Thyroid tests are normal?? Are you sure?

[TeaLeaf]

Hi Pam! Loves to ya! Hope you're having a good energy day!

[nonstickpam107]

I'd better be having an energy day today, lol. The garden...it's huge, and there's only two of us to work on it...so more raking today. "Maybe' it'll be all in this coming weekend. Maybe. LOL Thanks for the good thoughts Tealeaf!!

Pam

[ew1]

Hi Pam-new doggie avatar! Nice pix!

Glad to hear you are hanging in there.

I had my follow up blood work done Sat morning, my appt is Thursday with the doc, will let you know what happens. Not sure if I am optimized yet, right now I have lousy sinus stuff going on (my car is a Shrekmobile from all the green pollen!), but I noticed I am not quite dragging out of bed in the morning anymore. Stil early days, I am sure some tweaking needs to be done.

Just dropping in to say Hi.

Elaine

[loveshinesthru]

i just got my blood tested yesterday with healthcheckusa. they let me call in and they faxed the paperwork over to the lab so i didnt have to wait for it to be mailed so i could go since they didnt have one near me. but i am near one right now out of town. woot woot!

[nonstickpam107]

That's great Christie!

Pam

[BBAddict]

I got my 6 weeks thryroid check results back today.

6 weeks ago when I got tested and diganosed as hypothyroid my TSH level was 11.25 and the lab range was 0.30 - 4.70.

Today my TSH was 2.25!!!!! Much better, although I'm still feeling sluggish somewhat but I'm definetly not as cold. And my hair is growing again


My FT4 was 11.3 and lab range was 9.1 -23.8

For me, I'm still thinking that its too low and needs to be higher.

My FT3 was 5.0 with lab ranges of 2.5 - 5.7 so I think I'm ok there.


Pam, could I get you expert opinion please on the FT4 result? I'm currently taking 0.112mg of Synthroid each day. My doc thought that my TSH levels may drop lower on my next blood test 3 months from now as they fell so quickly once on the Synthroid. I'd like to see my TSH fall to under 2.0 as well, but will have to fight that battle next visit.

I asked for a referal to an endo -- but she warned me that all of them in my city and surrounding area (there is only 3) are old school and don't consider anything wrong with people as long as they fall into the ranges of normal. That's reassuring. Too bad more docs don't keep upto date. Even the lab has their ranges outdated.

And my thryroid ultrasound was normal!!! yeah!

thanks Pam for any input on this!!

[nonstickpam107]

Well, although you are 'on your way'...um, those results don't look 'right'...like they 'switched' the FT4 and FT3...do you have the COPY of the lab results IN YOUR HANDS?? Or did you get this over the phone?

The range for the FT3 looks like the FT4 and the FT4 you give, the ranges look like those for a T3 Uptake and not an FT3.

Please look at the COPY from the lab and reply. Cuz if that's the real FT3, something's way wrong somewhere.

Pam

[nonstickpam107]

Well, although you are 'on your way'...um, those results don't look 'right'...like they 'switched' the FT4 and FT3...do you have the COPY of the lab results IN YOUR HANDS?? Or did you get this over the phone?

The range for the FT3 looks like the FT4 and the FT4 you give, the ranges look like those for a T3 Uptake and not an FT3.

Please look at the COPY from the lab and reply. I've had a LOT of people get this over the phone, and have the wrong ranges for the wrong test.

Pam

[BBAddict]

Originally Posted by nonstickpam107

Well, although you are 'on your way'...um, those results don't look 'right'...like they 'switched' the FT4 and FT3...do you have the COPY of the lab results IN YOUR HANDS?? Or did you get this over the phone?

The range for the FT3 looks like the FT4 and the FT4 you give, the ranges look like those for a T3 Uptake and not an FT3.

Please look at the COPY from the lab and reply. I've had a LOT of people get this over the phone, and have the wrong ranges for the wrong test.

Pam

I copied them right off the paper myself and double checked. They showed the name of the test, then my value and then the ranges. I'll grab a copy of the tests physically again -- maybe call the lab and see if they didn't do the right test?

[nonstickpam107]

Well, maybe the ranges in your country are completely 'different' but I know others in Canada and have seen their results. I just think it's pretty odd that your FT3 would be THAT high...and could see if it was even Total T3 (TT3) cuz that's a really skewy test in females.

