Thyroid tests are normal?? Are you sure?

[olsufka2]

OK one more time here. So sorry, i guess the lab test reads FT4IM and my
number is 0.71 on the low side. Is this just the T4 test or is it a little more
extensive and involves more that the T4? Sorry for all the confusion, i'm
just learning. I do appreciate all the help.

[nonstickpam107]

It's just the FT4 test. A complete panel is a TSH, FT4, FT3 and TPO antibodies tests WITH ranges. Um, your neuro? Neuro's don't usually do thyroid treatment (unless it's a tertiary thyroid condition involving the pituitary) so that might be why the doc hasn't said anything. I know MY neuro wouldn't know the first thing about interpreting MY thyroid labs..I leave that up to my thyroid doctor.

Pam

[Gracie514]

Thanks Pam! I'll watch out for the fruit. My endo appointment is this Wednesday so I'll mention all of this information.

[nonstickpam107]

Don't be surprised if the endo doesn't agree. They are great with diabetes, but I've only found about 22 endo's through the US that treat thyroid well. What book/Doc's diet are you using for your LC diet, btw? (Protein Power is great, will explain when and why to add in carbs/etc.).

Pam

[olsufka2]

Thank you so much Pam. Would you suggest I start looking for an endo.
just to go over my results with? Do they usually treat someone with a low
T4?

[nonstickpam107]

Well, you don't give a clue as to your: age, if you have low iron/ferritin, if you are perimeno, or meno, if you eat a lot of soy (inhibits thyroid hormone production), what your symptoms are, WHY you are seeing a neuro in the first place, what meds you are on, etc. etc. All of which can influence the testing. Also, certain antidepressants can also slow the thyroid and influence the testing.

If it were ME, and I'd ruled out ALL the other factors (low iron/ferritin/perimeno, low progesterone, etc.) and had the symptoms of hypothyroidism, I'd get a FT3 and FT4 with TSH and TPO antibodies and THEN go from there. But I'd definitely want a reason as to why my FT4 was that low...

Patients are 'confused' about endocrinologists. Some are very good at thyroid (and I have lists that are), but most are great at diabetes and won't deal with subclinical thyroid test results. So...many DO's (doctors of osteopathy), almost ALL anti aging docs, and many naturopathic (the ones that can write prescriptions...not the ones that give you iodine...there hasn't been a case of iodine deficient hypothyroidism in the US in over 40 years, and we all know the 'supplements' for thyroid you can get without a Rx. have NO therapeutic levels of thyroid hormone in them) physicians also do great thyroid care.

Pam

[Gracie514]

I was basically following Atkins' induction and never really working my way back up the carb ladder. My carbs were limited to small amounts of veggies. I'm going to check out protein power.

[WendyOH]

I went to an endo and it was a disaster. I am now seeing a wonderful anti-aging doc. I'm sure there are some good endo's out there but I won't be trying again any time soon

[Gracie514]

Thanks Wendy for the warning! From what I understand it's hard to find a good endo. My main reason for going is more for fertility issues and TOM cycles being all out of whack. Which, actually, is probably starting from the thyroid issue So, who knows? Maybe I'll be pleasantly surprised

[WendyOH]

Gracie, the endo wasn't any help in that area for me either. I also have TOM issues. I only get them maybe 2 times per year and haven't had one since January. I'm only 30 years old. You'd think that endos should be experts on hormones, but most aren't. It was a complete waste of my time and my insurance's money. He ordered something like 3000 dollars worth of worthless labwork, including only a TSH for my thyroid. I hope you have better luck!

[nonstickpam107]

Gracie, Atkins books are wonderful too...I like the fact that Protein Power gives you an 'equation' to determine how MUCH protein you should have at each meal (and some wonderful suggestions on menus too!). I like Atkins books too (but I transitioned from Protein Power into Atkins'72) but I 'got it' with the explanations of 'why' in the PP book. It was an eye opener.

