Thyroid tests are normal?? Are you sure?

[nobimbo]

Pam,

Could you please look at these test results and tell me if you think I might be hypo:

TSH 3.00 (0.40-5.50)
FT4 1.2 (0.8-1.8)
T3 Total 147 (60-181) I forgot to specify that I wanted a FT3, sigh

Do you think I should have an antibodies test done? I have PCOS, and I am aware that there is often a connection between PCOS and Hashi's.

My symptoms are inability to lose weight (despite losing 107 pounds after starting Metformin two years ago, I have been stalled for over a year now), consistently low body temps, abnormally heavy periods, tiredness.

Thanks in advance,
Linda

[nonstickpam107]

Hi Linda,

Well, under the new guidelines for testing, your TSH is considered on the hypo side, although your T4 doesn't look really terrible.

So....I would first suggest having a ferritin test done (and most of the lab ranges for that goes from about a 10-210) but we see anything under a 50 to 70 range contributing to a high TSH and hypothyroid symptoms. Knowing that a low ferritin/iron and low estradiol will MIMIC hypothyroid, you would want to get tested for those too. If it were me (I'm not a doc, can only advise), I would want the ferritin and iron and estradiol checked, AND tested for Hashimoto's autoimmune antibodies also.

Let me know what the ferritin comes back as, will you please? I seem to be batting a thousand over the last week----four out of ten women have found out that their high TSH and hypo symptoms were from low ferritin and iron, lol. I just would want to cover all bases if I were you---and you are so correct that if you have one autoimmune condition, there could be more.

Good luck in finding the answers, and if you need help in locating a thyroid friendly doc feel free to PM me.

Pam

[nobimbo]

Thanks for responding so quickly, Pam! I have been lurking for a while here, and have gained so much information from reading your posts. I only wish the docs I see knew as much as you.

I did have a comprehensive panel done last week at my gyn's, but will be going for my complete annual exam at my internist's in two weeks so I will ask for the ferritin test. I was diagnosed with severe anemia last March, after two years of heavy bleeding which was due in large part, I think, to a large fibroid (I had a uterine artery embolization for that in March to shrink it). I have been on prescription iron supplements as well as folic acid and B vitamins since March. My red blood cell count is now 4.69 (3.80-5.10). Could my ferritin levels be low even though my red blood cell count is now back to normal?

My estradiol was 76 (range was 15-260 for luteal phase). Testesterone, progesterone, FSH, LH, DHEA are all within normal limits, although my LH/FSH ratio is about 2:1 (normal is 1:1), which happens a lot with PCOS.

I am 47, and started to think maybe I was closer to menopause than I thought, but now it doesn't look like it is all that near. The reason why I was so interested in my hormone levels right now is that I found out recently after an MRI that my UAE failed, and my fibroid is still alive, although smaller. Since I still have plenty of estrogen in my sytem, there is a good chance it will grow again, sigh.

Thanks again,
Linda

[nonstickpam107]

Well, there is your high TSH and symptoms right there. The doctors check the iron (that's what they've been taught to do) and if it is ANYWHERE in the lab range, then they tell you to stop with the liquid iron (if they even Rx'd it) but they don't understand about the ferritin (and it DOES seem odd, after all ferritin is a stored iron level). But that's what happens when your ferritin is low---shoves the TSH UP, and brings on the hypo symptoms. Don't accept a ferritin level of under 50-70, either.

If you DO indeed have Hashi's, it can make you meno early and bring on symptoms of PCOS too. It's all related! Yes, if I were you, I would want antibody levels checked.

Hashimoto's, Graves, and hypothyroid tends to rear it's ugly head before, during or after a hormonal "upheaval": meno, giving birth, pregnancy, and especially after a hysterectomy or an ovarian disease, or problem.

I'd say you would be safer seeing everything on paper. Keep in mind that a T3-Uptake is NOT a test to determine your level of T3 or to check conversion of T4 to T3, and we see doctors everyday that will ARGUE about it being a definitive T3 test because it starts with "T3".

Also, your TSH can fluctuate up to 3 full points in any given day, and is NOT a good test to determine your total thyroid condition. They say your lowest TSH will be in the afternoon, many who do not want their thyroid meds lowered go as early as possible in the morning. Eating phytoestrogens can slow the thyroid hormone output greatly also.

