Thyroid tests are normal?? Are you sure?

[laurawd]

Originally Posted by treenac

Good grief! I wouldn't be able to afford that - she might be better off flying over!
I am able to buy thyroid medication over the counter here but I don't want to do that obviously without an idea of dosage...

Treenac I live in Hong Kong and can recommend a doctor if you need one (here). Lauren Bramley is quite good.
And she prescribes Armour! (usually prefers to add T4 to it )

[nonstickpam107]

Thank you so MUCH laurawd...recommendations are always a wonderful thing!

Pam

[nonstickpam107]

Originally Posted by laurawd

Hi Andrea. I am currently 6 weeks pregnant and have had lots of thyroid tests in the past year because I suspect I'm hypo, but my TSH is firmly normal!

Since becoming pregnant, I have learned that low FT4 is a problem (mine is perpetually low.) There was a Swedish study that showed that FT4 needs to be above 10 mmol/l for proper psychomotor devt of the fetus.

A score of 1 ng/dl is about 13 mmol/L. Now, that doesn't mean that her FT4 could have been lower at the time. It's also possible that her levels vary throughout the day. Anyway, I think it's still worth investigating. How's she doing?

Abstract below:
> Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy*. Original Papers
>
> Clinical Endocrinology. 50(2):149-155, February 1999.
> Pop, Victor J. *; Kuijpens, Johannes L. +; van Baar, Anneloes L. ++; Verkerk, > Gerda *; van Son, Maarten M. [S]; de Vijlder, Jan J. [P]; Vulsma, Thomas [P]; > Wiersinga, Wilmar M. ** ; Drexhage, Hemmo A. ; Vader, Huib L.
> Abstract:
BACKGROUND: Maternal thyroid function during early pregnancy is an important determinant of early fetal brain development because the fetal thyroid is unable to produce any T4 before 12-14 weeks' gestation. Overt maternal hypothyroidism as seen in severe iodine-deficient areas is associated with severely impaired neurological development of the offspring. At present, it is not known whether low free T4 (fT4) levels during pregnancy in healthy women from iodine sufficient areas may affect fetal neurodevelopment.

METHODS: Neurodevelopment was assessed at 10 months of age in a cohort 220 healthy children, born after uncomplicated pregnancies and deliveries, using the Bayley Scales of Infant Development. Maternal TSH, fT4 and TPO antibody status were assessed at 12 and 32 weeks' gestation. Maternal gestational fT4 g t; concentration was defined as an independent parameter for child development.

RESULTS: Children of women with fT4 levels below the 5th (<9.8 pmol/l, n = 11) and 10th (<10.4 pmol/l, n = 22) percentiles at 12 weeks' gestation had
> significantly lower scores on the Bayley Psychomotor Developmental Index (PDI) scale at 10 months of age, compared to children of mothers with higher fT4 values (t test, mean difference: 14.1, 95% confidence interval (CI): 5.9-22 and 7.4, 95% CI: 1.1-13.9, respectively). At 32 weeks' gestation, no significant differences were found. In the group of women with the lowest 10th percentile

fT4 concentrations at 12 weeks' gestation, a positive correlation was found
between the mothers' fT4 concentration and children's PDI scores (linear
regression, R: 0.46, P = 0.03). After correction for confounding variables, a
fT4 concentration below the 10th per centile at 12 weeks' gestation was a
significant risk factor for impaired psychomotor development (RR): 5.8, 95% CI: 1.3-12.6).
>
> CONCLUSIONS: Low maternal plasma fT4 concentrations during early pregnancy may be an important risk factor for impaired infant development.
> (C) 1999 Blackwell Science Ltd.

Most of us in the 'endocrine research world' were plenty 'peeved' when they didn't mention T3 at ALL!!! In women, low T3 is more dangerous to the fetus than not having high T4! This all pertains to early pregnancy, first trimester, not conception ability too...wherein low T3 ALSO is a factor. Just like doctors to stress TSH (who does that anymore??!!) and T4 but 'ignore' the T3 that we women have to have in order to function properly.

Pam

Pam

[Gracie514]

Hi Pam

I've been reading through this thread and it is so confusing! I just had my thyroid checked because of menstrual issues and other symptoms and my doc says everything is normal. I do have an appointment with an endo on May 7th to check me for fertility issues. I wanted to share what my labs say and see what you think. Thanks for any information you can give me!