Pam

[olsufka2]

You must have missed my post on my age.... I am 45, my ferritin was 51 a year ago and was put on iron supplements, it is now 94, my iron seems to be fine. I have MS but am doing fine on no medications, the only thing I can
think of that I take is ibuprofen or tylenol when needed. I do not use any soy
My periods have become alot heavier, my joints ache and I am just exhausted out of my mind. I am alot heavier than I used to be and can not lose weight no matter how hard I try. I have almost everyone of the hypo.
sypmtoms. I just talked to my neuros office and his nurse said my low t4 reading was nothing to worry about since it was just minimally off 0.71
none the less it is in the low range. I have looked up my previous tests and
my t4 as well as my tsh have dropped in the last year.

Dec. 2007 TSH 1.15, April 2008 TSH 0.98 DROPPED

Dec. 2007 T4 1.06, April 2008 T4 0.71 DROPPED

I am quite perplexed as to why this would be happening. Both my TSH and my T4 have dropped.

Can anybody help????

Thanks so much.

[nonstickpam107]

But TSH can change up to three whole POINTS over the course of any given day. Ok? So don't go by that, otherwise why was I so ill and hypothyroid with a TSH of .22 when diagnosed? See? I'm saying your FT4 is VERY VERY low, and you need tested for FT3 and TPO antibodies to rule in/out Hashimoto's. You might very well have Hashimoto's (cuz when the antibodies attack, your labs are all over the place). What you need to do is find a doctor who treats thyroid. And knows what tests to do for it. And knows that a human needs T3 as well as T4. That nurse obviously doesn't 'get it' (and many doctors don't either).

Most neuro's don't do thyroid..unless it's tertiary hypothyroidism (pituitary driven). That's why I asked why a neuro to do the tests?

So, you need a FT4, FT3, TSH and TPO antibodies. You can get those through Online Lab Tests: blood work, blood testing and laboratory tests if you want, OR you can just start hunting up a thyroid doc now. ArmourThyroid has a great docfinder feature. Or you can tell us where you are and see if someone has a suggestion of a doctor who does the correct tests who is near you. Having a FT4 UNDER the range isn't a good thing...FT4 should be at least near midway of it's range, and doing ONLY a FT4 without seeing if you are converting to FT3 is pretty useless too. Not to mention that not doing a TPO antibodies test isn't a good thing either seeing how almost ALL hypothyroidism in women is autoimmune Hashimoto's.

Pam

[olsufka2]

Thank you so much for replying to my post Pam. You are a god send!!!!!!
Yes, I do believe I am going to get on this I felt so awful today. I just ache
all over. It feels as if I have arthritis in all of my bones and I am so tired I
could literally sleep half the day away. I will keep you posted on what is
going on with me. Thanks again I so appreciate it.

[nonstickpam107]

Well, you are welcome, but you can't treat hypothyroidism on your own. When you decide you need a good thyroid doc let us all know...several people here have found really good thyroid treatment and doctors.

Pam

[WendyOH]

Originally Posted by nonstickpam107

Well, you are welcome, but you can't treat hypothyroidism on your own. When you decide you need a good thyroid doc let us all know...several people here have found really good thyroid treatment and doctors.

Pam

Too bad it took SIX years to do so

[nonstickpam107]

Better late than never sweetie! Took me seven doctors and from the time I was first told I had TPO antibodies (but, sorry, can't treat ya!!) till when I was treated, it was over TWENTY years!

We ARE making progress though! Everytime a GP or endo, or other doctor ONLY does a TSH, or ONLY does a T4 and TSH and decides that 'anywhere in range is fine, even UNDER the range' and that patient decides to pay a doctor who DOES treat hypothyroidism...it's a strong message. The message is this: doctors need to listen to the patient's symptoms, the doctor needs to do the correct tests, and needs to learn to interpret that test....or they won't have a paying customer. They need to quit pushing synthetics and telling patients they are 'bioidentical' and they need to stop putting all our money into BigPharms' hands instead of reaching for a natural hormone first.

