Thyroid tests are normal?? Are you sure?

[DebM]

Pam,

these are my latest results - curious as to comments.....

TSH 1.05 0.50-6.00
T4 6.7 4.0-11.0
TU 32 25-38
FTI 2.14 1.0-4.2

also did glucose 82 70-99

I have been sick the past 3 weeks - doc diagnosed a sinus infection so I'm on the mend but feeling pretty crappy.

Thanks!

Debbie

[nonstickpam107]

Deb, need to see your Free T3 and Free T4. If the doc didn't DO them, he/she should. Can't tell much from the tests you've got there. FT1 hasn't been used in years...you used to have to do equation to get T3 result, but that's changed now that Free T4 and Free T3 is available.

Looking at the T4 (and that's a total T4 they did, it doesn't show what's available in the body, just what's 'floating around'...not a good test!) it's very low, indicating you are HYPO, not any trace of hyPER. You REALLY need to see a FT4/FT3...and I'm betting you were NEVER hyPER...you just went through the normal symptoms of Hashimoto's. (I'm getting a little 'irritated' by docs who proclaim EVERY patient hyPER just by TSH alone...sigh).

Pam

[DebM]

Pam,

I see the doc on Tuesday......

Did I mention that they did an iodine uptake in April, 2007 and it was 32% (not sure of ranges) and that and the supressed TSH is how they determined the hyper? And the panic attack episodes?

Deb

[nonstickpam107]

Suppressed TSH is NOT how you determine hyPERthyroid! You first get an TPO antibodies test, and hyPER is determined either by an TSI test (GRaves autoimmune hyper), OR an over the range FT3 test. ACKK..this makes me just mad! Panic attack episodes are usually from low progesterone and/or having Hashimoto's autoimmune hypothyroidism (where is your TPO antibodies test to rule that in or out???).

If you want a FT3, FT4, and TPO antibodies you can get it yourself through Online Lab Tests: blood work, blood testing and laboratory tests .

Pam

[DebM]

Thanks so much Pam. I will probably have to go that route. I wish I could rent you for my appt since you are sooo knowledgeable about this all. I'm about at page 40 of this thread. Still alittle confused but you sure help to arm me with info....

[nonstickpam107]

Deb, if I were closer I'd gladly go with you (to date, I've 'gone with' over 100 patients, lol). I was shocked at first when a patient wrote to me (about four years ago) that a doctor (an endo, of COURSE...jeez...98% of all endo's are GREAT with diabetes, but not with thyroid) actually had her talked into ablating her thyroid (killing it off with RAI) and had her on methimazole (anti thyroid). She felt terrible, was gaining approximately 10 pounds a month on that med, and sluggish, cold, tired, constipated, heart palpitations, least little bit of stress would give her panic attacks, etc.

She fax'd me her tests and low and behold, he'd only done what your panel is! And only her TSH was 'lowish' (mine is kept very low, yet my FT's are where they should be)...the other tests showed hyPOthyroidism. Well, about a month after SHE wrote me, I started getting email from others...about 33 I do believe...who also went to this particular doctor and had been talked into either REMOVING their thyroid or ablating it! NONE of them were actually hyPERthyroid!

Most of them had Hashimoto's autoimmune hypothyroidism and a combo of perimeno and menopause! Long story made short....it took over 100 complaints on this physician to have him investigated and a lot more to finally STOP him from ruining these patients' lives like that.

I thought at the time that he was just a 'fluke'...but I've SINCE found out there are LOTS of endo's who ONLY look at Total T's and TSH (some ONLY TSH) and do this. Two of them I met in person (went with a patient to 'help')...both were NASTY to me (of course)...and one told me to 'stop interfering, thyroids just mess up women's lives'. This just horrified me. I have emails from over 50 patients (all women, of course, sigh) who were 'fired' by their physicians when they asked questions, or asked for there lab copies. And lots of us are told "Armour is HORRIBLE, it's dirty, they rip the thyroid out the pig's throat in the doc's basement and chop it up and make it into pills"...can you imagine an educated doctor believing a drug rep who told that to him? Why, when I said "Think about what you are saying doctor, do you realize how 'silly' you sound??" he turned redfaced and was quiet.

Pam

[ew1]

Happy New Year Pam! Have to catch up with your threads!!!

I have my latest test results and would love your input.(FYI this is a different lab from my previous ones-the Seneca one in my doc's office building. Usually use the local hospital lab) This is NOT a fasting test.

