btw.

06-19-2008, 11:54 AM	#1958
nonstickpam107 Thyroid Patient Advocate Join Date: Nov 2002 Location: NE Indiana Posts: 11,665 Gallery: nonstickpam107 Stats: 230/116/120 (BF<26%) WOE: Started w/Atkins/Now BFFM Start Date: Nov. 23 2000	olsufka, no, I didn't 'get to' the pit tests...after getting my TPO back at ABOVE the 5,000 range. It was pretty evident. Why bother doing the rest of the tests? BTW...it's pit involvement if the TSH is UNDER the range, as well as both the FT4 and FT3. Most docs don't delve further if the TPO comes back high (cuz out of all the women who HAVE hypothyroidism, 98% have Hashimoto's). Now, if you are medicated for some time with both T4 and T3, and THEN your FT4 and FT3 BOTH fail to respond, your endoneurologist would do pit testing. Mandy, the new range for TSH is .30 to 3.0. Out of all the studies of TSH testing for women between the ages of 20 and 45, all the normal (NON thyroid disease affected) women had a TSH of around a 1. That is why you wouldn't want to be medicated JUST using TSH...if you are, then you run the chance of having a TSH of around 3, and STILL feeling terribly hypo with a 'TSH worshipping' doc saying "I don't know WHY you don't feel good, you're right in the 'middle' of the range". KWIM? Pam __________________ So many fireworks. So little time. "The thyroid is nothing to mess with" ... Sunset Last edited by nonstickpam107 : 06-19-2008 at 11:55 AM.

06-19-2008, 03:12 PM	#1959
PalmTreeGal MAJOR LCF POSTER! Join Date: Jan 2007 Location: MD Posts: 1,642 Gallery: PalmTreeGal Stats: 181/175.6/120 WOE: Atkins Induction Start Date: 9/1/08	My doc called today to start me on Synthroid. She told me my FTs were "normal" and told me what they were and the ranges, but she was going fast and I didn't catch them. She ordered a TPO but the lab didn't run it, so she reordered it. I am going by the office tomorrow to get a copy of my labs. I don't like it that the office doesn't automatically send me a copy. So here's my plan: will get the values, and post them here for commentary. I will start the Synthroid as she prescribes it, and get cracking on finding a good thyroid doc within a couple hours drive. She wants to retest me (for TSH I assume) in August, but hopefully by then I'll be established with a thyroid doc. I'm actually kind of excited about this - a treatment for my lack of energy and depression! I suppose a lot of thyroid sufferers have felt like this - elated to get a diagnosis at last. __________________ Mandy <------- Me at 130ish My Journal: http://www.lowcarbfriends.com/bbs/we...8-journey.html

06-20-2008, 02:45 PM	#1970
nonstickpam107 Thyroid Patient Advocate Join Date: Nov 2002 Location: NE Indiana Posts: 11,665 Gallery: nonstickpam107 Stats: 230/116/120 (BF<26%) WOE: Started w/Atkins/Now BFFM Start Date: Nov. 23 2000	Mandy, prayers for you, and inlaws/family...my MIL has been in hospital for two days now...she just bottomed out (pulse and heart failure) during her dialysis a couple days ago. AH HA..you take BCP's!! It's even MORE important to go by FT's. Total T's show what's in the blood...and Free T's show what's USABLE. And BCP'S bind up conversion and FT3 in the bloodstream. Um, yeah, your doctor 'doesn't get it'. Yep, get that iron test (and NO, a hemoglobin is NOT the 'same thing'...watch in amazement when it comes back and your doctor says you're 'normal' if it's a range of 10-210 and it comes back, say 11'ish...I hear that all the time..oh, so normal..NOT). If you want to hear a hypothyroid story/coupled with low iron...ask inatic! She went through that...and finally got her iron levels up so she could get her FT's up (with T4/T3 at first, and now Armour, but her iron had to be brought up...it took about a year for her). Pam Last edited by nonstickpam107 : 06-20-2008 at 02:46 PM.