Pam

[Mom2Boys]

Hi Pam (and all)

I was referred to you because you seem to be the leading expert on hypothyroidism and weight loss !! I am on week three of induction, have lost seven pounds, I think......I keep going up two pounds, down a pound, up three pounds, down two. My starting weight was 205; this Saturday I weighed in at 198.6. Yesterday I was 200.1. Today I am 201.

I also have Hashis and Sjogrens. I have had one positive antibody test for Lupus. For most of the 1990s I was one of the walking (crawling) dead. Couldn't find a doctor to help. All they wanted to do was prescribe antidepressants (I've been on them all - currently Effexor XR- which give me wierd brain quivers if I don't take a dose on time - yeesh!). I quit my job. I quit living. I slept 14 hours and still couldn't get out of bed.

A couple days aftera routine OB/GJN appt. with a new osteopathic doc, I got a phone call from her saying my thyroid levels were quite low and that she wanted to phone in a script for Levoxyl.

After this, I went online and did research. I found a site that discussed Hashimoto's symptoms and the type of testing required to confirm a diagnosis.

I asked for an antibody test at my next appointment - sure enuf I had Hashis!

Thank you for posting so much information. If your endo is like mine, he rarely looks up from the chart!

shelia

[nonstickpam107]

Well you are most welcome. If you want to know even more and read about others who are battling Hashi's, adrenal and other autoimmune diseases (along with just trying to be effective Mom's and Dad's on an everyday basis) please take a look at our group: http://nonstickpam107.ontheweb.com/

I hope your doc checked your FT4 and FT3 levels as well as just TSH....most people with Hashi's don't convert T4 to T3 very well (T3 is the "energy" thyroid hormone, and people low in T3 also feel depressed!!). The med that was called in (Levoxyl) is a T4 only med, no T3 in it. Also, when you get the print out of your thyroid lab results (yes, always get a print out for your records so you can see progress being made), feel free to bring them up at the group, or feel free to PM me.

It takes a long time to heal from Hashi's....and you tend to go up and down in thyroid hormones as the antibodies gradually kill off the thyroid completely. I take Levoxyl, and found that getting in 200 mcg. a day of non-yeast selenium really helps me with conversion of T4 to T3. Always take your med on an empty stomach (I get up at 5am, take MY thyroid med, give the dog hers, and go back to sleep for an hour) about an hour before you eat, and try to not eat fiber, calcium, iron for four hours around the time of the med. This will help you absorb the Levoxyl better and faster.

Good luck to you as you are medicated and feel better!!!

Pam

[beckamoo]

Pam,
is it okay to take the Levoxyl at night? Is there some reason, why we shouldn't? I have always been taking at bedtime as I had heard to take on empty stomach.
One more question...sorry I have been asking you quite a few questions..btw...I did join the list, thanks for referring us to it.
My question is if one has Hashi and is on Levoxyl, like myself...why wouldn't Armour be better if that has the T3 (energy one) or something else that does have T3? Wouldn't we want something with energy and help us lose weight and not feel so depressed? If we are only on a med that has T4....than what about the T3 part?
hugs~
Bec

[nonstickpam107]

It would be fine to also add T3----IF you aren't converting. When a person goes hyPER, it is usually due to a low TSH and a high T4 and T3. If you don't "need" T3, you will know it right away,,,,heart palps, sweating, bloating, etc.

If you are going to take something with T3 in it, than you need to get labs that include a T3 test from time to time. There are a LOT of people who add Cytomel (Rx. from doc) along with their Levoxyl. Oh, just in case your doc doesn't have much experience with Cytomel...you would want to get the 5 mg. strength, and a lot of people start with that (even cutting that teeny little 5 mg. in half and take half in the morning, and half early afternoon---you don't want to take this at night, unless you work midnights).

It's ok if you take your Levoxyl at night----as long as you don't take calcium, iron, or fiber within four hours of it. My doc keeps me very well medicated, my TSH under a 1, so if I took mine at night, I would be up all night!!

Let me know if you are going to do the Cytomel...I know a LOT of people who use that along with the T4 med and it works really well for them.