1.After taking CVS iron 65 (325 ferrous sulfate) twice daily along with my old multi with a little iron, my Ferritin is up to 82.6, was told 70 was min for good thyroid uptake. (History is that it was down to 25 last summer, got it up on iron supps to 39 in Sept)
So do I stay on this dosage on cut back and if so, to what?
Iron Binding Total:
IRN 67 range 40-150
TIBC % SAT 23 range 15-30

2. TSH 0.004 range 0.35 -5.5
3. Free T3 3.2 range 2.3 -4.2
4. Free T4 0.93 range 0.89 -1.76
I did not take any thyroid med after 5 PM the night before.

GLU is 99 .
Potassium is 4.1 3.5 -5.1

Doc ran a comprehensive metabolic and CBC. MCV and MCHC were below normal last time, they are low normal to normal this time which is good.

Only comment from doc is he thinks I am getting too much thyroid.
RX on bottle says Armour thyro tab 1 1/2 gr, directions-take 1 and 1/2 tablets daily. Too much? Was actually starting to take an extra half pill around 4-5 PM, I felt ok on that. Maybe because I have more iron I am uptaking more Armour?

Everything else seems to be ok.

Whenever you get a chance to reply is fine. Don't you think I had to add the Free T3 to the list, haha? I LOVE knowing what to ask for!!

Hugs.

[nonstickpam107]

Elaine, he's just worried cuz of the TSH...and it is VERY low....meaning it may point to a pituitary problem still. You could cut back on the iron, but not sure to what....use your discretion or ask the doctor. Did you ever google 'suppressed TSH, low FT4 and FT3' and see what it tells ya (it'll say it's pituitary driven, lol). As long as YOU feel good, with no hyPER symptoms then ok, but you need to ask the doc WHY the FT's are kind of lowish with the TSH completely suppressed and see if he can give an answer.

Pam

[ew1]

Hi Pam, thanks, will discuss this with him. He's not an endo, just my GP, but is a very open minded guy and willing to try new things or Rx whatever I need if it has some sound reason behind it. Can't find a decent endo in the Philly area.
I was thinking of backing off the iron to one tab a day and then test again in 3 months.

[traddycath]

I am new here

I am 39 with five children under 10. I used to be 112 and cannot seem to get below 130 no matter WHAT I try!

In my fourth pregnancy I was diagnosed with Graves disease. I was actually hospitalized I felt so lousy.

I have lately been feeling lousy again. Shaky - heart "fluttering" feeling, muscle fatigue etc...

Finally went to the GP and he ran some labs. Can you guys help me with this. He says he doesn't suspect my thyroid because I haven't lost any weight.

T-3 Uptake was 34%
T-4 Thyroxine, Total was 7.8
Free T-4 Index (T7) was 2.7 (1.4-3.8 the norms say on my sheet)
and my TSH was 1.58.

The only other things on my labs that I have noticed was creatinine at 0.74 (norms are 0.50-1.2) and carbon Dioxide was 23 (norms 21-33).

I wonder if trying to lose weight and being HYPER-thyroid now might be the case??? I don't know.... Thanks in advance!
Kelly

[nonstickpam107]

Kelly, a T7 is pretty useless without the other two tests you need for an 'equation' (again...all they had to do was take a FREE T4 and FREE T3...an 'index' isn't the same) and you give NO range for the T4 (???). So, couldn't tell ya. But when determining hyPERthyroid you need FT3 to tell (it would be OVER range) and the TSH would be VERY VERY low (under .30) if you were! You also will have an TSI antibodies for Graves (Graves is an autoimmune disease).

Many docs say it's 'Graves' and don't do any of the tests...they just 'guess' going by the TSH. Heart palps and all the rest can be a sign of Hashimoto's HYPOthyroidism (autoimune) NOT hyPERthyroidism (but you won't know unless they do the correct tests).

As far as the 'doesn't suspect cuz you haven't lost weight' um....MOST hyPER patients GAIN weight worse than hyPO....I would ask for the following tests:

Free T4
Free T3 (NOT a 'T3 Uptake' and BTW, your uptake shows hyPO)
TPO antibodies

Pam

[traddycath]

(Graves is an autoimmune disease).

Yes, I know. When I was pregnant with my fourth child I saw an endocrinologist while I was hospitalized and he ran a whole series of tests and put me on meds. That's when I was diagnosed.

and you give NO range for the T4 (???).

