Thyroid tests are normal?? Are you sure?

[michelemomof2]

Yes, don't know why I forgot that very important symptom! I hate when the hot flashes happen in the grocery store! When I was shopping at Christmas, I actually went to the ladies room and went in a stall just so I could remove my shirt until it passed!

I guess it's back to the drawing board to find a good doc who will give me a low dose cream and/or creams, instead of just testosterone.

Thanks, again, Pam.

Happy New Year to you!

Michele

[IMImproving]

Bumping and...

I am suspicious that I have a thyroid problem. Is body temperature actually an indication for hypothyroid conditions? For the past four or five days my temperature range (taken on wake up, before meals and at bedtime) is: 96.7 to 97.8. Is that enough of a difference to be significant? I still need to get in for the Free T3 and Free T4 testing, I've just been distracted with the holidays, so will get that done this coming week. Why on earth aren't all labs on the same page with the "normal" range? And Why are doctors so unwilling to diagnose or treat?

DJ

[nonstickpam107]

I have been told that doctors only do about one day's worth on the thyroid...most endo's are much better at treating diabetes than adrenals and thyroid.

You body temp. isn't that low, actually. Do you have any other symptoms? If I were you...I would also add in a ferritin test, and depending on your age and hormone status (meaning if you are approaching menopause, OR have just had a baby in the last year....change in hormones). Also, please be advised that taking birth control will change your thyroid also. Birth control, being a form of HRT will bind part of the usable thyroid hormones.

Make sure they know you want (if this is just a lab near you, not healthcheck) a Free T3...not a T3 uptake...and some labs will NOT do that test unless it is written in on the order. Some won't do it unless the TSH comes back OUT of range. So lab rules add to the consternation of the patient who needs to be diagnosed also.

Low ferritin (that will be anything under 70, no matter the stupid range) and low estrogen (peri meno/meno) will both mimic hypothyroidism....with low body temp. Low ferritin will actually cause a patient to not be able to tolerate thyroid med until it is brought up, same with low adrenals.

Pam

[IMImproving]

Hello Pam,

Thank you so much for taking the time to write.

I am planning to go to Healtcheck for their Comprehensive Thyroid Panel II, which includes: Free T3 (Triiodothyronine), Free T4 (Thyroxine), and TSH (Thyroid Stimulating Hormone). My previous bloodwork was done in October, so should I be getting more? I don't know what test to ask for to check the other things you mentioned, ferritin and other hormones.

I am surely perimenopausal at over 50, here are SOME of the sypmtoms that I think may relate to the possiblilty of having some thyroid or hormone problem:

After losing 60 pounds in about 7 months (about a year ago), weight will not budge even with continued execellent diet and regular exercise.

Unexplained tinnitus (since about 1993)

NO, NO, NO, that is ZERO sex drive

Significant hair loss, much of eyebrows too

Ezcema on hands and ears (24/7 torment)

Cholesterol jupms in last year from apx. 200 (before diet)
to 242 AFTER a 60 pound weight loss.

Stiffnes in ankles/feet, especially in the morning, so much so it feels weird to walk. Also recent aches in other joints

Lower body temperature (96.4 - 97.8) consistently

Heavy, irregular periods

Difficulty concentrating/focusing

Depression

Frequent constipation

Dry eyes (enough to make contact lenses to roll up like a tobbaco leaf)

Feelings of not getting enough air, this does not get worse when exercising

Anxiety (diminished with diet change to Atkins)

Heart palpitations (diminished almost completely by stopping Aspertame)

Tired

Muscle fatigue (have had bouts where just folding a load of laundry is over tiring)

Tingling (needles and pins) in legs and arms

These are all symptoms that I am living with, I don't know how bad things should get before there is some treatment. I can tolerate most of these, the lack of weight loss (with 100 pounds to lose) is most bothersome to me.

Thanks for any further info.

[IMImproving]

Oh, also, I do not take any medications at all, only vitamins and then not as often as I should.