T3, FREE 288 (230-420)RANGE "PG/DL"

TSH, 3RD GENERATION 1.42 (0.40-4.50)RANGE "mU/L"

T4, FREE 1.5 (0.8-1.8) RANGE "NG/DL"

[Gracie514]

Oh, I was also reading through the thread and saw that Free T-3 can be affected by a LC diet when the test was taken. I had been following LC for a while and that morning for breakfast I had 3 hard boiled eggs and nothing else. Don't know if that makes any difference?????

My symptoms are restlessness, agitated, headache, and missed periods. I'm thinking my problem is more related to estrogen. Also, my temps. in the morning are always around 96.9-97.2 and in the afternoon about 97.3 even in my luteal phase.

I'm sorry to bother you, hope you can give me some insight.

[nonstickpam107]

Gracie you also need your progesterone level checked and your iron and ferritin. Going too low carb forces the thyroid to stop converting T4 into T3 (your FT3 is miserable!!). If you're going low carb (under 30net with under 1300 cals or so) you can really inhibit that conversion (which will leave you fatigued and your thyroid may just decide to say quit!). Progesterone is the thyroid's BFF. Yep, once the progesterone starts falling (and that's what happens in perimeno and going into meno) the thyroid tries to 'take over' for it and compensate. Which, eventually, tires it out. This is precisely why women in peri meno and meno have more cases of hypothyroidism diagnosed.

If you are using any hormones (birth control pills, BHRT, etc.) they all bind thyroid hormone in bloodstream. So, that could be a conversion culprit too. At any rate, I think personally I would have wanted a TPO antibodies test with that panel. Just in case...to check for Hashimoto's..one of the first signs is highish T4 and very low T3.

Last, but not least, you aren't consuming soy or soy products are you? They can bind the thyroid really well. You want to avoid soy with that conversion.

But for the record, it just looks like you have poor conversion. Your FT4 is really high, yet the FT3 is bottom of range...you might want to raise carbs but if you are anemic, this could be it too. I don't think it warrants 'blaming' your symptoms on thyroid though.

I hope your fertility issues are resolved soon...good luck.

Pam

[ninammam]

Greeting's everyone My name is Nina and i am new here. I have been on synthroid for the past 4 yrs. it seemed to keep my weight down a bit and made me feel ok even with ebstein bar virus, however i changed drs last year and i have been feeling worse than ever my thyroid has been lowered 3xs and i have gained weight and feel terrible, i suggested to my dr. that it is my thyroid and my levels have to be off he did the blood work 3 seperatec times and upped it a bit each time, it's like slow torchere. He say's my levels are good now even though i don't feel like they are, i went to an endo. and he basically said the same thing. Well i am still over 200 lbs. and feeling Terrible. I went back to my reg. dr and through much research on the pc found out abot Armour i practically begged him to try it suggesting that the synthroid was not working he finally agreed and put me on a comparible dose to synthroid 100 mcgs armour 95 mgs. here are my last lab results hopefully i will stop loseing my hair and feeling terrible.


Thyroid peroxidase antibodie's 586 H 35 IU/mL
T-4, Free 1.5 0.8-1.8 ng/dL
TSH 3rd generation 1.01 mIU/L

Thyroglobul in panel
Tyroglobul in antibodies
This specemin was found to containAnti-thyroglobul in antibodies. The presence of these Autoantibodies may cause falsly low thyroglobul in values

I did have an ultrasound of my thyroid and showed boarderline enlarged thyroid with small solid noduels bilaterally. increased blood flow is seen bilaterally.

Any help would be so appreciated. I just dont trust drs anymore.

[nonstickpam107]

Where is the Free T3?? And 90mg. Armour is NOT comparable to 100mcg's T4 in most women. You are only taking 1.5 grains of Armour (most adult women over 125 lbs. need closer to 2 grains up to 3 grains). Most with Hashi's feel best with TSH closer to .30 (some of us lower than that, sigh...I'm one of them) and FT3 about midway of lab range or higher. Endo? Endo's are great at diabetes. Only about one in every 100 is great at thyroid disease. Sigh.

And giving Armour without taking a FT3 test would be tantamount to giving insulin without getting any blood glucose test. Where are you? (State, and any state lines less than an hour and a half driving time)? Perhaps we can help you find a doctor who knows how to help you better. Don't NOT trust ALL doctors...seriously, the number of doctors most Hashi's patients goes through before finding one who works with the patient is five. You may have to travel though (I travel well over an hour one way to my thyroid doc who IS an endo, but specializes in thyroid disorders and endocrine disease, not diabetes).