T4 (Thyroxine), total = 7.8 (4.5-12.5 norm) Sorry. Have screaming babies on me while I type 90% of the time

Heart palps and all the rest can be a sign of Hashimoto's HYPOthyroidism (autoimune)

Well, I about can't take much more of them I know that. It's been going on for two weeks now and I feel like complete crap. My feet and hands are swollen today too. *sigh*

Thank you for taking the time to reply.
Kelly

[nonstickpam107]

A 'normal' T4 would be about midway (or higher) in range. That doesn't look hyper at all (mine is MUCH higher). So, you might want to dig out your copy of your TSI and TPO antibodies and look at them (they told me I had Graves for three years...I did NOT...I had and still have Hashimoto's and still had: heart palps, lost weight, then gained, swollen extremities, adema, hairloss). I had to have beta blockers for the heart palps (which also were caused by my progesterone going to NOTHING....if your progesterone levels are low, replacing that may help also...so look for your estradiol and progesterone labs too) while being replaced by T4/T3...this is called a 'block and replace' treatment.

Hashimoto's is called the 'rollercoaster' disease...the patient swings from one extreme to the other...from hyPER symptoms to hyPO and back and forth. Kelly, I hope you get some relief from all those symptoms soon, I know I was miserable...saw ELEVEN doctors and none of them would help me....one would say 'hyper' the next 'hypo' but no one was doing the antibodies testing on me at all. And I haven't seen a T7 done in a LONG time (about six years, many of the old 'equation' thyroid tests have been replaced with Free T4 and Free T3, so you might want to ask for those).

The T4 you have is a Total T4, not a free. Total T4 shows the hormone in the body, and FT4 shows the part you are actually getting to USE.

Pam

[carrielyn]

Originally Posted by nonstickpam107

....if your progesterone levels are low, replacing that may help also...
Pam

Pam, if you would please, I would appreciate how one might suspect low progesterone? My tests are pretty good (though you suggested my FT3 might be a bit low) but I have some 'symptoms' I'm not sure about and was wondering how low progesterone or other hormones might be recognized or suspected.

Thanks for your time.....it's such a valuable thing and you give of it so graciously.

Carolyn

[nonstickpam107]

Carrielyn, if you are female, over 35, the first 'phase' of perimenopause is declining progesterone levels. (some say 'estrogen dominance', but it's NOT that really, it's just that our progesterone starts to 'go away'). When the thyroid senses the lowering progesterone, it tries to 'make up' for it, and it can cause heart palps, edema, bloating, etc. (all the sign of perimeno). Even small hot flashes, and sleeplessness.

So, a female would want a sex hormone panel done (estradiol, progesterone) at that time. The adrenals become involved also, as progesterone goes down. So, in effect, women who are going through perimenopause have declining progesterone levels...and they should be replaced.

And you are very welcome!

Pam

[traddycath]

My GP actually just called and told me to come in for an echo and holter monitor. (going in today) My endo is also ordering a full panel so I suppose we will soon get the the bottom of whatever all this is.

My GP has insisted for the longest time this is all due to stress. He has me on an anti-depressant (have been for about 8 years now). His answer is to "up" the amount. He says I have a lot on my plate running a farm (small farmette actually), homeschooling 5 kids etc. BUt I know a lot of other people who have more on their plate and don't have heart palps, swollen extrem., insomnia etc..

I have suffered insomnia for about a year and a half now, for which I take a sleeping pill each night. It was written off as my body not adjusting from all the babies and lack of sleep. *sigh*

My gut says it's more than just stress.

[carrielyn]

I am a 60 YO female and I've been post menapausal for sometime now. I was diagnosed with thyroid problems about 7 years ago. Perhaps it would be a good idea to have these tests run. I know I have a very low libido so my husband would probably like to see that addressed.

Carolyn

[nonstickpam107]

Originally Posted by traddycath

My GP actually just called and told me to come in for an echo and holter monitor. (going in today) My endo is also ordering a full panel so I suppose we will soon get the the bottom of whatever all this is.

My GP has insisted for the longest time this is all due to stress. He has me on an anti-depressant (have been for about 8 years now). His answer is to "up" the amount. He says I have a lot on my plate running a farm (small farmette actually), homeschooling 5 kids etc. BUt I know a lot of other people who have more on their plate and don't have heart palps, swollen extrem., insomnia etc..

I have suffered insomnia for about a year and a half now, for which I take a sleeping pill each night. It was written off as my body not adjusting from all the babies and lack of sleep. *sigh*

My gut says it's more than just stress.

The person who knows the MOST about you...is YOU. And antidepressants 'bind' thyroid hormone in the bloodstream (some are worse than others..like Zoloft, Paxil, Prozac all bind large amounts). The number TWO symptom of hypothyroidism is depression. The number ONE symptom of Hashimoto's is heart palps. But..heart palps are ALSO a sign of perimenopause and menopause and low progesterone. Hope you get to the bottom of this really soon.