06-21-2008, 09:07 AM	#1971
mrshelenmarie Junior LCF Member Join Date: May 2008 Location: Ft Lauderdale, Florida Posts: 13 Gallery: mrshelenmarie	The journey has just begun............ [b]Results are in.... -------------------------------------------------------------------------------- Hi Pam, I had the blood work done at the lab you recommended. Could you please tell me what you think???? I have an appt in June with Dr RM Harrell, of Ft Lauderdale. Although he's on my insurance plan, I'm not sure he's the one. I broke down on the phone when they told me his first available appointment was October; seems the receptionist had some empathy and SQUEEZED me in. The reason I want to stick within my plan is the goiter issue. I feel so tight in the neck, makes me think it's grown. I've been so dizzy and utterly confused; my focus is so off, it's almost as if I can feel the disconnect in my head. Let me know what you think of the tests. Thanks so much!!!!! Helen Thyroid Peroxidase (TPO) Ab <10 0-34 IU/mL Antithyroglobulin Ab <20 0-40 IU/mL Siemens (DPC) ICMA Methodology TSH 1.643 0.350-5.500 uIU/mL Adult TSH concentrations below 5.5 uIU/mL do not rule out the presence of subclinical hypothyroidism. Triiodothyronine,Free,Serum 2.8 2.3-4.2 pg/mL T4,Free(Direct) 1.11 0.61-1.76 ng/dL Well, you don't have Hashimoto's at this point, no antibodies are showing. Your conversion from FT4 to FT3 is..um..not even there. That could be from something you're eating/taking...from low iron to perimeno/meno...to birth control, to eating too few carbs/calories, to eating soy and suppressing. You really need to have an ultrasound/and then follow up testing if there are nodules/cysts on the thyroid. There's a patient recommend on that doctor, but .. um..that he'll add T3 to T4 (meaning synthetic, but that's ok..) and that he ultrasounds, and is very attentive. So, that's a good place to start, I'm glad they could fit you in. Oh, and that doctor is also supportive of lowcarb eating, so that's a plus. Let me know how it all turns out..anytime a goiter is growing, you need to find out why. Pam __________________ So many fireworks. So little time. Pam..........I thank God for you and the others that offer information to those of us with many symptoms and no reason.......... Dr Harrell did an ultrasound, ruled out cancer and informed me I had a few more nodes on my thyroid. He told me my symptoms were not endocrine related, were depression and I was perimenopausal. He didn't suggest estrogen for me, it may cause clots; gave me paperwork on the South Beach diet, and told me to go to the gym and work out with a trainer. All this was done BEFORE he looked at my blood test results, which of course were normal to him. I walked out of there feeling awful, lost and more depressed than ever. I had hopes that I would finally feel better and that I wasn't crazy. Today, as I read some new pages in this thread, I TRULY understood the pain of all those in search of help. Helen

06-22-2008, 07:55 AM	#1975
lisabinil Big Yapper!!!! Join Date: Apr 2007 Location: suburbs of Chicago Posts: 8,179 Gallery: lisabinil Stats: 214/185/180 287 in 00 WOE: higher carb Atkins Start Date: SBD 3/5/07,Atkins 4/18/07	Hey Pam My tests results from the endo came back-all my hormones are low not just the thyroid and I am low on Vitamin D. He has prescribed 50 mg of synthroid and Vitamin D to hopefully start me feeling better. He wants to go slow and see how the synthroid does-of course he is checking again in 2 months and if things are not changed he will being pituitary testing. I called for a copy of my labs to be mailed to me. So I am hoping the synthroid will at least start to make me feel better along with the Vitamin D and further testing will get to the root of my problems. __________________ 26 hrs of 10 in 10 Callanetics completed Walk Away The Pounds Challenge 5/18/08-52.5 Walk Away Your Waistline-33 miles Muscle Mile-10 hr 4 Mile Super Challenge-16 Jog/Walk-7.5 Super Fat Burning-7

06-18-2008, 03:48 PM	#1951
olsufka2 Junior LCF Member Join Date: May 2008 Posts: 26 Gallery: olsufka2	Hey Pam thanks for replying to my thread. I understand the TSH levels can fluctuate daily but to drop 30 points in a month on the starting dose of levo. My goodness when its bumped up to say 50 mcg will my TSH levels just continue to plumet? Isnt that indicative of a pituitary problem? One should have a moderate to high TSH when the T4 is low right??? I started out with a low TSH and although my T4 has risen slightly my TSH has taken a dive, I wouldnt be so concerned if my TSH would have started out on the high side and had room to drop 30 points in a month but starting out low and then dropping that much is a concern to me. What happens if ones TSH drops out of range exactly what does that mean???? It means there is a problem with the pituitary from everything I have read. Right???? Or am I misunderstanding all the information I am getting off the net????? Thanks