While you are waiting to get back to me, please do a Google search for 'anti aging doctor in _____' and use your town, nearest large city in the ______. Tell me who you come up with.

Pam

[laurawd]

Originally Posted by nonstickpam107

Well, first off I wouldn't have taken the thyroid hormone before making sure my ferritin and iron came up. Low iron mimics thyroid disease and lowers thyroid hormones. Secondly, I'd make SURE my adrenals were good (4x salivary for adrenals testing) and what about your progesterone levels? Again, many of us slide into low thyroid when our progesterone starts to go down (perimeno...first thing that lowers is progesterone, not estradiol).

Are you eating soy? That also drops the FT's quite low (it being a phytoestrogen). Other than that...I'd really rather not take thyroid hormone until everything else is investigated with numbers like yours (you see, I see numbers UNDER range all the time with FT's and way over with TSH).

OR..the hormone you are taking is of low quality and is reflected in your testing. OR the testing is 'skewed' or isn't Free T's, but Total T's (just to cap off the entire list of reasons why

Pam

Hi Pam. I'm coming back to this thread to ask if you know anything about TRH stimulation tests. I had one done and the response was slightly exaggerated (indicating hypo).

I also wanted to ask - a ferritin of 40 or so could be a result of hypothyroid as much of a cause, right?

Thanks!

[nonstickpam107]

TRH will hardly show a rise of TSH if the patient has too much FT4. And TSH should shoot up to 10 to 20 with the injection. People with a high FT4 and low TSH (under 1) usually have a pituitary problem, not hypothyroidism.

FT4 tends to be lower that midway of it's lab range in pregnant women, that's WHY the doctor should check the FT3....it needs to be above midway of it's range. If you aren't converting your FT4 into FT3, that can be a problem.

Not everyone is hypothyroid. Many other factors can cause low conversion...one of which is progesterone. If progesterone is very high (like in pregnancy) the FT4 can be slightly suppressed (that's why doing just FT4 doesn't 'jibe' in that study) but FT3 will be quite good, because progesterone aids in conversion. If your progesterone is low (as in perimenopause), the thyroid doesn't function well, so low progesterone is also a cause of lowered conversion.

Pam

[laurawd]

Originally Posted by nonstickpam107

TRH will hardly show a rise of TSH if the patient has too much FT4. And TSH should shoot up to 10 to 20 with the injection. People with a high FT4 and low TSH (under 1) usually have a pituitary problem, not hypothyroidism.

FT4 tends to be lower that midway of it's lab range in pregnant women, that's WHY the doctor should check the FT3....it needs to be above midway of it's range. If you aren't converting your FT4 into FT3, that can be a problem.

Not everyone is hypothyroid. Many other factors can cause low conversion...one of which is progesterone. If progesterone is very high (like in pregnancy) the FT4 can be slightly suppressed (that's why doing just FT4 doesn't 'jibe' in that study) but FT3 will be quite good, because progesterone aids in conversion. If your progesterone is low (as in perimenopause), the thyroid doesn't function well, so low progesterone is also a cause of lowered conversion.

Pam

Hi Pam. Thanks.

Before I knew I was pregnant, I took a TRH stimulation test. I had been off thyroid meds for 7 weeks prior to testing.

Basal TSH was 2.01
Base FT4 was .72 (.83-1.38)
Base FT3 was 2.44 (2.23-3.61)

After injection of 200 ug TRH, my TSH rose to 30.82 at 30 minutes, and was 26.79 at 60 minutes.

My doctor called my results normal, but the majority of studies I have read
suggest that a rise of over 20 uIU/ml or 25 UIU/ml is exaggerated, and suggestive of hypo. I was also confused by my persistent low FT4 (not just in this lab, but others) despite "normal" TSH.

My antibodies last March: THyroglobin AB (ATA) were 27 Ui/mL. Anything under 34 considered OK. Thyroid Peroxidase AB (TPO) was 4.3. Anything up to 12 considered OK.

I read the realthyroidhelp folks consider ANY antibodies a problem. Does that consider those "under range"?

I have had a hard time figuring out if my problem is hypo, but the test seems to confirm it. The endo that did the test - when he found out I was pregnant - said that I certainly should be treated if pregnant. ...

I just wanted to know what you'd read on the subject. TRH stim tests are rarely performed in the States nowadays.

Unfortunately, this doc doesn't use Armour but he's not opposed to it. My GP prescribes it for me, but she's not really familiar with dosing. I'm trying to go slow and test every 4 weeks, which is common procedure while pregnant.