Thanks again for your perspective.

[nonstickpam107]

Well, for one thing, the thyroid loses it's "buddies" estradiol and progesterone and it will decide to take a long nap, lol. This is precisely why autoimmune hypothyroid is triggered in menopause. When the estradiol (estrogen) drops and progesterone drops, the thyroid tries to take over their jobs...it doesn't work, and hypothyroid is triggered.

It takes a long time to be balanced in hormones, and you need to find a doc who will take the time and knows about bio identical hormones, too, as well as optimizing your thyroid meds.

Part of your symptoms could be low ferritin (and that test is called just plain ferritin, get iron too, while you are at it)too. You need: estradiol, progesterone, testosterone, FSH, TSH, FT4, FT3, ferritin, iron, TPO antibodies...that would most likely show whatever is out of whack.

I tried using soy products at first for symptoms of menopause and ended up triggering a really bad bout of Ha****oxicosis...I didn't know that could happen. Soy isn't something you should be using. What (again if you posted) were your last test results? With lab ranges.

Pam

[Rustyjack]

Originally posted by Rustyjack
Pam,

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
Triliodothyronine, Free 2.8 pg?mL 2.3 - 4.2

Now she has add another 1/2 grain to the 1 1/2 to be split. 1 grain in morning and the other one after lunch.

Pam this is my lastest test results after 10 weeks on 2 grains. I can't say I feel better on 2 than the 1 1/2.

TSH 0.420 uIU 0.0350 - 5.500
T4 Free 1.07 0.61 - 1.76
T3 Free 3.9 2.3 - 4.2

She said this is perfect. Will not up the dose again. Will it take a little longer to feel better.? Now we are working on getting the progestrone and testostrone in the right range. They are both lower than she wants.

[nonstickpam107]

BUT...the more progesterone and testosterone she gives you (what's your labs on that////and estradiol? with ranges, please), the more the Armour hormone is BOUND UP...get it? So that half a grain you just went up?? Useless if the sex hormones are increased...most docs go up by a GRAIN at a time, and the USUAL dosage of a female is around FOUR grains...your T3 is too low still....most docs pretty much ignore the TSH on Armour and get the FT3 into the last quartile of lab range...you MIGHT have to add a teensy bit of T4 to that mix.

Pam

[Rustyjack]

Pam,

Estradiol 76

Progesterone 4.2 she wants it 10-25

Testosterone Free 0.05 0.0 - 1.8
Testosterone Serum 68 14 - 76
she wants this up just a little.

[nonstickpam107]

Post menopausal women try to keep their estradiol between 70 and 110...does this tell you anything? You can't raise TWO hormones and not balance the third....if you get too much progesterone (or unbalanced progesterone/estradiol) than you will bloat up, be depressed, etc. Ask her why she is so adamant about your progesterone being so high, yet is willing to leave the estradiol where it is. Have you read "Screaming To Be Heard" by Elizabeth Vliet?

Pam

[michelemomof2]

Bumping for newbies and because it is so interesting.....

[Kitzie]

Hi NonstickPam;

You seem very informed on thyroid, and I would really appreciate an opinion from you.

I am 43 years old, but I have suffered almost all of these "hypothyroid" symptoms for 16 years. I have been placed on synthroid 2 times over the years, both times for about one year each, it did not do anything, except help with the constipation. They told me I didn't need to continue. That was a few years ago. They just told me my numbers were better.

I was told the tests show that my thyroid was badly injured from illness when I was young, but the results showed that it has healed itself somewhat. I didn't really understand this, I still don't.

I have extremes in temperature, very cold at times to profuse sweating at other times. Very dry skin and hairloss, constipation, high blood pressure, I could go on and on. When I read the symptoms list I have almost all of them. My waking temperature in the morning is usually around 96.2, unless it is right before my period, then it goes up just past 97 degress.