06-18-2008, 03:57 PM	#1952
Lilgrnize Blabbermouth!!! Join Date: Feb 2004 Location: San Antonio Posts: 5,996 Gallery: Lilgrnize Start Date: 02/04	Your TSH will naturally drop when you start thyroid hormone, but at that point, like Pam said, the TSH is meaningless. No, a low TSH does not automatically mean you are hyper or have a pituitary problem. My TSH is <.001 and I'm far from hyper! You shouldn't even pay attention to the TSH after you have started thyroid hormone unless it is still high. Have you had TPO antibodies checked? Often a low TSH with low free t's is a symptom of hashi's. That was the case with me.

06-18-2008, 04:40 PM	#1953
olsufka2 Junior LCF Member Join Date: May 2008 Posts: 26 Gallery: olsufka2	Thank you so much for your reply Niki. I guess when I first started researching all of this I was quite confused as to why my FT4 was low as well as my TSH. I know when the FT4 measures in at low the TSH should be at least at a moderately high number hence the pituitary kicking out Thyroid Stimulating Hormone, but mine was not high at all, it was actually borderline low, so that in itself was a little alarming to me. I do know that secondary hypothyroidism involves the pituitary and TSH as well as T4 are usually both low in these cases, since the pituitary is not working well it is unable to kick out the thyroid stimulating hormone, hence a low TSH. So, once thyroid medication is started one should just ignore the TSH levels???? They are really of importance no more????? It is just the T4 that I should focus on?? Well, I can say that has came up somewhat. I still feel like absolute CRAP though!!!! I do see an internal med. doctor next week as my PCP also thought it was very strange that my TSH would drop so far on such a low dose of levo. in just a months time. This is all sooooo very confusing to me, you are all a little more seasoned in this than I so I do truly appreciate your patience and understanding with me. I'm learning. This thyroid stuff is a tricky business!!!!!!!!!!!!!

06-18-2008, 07:29 PM	#1954
olsufka2 Junior LCF Member Join Date: May 2008 Posts: 26 Gallery: olsufka2	OK I just ran across a site that said "Patients with a Free T4 of less than 0.9 mg/dl and a TSH of less than 1.0 mU/mL are likely to have central hypothyroidism. Hum, that pretty much sums up what I was thinking all along. My Free T4 was at 0.71 less that the 0.9 and my TSH was at 0.98 also less than the 1.0 Well, we'll see what my endo. says about all of this next week. I'll make sure to keep you all posted. Thanks much

06-19-2008, 01:53 AM	#1955
nonstickpam107 Thyroid Patient Advocate Join Date: Nov 2002 Location: NE Indiana Posts: 11,665 Gallery: nonstickpam107 Stats: 230/116/120 (BF<26%) WOE: Started w/Atkins/Now BFFM Start Date: Nov. 23 2000	olsufka...that doesn't 'clarify' it. My TSH was LOWER and my FT4 about the same. I have Hashimoto's. That's about the most COMMON form of hypothyroidism to have. And that's determined by TPO antibodies. Not TSH and T4 (and you NEED T3 testing). Pam

06-19-2008, 03:21 AM	#1956
PalmTreeGal MAJOR LCF POSTER! Join Date: Jan 2007 Location: MD Posts: 1,642 Gallery: PalmTreeGal Stats: 181/175.6/120 WOE: Atkins Induction Start Date: 9/1/08	I don't have all my labwork back but I sneaked a peek at my labs yesterday at work (sshhh, don't tell!) and my TSH was 5.1. The upper end of the range was 4.89. So there ya go. Looking forward to seeing my FTs and TPO.

06-19-2008, 06:02 AM	#1957
olsufka2 Junior LCF Member Join Date: May 2008 Posts: 26 Gallery: olsufka2	Thanks Pam. I realize it doesn't "clarify" it but if that is the case with secondary hypo. one should definately have more tests done. I am going to insist on an antibody test when I see my endo. next week, but I cant imagine he will overlook the possibility of having something going on with my pituitary. May I ask, since your labs were indicitive of a pituitary problem did you have all of the pituitary hormone tests run to absolutely rule out the possibility of something being wrong with it or did they just determine it to be Has. due to the antibody test?