On my last test, I'd only been on the meds for 2.5 weeks, but the results were:

The TSH is .125 (.35-4.94)
FT4 1.16 (.70-1.48)
FT3 2.64 (1.71-3.71)

That was 100 mcg T4 + 1.5 grain Armour. I've bumped T4 down and Armour up since then. Now I'm taking 75 mcg T4 + 2.5 grain Armour, and I'm gonna stay here for another 3 weeks before I retest. (Have been on it for 1 week.)

SUNNY THANK YOUS from me to you.

[Gracie514]

Originally Posted by nonstickpam107

Gracie you also need your progesterone level checked and your iron and ferritin. Going too low carb forces the thyroid to stop converting T4 into T3 (your FT3 is miserable!!). If you're going low carb (under 30net with under 1300 cals or so) you can really inhibit that conversion (which will leave you fatigued and your thyroid may just decide to say quit!). Progesterone is the thyroid's BFF. Yep, once the progesterone starts falling (and that's what happens in perimeno and going into meno) the thyroid tries to 'take over' for it and compensate. Which, eventually, tires it out. This is precisely why women in peri meno and meno have more cases of hypothyroidism diagnosed.

If you are using any hormones (birth control pills, BHRT, etc.) they all bind thyroid hormone in bloodstream. So, that could be a conversion culprit too. At any rate, I think personally I would have wanted a TPO antibodies test with that panel. Just in case...to check for Hashimoto's..one of the first signs is highish T4 and very low T3.

Last, but not least, you aren't consuming soy or soy products are you? They can bind the thyroid really well. You want to avoid soy with that conversion.

But for the record, it just looks like you have poor conversion. Your FT4 is really high, yet the FT3 is bottom of range...you might want to raise carbs but if you are anemic, this could be it too. I don't think it warrants 'blaming' your symptoms on thyroid though.

I hope your fertility issues are resolved soon...good luck.

Pam

Thank you Pam, everything you say here makes sense. I have been doing LC on and off for quite a while and it always seemed like if I was very strict or only did meat/eggs my menstrual cycle would get out of whack. Now, when I go to the endo on May 7th should I ask for progesterone/iron/ferritin testing? Is there anything I can do naturally to help my progesterone level? I have added back in lots of fruits, veggies, and LC grains. I also was surprised when you said "anemic" because I remember when I was in my early 20's a doctor told my mom that I could be anemic because my blood work showed semi-low iron. BUT......I think my "cycle" problems started after eating LC. So many things to consider huh? Thanks again and any other pointers you have for me will be much appreciated, you really know you stuff!
or

[nonstickpam107]

Laurawd, you do not have antibodies elevated enough to be Hashimoto's. (if you wanted clear, concise ruling out, it would be a FNB of the thyroid itself and then biopsy of cells, but I wouldn't bother). Yep, your 'before medication' panel does, indeed, show hypothyroidism...but with that LOW of FT4/FT3 (yes, both miserably low) but a TSH of only above 2..I'd suspect either pituitary or hypothalmic involvement. So..a lot of people have tertiary hypothyroidism (caused by pituitary being sluggish), and a TON of them have hypothyroidism because of having had certain virus'...mainly EBV virus (mono).

At any rate, I (personally) feel best with a VERY high FT4 and an under/exactly at..midway of FT4 range. I've had my doc give me supp. T4 WITH Armour but it doesn't do much for me (and I react to Synthroid or synthetic T4 the same way I react to ANYTHING made with/from corn). You might even want someday to have your doc trial you on 3 grains of Armour and no T4...just to see where that puts you.

But the testing on pregnant women is 'flawed' without the tests including FT3 ranges (sigh..endo's and the Amer. Endo. Society is just set on the fact that we just only need T4, and until THAT changes, nothing else will change).

Hope you are feeling VERY well!!