I had a iron test drawn by a derm Dr. years ago, it was 50, he said it was fine. I will be going in next week for a blood pressure check, so I will ask to be checked for thyroid.

What tests should I ask for? I will post my results here when I get them. Thanks Pam for any help you can give me. Believe me any advice you give me will be better than anything I have gotten. I can't get any Doctor to listen to me when I say "I just don't feel right, I know something is wrong". My guess is they just don't have a clue themselves. Thanks. Kitzie

[nonstickpam107]

Hi Kitzie,

Well, perhaps I can explain the WRONG thing was done to you like this: If you are a diabetic and you take your blood sugar and it's high you take insulin. So.....if your blood sugar is then FINE, do you NEVER take any more insulin???? Ask the doctors who took you off Synthroid that.

I have autoimmune hypothyroid...Hashimoto's. Sounds like you may have that too. A lot of times docs think because the numbers are good (well OF COURSE they are.....cuz you are on the MED!!! ARGHHH) that it was a case of viral thyroiditis...but most viral thyroiditis cases are actually autoimmune....they just didn't ever check for antibodies.

So, you need the following: TSH, Free T4 (FT4), Free T3 (FT3...NOT A T3 UPTAKE....that's a useless test...make SURE you get Free T3)....if these come back low in range (the FT's) or TSH above a 3 or so (new lab range for this but most doc's ignore it) then you would want a TPO test (test for antibodies for autoimmune hypothyroid).

You would check ferritin, not just iron BTW. When you post your labs, make SURE you get a COPY of the lab report, not over the phone, not just telling you...a COPY....cuz you will need the lab ranges with the labs.

Edited to add: That TSH, FT4, FT3 panel costs around 400 dollars, BTW...if you don't have coverage through insurance, or you can't afford that, go to www.healthcheckusa.com and you can order thyroid panel II (give thyroid site at about.com's promo #...that's: 12345, will save you a lot) and they send you to a lab near YOU...then report the labs back to YOU via email or fax....it will be around 80 dollars...a HUGE savings and you get the correct tests. You can then take the tests to a good thyroid doc near you (yes, I have lists of great thyroid docs for every State).
Pam

[Karsen]

Pam - I need to go get the appropriate thyroid test done. (I was borderline before) He put me on .88 synthroid. Immediatley, I "felt better" as in not as fatigued - so I know I needed it. . .
(He said it wasn't that I really needed it by the numbers - but when some complains of bad fatigue & borderline he does give them a low dose)

BUT - I have alot of the symtoms going on mentioned here.....
Always low body temp.

Tingling in hands & feet.
COLD fingers & toes - HANDS HURT they feel so cold - Sometimes they ARE cold to the touch & sometimes they are not all that cold on the outside to other people (but inside my head - they feel literally frost-bite cold - - with pain!!)

I have had a complete Hyst. (no ovaries -nothing) - I quit my hormones over a yr. ago.
I wake up sweating bad at night - one minute -throw covers off, then get cold & pull them back up.
Daytime - sometimes have this same flush of heat in head -even stings in head - then goes away in a couple min.

NO NO NO sex drive here either!! (I'm 54)

Fatigue - (that is some better w/ the synthroid .88)

Chronic Constipation - (always had this problem) - just have to go from one laxative to another -to get it to "work".

My body can be hot - sweating - & toes cold (and hands)

What Test's do you suggest when I see my Dr.??
Thanks!
Judy

[nonstickpam107]

Karsen,

You do know that the thyroid is in 'charge' of the sex hormones, right? That's why menopausal women trigger hypothyroid...it's not that the thyroid is always diseased, it's worn completely out! So, if you don't have enough estradiol or progesterone the thyroid just shuts down. So...essentially taking just that Synthroid doesn't replace your estradiol and progesterone.

It's not enough to just know TSH...thats thyroid stimulating hormone, NOT the actual hormone levels. And Synthroid is a T4 ONLY med. Perhaps you are not converting any T4 to T3. I take bio identical hormones (estradiol and progesterone, I went post meno at 41 from a bum thyroid).