06-19-2008, 03:14 PM	#1960
inatic Way too much time on my hands! Join Date: Jul 2002 Location: Alpharetta,Ga. Posts: 12,442 Gallery: inatic Stats: 182/126.2 5'4 46!yo 16/4 5 kidlets later! WOE: Coach Supervised Start Date: LC since 2/02 B'building since 10/15/02	how much synthroid did she give you?

06-19-2008, 03:16 PM	#1961
PalmTreeGal MAJOR LCF POSTER! Join Date: Jan 2007 Location: MD Posts: 1,642 Gallery: PalmTreeGal Stats: 181/175.6/120 WOE: Atkins Induction Start Date: 9/1/08	I don't know, I'll pick up the prescription tomorrow! Is there a usual starting dose?

06-19-2008, 05:29 PM	#1962
olsufka2 Junior LCF Member Join Date: May 2008 Posts: 26 Gallery: olsufka2	Thank you so much for all your information Pam. I guess I didnt realize if you dont respond to medication that has something to do with the pituitary. I guess I really dont understand that at all. Could you please explain. YOu have been soooo helpful!!!!!

06-20-2008, 06:40 AM	#1963
PalmTreeGal MAJOR LCF POSTER! Join Date: Jan 2007 Location: MD Posts: 1,642 Gallery: PalmTreeGal Stats: 181/175.6/120 WOE: Atkins Induction Start Date: 9/1/08	Okay, here are the long-awaited labs: TSH 5.11 (0.46-4.98) Free T3 2.7 (2.4-4.2) Free T4 1.22 (0.71-1.85) T3 Uptake 1.15 (0.8-1.3) TPO 0.3 (0.0-3.9) Antithyroglobulin AB 3.2 (0.0-14.4) (states anything under 14.4 is considered negative)

06-20-2008, 07:05 AM	#1966
Lilgrnize Blabbermouth!!! Join Date: Feb 2004 Location: San Antonio Posts: 5,996 Gallery: Lilgrnize Start Date: 02/04	For most women, the ft4 should fall around 50% on the range and the ft3 should be around 75% to feel good. Of course this varies with each individual. Your ft4 is at 45% of the range, and the ft3 is at 17%! That ft3 is really low...here's hoping you convert, or the $ynthroid alone isn't going to help you alot. I was lucky and started on Armour from the beginning. That low ft3 will definitely cause the fatigue and depression.

06-20-2008, 10:59 AM	#1967
olsufka2 Junior LCF Member Join Date: May 2008 Posts: 26 Gallery: olsufka2	Oh, your such a blessing Pam. Thank you so much for answering my questions. I am learning more and more every day. I am going to demand an FT3 and antibody test be done next week. I just dont understand why Dr's dont think an FT3 is important in all of this. On a side note, when I was going through all of my records the other day to take to my endo. I was reading one of my EEg reports from a year and a half ago that stated I have polyneuropathy, multiple nereve entrapments. My Dr. said in his notes that this is usually caused by chronic illnesses such as thyroid diseases, diabetes... I am starting to wonder if my thyroid may have something to do with this. At the time of this test both my TSH and FT4 were on the low side and have been for the last 3 years but he has always told me my thyroid was fine. SHEESH!!!!

06-20-2008, 01:00 PM	#1968
nonstickpam107 Thyroid Patient Advocate Join Date: Nov 2002 Location: NE Indiana Posts: 11,665 Gallery: nonstickpam107 Stats: 230/116/120 (BF<26%) WOE: Started w/Atkins/Now BFFM Start Date: Nov. 23 2000	I had 'frozen' shoulder (nerve entrapment) and carpal tunnel until I was treated optimally. I don't have EITHER now. And I almost let a surgeon cut me for the carpal tunnel....good thing I waited it out. The pituitary involvement I 'think' you may be talking about is the TSH test. TSH means 'Thyroid stimulating hormone'...meaning that it tests the pituitary's action UPON the thyroid. That's why it's less important to go by TSH than it is to go by the actual hormone levels (T4, T3, FT4, FT3). Pam