Pam

[olsufka2]

Well, I have made an appt. with my PCP for next week and am going to ask
for a TSH, T4, T3 and antibody test. I will go from there. All I really know
right now is that my T4 is low. I live in Wakefield, Nebraska about 30 miles
from Sioux City, Iowa and about 80 miles from Omaha, Nebraska. I do think
there is a Dr. in Sioux City by the name of Bainbridge? that is supposed to be a pretty good thyroid Dr. My cousin sees him.
Do you think I should just skip the PCP and head straight for the thyroid Dr.?
I guess I dont know ~ is it pretty serious to have just a low T4?
Thanks for all your help.

[nonstickpam107]

If you've read this thread, you know what a low FREE T4 (and FT3) mean. It means your thyroid isn't making enough thyroid hormone, classic for hypothyroidism. And you need a FREE T4 and FREE T3, not a T4 and T3 (which would be 'totals' showing only what's in your body circulating, not what's usable). The most important test will be a TPO antibodies (showing autoimmune hypothyroidism).

My BEST friend lives in your area in Iowa..and neither of us (and many others) can recommend ANYONE in that state who's actually 'great'. Most do TSH only and the couple of naturopaths who DO give Armour, don't give enough to make any difference..and are also hooked on TSH!

I CAN, however, recommend the following Dr. in Omaha (and he comes HIGHLY HIGHLY recommended!!!):
Dr. Jeffrey Passer, Internal/Integrated Medicine, 4239 Farnan Street Ste 800, Omaha, Ne 68131 , 402 552-2900, Anti-Aging Medicine - Dr. Jeffrey Passer, MD, PC, Omaha, Nebraska

I think I speak about patient recommended doctors for thyroid..and I'm always AMAZED at the recommendations of patients when they say "OH, oooh...he LISTENED to me!!"...and then when I ask what treatment they got..they tell me: "oh, none, but he listened to me!'. I want patients to actually have doctors who work with them on thyroid treatment and know what tests to do. The doctor above doesn't pussyfoot around, and treats subclinical labs.

Most of us who now HAVE great and caring physicians went through a couple of GP's, and then a couple of other docs, and so on, until it took over three YEARS (in my case) for the replacement hormone to do anything for me. The longer you go without treatment, or being undertreated, the longer it will take for you to feel 'normal' again.

ETA: Just talked to three patients in the Sioux City area and they all say that the doctor you mention won't treat subclinical labs and only gives synthetic T4 (not surprising for that area).

Best of luck to you!

Pam

[olsufka2]

I just came across a list of symptoms with hypo. Not long ago my neuro.
ran some tests on me because I was complaining of increased weakness,
both thinking it was part of my ms and appears that I have polyneuorpathy (several areas of nerve entrapment) and in one of my arms I have carpell tunnel. My lipid panel came back high just a few weeks ago. From what I have just read these are all symptoms of Hoshimotos hypothyroid. As I said
before my FT4 came back low so I'm now wondering if all of these other
things my Dr. has found wrong with me could be from this. Oh my gosh,
I definately need to go get an antibody test done. Should I request a Free T3 or just a T3? I will definately request an antibody test be done.
Thanks!

[nonstickpam107]

If it were ME, I'd want a FT3 and FT4 and TSH and TPO antibody (and carpal tunnel is INDEED a thyroid symptom, but not JUST the Hashimoto's variety). My carpal tunnel (and my frozen shoulder) went completely AWAY about a year after I started treatment with my thyroid doc.

Oh, the reason I am suggesting FT's is because of your age group...at that age, progesterone drops, and then the thyroid tries to 'make up' for it...and can't, and fizzles out...but Free's will show actual usable hormone, not just what's circulating...your hormone 'changes' will prevent a total T3 from showing usable hormone.

Requesting a test is one thing, but having a doctor INTERPRET it and treat is quite another. I had doctors telling me a T3 Uptake WAS a measurement of T3...and that's not correct, so making sure you get to a doctor who KNOWS what they are doing is essential. I was tested all kind of times, but not ONE doctor knew to interpret it correctly, and one even told me: 'Women who don't work hard enough have Hashimoto's'...ACKKK!!! LOL (seriously, he did). If you get to the right doctor, you won't HAVE to 'request'. (hint: that panel from healthcheckusa.com ...is less than 120 dollars with the TPO antibodies, yet if your doc does it, you can pay as much as 400 dollars for it...and some insurance will NOT pay for a FT3 and FT4, and some labs won't DO them unless the TSH is over a 5 or so).