Pam

[nonstickpam107]

Originally Posted by Gracie514

Thank you Pam, everything you say here makes sense. I have been doing LC on and off for quite a while and it always seemed like if I was very strict or only did meat/eggs my menstrual cycle would get out of whack. Now, when I go to the endo on May 7th should I ask for progesterone/iron/ferritin testing? Is there anything I can do naturally to help my progesterone level? I have added back in lots of fruits, veggies, and LC grains. I also was surprised when you said "anemic" because I remember when I was in my early 20's a doctor told my mom that I could be anemic because my blood work showed semi-low iron. BUT......I think my "cycle" problems started after eating LC. So many things to consider huh? Thanks again and any other pointers you have for me will be much appreciated, you really know you stuff!
or

Yeah, many will see really great FT4 and TSH and miserably low FT3 when something you are doing is inhibiting the conversion. Things that inhibit:

Too low carbs, too low calories
Too low progesterone (but you can get OTC progesterone...some are quite good, until you're 'old enough' to use compounded Rx'd...ask your doc to test though, AFTER you've brought your carbs and cals up to optimum for your metabolism)
I'd want my iron and ferritin tested for sure. Women who have TOM lose iron, and can benefit by getting more iron in diet, or replacement.

Cycle problem during LC'ing are because when you are burning fat (ketone release), your body is releasing estrogen and unbalancing your progesterone. And if a person goes under 1300cals/under 30 grams carb for extended periods of time, it actually damages the thyroid (which tries to make up for, and balance the progesterone).

I've 'experimented' with soy..I've eaten soy flour and soy nuts and soy pods (edamame) ..had two servings a day for a week, had my FT4 and FT3 checked, and my FT4 was pretty dang high , and my FT3..um..nonexistant! So, beyond just having fun using my body as the laboratory I actually saw proof of just how strong phytoestrogens can be. Birth control pills, and other phytoestrogens do the same thing.

If I were you, I'd try and eat as healthy as I could, no soy, bring your calories up to your metabolic requirements, make sure you are getting enough iron if you are low in it, and then have that panel done again in about six months and see if it changes. Best of luck to you.

Pam

[Gracie514]

Just wondering about something; If you are following a LC WOE, is it safe to try to conceive? I know that if you're progesterone levels are low you have a higher chance of miscarriage. And, if you're following LC couldn't you be causing your progesteron levels to be low? Wow! Too much information for me to process at once!!!!

Pam, also, I see that you lost a lot of weight doing Atkins; do you think that could have had a hand in your thyroid issues? Since reading all of this I am definitely eating lots of fruits, veggies, and lean meats! I can't believe that my Doc didn't tell me any of this - amazing his lack of info.

[nonstickpam107]

Actually, I lost that weight by doing more Protein Power (by the Eades) and was post meno at age of 41 because of autoimmune Hashimoto's. When I was young, I had three miscarriages and two stillborn infants though...all because of Hashimoto's. BTW, I didn't go below 30grams carb and I don't think I EVER ate under 1600 calories (that was probably a 'low day' for me).

I wouldn't hazard a 'guess' at going LC while TTC..but I would say that lower in carbs (sugar) would be a good thing...but too many try to go too low in calories AND carbs. And makes a huge difference if you have PCOS too...to the good.

Depends on what problems, hormone wise, you are having I would suspect. I've probably had Hashimoto's my whole life...I just couldn't get a doctor to treat me until my children were all grown (I have two).

Pam

[laurawd]

Originally Posted by nonstickpam107

Laurawd, you do not have antibodies elevated enough to be Hashimoto's. (if you wanted clear, concise ruling out, it would be a FNB of the thyroid itself and then biopsy of cells, but I wouldn't bother). Yep, your 'before medication' panel does, indeed, show hypothyroidism...but with that LOW of FT4/FT3 (yes, both miserably low) but a TSH of only above 2..I'd suspect either pituitary or hypothalmic involvement. So..a lot of people have tertiary hypothyroidism (caused by pituitary being sluggish), and a TON of them have hypothyroidism because of having had certain virus'...mainly EBV virus (mono).

At any rate, I (personally) feel best with a VERY high FT4 and an under/exactly at..midway of FT4 range. I've had my doc give me supp. T4 WITH Armour but it doesn't do much for me (and I react to Synthroid or synthetic T4 the same way I react to ANYTHING made with/from corn). You might even want someday to have your doc trial you on 3 grains of Armour and no T4...just to see where that puts you.

But the testing on pregnant women is 'flawed' without the tests including FT3 ranges (sigh..endo's and the Amer. Endo. Society is just set on the fact that we just only need T4, and until THAT changes, nothing else will change).

Hope you are feeling VERY well!!

Pam

Hi Pam,

I really don't want to bother you again, but I have to ask. Why would T4+Armour not work well? Why didn't T4+Armour work for me?

And Armour only work better? I've been taking the T4 for insurance against pooling of the T3 and lowering of the T4, which my doctor says Armour sometimes does. I think she'd be OK with trying Armour only, but I'm not sure why it would work better.