Pam

[traddycath]

The number ONE symptom of Hashimoto's is heart palps

Mine is more a "bounding pulse" than actually palps which sometimes indicate a rapid heart rate.

I got a copy of my labs from '04 when I was diagnosed with graves and my TSH level was 0.08 and my free t3 was 319. My T3 uptake was 17%.

Well, I am going to be 40 this year so perhaps perimenopause is a consideration.

[nonstickpam107]

Perimeno can start as early as 30 yrs. old (and does) and I was fully post MENO (my 'TOM' wasn't really that, it was just sloughing of uterine lining) at 41 yrs. old. Having Hashimoto's will push you into very early menopause. And that TSH is higher than mine and my FT3 was almost 1 1/2 times the range at one point...the rollercoaster disease will do that...it doesn't mean it's Graves, it just means that's how many of we Hashimoto's patients 'start off'. I started off with shaking hands, quivering muscles, could barely stand, lost 40 pounds in as many days, than rapidly turned around, GAINED 70 pounds and went hyPO and post meno at the same time. I was a 'classic case' according to my thyroidologist. While my GP wanted to give me anti thyroid and radiate me right away, my thyroid doc held off and did the right antibody tests and the block and replace treatment along with progesterone and estradiol.

That was eight years ago...I feel great now. Thyroid wise at least

Pam

[ew1]

Hi Pam, quickie question on the iron supplementation. I am at 82 ferritin on the last test, up from the low of 25. This was on 2 otc pills a day plus switching back to my old Country Life Maxine multi with iron. Should I be cutting back on the OTC supps and if so, over what period of time? I am trying to get back to just using my multi and maybe an OTC once in a while. I just don't want to undo anything I've done. I am post meno so know I need to store iron but not too much.
Thanks and hugs.

[nonstickpam107]

Do the vitamin and one of the OTC pills....see how that does. JMHO...if you want a professional opinion, ask the doc to direct you (as always). Have you had your B12 and B6 tested recently?? Low B's can also pull the ferritin down.

Pam

[itsmevkb]

I'm looking for some honest opinions. Here's my story:

In September of 2006 I had a baby. Within a few weeks of delivery I had lost all the baby weight and then some. However, over the course of the next few months I gained almost all of it back. I assumed that it was because I was home and I snack a lot at home. I figured that once I was back at work that I would lose the weight. That hasn't happened despite months spent on Weight Watchers and a return to low-carb eating which was very successful for me in the past.

I also figured that once the baby was sleeping through the night that I wouldn't be as exhausted. However, I am as exhausted now as I ever have been. There are nights when I am in bed at 7:30 and I'll sleep until 6:00 and still be tired.

One other thing I've noticed is very dry skin, even in the summer, which is new for me.

All of these things led me to ask my doctor to have my thyroid tested. In September I had it tested and was told that the result was normal. I didn't think much more about it until I began reading about infertility (we've been trying for over a year now to have a second child with no success despite getting pregnant the first time around very easily). Lots of things I read said that thyroid problems can cause infertility. So, I began reading up on thyroid problems and decided to find out exactly what my test results were. My TSH came back as 2.11, which is well within the normal range. The test they had done when I was pregnant in February of 2006 came back as 1.6.

So, my question is this, is it possible that despite my TSH testing normal could it be that this just isn't normal for my body? Should I pay more attention to my symptoms or to the test results?

I'm in the process of trying to find a doctor who won't just blow me off with the answer that my results are normal and that my symptoms all go back to being a full-time working mom but I thought I'd seek some opinions here before paying out of pocket for more doctor visits and tests.

Thanks so much.

[ew1]

Hi Pam, the B 12 is good, it always was.
That's what I was thinking-take 1 OTC with my afternoon multi (I split my vits, take some after breakfast, some after lunch). I want to see how the ferritin looks in 3 months after doing that. As long as it's 70 or above, I will be good.

[nonstickpam107]

Originally Posted by itsmevkb

I'm looking for some honest opinions. Here's my story:

In September of 2006 I had a baby. Within a few weeks of delivery I had lost all the baby weight and then some. However, over the course of the next few months I gained almost all of it back. I assumed that it was because I was home and I snack a lot at home. I figured that once I was back at work that I would lose the weight. That hasn't happened despite months spent on Weight Watchers and a return to low-carb eating which was very successful for me in the past.