Pam

[MistyJ]

Originally Posted by nonstickpam107

If you've read this thread, you know what a low FREE T4 (and FT3) mean. It means your thyroid isn't making enough thyroid hormone, classic for hypothyroidism. And you need a FREE T4 and FREE T3, not a T4 and T3 (which would be 'totals' showing only what's in your body circulating, not what's usable). The most important test will be a TPO antibodies (showing autoimmune hypothyroidism).

My BEST friend lives in your area in Iowa..and neither of us (and many others) can recommend ANYONE in that state who's actually 'great'. Most do TSH only and the couple of naturopaths who DO give Armour, don't give enough to make any difference..and are also hooked on TSH!

I CAN, however, recommend the following Dr. in Omaha (and he comes HIGHLY HIGHLY recommended!!!):
Dr. Jeffrey Passer, Internal/Integrated Medicine, 4239 Farnan Street Ste 800, Omaha, Ne 68131 , 402 552-2900, Anti-Aging Medicine - Dr. Jeffrey Passer, MD, PC, Omaha, Nebraska

I think I speak about patient recommended doctors for thyroid..and I'm always AMAZED at the recommendations of patients when they say "OH, oooh...he LISTENED to me!!"...and then when I ask what treatment they got..they tell me: "oh, none, but he listened to me!'. I want patients to actually have doctors who work with them on thyroid treatment and know what tests to do. The doctor above doesn't pussyfoot around, and treats subclinical labs.

Most of us who now HAVE great and caring physicians went through a couple of GP's, and then a couple of other docs, and so on, until it took over three YEARS (in my case) for the replacement hormone to do anything for me. The longer you go without treatment, or being undertreated, the longer it will take for you to feel 'normal' again.

ETA: Just talked to three patients in the Sioux City area and they all say that the doctor you mention won't treat subclinical labs and only gives synthetic T4 (not surprising for that area).

Best of luck to you!

Pam

Are you ever right about drs in Iowa. I just moved back, went to a dr that was "recommended" and she cut my dose in half and handed me 3 wks of an anti-depressant. NO THANKS! I will be going to my 3rd dr Thursday. If she doesn't raise my dose back up, I will be asking Pam about drs.

Also when I asked the pharmacist about drs in my area treating with armour they laughed at me.

The 2nd dr I went to here said they are going to stop making armour.

Okay, end of rant about drs in Iowa.

[mrshelenmarie]

Hi Pam,
I'm in a tailspin since I found this "thread". In fact, I used to think the term "thread" only had to do with sewing. I've been feeling pretty tired and run-down for years, however, the other day I decided to donate blood and was rejected for low iron levels. That got me to thinking and "google-ing", which is how I found you and the wealth of information I have started to digest. Although the details of my memory are "fuzzy", I can give some background to help you understand where I am to date.

About 12 years ago, my then OBGYN told me I needed to seek pshchiatric help when I informed him I thought I was progesterone deficient and felt better after rubbing USP progesterone cream into my skin. Even though I had miscarried and needed a few D&C's, he didn't believe progesterone was the answer. I actually felt better and would know when I needed it. I moved on to an infertility doctor who confirmed it for me but his answer was "clomid", which would help help my ovaries to spit out eggs, thus getting my ovaries to produce progesterone again. This resulted in my one and only little girl. Of course, I knew nothing about testing or hormone levels then, so I can't give you any of those. I breast fed for awhile and actually felt good for a 40 year old fulltime working mother of a newborn, but as time went on I became exhausted, irritable and not so nice to those I loved. Even after becoming a stay at home mom, I was still tired.