Pam

[oow-woo]

Just jumping in here Bec....I have Hashi's and have been on Armour for a few years and believe me, I have been on strict lowcarb, NO cheats, no caffeine, no sugar, flour, sodas, etc....AND I exercise daily. Would you believe even with the Armour, I am still at the 155 lbs I started Atkins at 4.5 years ago? I may have lost a few inches, but nothing much to speak of. I am also losing hair at an alarming rate--so I'm not so sure that Armour is necessarily what it's cracked up to be. I guess each one of us has to find just the 'right' medication....Hoping that you are able to find the right mix for you!

Carol

[beckamoo]

Carol, how frustrating it must be for you. I have been on/off Atkins since 8/99. I am trying to lowcarb again in hopes my weight starts coming down. If Armour hasn't work for you...when do you know to change meds? Does you doc still want you to continue on it?
Pam, I think from what you have told me here and in other post...is that it would be in my best interest to wait until my TSH is lower, than have my FT 3 & 4 tested before I ask him to start me on a T3. Is the correct?
hugs~
Bec

[oow-woo]

Bec- I just realized my doc is a crackpot- on my last visit in August, he had me hold a 'healing box'!! (go to www.gentlewindproject.com) I think that is the website and you will see the 'device' there....

I just made an appt. with a new doc- got his name of about.com thyroid site (sure hope he is worth the long wait til Nov,20th)
My TSH has been at .01 for a long time but I do not have any hyper symptoms-- still have a slow heartbeat, cold all the time, hair shedding, NO weightloss no matter what, etc...

I have no idea how to adjust my Armour--still taking 165/day as prescribed by the 'witch doctor'

Carol

[Coopergrrl]

Was it a Reiki healing box? Reiki is a very powerful form of healing; I have used it on my husband for months with very promising results. (I am certified Level one Usui Reiki) However it should complement your medical treatment, not replace it all together.

If it's not Reiki, a healing box is still a cool tool, and very strong as well. I would love to meet your doctor!

[nonstickpam107]

Bec,

Yes, you are correct,,,,get the TSH down first (where YOU feel good--if that is all the way down to a .02, than fine, or if it's up at a 1.5, that's good too---it's the individual you need to be concerned with, not the general population), THEN check the FT4 and FT3 (and of course, your doc will be checking the FT4 all along anyway).

Many things work for many people--none of us are the same. As for using natural healing methods--like a Reiki box--I personally believe that if YOU do NOT believe, it's not going to work for you.

Carol, I had to get my estradiol/estriol in the 100-110 lab range (post-meno) and my progesterone up a bit before I started losing really well along WITH my thyroid med balanced.

I think it is so odd how I struggled literally for YEARS and couldn't KEEP the weight off, no matter what, and then within a couple months of getting my hormones in balance (very difficult when you have several autoimmune diseases AND go post meno quickly) my weight was rock solid and I no longer have to struggle to maintain my loss.

One thing I know for sure works for ALL--Balance your hormones while you are eating a healthy lifestyle.

Pam

[oow-woo]

Coopergirl I don't mean to sound cynical, but believe me, this Dr. was not listening to me and how I am feeling! After explaining to him that my hair was falling out and that after 4.5 years on strict lowcarb -absolutely NO nitrate products (i.e. no ham, bacon or processed meats --I even roast my own turkey--don't use deli meat!), no caffeine, no sodas etc....AND exercise--AND even trying 8-900 cals/ day-- he tried to tell me that it was my 'karma' (or some such thing). Anyway, here is the sight that sells the 'healing box' - it tells about the project...

http://www.gentlewindproject.org/

[b]Pam- I sure hope this next Dr. is savy enough to check everything that needs checking!

Carol

[Coopergrrl]

Carol, thanks for that website. They seem to be a little further out there even than I am LOL After reading your explanation, it certainly does sound like that doc has his head too far in the clouds (or other places )
Different strokes for different folks and I respect everyone's right to choose how to deal with stuff. Didn't mean to sound preachy in my other post!
Pam you are so right, if you don't believe it, it can't work.
Have a great day everyone!

[nonstickpam107]

Bumping for info.

Pam

[valg]

Bumping for Gina.

[nonstickpam107]

Bumping for information.