Yes, please check, just for my 'piece of mind' cuz if you are converting that well, than that would be WONDERFUL (seriously, most of us don't convert T4 to T3 with that HIGH of a TSH ...and most of us want to be well under a 1).

Pam

[BBAddict]

Pam,


I have photocopies in my hand:

March 14th 2006

TSH 11.82 Ranges 0.30-4.70 MU/L
FT4 7.7 Ranges 9.1-23.8 PMOL/L
B12 149 Ranges >131 PMOL/L
Ferritin 45 Ranges 13-145 UG/L

Then I started the Synthroid at 0.112mg

Results for May 8 2006

TSH 2.52 Ranges 0.30-4.70 MU/L
FT4 11.3 Ranges 9.1-23.8 PMOL/L
FT3 5.0 Ranges 2.5-5.7 PMOL/L


Does that help you see anything odd? I'm in Canada so maybe we have slightly different ranges than the US?

Thanks in advance Pam!

[nobimbo]

Originally Posted by BBAddict

Pam,


I have photocopies in my hand:

March 14th 2006

TSH 11.82 Ranges 0.30-4.70 MU/L
FT4 7.7 Ranges 9.1-23.8 PMOL/L
B12 149 Ranges >131 PMOL/L
Ferritin 45 Ranges 13-145 UG/L

Then I started the Synthroid at 0.112mg

Results for May 8 2006

TSH 2.52 Ranges 0.30-4.70 MU/L
FT4 11.3 Ranges 9.1-23.8 PMOL/L
FT3 5.0 Ranges 2.5-5.7 PMOL/L


Does that help you see anything odd? I'm in Canada so maybe we have slightly different ranges than the US?

Thanks in advance Pam!

US ranges for FT3 are usually stated in "pg/ml" units (picograms per milliliter...typical range is 1.4-4.4 pg/ml); FT4 ranges are usually stated in "ng/dl" (nanograms per deciliter...typical range is .8-2 ng/dl). Your Canadian lab is using "PMOL/L" units (picomoles per liter).

No wonder your results looked goofy to Pam!

Linda

[nonstickpam107]

So, Linda, can you convert them??

Janis that low of a ferritin and B12 could very well "mimic" hypothyroidism, right down to the high TSH. And most can't 'tolerate' much incoming hormone until the ferritin and B12 are brought up to 'par'. It will 'skew' the FT's testing too. Have they gotten a MRI or CT of your pituitary? There are many causes for hypothyroidism....and I've never seen anyone come up in FT3 very much when having a TSH where YOURS is...unless it's either pituitary driven or other reason. Did the doc's do an anti TPO antibody on you?

Pam

[BBAddict]

No MRI or CT yet. I can't get into the endo until September They didn't do an anti tpo antibody on me. I'm going to request it in August when I go back. This time I'm going armed with data to back up what i'm feeling as they seem to focus on the numbers. Even the forthcoming TSH ranges of .3 to 2.5 since they didn't seem aware of it. My new endo isn't on the about.com list of docs, but i'm hoping to convince her. I've got some B12 pills and will start taking a multi vitamin with extra iron and hope that bumps it up and lowers the TSH a bit.

Linda -- are you able to convert those numbers for Pam? I couldn't find a translator online to do it.

[nonstickpam107]

Janis, there are a couple doc in Canada that Rx. Armour and know the TSH is kind of irrelevant in view of FT's. I know most people are paying out of pocket or have their own insurance in Canada that ARE seeing the good docs. I know a woman in Canada who waited MONTHS to see and endo and when she got there she was told since her TSH was 'normal' (it was at highest range) that she didn't need treated. OH...and only six weeks...this testing could be 'skewed' just by that.

Ok...whoever is in Canada that is reading this, and that is on Armour or has a doc that is medicating according to Free T's....can we get your doc's name in PM to Janis?

Pam

[nobimbo]

The FT4 conversion factor is 12.87 (meaning you divide the SI units by that number to get the conventional units). I couldn't find the conversion factor for FT3 using the conventional units of pg/ml, but I can find the conversion of the conventional units using pg/dl (typical lab range for that would be 230-619). That would be 0.0154 (divide the SI unit by that number).

