Thyroid tests are normal?? Are you sure?

[pscaulkins]

Pam,
Thank you for all your posts on the thyroid. I have Hypothyroid and I requested my medical records and labs copied because she just won't listen to me. I have maintained the same weight for months even though I am on strict induction and still have all the symptoms for 4 years that didn't go away. My labs back a year ago was 4/02 TSH 4.815 - 0.5-4.6 uIU/m, Free T4 0.90 - 0.71-1.85 mg/dL. She kept me on same dose of synthroid. Labs taken 11/02 was TSH 3.756 and Free T4 was .91, she never changed meds than on 11/03/03 TSH was 2.51 and Free T4 0.88. She told me I didn't need meds anymore. They did a complete blood work up and my EOS% was 6.0 H - norms are 0-4.7%. I called the labs to find out what this is and they said to ask doctor. I called doctor and they said don't worry about it. I am going to a new doctor this Friday. I can't understand the thyroid business of changing when my meds are the same. Any input would be appreciated.
Thanks
Sandy

[nonstickpam107]

Sandy,

You thyroid is "dieing", and every time you go to doc to get lab tests, it dies a little more, and the med TAKES OVER IT'S "JOB". So, your T4 is WAYYYYYYY too low (you want that in the midway or HIGHER of lab range---see how low it is???) and your TSH is too high---normal people's is around a 1. Hopefully your new doc will know more about thyroid disease.....do you have Hashimoto's??? Also, if you are eating soy,,,,stop for a couple months and see if you feel better.

nobimbo..

Get the complete print out: re-post to me the TSH, FT4, FT3, and the entire workup with all hte lab ranges (just PM me). I have NEVER seen a TPO or any other antibody (for thyroid) range that exceeds 60 and is "normal"---someone is confused.

Pam

[nobimbo]

Pam,

Sorry I said that in a confusing way. What the doc said was over 60 for TPO would indicate a problem, under 60 indicates there is not a problem, and since I am at 53 there is no problem. I will pm you with everything again when I get the actual report. I'm just curious why my body is producing any antibodies at all. I have searched this a lot and have gotten confusing info. I've read on some sites that some docs will treat for Hashi's with any positive test for antibodies, no matter what the number is.

Thanks again,
Linda

[nonstickpam107]

Perhaps the doc has a "preconceived notion" of his own about where the antibodies and other test results need to be....wouldn't surprise me!! I had several docs tell me they "don't worry or treat" a TSH under a TEN!!! So, when I asked "But what if the patient is suffering and has the symptoms with a TSH of over 3, and their FT4 and FT3 are really low?" The answer: "I'm too BUSY to mess with that!!" Oh, dear, how busy does a doc have to be to not help the patient???

Please do post it to me...and I have a list of docs who treat thyroid...lists for the US and outside the US.

Pam

[nonstickpam107]

Bumping for folks who think this is an "easily treated" disease.

Pam

[nobimbo]

Hi again Pam,

I got my doc to fax me the results of my antibodies tests. Here are those along with the other ones I reported to you earlier:

9 a.m. fasting 10/21/03

Thyroglobulin Autoantibodies: Less than 10 IU/ml (range <60)
Thyroid Peroxidase Autoantibodies: 53 IU/ml (range <60)

T4 Total 10.35 (range 4.50-12.00)
T3 Free 2.10 (range 1.40-3.04)
TSH 1.29 (range 0.49-4.67)

Iron 35 (range 28-138)
RBC 4.10 (range 4.20-5.40)

I had asked for a ferritin test and he had agreed, but when it didn't show up on the lab report and I asked him on the phone, he said "we don't do that test").