Fast forward to January 2005, my mother was diagnosed with stage 4 lung cancer and died within 5 weeks time. The chaos that followed forced me to reach out for help. I had an independent full body scan done so that I could find out if there were any obvious signs of a major illness. My thyroid had a multi-nodual goiter and my ENT or ENDO weren't as concerned as me. I had swollen neck glands and had attributed them to the stress of losing my mother. The mere mention of her untimely death had the doctors doing whatever test my insurance company would approve; I was biopsied and had the radioactive uptake tests done, all of which were non-cancerous or normal. My doctor prescibed Synthroid just to appease me and didn't believe I needed it. I took it for two weeks and threw it out.

I found some test resuts, I'm not sure what to make out of them, especially since they don't have everything you usually like to see. They read as follows:

3/05 FT4 1.1 (0.8-1.8) TSH 2.91, Throid peroxidase antibodies <2
5/05 FT4 1.1 (0.8-1.8), TSH 1.57, FT3 276, Thyroid peroxidase antibodies <2,
normal iodine uptake 22.4%
9/05 TSH 1.52, Estradiol 198, Testosterone 42, DHEA 210

As time went on, I felt as though I was starting to lose my mind, I described my foggyness as "a detachment of my head and body". I was cold, moody, gained weight faster than ever before and was so depressed that I couldn't save or even help my mother. I started to see a therapist who wanted to put me on drugs, but I wouldn't take them because I felt it meant admitting it was mental and not physical. I went on something natural called "Deprex" and had some relief of my symptoms; I took them for about 1 year.

Finding your postings and the data I've been absorbing makes me feel as if I have found "the problem". I actually have hope that I can become the person I used to be. I bought the book, "The Thyroid Solution" and have been reading it. It's incredible and I'm so motivated to finish it, and that's BIG because I've probably only read five books in the past 10 years. I always thought, why bother reading them if I can't remember what I've read, however, this time I am highlighting everything I believe is relevant. My minds inability to remember has been quite debilitating to me.

Here's my game plan and that's actually where I need you. I thought I would have the FT3, FT4, TSH and Thyroid antibodies blood tests done via the site you have previously mentioned. (I have a huge insurance deductible, so I'm probably going to have to pay for everything anyway) However, you have suggested that progesterone plays an important part in this scenario. Do you think I should get a hormone panel or some other test to go with it? What about the iron levels, do they sound like part of this equation??? I live in South Florida and I have read that you know "THE" doctor to see in Boca, could you please give me his name. Pam, I need help and believe that I am on the right path this time!!!!!

[nonstickpam107]

Wow. Your post has a familiar ring to it. Here's the doc in Boca (I've never 'met' him except years ago online at the about site...I've since probably sent 50 patients his way...and it's a pleasure to see the great 'I feel like me again' stories and email I get...tickles me, if you go, let him know this!...oh..hint hint: he knows me as 'pyroteknicpam' most likely..the gal that perchlorate almost killed with pretty colors).

Kenneth N. Woliner, MD, ABFP, Holistic Family Practice, 2499 Glades Road, #106A, Boca Raton, FL 33431. 561-620-7779.

He knows his biodentical hormones, he does Armour Thyroid (he does nutrition...um...not the way I do mine...feel free to tell him if you don't like his 'methods'...he's pretty cool and not bigheaded), and tests.

IF you want the tests for less at Online Lab Tests: blood work, blood testing and laboratory tests (give 12345 as a 'coupon code' discount) you would want the: Thyroid panel II and TPO antibodies, and the female ones: progesterone, estradiol, estriol, free testosterone (free on females, not total), and that would probably give a nice rounded 'hint' as to what's up with you. And if you liked the OTC progest. cream, you'll LOVE compounded!!

Let me know how it all works out (and call healthcheck and ask when in cycle, if you even have one, you get that sex hormone panel).

Pam

[Beth1121]

Hi, all! Jut thought I'd pop in and say that Mercola had a pretty good thyroid article in his newsletter today. I'll have to post it later.

My regular thyroid doc that I drive 2 hours each way to see is leaving his managed care practice and is opening a "direct care" practice, which means that he will no longer accept insurance. Along with that he is opening a non-profit thyroid research clinic. For $1000 a year (plus a $200 first time consult fee if you are a new patient), he will do all of your labs, heart holter, bone density testing, etc...in other words, all of your thyroid care. He plans to publish. Although insurance co-pays are cheaper than this, I have decided to stay with this doctor because he is so good.