Pam

[mommedawne]

OMG, I have to get checked ASAP for hypothyroid. I don't know why I have not read this thread before.
I also have PCOS and so many of symptoms of hypothyroid. I have been afraid to talk to my doctor about this b/c in the past I have been brushed off. I can't live with this constant fatigue and anxiety anymore, I will call my doc tomorrow. Thank you so much for your help, all, especially Pam.

[oow-woo]

Pam- I finally went to the new Endo today-- here is an account of what happened....
What do you think?

Well, the appt. went off just about the way I predicted it would.
The Doctor was very personable, friendly and at least not a weirdo like the last one. However, he is questioning whether I even have a thyroid problem....(due to my low TSH levels .01)--I had already been diagnosed with Hashimotos thyroiditis 2 years ago. Now, who am I to question an educated medical doctor? I just felt that he was not really hearing me (I told him about my inability to lose weight no matter what plan I follow, exercise, etc.... --his response? "Too much thyroid can make you lose muscle and turn it into fat"-- or "maybe you have a really slow metabolism"....(duh--ya think??). Am I asking too much here? I told him about how tired I am and how I had spoken to the pharmacist at Forest and that he told me if I was on too much thyroid, that I would be unable to sleep, sweating, have a rapid heartbeat, eating like a horse and losing weight, etc..... (I obviously have none of these symptoms).
Maybe I am missing something here, but this doctor insisted that I appeared to be on too much Armour. I still am having a problem comprehending how that can be if I am not having any side effects? Anyone? Is there anyone out there who can answer this question?

Well, anyway, I am scheduled for {more} bloodwork.....

Thanks for listening.
Have a nice lowcarb day!

Carol


__________________
Started Atkins 4/7/99 5'3.5" 155 lbs

165(!)/156/140



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11-03-2003 11:43 PM

[nonstickpam107]

Did he even check your ferritin, iron and estradiol levels with that blood work?

Yes, sad to say, many endo's are mainly "diabetic" docs. If you aren't having symptoms of hyPER, (oh, and why is this doc focusing on JUST your TSH??? Why wasn't the doc wanting to look at FT4 and FT3--those are the tests that show if the hormone levels are too high once you have been medicated---might just be against Armour---maybe his favorite drug rep just visited him that day---and wasn't pushing Armour. lol)

Lets wait for the tests to come back,,,,and make sure you are getting a print out with lab ranges when it does.

No, being hyPER doesn't "change your muscles to fat"!! Hee, hee, but it does break down muscle if you are truly hyPER---and you can have trouble losing as well as actually gain weight when too hyPER---but you CANNOT go by the TSH alone. Ummm, watch out for this doc coming back with a high FT3 (and it SHOULD be cuz Armour contains a bigger percentage of T3 than the human body makes) and telling you that Armour isn't "good" for you....instead of saying "Oh, we need to drop the dosage of Armour a bit and add in a little T4 to even things up".

Actually, being post-meno and NOT using estradiol (if it is GONE as is usually the case) will harm your musculature and make you more hypo, as well as harm the bones. You CAN'T expect one hormone (thyroid) to pick up the pace for all the others you are deficient in---you have to try and balance things, and the thyroid NEEDS progesterone and estradiol in balance in order to help your metabolism.

Pam

[oow-woo]

Pam- Thank you for taking the time to address this-- I just checked the bloodwork sheet---here is what he ordered:
Cortisol a.m
FSH & LH (what is that?)
Glucose
Prolactin (What is this for?)

T3 Total
T4 Free
TSH

The first thing he said to me yesterday was "Wow, you're on 180 of Armour?--That's a really high dose!"

I guess he just threw me when he suggested that I didn't even have a thyroid problem (I mean, I tested positive for Hashimoto's on two tests 2 years ago)-- could my hypothyroidism have cured itself? Hey, that would be great.

I am really curious about how someone who is hyper could get fat? I thought all hypers would be losing wt?

I am considering going off my meds for a few days before having this bloodwork done--maybe I need my levels to come down a bit before I do it.

Carol

[nonstickpam107]

AH HA (Oh, don't mind me....it's just that when a doctor suspects the very same thing I do.....lol vidication!!!). The FSH and LH are to determine your menopausal status (he is looking to see if you are truly meno, and are taking too much thyroid in lieu of being on estradiol and progesterone), and the prolactin is to see if you have a prolactinoma (it's a small tumor that results in making your thyroid tests look like you have a worse case of hypo than you really do--it's more involved than that, but that will do for now--) and I agree that you are taking quite a bit of Armour (and too much T3 which is what is seen in hyPER folks and a very depressed TSH, which you have, is apt to make you GAIN not lose).