You need: TSH, FT4, FT3 (Free T4 and Free T3 and NOT a T3 uptake), ferritin, estradiol, progesterone, testosterone, DHEA, DHEA-S, cortisol as a baseline at this point.

Pam

[Kitzie]

Thanks for the quick reply on my post Pam!

I wrote down the tests and will have them run next week when I go to my appointment. Will ask for a copy, and will post results here.

The last time I was treated was for Hashimoto Thyroid, they put me on a very small amount of synthroid, and weeks later my heart would race, so they told me to cut the pill in half, it would be fine for a while then start to race again, then take half a pill every other day, same thing happened. So they told me I didn't need it anymore.

They never tried any other medication, the synthroid didn't do anything for my symptoms, only gave me the racing heart.

Big question.....if I need the hormone, why would my heart race like that on such small amounts of synthroid? Wrong thyroid medication? Allergic/sensitive reaction? Should I ask for armour natural?

Also Pam, I am from Wisconsin, can you tell me the names of some Doctors that could help me out. I just go to a GP family practice Doctor and a GYN.

Again thanks!

Kitzie

[nonstickpam107]

Don't be surprised if the doc won't do those tests either. I'll get the list rounded up for ya in the next day or so.

In the meantime....I now have four autoimmune diseases because my Hashimoto's went untreated, so it's nothing to screw around with. Tachycardia (rapid heart beat) is the BIGGEST, most COMMON symptom when starting meds...and most start with a tiny dose and work upwards.....BUT......usually goes away once your numbers fall again (this can take months...took me two years cuz I kept cycling between hyPER and hyPO as MOST Hashi's patients do).

If your doc won't do the tests OR can't interpret them, OR doesn't use anything but synthetic T4 ONLY med (Synthroid...I'm terribly allergic to it myself....made with corn) OR your insurance won't pay the 400 bucks for those tests (yep, you are reading that correctly) then just go to www.healthcheckusa.com and have them done. And don't be surprised if they don't do the correct tests....happens all the time.

Edited to add the Wisconsin list: http://www.thyroid-info.com/topdrs/wisconsin.htm you may have to paste that into browser. Be advised this list is patient recommended docs...meaning that what's good for one patient isn't necessarily good for another. HTH

Pam

[Karsen]

Thanks Pam - Going to see if my Dr. will run what you suggested.
Wonder if he will know what to do with the numbers...

Auto-immune disease here also - MS

[nonstickpam107]

I thought this article would be interesting. I have a friend up in my hometown in NY state that was told for the past 14 years she has MS. She does NOT have MS....but untreated hypothyroid has left her weakened and with other autoimmune diseases. For those WITH MS, this is good news:

Thyroid Hormone May Treat Multiple Sclerosis
From Mary Shomon,


Nov 11 2004

In a study published the Nov 16, 2004 issue of the Proceedings of the National Academy of Sciences, researchers reported on studies that looked at use of thyroid hormone as a potential treatment for multiple sclerosis. The animal studies found that thyroid hormone might protect against further nerve damage and facilitate more rapid repair of damaged nerve fibers.
In particular, use of thyroid hormone during early nerve damage could help protect the important myelin sheath -- the insulation that surrounds neurons -- and create precursor cells prepared to form new myelin sheaths in damaged nerves.

Loss of myelin is the key problem in multiple sclerosis According to the researchers: "We suggest that thyroid hormone could have a role in potentiating reluctant myelination by inducing (precursor cells) to differentiate into myelinating (cells) during a specific phase of the disease."

SOURCE: Fernandez, M.


Proceedings of the National Academy of Sciences, Nov. 16, 2004; vol 101

[Carb&Driver]

How do you juggle iron and calcium pills with armor and synthroid?