A couple of weeks earlier, I had these test results at my gyn's:

5 p.m. non-fasting 9/30/03

RBC 4.69 (range 3.80-5.10)
T3 Total 147 (range 60-181 NG/DL)
T4 Free 1.2 (range 0.8-1.8 NG/DL)
TSH 3.00 (range 0.40-5.50)
Progesterone 12.1 (range for luteal phase: 3.3-26.0)
Estradiol 76 (range for luteal phase: 15-260)
Testesterone Total: 21 (range 15-70)
Testesterone Free: 3.2 (1.0-6.5)

I am 47, have PCOS (diagnosed 20 years ago), diabetic, and have been on Metformin for two years. I am also on Verampamil (calcium channel blocker) and Altace (ace inhibitor) for blood pressure. I have lost 107 pounds and have 120 more to lose, but I am struggling to lose more weight and have been at a standstill for over a year (except for a recent 5 pound loss the past two weeks.) Although I began to lose again, and my body temps went up after I went off of Atenolol (beta blocker) a few weeks ago, they are still running low (this morning it was 96.5, day 7 of my cycle). Other possible hypo-related symptoms I have are tinnitus and absent ankle and knee reflexes (for several years now). My energy level is pretty good as long as I low carb and exercise, which I do fairly consistently.

I have begun including 2 Brazil nuts a day in my diet, because I understand that selenium can help in my T4-T3 conversion. I have been taking other supplements for quite some time: Multivitamin, 1000 mg. Vit. C, 400 IU E, Folic Extra (contains folic acid with B's), and a prescription iron pill (since March; I had been taking 2 a day, and a few weeks ago decreased to 1 a day). I have a large fibroid and heavy menstrual bleeding, but that has gotten better the past few months (despite a failed uterine artery embolization procedure), and now only have one really heavy day each month.

I understand that my thyroid tests look pretty good right now, except for the T3 Free being a little low. Do you think I need to be concerned about the presence of the TPO antibodies, even though they aren't all that high? Should I see an endo and pursue this further (I have the name of someone who is recommended on the about.com thyroid site)? I realize my ferritin levels are probably low due to my low iron and RBC's, and that my hypo symptoms could be the result of that. However, the fact that I have any antibodies in my blood concerns me. I have read conflicting thoughts on this, ranging from "a healthy body doesn't produce these antibodies, any positive antibodies needs to be treated" to "only needs treatment once the thyroid tests become abnormal". What are your thoughts on this?

Thank you so much once again

Linda

[nonstickpam107]

Have you also learned that TPO antibodies go up and down, and at time may not even register, but the patient still has Hashi's??

If it were ME (I'm not a doctor)....I would make sure I had the same round of thyroid testing next year. TSH doesn't "matter" as much as T4 and T3 tests, and yours look halfway decent (in other words, your low RBC may contribute, and your PCOS would also contribute to your overall symptoms).

If a person is gonna have Hashi's, than they are gonna have Hashi's.....meaning I think it is best to leave it alone if your thyroid is still working right now. As the antibodies attack the thyroid, the thyroid will slow down----but I think it would be a mistake to medicate right now.

You probably already know this, but if you medicat right NOW, the thyroid will say "Oh, incoming hormone, I can die now"....you certainly are better off with a working thyroid at this point, while you are losing the weight.

We ALL get stalls....the only reason I didn't actually stall out all the way through was because I ate nothing but whole foods (this is my thoughts on why) and because everytime I would slow down for more than a month, I would go back to induction.....for a month.....then take off again.

Pam

[nobimbo]

Pam,

Thanks so much for your input. I really don't want to go on medication for thyroid at all, especially because of my high blood pressure and history of supraventricular tachycardia (fast heartbeat). However, I also want to maintain my thyroid function, and had wondered if treatment might prevent full blown Hashi's in the future. I didn't realize that treatment might make the thyroid output lessen.

So can I assume then that I do have Hashi's? Or might there be some other reason for the antibodies in my blood that isn't thyroid-related?

Thank you!!!

