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Old 03-14-2013, 07:09 AM   #1
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(Very long first post!) Opinions on my lab results?

Hello!

I used to be a frequent poster over on the Nutritional Ketosis board here on LCF, but I recently downgraded to "lurk mode" because I felt like my posts were getting too negative and discouraging. I started following the NK WOE on November 3 last year and have had very little success although I'm not ready to give it up just yet. I am going to put a lot of background and detail in this post in the effort to not leave out any possible factors...sorry in advance for the length!!

I'm 32, 5' 3", with a starting weight of about 147, and my current weight is 141. A DEXA scan a couple of weeks after I started NK last November showed that I was at 37.1% body fat (not good). For most of my adult life I weighed in the 120's, but was never satisfied - always wanting to lose 5-10 pounds. I was always vaguely dieting in some way or other, although I never committed to any kind of strict plan until recently. Also, I've been an exercise fanatic for the past 10-11 years.

The two major health issues I've had in my life (so far) are severe psoriasis and very premature menopause. I have had great success in treating the psoriasis by participating in a clinical trial for a new drug. I started taking the drug, which is a new variety of immune suppressant that can be taken orally rather than injected, in July 2011. I never had any detectable adverse effects that I would attribute to the drug, but it's certainly possible that it could play a part in the events that followed.

With my busy work schedule I barely noticed that I had gained 20ish pounds somewhere along the way. I know it was at some point between July 2011 and August 2012 because I have a record of my weight thanks to the clinical trial. I finally considered the idea that I might be experiencing some menopause symptoms after several months of no menstrual period. So I visited a gynecologist and was officially diagnosed as "post-menopausal" in August 2012 (very high FSH). Looking back, I think I was having more pronounced symptoms than I realized at the time, simply because of my high stress job. I blamed everything negative that I felt on the job rather than something health-related. It was hot flashes that finally made me wake up! One more thing to mention: Along with FSH, I also had TSH and prolactin tested. My TSH was "normal" but my prolactin was elevated, out of the lab's reference range, but the doctor said it was nothing to worry about. She prescribed a low dose birth control pill to help with the menopause symptoms.

I might have thought that the BC pill would be magic and I'd start losing weight without changing anything, since it was supposed to be fixing my hormonal irregularities (ha ha). Once I realized that was not the case, somewhere I ran across the idea of the NK diet (very low carb, adequate protein, high fat) and decided to try it. That was at the end of October 2012, and after researching the science behind the diet as much as time would allow, I officially started on November 3, 2012. I happily lost about 5 pounds within the first 10 days or so, which I know was water weight, and then I totally stalled. I tried decreasing carbs and protein even more and even started trying to limit fat just to get my calories down. No luck...the scale went up and down slightly, sometimes as high as it was when I started.

I had another regular checkup for the psoriasis drug clinical trial in January 2013 and discovered that my LDL cholesterol had skyrocketed. Everything about my blood work had always been great, especially my HDL cholesterol and triglycerides. Those numbers were still great, but now my LDL had went through the roof, bringing my total cholesterol to 302. This, along with the lack of weight loss and some other symptoms that I had gradually started to notice, made me take a closer look at my diet. This is when I first read about the link between very low carb diets, hypothyroidism, and elevated cholesterol. I won't take the time to list all the symptoms, but the list was long enough to make me 99% sure that something was wrong thyroid-wise. So, in February, I went back to the gynecologist to request more thorough thyroid testing but had a pretty bad experience at this visit (which will be my last). Even before agreeing to do the blood tests, she was convinced my thyroid was fine and that my inability to lose weight was because I was eating more than 1,000 calories a day (my average was about 1,500, net carbs 25g max, protein 85g max). I decided not to spend much time talking to her about my symptoms...just get the blood work done, and get out of there. And I was very disappointed to find out, upon receiving the test results, that neither total T3 or free T3 had been tested. Guess I should have asked what she considered a "full thyroid panel." I'll pause the narrative here to show these test results and lab ranges.

FSH: 43.2 (post menopausal range: 34-153 mIU/mL)
Prolactin: 48 (3-23 ng/mL)

Total T4: 8 (4.5-12 ug/dL)
Free T4: 1.17 (0.71-1.85 ng/dL)
TSH: 1.536 (0.35-5.5 uIU/mL)
T3 Uptake: 27.3 (23-36%)

Vitamin D: 44 (32-100 ng/mL)
Cortisol: 12 (PM range: 3-17 ug/dL)

I should add that my FSH had gone down some from my previous visit, but my prolactin had gone up since then, now even further out of range. The results were mailed to me with a handwritten note from the doctor stating that the prolactin was not significant unless it was over 100. No other comments, and I did not go back to see her again.