I'm on 30 mg. of armor 3 X a day and .025 mg. of synthroid 1 X a day. I was on the armor alone before and got these lab results:

FT3 5.6 (3.5 - 6.5)
TSH 4.01 (.35 - 5.0)
FT4 13 (9 - 23)

After seeing those results, the doctor gave me the synthroid. Do you think that will help, and how soon?

Thanks.

[nonstickpam107]

No, I don't think the Synthroid is going to help much. Sorry, but your doc should KNOW the "usual" dosage of Armour is around 3-4 grains. And on Armour patients have a very LOW TSH (if they are properly medicated) and a very high FT3 and a low-ish FT4.

Most doc's good with thyroid get the TSH down to under a one (unless they are TSH 'worshippers'), THEN you tweak. My TSH on Armour is around .35 or LOWER (not unusual to see is <.01), my FT3 (and you WANT FREE T's, not total) is about 3/4 of it's range and my FT4 stays lowish. I think you might want to ask the doc where he is going with your TSH. Also, did you JUST take a dose before these tests??? (Within three hours?).

How long were you taking that Armour before testing?

I take my Armour at 6am, and don't take my calcium supps until after lunch and dinner. Iron and calcium need to be taken four to six hours away, and most using them take their Armour and T4 sublingually. I don't see why you would split that teensy dosage of Armour 3x......60 mg. (one grain) is the usual starting dosage of Armour. New range for TSH is .3 to 3.0...so you see how hypo you still are. A lot of docs don't know how to dose Armour or that it contains 37mcg. of T4 and 9mg. of T3 (and T3 is four times stronger than T4). So, a grain of Armour works out roughly equivalent to 88mg. synthetic T4.

Edited to add: How soon??? You should be having blood labs every eight weeks, it took me about a year to get my TSH under a 1, and to see improvement.......at that time my FT3 was FINALLY over the midway of lab range point. As I said, T4 stays LOW on Armour, I'm on three grains now and feel pretty good. "Most" good thyroid docs give increases until the TSH is under a 1, and then they pretty much ignore the TSH (on Armour) in favor of getting the FT's up in range.

Pam

[Kitzie]

Hi Pam,

Thanks for all this great information!!

I was wondering if the medication I am taking will alter any of my thyroid tests. The medications I am taking are:

Lisinopril 20 mg and
Hydrochlorothiazide(water pill) 25mg for high blood pressure.

Amitriptyline 10mg for muscle and joint pain.

Doxycycline 100mg 2X/Day for Ocular and facial Rosacea.

Restasis Eye Drops Prescription for Dry Eyes, Sojerns(sp).

I have my blood tests next week Thursday the 27th, and I want to be as prepared as I can be.

Pam, you have sent me some hope , for that I am thankful. Talk to you soon.

Kitzie

[nonstickpam107]

The Lisinopril can slow the thyroid, as can beta blockers. OMG...you have Sjogrens too? So do I and it is VERY common to have both Hashi's and Sjogrens...even MORE common to be misdiagnosed...Hashi's skews the tests for Sjogrens and TED (thyroid eye disease) happens in both hyPER and hyPO.

Edited to add: HIGH BP is a direct result of UNDERtreating the thyroid too, did you realize that? Some docs think if the BP is up it means you have too much thyroid med.

If you go to www.about.com and look under health in the forums...go to the thyroid disease site there, it's the best on the web. You can do a search for high BP and undertreated hypothyroidism.

Pam

[Karsen]

Pam - meant to ask, do I need to be fasting for the tests you suggested I have.
Karsen

[Windchimes]

Hi Pam,

I have a couple of questions for you, if you don't mind.

I was diagnosed hypo 1-2 years ago (I can't quite remember exactly when). My Levothyroxine has been adjusted to 75 mcg, and it's stayed at that level for quite awhile now. 5 months ago my doctor gave me the Pill to help regulate my period. I've read what you've said about BCP and Thyroid meds, and she said nothing about it! If I would have known that information, I'd have said forget the Pill. The first brand I tried made me very blurry, and lots of other bad side effects, so I quit and asked to be put on another brand. When I started the 2nd brand, things seemed to go very well. No blurry vision, no bouts of high blood pressure, nothing. To make a long story short, I was on that Pill for 3 months. Each week I got progressively worse with what seemed like a horrible hormone imbalance. I quit the Pill altogether almost a month ago. I do feel a whole lot better, but there are still problems.