Linda

[nonstickpam107]

Well, the only SURE way to find out if you have Hashimoto's (and I'm telling ya now....some have high TPO antibodies because of another, yet unfound, autoimmune disease--I also have Sjogren's, and it can raise those SAME antibodies...they really don't know why yet....but it does occur) is to have a FNB (fine needle biopsy) of the thyroid. Otherwise, if the TPO antibodies are high in range (and most ranges say <2 BTW...yours is the first I've seen use that range, hmmm) AND the TSH fluctuates wildly, AND the FT4 and FT3 are very low in range, than it is assumed you probably have Hashi's, or will acquire the rest of the "proof" later.

A low estrogen level, using certain types of birth control, etc. can ALSO skew the results. Hashi's is something to keep an eye on, and know that if you have a baby, or when you go peri-meno or post-meno....that it is then that it may rear it's ugly head and finally go full blown.

That's why most finally go fully hypo after giving birth, and after menopause starts (and we also go menopausal and peri-meno earlier, and have more misscarriages and trouble conceiving).

Pam

Pam,

I got this link from a PCOS message board and have been reading the posts from this thread and boy do you know your thyroid stuff!! I dont know anyone that knows alot about this and my husband's military doc and civilian endo arent very helpful. Of course it would help if my husband could retain what he is told so he could inform me! I would really like your input on his situation.

July '02 my dh weighed about 195 (6ft3). He was out in CA on deployment and felt great. He got sick (flu like) over there and the docs never could find out what was wrong. He came home and still felt great. Had the best run time in his USMC career. Then around Jan he started gaining weight and feeling bad all the time. He got in big trouble with the military for being overweight and his cholesterol was high so they sent him to a clinic. He finally mentioned to his doc about his night sweats and restlessness, snoring, sleep apnea, etc, etc. And the doc tested his thyroid.

I didnt know his initial #'s until yesterday. His TSH was around 140 and was put on Synthroid (was upped a couple of times). He got a referral to an endo in March '03 but missed the appt which was in July. The next avail was in Nov. So he went to that and was tested again. My dh had to call to get the results several times but finally got them after me getting on to him. He wrote down what the nurse told him so I dont know what exactly was said. Here they are:

TSH: 6.586
FT4: 1.03
FT3: 3.6
TSI: 83
He just wrote down "Graves" for this one, I think it might be his TT3: 201

The endo told him he has Graves disease AND Hashimoto's. I've never heard of this other than alternating btwn the two. Didnt know you could have both at one time. Sorry this is so long. I'm concerned about him b/c he now weighs 235 and is tired ALL the time. Also has really bad headaches and depression. I talked to the endo Fri and he was not very nice and pretty much blew off my concerns. Told me dh was mildly hypo and that the condition might or might not be causing depression or his other symptoms!! I dont believe that. Dh was perfectly healthy, thin, and fit mentally and physically before all this! His career has already been effected by this b/c of the weight gain and failing physical tests. I look forward to your opinions.

Emily

[nonstickpam107]

Emily,

You have a PM.

Pam

[beckamoo]

Hi Pam,
I finally got my FT3, FT4 and TSH redone again. Please reveiw the results.
TYROXINE (T4) free direct: 1.48 (normal 0.61-1.76)
TSH 0.444 (normal 0.350-5.500)
Triiodothyronine, Free, Serum 3.1 (normal 2.3-4.2)....is this the FT3? I know my lab slip stated FT3 & 4 plus TSH.

My question to you is, right now I am on Levoxyl, If I want to change to Armour....would this be a good idea? I just read so much negative stuff about Levoxyl. I just don't know if for me, should I request a change? Is it necessary? I feel a little bit better but not much difference that when my TSH was 15. something.

Would appreicate your advice
hugs~
Bec

[nonstickpam107]

Hi Bec,

Good to hear from you. Those numbers are quite an improvement over a TSH of 15!! Unfortunately for ALL of us with hypo, it takes about six weeks for the blood to reveal healing, and then you can go roughly another six months and STILL do more healing from the inside.