I also figured that once the baby was sleeping through the night that I wouldn't be as exhausted. However, I am as exhausted now as I ever have been. There are nights when I am in bed at 7:30 and I'll sleep until 6:00 and still be tired.

One other thing I've noticed is very dry skin, even in the summer, which is new for me.

All of these things led me to ask my doctor to have my thyroid tested. In September I had it tested and was told that the result was normal. I didn't think much more about it until I began reading about infertility (we've been trying for over a year now to have a second child with no success despite getting pregnant the first time around very easily). Lots of things I read said that thyroid problems can cause infertility. So, I began reading up on thyroid problems and decided to find out exactly what my test results were. My TSH came back as 2.11, which is well within the normal range. The test they had done when I was pregnant in February of 2006 came back as 1.6.

So, my question is this, is it possible that despite my TSH testing normal could it be that this just isn't normal for my body? Should I pay more attention to my symptoms or to the test results?

I'm in the process of trying to find a doctor who won't just blow me off with the answer that my results are normal and that my symptoms all go back to being a full-time working mom but I thought I'd seek some opinions here before paying out of pocket for more doctor visits and tests.

Thanks so much.

And if you've read this entire thread (I know it's long and tedious...but just the first couple of posts would have been enough) you know that TSH is NOT a test of your thyroid. Congrats, your pituitary is ok.

Now, what are your actual thyroid hormone levels? You need a Free T4 and Free T3 test and an anti TPO antibodies test. If you can't get your doc to run those, you can get them yourself at Online Lab Tests: blood work, blood testing and laboratory tests where you order thyroid profile/panel II. They send you to a lab near you and report back to you. KEEP copies of ALL your tests too, from there or from docs. My TSH was .33 when I was horribly ill from Hashimoto's hypothyroidism....my FT4 and FT3 were barely within bottom of range and my TPO antibodies were in the thousands (proving over and over that TSH is NOT the definitive test for thyroid disease).

Also, have your iron and ferritin checked (if you didn't already), low iron can mimic hypothyroid symptoms too.

BTW (edit) the site I gave charges under 90 dollars for those tests, while your doctor charges anything from 150 to 300.

Pam

[dooy]

Hiya Pam!

Sorry that this is off topic, but I was wondering if Tom would consider giving you a sticky with all the tests recommendations (like the importance of ranges, the low down on THS, etc), the online lab site and any other info that you seem to have to repeat here over and over...

I soooo appreciate that you do that, but a sticky just seems like an easy place to refer newcomers to thyroid issues? And of course EVERYONE should read the thread through b/c it is so helpful to read about others' experiences!

Just my 2 unasked for cents!

[dooy]

OOOPPPS! I realiz this IS a sticky....

I guess I mean just one post with all the hard info. so peeps even know what to ask for, how to present their testing results here and the other wonderful resources you offer!

sorry!

[nonstickpam107]

dooy, that's why this was made into a sticky. But..if people will just read it, the very FIRST post gives what's considered 'optimal/normal' ranges, and which tests are pertinent and why you don't want to use TSH as a thyroid test. The reason I keep 're-explaining' is that people sometimes 'don't get it' or can't believe their doctor insists on using a pituitary test as a thyroid hormone test. And that their doctors are told by drug reps that only Synthroid is used as thyroid treatment, etc.

I once got the same PM over and over again from the same person saying "Are you SURE TSH isn't the only test and are you SURE my iron (it was 11 in a range of 10-210) isn't ok just cuz it's 'anywhere at all' in range????" The PM's were from a nurse practitioner who worked for an endo. She was just flabbergasted. And has since moved on and works for MY doctor, heh heh.

Pam

[dooy]

I bet she appreciated meeting you!!! We're all lucky to have you!

You're the best Pam!


Oh, and I go back for my recheck on the thyroid panel the end of Feb...that would be 3 months on the progesterone. I'll let you know!

[itsmevkb]

I understand that the TSH isn't a definitive test, however, that is the only test my doctor would perform so at this point those are the only results that I have. Because that test is within the normal range neither my ob/gyn nor my reproductive endocrinologist want to even bother looking further.

My question was simply that given the symptoms I've been experiencing would it be beneficial to have more tests done, or, is it more likely that what everyone keeps telling me is true and I'm just feeling this way because I'm a newer mother? These are tests that I will have to pay for fully without insurance and since I will need to see a new doctor who may be willing to order the tests and/or treat me, those visits will be paid for solely by me.

Thank you for the link to the testing site. Perhaps I will have them do the further testing and then worry about finding a doctor later if need be.