My questions are:

Will my thyroid levels get back to normal because I've stopped the Pill? Or are they now going to stay at a lower level because of what I did?

Will this imbalance go away in awhile, or do I have to do something to help it along? I'm not even sure if this is an estrogen imbalance or a thyroid one. I get a red hot flush on my face and down my neck daily, which lasts for 10-30 minutes. Sometimes it even feels like the inside of my ears are burning up. I also get weird headaches once in awhile, usually with spaciness, and sometimes just the spaciness alone without the headache. I'm even lactating, and I'm not pregnant! Hmmm. I'm cold constently, which was a symptom before. I'm still blurry, but only once in a great while. I think those are the major problems at the moment. From what I've read, those could be from either, so I just have no idea. Which leads to my final question:

I am planning to see my doctor very soon, and I want to ask for some tests. Usually she just tests my TSH, I guess because I've been this way for awhile or something. What tests should I ask for? Should I also ask her to check my estrogen?

Thank you!

[nonstickpam107]

Karsen,

No, you don't have to fast for those.....unless you are going to do cholesterol at the same time (or blood glucose). The TSH can go up and down by three whole points during the course of any given day...this is precisely WHY a doctor SHOULD NOT medicate a patient by TSH alone (Erin.....that's for you too).

Erin,

If the doc is only doing a TSH and you are only on a T4 only drug......why would you expect THAT doctor to know anything about hormones? Sorry, but if you read the above, you will know WHY the doc should be checking FT's too. Can I please see your latest (with date) TSH and range used by that lab? And do you have autoimmune hypothyroid, tertiary hypothyroid or clinical hypothyroid? Hypothyroidism is for life...this is why you must be very careful about having the proper tests taken and be medicated accordingly. With the most common type of hypothyroid, autoimmune (Hashimoto's), you will need testing EVERY six to eight weeks and then dosage increases accordingly until you reach a 'maintenance' dosage. This took me four years (my antibodies were still attacking my thyroid during all of this). I would get tested, raise med levels (and my T3 was very high at first, then dropped out of sight....therefore needing T3 as well as T4, like a normal human being has), then wait six months during heavy antibody activity.

If you need a list of GOOD thyroid docs in your state, pm me.

Pam

[Karsen]

Pam - Thanks for quick reply. I'll be going to Reg. Family Dr. for these on Tues. & will be back in touch.
Karsen

[michelemomof2]

Originally posted by nonstickpam107
The Lisinopril can slow the thyroid, as can beta blockers. OMG...you have Sjogrens too? So do I and it is VERY common to have both Hashi's and Sjogrens...even MORE common to be misdiagnosed...Hashi's skews the tests for Sjogrens and TED (thyroid eye disease) happens in both hyPER and hyPO.

OMG! In reading your post to Kitzie, it is like an awakening! My eyes have been so dry for a few years and they are much worse lately. I, as you already know, have Hashi's. My eye doc said, "we'll keep an eye on it." It is uncomfortable, to say the least. Now, I'm wondering if I have Sjogrens. Don't know what Sjogrens is, but now I'm going to have to learn about another disease to rule it out or see if that is why my eyes are dry. Care to share what it is? Thanks.

[inatic]

Michelle my eyes are dry as well, lately becoming more dry.. like I need to be thinking about adding drops in.. It is also a thyoid thing.. unless I need to be looking at something else as well, but I dont think so.

[michelemomof2]

Hi Ileen. I'm glad to hear it is also a thyroid thing, because I am hypothyroid so maybe that is just what it is. Thanks.