So....to convert Janis's May 8 results:

FT4 11.3 divided by 12.87 is 0.88 (typical range being .8-2 ng/dl).
FT3 5.0 divided by 0.0154 is 325 (typical range being 240-619)

Note: the normal reference range for pmol/l is 3.5-7.7, but Janis's lab gave the range as 2.5-5.7. See how crazy this can get? I think it's best for Janis to just look at her results in relation to the lab range and units used at her lab and not try to convert.

Here is a link to the conversion table I used:

http://72.14.203.104/search?q=cache:...s&ct=clnk&cd=1

Some info about FT3 reference ranges:

The National Academy for Clinical Biochemistry (NACB) published a consensus statement in November 2002 with guidelines stating that the normal range for Free T3 should be 3.5-7.7 pmol/L (0.2 - 0.5 ng/dL).
In other sources, such as a web site called Family Practice Notebook, they list a reference range for Free T3 of 230 – 619 pg/dL.
Meanwhile, Diagnostic Automation, Inc, one company that makes a lab test for Free T3, lists their reference range as 1.4 – 4.2 pg/mL.

http://72.14.203.104/search?q=cache:...s&ct=clnk&cd=1

Linda

[loveshinesthru]

pam i just got my results back. they look fine to me? but why do i have almost every single symptom of being hypo-thyroid? my temp is never above 97.6 either??

here are my results:

FREE THYROXINE (FT4) 1.0 0.8 - 1.8 NG/DL
TRIIODOTHYRONINE FREE 2.6 2.3 - 4.2 PG/ML
TSH (3RD GENERATION) 1.538 0.35 - 5.50 MCIU/ML

Fatigue, exhaustion, depression, moodiness, sadness, difficulty concentrating, difficulty remembering, migraines, sensitivity to cold, cold hands and feet, muscle and joint pains, aches and weakness, tendinitis of arms and legs, plantars fascitis - sole of the foot pain, swelling or puffiness of eyes, face, arms or legs, heart palpitations, low sex drive,worsening allergies, itching, prickly hot skin, rashes, hives (urticaria), panic attacks, anxiety attacks, chronic infections, including yeast infections, and sinus infections, shortness of breath, constipation, neck feels full or sensitive, raspy, hoarse voice,neck check reveals visible lump or thickness in neck, low basal body temperature below 97.8 to 98.2 degrees in the morning


sometimes i have these hyper symptoms: insomnia, difficulty falling asleep or staying asleep, nervousness, irritability, difficulty concentrating, short attention span, palpitations, irregular heartbeat, feeling hot, hand tremors, dry skin, muscle weakness, especially in the upper arms and thighs, eye problems, including double vision, scratchy eyes, sensitivity to light

of course some of these are hypo and hyper symptoms. right now out of the hyper symptoms i am having problems with my eyes. blurry vision and sensitive to light. dry skin, difficulty falling asleep.

does thyroid problems make you have headaches/migraines with a change in elevation?

[nonstickpam107]

Why does that look ok? Doesn't to me. Look at the FT3. It's supposed to be at LEAST midway of it's lab range or higher. Means you're not converting...BUT...people who eat very low carbs and calories stop or slow conversion. So, if you are eating very low carb (like under 30net) and very low calories (like under 1500) than that could be your culprit. This is the reason WHY Doc Atkins gave Armour Thyroid to his lowcarbing hypothyroid patients, he knew there was a lack of conversion until the patients got through the induction and then raised the carbs a bit.

You also need to have a ferritin and iron test (low ferritin..under 60 or so no matter lab range, or low iron MIMICS ALMOST EVERY SYMPTOM of hypothyroidism). Overall, your TSH And FT4 look good, it's just the conversion that looks crappy and could very well just be from either low ferritin/iron or from too low carbs/calories). OH, and how many TIMES have you been treated for plantar fasciitis? That's NOT just sole pain.

And your symptoms in last paragraph are those of low iron/ferritin too.

Next test: anti TPO antibodies, which would at least rule in or out Hashimoto's.