I started feeling a LOT better about five to six months after my labs looked a little like yours (your FT4 is excellent, your TSH looks very, very good, and you might want to add a little synthetic T3 to your Levoxyl down the road a bit...say another three to six months if you aren't feeling well yet).

I'm in my fourth YEAR of being treated and just now feeling better, but my FT3 is all the way high in it's range.

Sometimes the FT3 does come up after the TSH is as low as yours for a few months, but if you aren't feeling any better within, say, six months, I'd be talking about adding T3 to the T4 (Levoxyl) OR switching over to Armour. Please keep in mind that Armour is about 20% T3, and 80% T4, whereas the human body is about 5 to 7% T3 and the rest T4, so some like to switch to Armour and then if needed, add a teensy bit of T4 back in.

Have a Happy Thanksgiving Bec!!!

Pam

[beckamoo]

Thanks Pam!!! so much for your fast reply. I couldn't wait to get home to post my results and see what you thought. I told my doctor's nurse that before I made any changes, I needed to get some advice from someone very knowledgeable. I think she thinks I am nuts because I didn't ask to speak to the doctor. I told her, I wanted my lab results and than would schedule an appt if need be....lol

When should I request him to redo my lab work? How often do you get yours tested?

So, I may not necessarily need the Armour? Do you lowcarb? I am trying to get back on to it but having a hard time. I like happy hour on Fridays too much...lol.
Do you stay away from all soy products? Lots of lowcarb cereals or shakes have some soy isolate in it.
Thanks again and hope you have a very nice Thanksgiving
hugs~
Bec

[nonstickpam107]

Bec,

Depending on how you feel in about three to four months....if your skin is dry, if you are tired, if you have brainfog, if you can't concentrate, etc., then test again...especially the FT3. Some need T3 more, some don't. I don't, lol.

Yep....I started with Protein Power (which I still have a copy, and love to refer to it) and then went to Atkins. I do NOT eat any soy at all....I use a completely whey only shake mix to make recipes (flaxseed meal muffins) with, otherwise, I dont' drink any shakes. I eat pretty clean, lots of lowcarb veggies, lots of water, keep my protein under 100grams per day (sometimes a little lower, I am in maintenance now) and don't do a lot of dairy (keep the cheese under four ounces, even now, not much cream). I don't do alcohol at all...it bothers my thyroid...very simply, if I drink, I throw up, in that order. Not worth it.

I just found out that I have very bad food allergies that trigger my asthma. Some of them are: beef, wheat, grains, barley, oats, peas, beans, etc. so just when I tried to add a little whole wheat back in.....that's when I found out I can't have it. But...it's ok....I feel great eating the way I do. Take care.

Pam

[beckamoo]

Thank you Pam
btw...I am not a very heavy drinker either. If I have more than 2, I get drunk....lol and if I have more than 2...I will throw up and not even know I did. It's like I get blackouts...wierd but I am careful with alcohol. I like to have a margarita on Fridays...when we go to happy hour at this Mexican resaurant.
hugs~
Bec

[nonstickpam107]

Actually it's not "weird" to react that way to alcohol when you have hypothyroid. I know they gave an explanation for it on thyroidmanager.org at one time. It's been a topic of discussion several times at the group, too.

I also find that hypothyroid folks need the higher percentage of fat in the diet to lose (IF they are well-medicated, otherwise, it's a given that they need a lot less calories to lose and maintain....I'd rather be well medicated myself, lol).

Well, I've made a pineapple upside-down cake for the non-lowcarbers, and a pumpkin-praline/maple cheesecake for ME (and probably anyone who doesn't "guess" it's lowcarb!!).

Pam

[LunaAshling]

Ok I had one more question for Pam.


As far as antibody testing...what is the specific name to ask for?


I noticed on the HelthCheck site you recoomended that they have an "Anti-Thyroid Antibodies" test you can order that tests:
Thyroglobulin Antibodies and Thyroid Peroxidase Antibodies.


Would this be useful, or do I need to ask for a different specific one?