[MistyJ]

Hi Pam,

Since I have thyroid problems and hashi's, I want to save my girls all the years of crap I went thru so I had their bloodwork done. I received one of the results and would just like your input. I think her FT4 is low, but I don't think she can do anything about it. She is not on any meds for thyroid however she is 18 wks pregnant. Before she found out she was pregnant, she had an ultrasound done on her thryoid as they thought her neck looked a little full. They (military) told her there was a goiter but they wouldn't do anything about it now.

Okay her results:

TPO <10 range 0-34 IU/mL

Antithyroglobulin AB <20 range 0-40 IU/mL

TSH 1.183 range 0.350-5.500

FT3 3.1 range 2.3-4.2

FT4 0.99 range 0.61-1.76

I would love your input... especially on the goiter. When should she have that re-checked. (Oh her symptoms are mean and tired but she is pregnant!)

Thank you Pam.

[nonstickpam107]

Originally Posted by laurawd

Hi Pam,

I really don't want to bother you again, but I have to ask. Why would T4+Armour not work well? Why didn't T4+Armour work for me?

And Armour only work better? I've been taking the T4 for insurance against pooling of the T3 and lowering of the T4, which my doctor says Armour sometimes does. I think she'd be OK with trying Armour only, but I'm not sure why it would work better.

I 'know' over 3000 hypothyroid patients (some by internet, a lot in real life). The 'normal' thyroid generally has a Free T4 lab of about midway or UNDER, and a FT3 lab of anywhere from midway to all the way up to top of range.

Armour Thyroid 'mimics' the normal human thyroid so well, that most of us on Armour ONLY (if we are optimized on the right dosage), those are exactly where our labs are. So, it seems to be that your doctor wants YOUR T4 high. I don't know why. Maybe she see if it's that way naturally (my doctor actually does his OWN FT's and then shows it to patients...which is cool, cause it proves the fact that a normal thyroid results in a TSH of quite a ways under a 1, and a FT4 of only midway of it's lab and quite high in FT3..his is 3/4 of it's range...on no thyroid hormones but his own).

In order for our thyroids to run our metabolisms properly, the T4 must convert INTO T3. Most of us don't convert AT ALL. So..why would we need all that T4 if none of it were converting? See where I'm going?

I've NEVER, EVER heard of T3 "pooling' (unless you throw your Cytomel in the swimming pool), so I called my thyroid doc (he teaches at seminars all over the world) and he said he's NEVER heard that either. That's a new one on us.

Pam

[nonstickpam107]

Misty, the military doesn't treat any thyroid until the TSH is above 5. Period. I don't like the panel as per a pregnant woman either, and she should get a second opinion (not a military doctor either!). As well as an TPO antibodies test. That's not a shocker that the military doesn't care about the goiter (a goiter is a swollen up thyroid, which can't make enough hormone to give the baby enough not to have problems later in life, most manifest at school age with ADD, ADHD, and those types of behavioral difficulties).

If it were MY daughter (and believe me, my DD DID have same problem...) I would find another doctor to treat her. A pregnant woman needs MORE thyroid hormone than non pregnant..not less!! And I'd want to know if she had Hashimoto's too (TPO anitibody test). Best of luck to you all!

Pam

[MistyJ]

Originally Posted by nonstickpam107

Misty, the military doesn't treat any thyroid until the TSH is above 5. Period. I don't like the panel as per a pregnant woman either, and she should get a second opinion (not a military doctor either!). As well as an TPO antibodies test. That's not a shocker that the military doesn't care about the goiter (a goiter is a swollen up thyroid, which can't make enough hormone to give the baby enough not to have problems later in life, most manifest at school age with ADD, ADHD, and those types of behavioral difficulties).

If it were MY daughter (and believe me, my DD DID have same problem...) I would find another doctor to treat her. A pregnant woman needs MORE thyroid hormone than non pregnant..not less!! And I'd want to know if she had Hashimoto's too (TPO anitibody test). Best of luck to you all!

Pam

Wow you are fast! Thank you for your advice.

The TPO antibody test... that is the Thyroid Peroxidase (TPO). It was <10 with a range of 0-34. So I take it from that test, nothing is showing up yet.

I am not sure how she could get more thyroid hormone... she isn't getting any meds. Do you think another dr would treat her with her bloodwork showing in the "normal" range? Is there different ranges for pregnant women?

Thank you for taking your time to answer. Oh, I thought with a goiter, her bloodwork would have been way out there, not within range. Am I wrong?