Pam - I can PM you more detailed info if you want it for your "database" of doctor info.

While waiting to find out what it would cost to stay with this doctor, I started searching to see if there was a local doctor that I could go to if this one fell through. I asked two different pharmacists about docs in the area that prescribe Armour. I was told by both of them that since I was already on Armour, that ANY new doctor would keep me on it if I switched! WTH? I don't think so! I gave up at that point....especially since I had decided to stick with my original doc!

[nonstickpam107]

Don't believe that from the pharms! LOL...OR at best the 'new doc' would freak at the low TSH Armour provides and chop your dose! I agree best to stick with your doc. YES, please do PM me the new 'changes' and particulars. TIA. You're already gettin' optimized, so you could just stick with the doc and see him once/twice a year (that's what I do..just use my top thyroid doc for thyroid/hormones and go with someone else as my PCP).

Pam

[mrshelenmarie]

Pam, thanks for the quick response and referral. However, I about fell off my chair after talking to Dr. W's office. It's about $650 for the first consultation, including EKG and Body Fat Analysis. They don't accept anyone elses blood test results (effective Jan 08) and those are anywhere from $500-$1500 more. And, that's just to start!! Since they don't take insurance, the money won't even be applied towards my deductible. Is this the norm??? Helen

[nonstickpam107]

Um, no not the 'norm' (as my first consult with doc was well over 1200 dollars). I suggest you use the ArmourThyroid website and put in zip codes up to an hour and a half driving time away (it uses zipcodes). Hmm, his rates have gone up, but you ARE in Florida (so very difficult to get good treatment in that state...so many elderly and retired that many geriatric docs have settled there).

Does anyone want to recommend their Florida doc (one who does bioidentical hormones and Armour Thyroid and the correct tests??). Hmm, wait a minute...let me contact someone....

Pam

[nonstickpam107]

Here is a list of some other docs in Florida who do both natural thyroid and bioidentical HRT: (these are patient recommended, so what one did for one patient, may not be what you are looking for, but check these against your insurance plan, etc.)

Dr. Erika Bradshaw, Holistic Doctor, Mainstream Meds, 1209 Lakeside Drive, Brandon, FL 33510 813.661.3662

Nancy De Jesus, MD, Holistic Family Medicine, Bioidentical Hormones and more, 900 E. Atlantic Ave. Suite # 9, FL, 33483, Tel. 561-279-2722

Allan L. Fedosky, M.D., Family Medicine, Anti-Aging Medicine, 4554 Highway 20 East, Niceville, Florida 32578 850-897-1824/850-897-1827 ===== I don't know how far this is from you, but this one 'gets my vote'..PAM..

Robert A. Oesterle, Endocrinology, 300 Health Park Boulevard, Suite #3008, St. Augustine, FL 32086, 904-810-2425

Joya L. Schoen, M.D., 1850 Lee Road, Winter Park FL 32789, Phone: 407-644-2729,

HTH
Pam

[holladay]

Hi, I am confused on which step I should take next.

I am 32 and have been experiencing symptoms of hyperthyroid. My heart rate has been up to 160, I am weak, shaky at times, exhausted, eyes twitching, irritable. I saw my PCP and he ran TSH test and my level is .031. So I scheduled an appt with an Endo. I went to see him today and after waiting for 2 hours and not having a very good feeling about the office I decided to leave and try another route.

I am going to try and find a new endo tomorrow morning, but because that will probably take awhile, i think i'll ask my PCP to run the full thyroid tests that you have been recommending: TSH, FT4, T3, FT3, T4, TPO antibodies, and estradiol. I suspect that I may have Hashi. This way by the time I can get into the Endo I should have these results.

Is there anything else that you think I should do to get this handled as quickly as possible. I have two small boys and need to be able to take care of them.

Also, I had a really sore neck several times in the past year, and had thyroid tests run, and all came back "normal", but of course I did not question this at the time.

Thanks for any help you can give me,

Heather