My "sweet" spot (which we all find sooner or later) is a TSH of exactly .58, and a FT4 of allllll the way high in it's range, and a FT3 of jussstttt over the midway mark----I lose or maintain the best there, I feel great and wonderful,,,,,BUT even that wasn't enough for me before I went on estradiol and progesterone!!

NO do NOT go off your meds........that would really mess things up for better treatment for you!! This doc needs to see how that amount of meds is throwing the curve ball to the rest of your hormone status. He deserves to see exactly what's going on....and so do YOU. Don't touch a thing until the tests come back, or until he tells you after the tests. I STILL feel your estradiol/progesterones lacking are what are screwing up how you feel, your symptoms, and your weight and thyroid balance.

Pam

[nonstickpam107]

Whoops, the cortisol is to check your adrenal output of cortisol---if your hormones are not balanced, then the adrenals will produce more cortisol to try and keep up with the T3 from the Armour....and when they are pushed like that (because you don't have the necessary estrogens, they are having to MAKE up for THAT too) they will release MORE cortisol, and shut down your attempts to lose weight. This is much more involved than this little explanation, I'm just trying to explain in laymen's terms.

I really do believe that you FINALLY have found a doc who is "with it" though.....keep going!!! You are going to be so much better and feel so much better in the end result here.

Pam

[oow-woo]

Thank you Pam. I still think I may keep the appt. I have with an Endo I have an appt. with on the 20th of Nov. (I had gotten his name off the Top Docs list. It doesn't hurt to get a second opinion--I will give this guy a chance though. I guess he through me when he suggested that I don't even have a thyroid problem....

Carol

[redy_to_be_lean]

I think I'm going to sit down and think through a interveiw list for "First time doctor visits" to see if he/she is Knowledgeable about treating Thyroid patients.

I'v read about too many patients being disappointed in a first time visits with doctors. You go to them for help, you obviously are not feeling good and you need help (not a argument).

After reading "Is your Thyroid making you fat" there are several stories addressing the disapointment and frustation of patients because of unqualified doctors and you leave their office feeling worst.

So to save yourself stress and time it would be easyer to call the doctor first to ask for an appointment to interveiw his qualifications in the treatment of thyroid decease. That way you can make up your mind if you want to put your life in this doctors hands.

Questions would be:

Are you treating any Hashimotos patients?
How much contact/experience do you have with thyroid decease.
What is your history and education in this area of medicine.

[oow-woo]

Believe it or not, I too read that book! LOL! Even tried the diet....(didn't work).
I have never been able to access a doctor on a phone call (trying to make an appt. with a new doctor). I think that is a rare thing these days.....

Carol

[redy_to_be_lean]

I enjoyed the book I did'nt try the diet. I have givin up trying to loss weight, until I get my thyroid under control. Now I just LC to maintain my weight.

I just started "The Thyroid Solution" (book) and it's full of info.

After reading about so many people struggleing with these doctors. I decided I will make an appointment with a doctor and during the appointment I will first interview him and also share my history with him.

If he has knowledge and can make me feel his the doctor for me, I'll continue with him. If he can't make me feel secure in his wisdom and knowedge I'm walking out the door, I'm looking for another doctor until I find one that can treat my decease.

oow-woo, it sounds like you may have found a good doctor, I'll keep you in my prayers. I know what your going through I had to fire two doctors in the past two months for several different reasons.

But now I have a wounderful doctor and I feel very confident in him and his abilities to treat my condition.

[oow-woo]

I'm really happy to hear that you have finally found a doctor you can put your trust in! That must really be a wonderful feeling for you--now you are on the road to good health!
I will give this guy a chance but will keep my options open with this other dr too at the end of this month that I have waited so long to meet with (he is a endocrine and metabolic specialist).

Carol

[redy_to_be_lean]

oow-woo,

Better for you to have two good doctors then have NONE.

Now you can decide who is the best doctor for your health and treatment going forward. That sounds like a win all, win all situation for you.