[nonstickpam107]

Well, bloodwork 'in range' doesn't mean it's optimum for her and the baby. Yes, there are lots of doctors who will treat subclinical thyroid labs. No, sometimes a goiter just signals a thyroid 'condition' (make sure they gave an ultrasound AND an FNB (fine needle biopsy). Some go hypothyroid during a pregnancy because of the hormonal 'shifts' (almost all of us trigger hypothyroidism during or after pregnancy, or during peri and post menopause..anytime our hormones are unbalanced).

Depends...I know a lot of doctors would really keep a close eye on the labs...because she's pregnant...and many doctors would definitely treat her subclinical labs...but you have to find that doctor (and most of the very good ones don't take military insurance...some are cash only). What I'd suggest? If the goiter has been ultrasound'd and checked, and they are positive it's not getting bigger or she doesn't have nodules...than they should run that panel again in two months to see where she is. OR if she feels just awful, swells a lot, especially in the leg/shin area, feels fatigued, etc., she needs to either find another doctor, OR make sure she isn't getting worse.

Women who are pregnant need higher levels of T4 and T3 to compensate for the baby. BTW..my DD's TPO looked fine...until three years after the birth of her second child...they are now in the thousands...as were mine. Goiter means something is wrong with the thyroid...and I'd rather be safe than sorry.

The docfinder on ArmourThyroid works on zipcodes, so she can put in zips for..say..an hour driving time radius...or I also have a 'patient recommended' list which I'll give you (I don't put much store in the recommendations that a doctor 'listened to me'..you can pay anyone to 'listen' and not do anything...but look for 'doctor checked FT's and likes a suppressed TSH, or 'doctor treats with Armour Thyroid'):

Thyroid Top Doctors -- Best Thyroid Doctors in the World as Nominated by Patients, from Patient Advocate Mary Shomon

Pam

[MistyJ]

Originally Posted by nonstickpam107

Well, bloodwork 'in range' doesn't mean it's optimum for her and the baby. Yes, there are lots of doctors who will treat subclinical thyroid labs. No, sometimes a goiter just signals a thyroid 'condition' (make sure they gave an ultrasound AND an FNB (fine needle biopsy). Some go hypothyroid during a pregnancy because of the hormonal 'shifts' (almost all of us trigger hypothyroidism during or after pregnancy, or during peri and post menopause..anytime our hormones are unbalanced).

Depends...I know a lot of doctors would really keep a close eye on the labs...because she's pregnant...and many doctors would definitely treat her subclinical labs...but you have to find that doctor (and most of the very good ones don't take military insurance...some are cash only). What I'd suggest? If the goiter has been ultrasound'd and checked, and they are positive it's not getting bigger or she doesn't have nodules...than they should run that panel again in two months to see where she is. OR if she feels just awful, swells a lot, especially in the leg/shin area, feels fatigued, etc., she needs to either find another doctor, OR make sure she isn't getting worse.

Women who are pregnant need higher levels of T4 and T3 to compensate for the baby. BTW..my DD's TPO looked fine...until three years after the birth of her second child...they are now in the thousands...as were mine. Goiter means something is wrong with the thyroid...and I'd rather be safe than sorry.

The docfinder on ArmourThyroid works on zipcodes, so she can put in zips for..say..an hour driving time radius...or I also have a 'patient recommended' list which I'll give you (I don't put much store in the recommendations that a doctor 'listened to me'..you can pay anyone to 'listen' and not do anything...but look for 'doctor checked FT's and likes a suppressed TSH, or 'doctor treats with Armour Thyroid'):

Thyroid Top Doctors -- Best Thyroid Doctors in the World as Nominated by Patients, from Patient Advocate Mary Shomon

Pam

Thank you for answering my questions Pam. You always surprise me with all your knowledge/experience. I am going to pass this info to her and discuss it with her.

[nonstickpam107]

You are very welcome..um..it's a little 'easier' to have knowledge in just ONE area of expertise (if you'd written about a hangnail on a toe, I wouldn't have known the first thing to do

Pam

[Gracie514]

Hi Pam !

Well, I've been following your advice and I've added back lots of fruits, veggies, lc grains, etc. I seem to have more energy and hopefully I'm repairing the damage I've done. I have another question for you.....I saw that Netrition sells "T3-Thyroid", a supplement to help your conversion from T4 to T3. Okay, is it legit and will it help me??? I definitely don't like to take any pills if I don't need them. Right now I'm not on anything but a high strength multi-vitamin and 2 Fish Oil pills per day. What do you think?