Luckily, my aunt recommended a wonderful endocrinologist. I was able to get an appointment with him last Friday, March 8. It was such a relief to talk to him and find out that he believed there could very well be something going wrong, either with my thyroid or pituitary, and although my diet could be playing a part in it...the early menopause might be a bigger factor. He was especially concerned about the prolactin and suggested an MRI scan of my pituitary might be prudent. We talked for over an hour, and I was thrilled to hear that he "believes" in testing free T3 and even prescribing T3 if that's what might help. He ordered a ton of blood tests, some things I had never even heard of. I received the results yesterday, but my next appointment with him is not until Tuesday, March 26, so of course I am doing tons of Google searches, scaring myself half to death, and now coming here for some feedback from you guys.

(I will leave out the comprehensive metabolic panel results because I don't think there was anything significant there!)

Free T4: 0.79 (0.59-1.17 ng/mL)
Free T3: 2.2 (2.0-4.4 pg/mL)
TSH: 1.23 (0.34-4.82 mIU/L)
"Anti Thyroid Microsomal AB": 18 (0-34 IU/mL)

Adrenocorticotropic Hormone (ACTH): 8.1 (7.2-63.3 pg/mL)
Insulin-Like Growth Factor-1 (IGF-1): 129 (73-244 ng/mL)
Cortisol: 28 (AM range: 6.2-19.4 ug/dL)

Prolactin: 191.3 (4.8-23.3 ng/mL) (yes, 191.3 - that is not a typo)
FSH: 28.4 (post-menopausal range: 25.8-134.8 mIU/mL)
LH: 15.6 (post-menopausal range: 7.7-58.5 mIU/mL)

So, I am most concerned about prolactin, but it seems to me that the free T3 and T4 levels are low, although not "out of range." Cortisol is somewhat high, too. I'm shocked that the FSH has gone down that much, since it's at the bottom of the post-menopausal range now. I don't know what to think about ACTH and IGF-1...not familiar with those. One other thing to note... my TSH has gradually gone down since that first test last August at the gynecologist. It was 1.8ish at that time, then 1.5ish in February of this year, and now 1.23. Conventional wisdom would say my thyroid just keeps getting better and better, right? Ha ha.

If you've made it this far, thank you so much, you deserve a medal!!! I would love to hear any of your thoughts about these lab results.
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Old 03-14-2013, 07:33 AM   #2
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I don't have comments on your lab results (leave that to a physician) so much as your entire post.

First of all, this experimental drug you're taking for psoriasis--aren't those administering this trial concerned about your pre-mature menopause and other problems that are all hormone related? It ALL may be a negative effect of this drug. Personally, my major concern would be pre-mature menopause because that will involve a lot of bodily systems (I'm post-menopausal, so I've experienced them.)

Second, your Vit D3 level, while 'in range' is low. My sister had intractable, severe psoriasis that didn't respond to any treatment at all. She was convinced that her high-stress job was the cause, and doctors told her that was not only possible but that her psoriasis would persist with that level of stress. Her primary physician, noting her relatively low D3, presecribed a D3 supplement, and when her level rose to the 70s, her psoriasis disappeared. Low D3 symptoms are also very similar to those of low thyroid.
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Old 03-14-2013, 02:22 PM   #3
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prolactin can also bind thyroid hormones. Usually with protlactin that hi its affecting something else.

if all else is addressed and ok. I'd address why you feel crappy. Those thyoid levels arent optimal.
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Old 03-14-2013, 05:47 PM   #4
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Originally Posted by Leo41 View Post
I don't have comments on your lab results (leave that to a physician) so much as your entire post.

First of all, this experimental drug you're taking for psoriasis--aren't those administering this trial concerned about your pre-mature menopause and other problems that are all hormone related? It ALL may be a negative effect of this drug. Personally, my major concern would be pre-mature menopause because that will involve a lot of bodily systems (I'm post-menopausal, so I've experienced them.)

Second, your Vit D3 level, while 'in range' is low. My sister had intractable, severe psoriasis that didn't respond to any treatment at all. She was convinced that her high-stress job was the cause, and doctors told her that was not only possible but that her psoriasis would persist with that level of stress. Her primary physician, noting her relatively low D3, presecribed a D3 supplement, and when her level rose to the 70s, her psoriasis disappeared. Low D3 symptoms are also very similar to those of low thyroid.
Thanks for the reply! I don't know how concerned the clinical trial administrators are about my particular situation, but they do want to be informed about every health related event that happens to all participants. I've told them all about this (except the most recent blood work results; I'll do it soon), and the only thing they've paid attention to is the elevated LDL. They've already done so much testing on this particular drug for other auto-immune conditions (it has already been FDA approved for rheumatoid arthritis), they believe they know pretty much all the side effects to expect. As far as I know, there are two main side effects: an increased risk of infection (since it's an immune suppressant), and elevated cholesterol. Maybe there was also some risk of liver damage, too, but I'm not sure. They do a fairly comprehensive set of blood tests every time I go for a checkup, but interestingly enough, there have never been any hormone tests at all. And until the most recent check up, my blood work has been stellar in all respects. I have been taking this drug since July 2011 and didn't notice anything about my health deteriorating until about a year later. I suppose a bunch of negative stuff could have happened because of the drug, but I would have thought that it wouldn't abruptly happen a year into the study.