I apologize if you already posted it, I am trying to read back through all the posts but it is taking awhile!


THANK YOU!!!!

PS...I just wanted to let you know that because of you I started checking my husbands old medical records from the last 6 years. Going off of the new lab ranges I found that it shows he is hypo for at least the last 4 years. Some of his numbers were non existant! And no one ever said a damn thing.
And every single doctor just laughed off his normal body temp of 96 degrees.
I am very thankfull to have been able to learn more from you!!!!

[LunaAshling]

Ok I just looked up those two items in the test and I believe it is for Hashi's and Graves.


Seems like that would be a good test to have! Would you know what the numbers should be on those?

[Stevie Renee]

Hi Pam,
busy lady with this thread. Glad to see the Mod's keep it here too. Very cool. Ok, my results. My endo doc said all is well but would recommend an OTC iron pill. She said the cold could be from weight loss, the joint pain could be arthritis and the other stuff like fatigue could be from the low iron.

Chemistry:
Iron - results:80 - (ug/dl, 50-170)
TIBC - results:363 - (ug/dl, 250-400)

Thyroid Studies:
TSH, Ultra Sens - results: 1.190 - (mIU/mL, 0.27-4.20)
Total T3 - results: 0.96 - (ng/mL, 0.80-2.0)
Free T4 - results: 1.73 - (ng/dL, 0.80-1.90)

Harmonal Studies:
Estradiol - results: 62
(Ranges:
Follicular Stage - pg/ml, 10-178
Ovulation Phase - pg/ml 48-388
Luteal Phase - pg/ml 31-247
Post Meno - pg/ml 10-46)

FSH - results:6.48 - (mIU/mL, 0.11-198.0)
(Expected values:
Follicular:3.5-12.5
Ovulating:4.7-21.5
Luteal:1.7-7.7
Post Meno:25.8-134.8)

LH - results: 4.6 (mIU/mL - left blank)
(Expected values:
Follicular: 2.4-12.6
Ovulating:14.0-95.6
Luteal: 1.0-11.4
Post Meno:7.7-58.5)

**I just turned 40 and am on no permanent meds for anything. Cholestral was 220 last checked. I am not clear on what the follicular, ovulating, Luteal stuff means. I imagine a stage I am in life? lol - Any input is appreciated.

Thanks for any feedback. I hope it all looks ok so I can move on. My most urgent is the joint pain I have. Effects my footware and exercise.

Thanks Pam.

PS: Can you recommend any good books on this subject?

[nonstickpam107]

Luna,

Yes, the TPO (Thyroid Peroxidase) is for Hashimoto's and if it is over the range AT ALL, then you are suspect for it, and the other is for Graves (hyperthyroid), and the same for it.

Chantel,

Are you eating a lot of soy? Your T3 looks too low...I'd be cold, whiny, depressed, aches, pains, etc. And you don't say what phase you were in for the hormone testing, so I can't tell.

I (myself, my opinion) would want a FREE T4 and FREE T3 not a total T4 and T3....still your T3 is too low....you might try taking some selenium (non yeast, 100mcg. to 200 mcg. to start, than taper back after a couple of months). Low T3 can make you achey....and you could also have the beginning "rollercoaster" of up and down test results for thyroid that begins when you have Hashimoto's,,,,you don't have a Thyroid Peroxidase there either.

Pam

[nonstickpam107]

sorry,,,I like "The Thyroid Solution" by Ridha Arem, I also like the website over at www.about.thyroid.com, I like the books on female hormones by Elizabeth Vliet ("Screaming To Be Heard" is very good).

I especially like the website: www.thyroidmanager.org...it is written BY doctors FOR doctors, but you might want to get some basic understanding of the thyroid and how it affects the other bodily hormones first...or you may be overwhelmed.

Pam

[Stevie Renee]

Thanks Pam.
I do not eat any soy. I will look into the tests again. Darn, I thought I had it right. Is a thyroid peroxidase a test?