Thank you in advance, you are a Godsend!

[olsufka2]

Hello all. I am new here and need some help understanding my lab results.
I have been having quite a few sypmtoms so seen my neuro about a month
ago and have just gotten a copy of my lab results.
My TSH is 0.98 normal range is ( 0.40 - 5.50 )
My FT4IM is 0.71 normal range is (0.8 - 1.8 )
Just what does this mean? I literally had to beg for the test resuts to be sent to me and have not heard a thing from my Dr. since seeing him. I did
request my thyroid be checked because of fatigue, extreme joint pain, muscle pain, menstural changes...
Does this mean I am hypothyroid? From the research I've done it looks as if
that may be the case. Any help on this would be sooooo appreciated!!!!!!!!!!

[nonstickpam107]

Originally Posted by Gracie514

Hi Pam !

Well, I've been following your advice and I've added back lots of fruits, veggies, lc grains, etc. I seem to have more energy and hopefully I'm repairing the damage I've done. I have another question for you.....I saw that Netrition sells "T3-Thyroid", a supplement to help your conversion from T4 to T3. Okay, is it legit and will it help me??? I definitely don't like to take any pills if I don't need them. Right now I'm not on anything but a high strength multi-vitamin and 2 Fish Oil pills per day. What do you think?

Thank you in advance, you are a Godsend!

Well, I certainly wouldn't add in a lot of fruit unless you've mastered the rungs of the lowcarb diet. (I added back in berries when I was about 15 pounds from goal, and haven't added back any bananas...I followed Protein Power and Atkins as guidance in adding back things that turn to sugar).

No, sorry...any supplement sold without a prescription has not ONE iota of T3 or T4 in it. No, it won't help anyone who have hypothyroidism. No, it won't raise any levels of T3. If you aren't converting T4 to T3 than you need to see a doctor...T3 (called Cytomel if synthetic and found in Armour Thyroid and Westhroid and other natural thyroid hormones) is only available with a prescription.

Pam

[nonstickpam107]

olsufka, you don't have a T3 test there, nor a TPO antibodies test, so you only have 'half' a thyroid panel. You also don't say if you have low iron and ferritin, nor do you say where you are in life (your age...if perimeno or meno, than a panel with estradiol, progesterone, etc., would be good too).

Many doctors wouldn't test any further nor be interested in treating you...so don't be discouraged with the treatment (and begging for the correct tests...if the doctor doesn't KNOW what they are...why bother to beg??), we've all been there, and most of us have to find a doctor savvy in thyroid. You don't say where you live (state, and nearest state line..within an hour or so driving time radius).

You can go to Online Lab Tests: blood work, blood testing and laboratory tests and get your own tests (and doesn't cost all that much either! My doc's lab charges my insurance over 300 for tests this place charges under 90 dollars for!). Thyroid Panel II has TSH , FT4, FT3 and you can look up TPO antibodies and thyroglobulin there (all of that is usually under 100 dollars, give them coupon code 12345 for a discount). They send you to a lab near you and report back to you.

As you can see, your FT4 is UNDER the range (not good), so that's suspect, but if you have a doctor who worships the TSH test, he/she won't treat usually. So, you can go to ArmourThyroid and look for a doctor on their docfinder (uses zipcodes, so put in an hour's driving time radius) and I have lists of top thyroid docs for most states and some countries.

Pam

[olsufka2]

Thank you so much for replying Pam. No, my Dr. did not run a T3 or antibody test. I see him because I have MS and have had many new symptoms, extreme fatigue, very bad joint pain especially right before and the first day of my period ~ my periods have become very weird lately, I will have two a month then another 45 days later and they have gotten alot heavier, I have also gained quite a bit of weight and just cant lose any for the life of me.
I am 45 years old so at first I was thinking perimenopause but the joint pain I was experiencing was just god awful and I just know that its not a normal
part of perimenopause. That along with all of my other symptoms prompted me to ask for a thyroid test. I wonder why he did not check my T3. My
TSH is on the low side though which makes me wonder. Isnt it normal for the TSH to raise when the T4 is low? Hum, I am beginning to wonder about
something possibly being wrong with my pituitary. I also get extremley
dizzy and weak before my period. Maybe I shoud start looking into finding
and endo.

[olsufka2]

You asked how my ferritin was. A year ago it was 51 and i was put on iron supplements. It is now 94 so its still a little on the low side but not to bad.
Would a ferritin at 94 make my T4 that low?