Also, I did tell my new endocrinologist about the clinical trial and explained the drug to him (I brought all my paperwork and blood work history). He didn't seem to think that an immune suppressant would be likely to cause these kinds of effects. But it would be foolish for me or the doctor to rule out the possibility!!

That's interesting about the vitamin D and your sister's situation...It's great that she was able to find a successful treatment that is so straightforward and simple (rather than some obscure, expensive medication). If I don't forget to bring it up at my next endo appointment, I'd like to ask him what he thinks about my vitamin D level. It probably wouldn't hurt to supplement some more on top of whatever's in my multi-vitamin.

Thanks again for taking the time to give me some feedback!
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Old 03-14-2013, 06:01 PM   #5
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prolactin can also bind thyroid hormones. Usually with protlactin that hi its affecting something else.

if all else is addressed and ok. I'd address why you feel crappy. Those thyoid levels arent optimal.
Thanks, that's very interesting! I'd like to spend some more time researching the relationship between the thyroid and prolactin... so far, I've not found a good "explain it to me like I'm five" article.

It's nice to hear someone else say that my thyroid levels are not optimal...it's funny how much of a relief it is to be able to point to a test result and say "see, I knew something was wrong!!" And now we can get on with figuring out some kind of treatment.

This whole thyroid investigation started because I was concerned that my diet had something to do with my recently elevated LDL, and then I discovered the writings of Chris Kresser, Paul Jaminet, and others. They believe that, if a low carb diet was the cause of the thyroid dysfunction, then upping carbs is the solution. I'm willing to consider that, but at the same time, I know that menopause started for me many months before starting the strict low carb diet. That's the mystery....figuring out where it all started.
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Old 03-15-2013, 04:12 AM   #6
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Next step for me would be to have a scan to see if there was a pituitary hormone (and more tests..there are a long list for that). The 'early meno' was something I also faced at 31 yrs. old, along with my thyroid hormones 'tanking'.

Google pituitary tumor testing.
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Old 03-15-2013, 08:43 AM   #7
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Next step for me would be to have a scan to see if there was a pituitary hormone (and more tests..there are a long list for that). The 'early meno' was something I also faced at 31 yrs. old, along with my thyroid hormones 'tanking'.

Google pituitary tumor testing.
What a coincidence! I'm sorry to hear that you had to deal with the same problems.

I've been reading about pituitary tumors, including prolactinomas, and it certainly sounds possible. My endo had said at the last appointment that he'd like to do an MRI scan of my pituitary, and that was when my prolactin was only a little out of range high. I wonder what he will say about the latest reading!

The bright side seems to be that pituitary tumors can be treated with medicine alone, most of the time (surgery is kind of rare). Is that what happened to you? I couldn't tell from your post whether or not you meant a pituitary tumor was the source of your troubles.
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Old 03-17-2013, 03:47 AM   #8
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Surgery isn't 'rare' and there are 'pit tumor surgery centers' all over the USA...it's kind of the same 'rare' that hashimoto's is when you talk to a doctor who's never seen many I suppose Easy, out patient surgery too...

I have 11 members in my family (sister, cousins, etc.) that have had pit tumors...and even more that have hashimoto's (all female, naturally). Have you NOT had a TPO AB test? Goodness...I wouldn't go forward with anything without FT3 (and 'normal' FT4 is generally considered to be around midway of lab range, or slightly under, and FT3 is above midway and for some, all the way to 3/4 and higher).

That T7 and such hasn't been done since the dark ages. Lots of beating around the bush with you on testing there...you can get TPO AB (thyroid peroxidase antibodies) and Free T3 yourself at an online lab...they just send you to a lab near you after you pay. I wouldn't do much of anything until then.

Tertiery hypothyroidism (which is a problem with the pituitary..from tumor to just injury) is treated the same way any other hypothyroidism is treated (unless the tumor grows large, then it is extracted through the nasal passage)...but first you look at FT4 (which you have...but then...you look at FT3 to see if you are converting the T4 into the usable energy hormone T3). Totals only show (TT4, or T4, and TT3 or T3) what's circulating..Free's show what you are actually able to use.