Thanks for the reading info too.

Oh, as far as the harmone level, how do I know where I was at at the time? Is that what you are asking? Like when I was on my cycle or something?

Chantel

[nonstickpam107]

Chantel,

Didn't your doctor tell you (unless you are post-meno or have had your ovaries removed) that you needed to have the female hormone tests on a specific day of your cycle? Otherwise, why bother? So, when you are looking at the results: were you in a luteal, post meno, follicular or ovulation phase?? As soon as you know which one of those you were in, you can compare your results to the lab ranges.

When I say "low ferritin mimics hypothyroid" I'm actually talking about a ferritin test, not iron. Your iron looks fine, BTW. A total T3 (or is that a T3 Uptake??) is not as good as a Free T3 (FT3) and a total T4 is not as good as a Free T4 (FT4). But, to give you a little insight, your T4 and T3's should be midway or higher of their respective lab ranges. T3 is the hormone that can make you depressed if it is low (and yours is low) as well as limit your energy and metabolism...it is the "energy" thyroid hormone.

The antibodies test to try and determine if you have Hashimoto's hypothyroidism is called a "thyroid peroxidase" level, also known as a "TPO".

Pam

[Stevie Renee]

Pam,
nope, doc did not say that. That irritates me to no end.
I will be calling her on Monday.

Thank you Pam for your constant time and attention to this subject matter.

[Stevie Renee]

Hi again Pam,
there was a part 2 to the fax that the doc sent that I just became aware of today ( the fax was sent to my brothers house since I do not have a fax and page 2 got struck on memory or somethin' like that.)anyway...page 2:

Ferritin: results - 46 - mg/dL, 15-150

Thyroid Perox AB:results - <10.0 - IU/mL - 5.0-35.0


Please give me some feedback on this when you can.

tia

Chantel

[nonstickpam107]

AH HA!!! lol....your ferritin looks a tad low....but shouldn't interfere too much..if you eat lots of iron containing foods...most of us have some of the same symptoms of hypo if it isn't at LEAST 50 and 70 is even better.

If it were me...I would want the TPO checked again next year, unless you start feeling even MORE hypo symptoms...and in the meantime,,,,you sure would want to get that FT3 up there.

Pam

[Stevie Renee]

Pam,
good to know. Thanks a million.

Will contact my endo on Monday.

Thanks


PS: I was reading a post you typed in a tea thread that green tea is a no go for you because of flouride. I am curious. Is this just for you and your meds or is this a bad product for all thyroid patients? ANd is the flouride in the tea or the water? lol I would love to pick your brain on what food/drinks negativly effect thyroid patients. My MIL is very bad off and thankfully she has a great endo doc helping her but I like to share some of the things you post with her too. Did you learn the do's & don'ts by trial and error or from constatnt research & treatment? Thank you again.

[nonstickpam107]

Chantel,

Flouride can be goitrogenous----in other words, slows the thyroid down, and it's another "YMMV" type of thing as far as tea goes. People with Hashimoto's tend to have the same problems as people with other autoimmune diseases...with their teeth and bones (yes, Hashi's patients have a higher incidence of osteoporosis, just by having the disease, too). So, a lot of us who are over the age of 40 were given flouride in very large amounts in school programs and such... I cannot tolerate the sluggishness from the flouride in the green tea, but tell others to try it.....and if they feel as if they are getting aches, sluggish, just don't feel "right" to stop it.

I have about 24 years of research behind me of autoimmune thyroid disease (and other endocrine diseases). Of course, the internet makes it a little easier, but I'm still surprised over some of the people in the medical profession who just don't seem to understand the need for better screening tools and labs. Also those who don't associate thyroid disease with anything except weight gain and loss or don't associate it with the other hormones.

Pam

[Stevie Renee]

Pam,
interesting. You should write a book and publish it. Seriously.

Thanks a million. I am happy that you seem to have your health in tact and are so dilligent about it.

Appreciate your posts lady!