06-20-2008, 01:12 PM	#1969
PalmTreeGal MAJOR LCF POSTER! Join Date: Jan 2007 Location: MD Posts: 1,642 Gallery: PalmTreeGal Stats: 181/175.6/120 WOE: Atkins Induction Start Date: 9/1/08	On the phone I asked my doctor if she medicated to TSH or to FT3/FT4. She said "Your FT3 is normal." So obviously, she doesn't "get" it and won't have the privilege of managing my thyroid hormones! Pam - I get a lot of dietary iron, but have no idea what my iron stores look like. My periods are light and short from being on the pill so many years. Should I have iron/ferritin tested? I eat a little soy, in the form of about 1 Atkins bar a week. Would that be enough to have an effect? I am not perimenopausal (age 31) and am on BCPs so I think I'm getting all my female hormones. I don't eat terribly low carbs or calories - carbs are 20-35, usually toward the high end, and cals are almost never under 1600. My TSH was also high a year ago and I had not been dieting or low carbing in any way at that point, so I'm thinking that isn't the problem. I am heading out the door to go visit my in-laws in Boston - FIL has had pancreatic cancer for 2 years now and seems to be reaching the end of the road. We make it up to MA a lot so maybe I will look for a doc up there, if there are some good ones? Or I will keep checking out the ones in MD/VA/PA. Thanks so much, Pam and Niki for your input!

06-21-2008, 01:26 PM	#1972
nonstickpam107 Thyroid Patient Advocate Join Date: Nov 2002 Location: NE Indiana Posts: 11,665 Gallery: nonstickpam107 Stats: 230/116/120 (BF<26%) WOE: Started w/Atkins/Now BFFM Start Date: Nov. 23 2000	Helen, you need to find a better doctor than that. So, he didn't Rx. any progesterone (cuz just low T3 would benefit from progesterone). If he was only going to give your horse urine estrogen.. and didn't..then you are lucky he was such an asshat. There ARE other doctors, unfortunately for many, you will have to look for someone not on your insurance (I don't know too many women who find a good thyroid doctor who takes THEIR insurance...but there are many who will let your PCP do the blood work, and then let you file the insurance yourself to get some of it back). Ok, don't give up! First, go to the ArmourThyroid and look for the 'docfinder' feature. It uses zipcodes, so give zips up to a radius and about an hour's drive one WAY (most of us have to travel to get a good doc...it's worth it). Secondly, start calling the pharmacies around you...ask "Do you carry Armour Thyroid?" and if they say 'yes', tell them that you've just moved to the area, and need to find a doctor who Rx's that Armour Thyroid, to stay 'within your plan' (the reason I'm suggesting this is because most docs's who Rx. Armour also do the correct tests and know bioidentical hormones well...two birds with one stone). If that fails, then I'll give you a list of 'patient recommended' docs (although that one DID have ONE teeny recommendation...since you were geared to see someone on your insurance, I didn't suggest any others, but will if you want the list). Don't lose hope! When you don't feel well, you need to be listened to, and work things out until you DO feel well. It may very well be a problem with sex hormones and balancing...but first you need to find a doctor who works WITH the patient, not AGAINST you. Hang in there dear! We've been down this road before! Pam

06-22-2008, 04:11 AM	#1974
nonstickpam107 Thyroid Patient Advocate Join Date: Nov 2002 Location: NE Indiana Posts: 11,665 Gallery: nonstickpam107 Stats: 230/116/120 (BF<26%) WOE: Started w/Atkins/Now BFFM Start Date: Nov. 23 2000	Helen...it's gonna be rough. But here's the name of one doctor (he seems to like to give iodine for thyroid though (I don't approve of this...) and if he's gonna take your money, you have to right to say "I'm just here for BHRT if I need it, and Armour Thyroid, let's set up a workable plan for those things". Doctor Maiquez Anti-aging Age Management Physician Miami The following is a compounding pharmacy (and they will know which docs are Rx'ing Armour Thyroid, as well as be able to get you tested for the rest of the hormones). 8301 Florida Dr Pembroke Pines, FL 33025 (954) 241-0175‎ Pam

06-22-2008, 05:30 PM	#1976
pennylovesdarren MAJOR LCF POSTER! Join Date: Jan 2006 Location: Pacific NW Posts: 1,097 Gallery: pennylovesdarren	Forgive me if this has been answered somewhere else but what's the deal with Walgreen's saying they won't be carrying armour thyroid anymore? I picked up my prescription yesterday and was telling the pharmacy tech how fabulous it is etc., etc., and she said they can't get it anymore. WHAT? I live in Oregon btw.