Pam

[nonstickpam107]

Why does that look ok? Doesn't to me. Look at the FT3. It's supposed to be at LEAST midway of it's lab range or higher. Means you're not converting...BUT...people who eat very low carbs and calories stop or slow conversion. So, if you are eating very low carb (like under 30net) and very low calories (like under 1500) than that could be your culprit. This is the reason WHY Doc Atkins gave Armour Thyroid to his lowcarbing hypothyroid patients, he knew there was a lack of conversion until the patients got through the induction and then raised the carbs a bit.

You also need to have a ferritin and iron test (low ferritin..under 60 or so no matter lab range, or low iron MIMICS ALMOST EVERY SYMPTOM of hypothyroidism). Overall, your TSH And FT4 look good, it's just the conversion that looks crappy and could very well just be from either low ferritin/iron or from too low carbs/calories). OH, and how many TIMES have you been treated for plantar fasciitis? That's NOT just sole pain.

And your symptoms in last paragraph are those of low iron/ferritin too.

Next test: anti TPO antibodies, which would at least rule in or out Hashimoto's. Also...WHY does every little "Webmd" blurb give those temps as LOW. NO ONE I know personally ever gets their temp above 97.0 with Hashi's (Mine will go as high as 97.2 right AFTER I take my Armour, but I see norms of between 96.7 and 97.0 all the time).

At any rate, it's now time to gather up those test results and see your doctor for ferritin, anti TPO antibodies....why is you doctor ignoring that list of symptoms anyway (give him that list)?? Once you get your antibodies checked and all, I have lists of docs for almost every area in the US that do thyroid well if you need them. I'll warn you NOW..most docs won't treat if the tests are anywhere at ALL in range (you probably know this)....also, how many of your relatives have thyroid disease? Hashi's and Graves generally is seen within the family.

Pam

[loveshinesthru]

right now i have not been lowcarbing. i have been eating what i want to. i havent been treated for plantar fasciitis, but i get sole pain alot.(sorry i thought it was only sole pain, my hubby says it means my arches are falling?) i have it right now and my knee hurts so bad that sometimes i cry. (ussually at night) i dont do much of anything so i dont think its related to my weight.

my aunt and her son both have thyroid problems, but im not sure what kind.

[nonstickpam107]

Well, then, time for the doctor...any doc can do the anti TPO antibodies test for you (that's what it's called...) and also a ferritin and iron test. If your doc doesn't have experience treating subclinical hypothyroidism or Hashimoto's, then you may be able to find a doc that does have experience within an hour or two (one way...most of us are travelling that far to see REALLY great thyroid docs) from where you live (if you are in the US..you don't say where you are). It's very important to get a doctor who treats many thyroid patients (and don't go thinking that's an endocrinologist....it's NOT..most of them treat diabetes and won't treat within range thyroid patients). You might find out who your relatives see if they live in the area.

Pam

[loveshinesthru]

since im not low carbing, what do my test reveal?

[nonstickpam107]

You need more tests...as I stated above, you need to see your doctor.

Pam

[loveshinesthru]

sorry being a little dumb today..

[loveshinesthru]

should i start taking iron? does low b-12 mimic too? i do feel better when i take b-12 sublingually.

i looked up the symptoms. while some match it doesnt sound like me?

[loveshinesthru]

is this right or am i off base?

A low TSH with a normal FT4 and a low FT3 has been associated
with Secondary Hypothyroidism from the disease locus within
the pituitary or hypothalamus. Similar values have also been
associated with Nonthyroidal Illness in severely ill patients.
Clinical correlation would be indicated.

[nonstickpam107]

You don't have a low TSH. And actually, your FT4 isn't 'normal'...it's not even midway of it's range. Your panel looks autoimmune if anything...not pituitary driven. Out of all the women who HAVE hypothyroidism, 98% have Hashimoto's...not pituitary driven...it's mostly men who have pituitary driven (or pituitary adenenoma). This is WHY you need an anti TPO antibodies test. To test for the most common form of hypothyroidism...Hashimoto's.

I have a low TSH (.00034). That's what a low TSH is...not yours. Most people like a TSH around .50 (and some lower, like me).

Pam

[loveshinesthru]

i forgot to add earlier that i had thyroiditis in 99. didnt know if you remembered from our previous convo.

[loveshinesthru]

ok i found out... i have 2 aunts who have thyroid problems and my aunts son all on my dads side.

[loveshinesthru]

in case i have a thyroid problem do you recomend any books to read?