Start at the beginning with the correct testing...and then go forward. Best of luck to you.
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Old 03-17-2013, 05:19 AM   #9
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Surgery isn't 'rare' and there are 'pit tumor surgery centers' all over the USA...it's kind of the same 'rare' that hashimoto's is when you talk to a doctor who's never seen many I suppose Easy, out patient surgery too...

I have 11 members in my family (sister, cousins, etc.) that have had pit tumors...and even more that have hashimoto's (all female, naturally). Have you NOT had a TPO AB test? Goodness...I wouldn't go forward with anything without FT3 (and 'normal' FT4 is generally considered to be around midway of lab range, or slightly under, and FT3 is above midway and for some, all the way to 3/4 and higher).

That T7 and such hasn't been done since the dark ages. Lots of beating around the bush with you on testing there...you can get TPO AB (thyroid peroxidase antibodies) and Free T3 yourself at an online lab...they just send you to a lab near you after you pay. I wouldn't do much of anything until then.

Tertiery hypothyroidism (which is a problem with the pituitary..from tumor to just injury) is treated the same way any other hypothyroidism is treated (unless the tumor grows large, then it is extracted through the nasal passage)...but first you look at FT4 (which you have...but then...you look at FT3 to see if you are converting the T4 into the usable energy hormone T3). Totals only show (TT4, or T4, and TT3 or T3) what's circulating..Free's show what you are actually able to use.

Start at the beginning with the correct testing...and then go forward. Best of luck to you.
Thanks! All my info is coming from online medical websites, which is where I got the idea that surgery being required to remove pituitary tumors is not very common. Oddly enough, I think one of my uncle's brothers had to have a pituitary tumor removed, but I've never heard of anyone else in my family even having one (so far, that's 100% of the people I know with pituitary tumors...ha ha).

About the testing, I did have FT3 in the round of tests my endo ordered. He didn't order any totals. And, I don't think I've heard of FT7. Sorry if my novel-length post was overwhelming with too much info!

I'll paste only my most recent lab results again below...free T3 was the second one listed (which seems low to me). I'm not sure about "Anti Thyroid Microsomal AB." Is that the same thing as TPO AB? The endo did say he was going to test "antibodies" so I assumed the test he ordered was "the" thyroid antibodies test. But of course, there could be more than one!

Free T4: 0.79 (0.59-1.17 ng/mL)
Free T3: 2.2 (2.0-4.4 pg/mL)
TSH: 1.23 (0.34-4.82 mIU/L)
"Anti Thyroid Microsomal AB": 18 (0-34 IU/mL)

Adrenocorticotropic Hormone (ACTH): 8.1 (7.2-63.3 pg/mL)
Insulin-Like Growth Factor-1 (IGF-1): 129 (73-244 ng/mL)
Cortisol: 28 (AM range: 6.2-19.4 ug/dL)

Prolactin: 191.3 (4.8-23.3 ng/mL)
FSH: 28.4 (post-menopausal range: 25.8-134.8 mIU/mL)
LH: 15.6 (post-menopausal range: 7.7-58.5 mIU/mL)

Thanks again for the info. I would appreciate your thoughts on those two lab results that were bolded above, especially the Free T3.
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Old 03-17-2013, 10:52 AM   #10
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As you can see (and thank you for reposting the Ft's) your FT4 is just inside the bottom range ...certainly not 'optimal' at all, and your FT3 is ALSO just inside bottom range..meaning...that the doctor only 'sees' the TSH (BTW, women with hashimoto's start with low TSH yet are making hardly any FT4 or FT3..just like your labs)...and figures you're 'fine'. I was so awfully sick when I was diagnosed..my TSH was lower than yours (and still IS...it was barely in the bottom range) yet I had hardly NO FT4, FT3.

My TPO AB (and that is a different type of antibody than what they did for you...yours just shows a predominance towards an invading antibody, while the test you need (thyroid PEROXIDASE antibody) shows Hashimoto's hypothyroidism an autoimmune disease.

Women who've gone 'untreated' with hashimoto's will show low AB also though, because their thyroids have been 'attacked' so much that they aren't working and making much of any thyroid hormones.

Your prolactin is very high, denoting a pituitary involved type of hypothyroidism.

Bottom line? Many of your symptoms might alleviate if and when you find a doctor who knows enough to give both T4 and T3 thyroid hormone.

Oh, and cortisol should be ideally measured as a salivary test, taken at four distinct times of day and then sent to lab. Many of us have cortisol in a normal range in the am and then it doesn't follow the 'ebb and flow' during day/into night.

Doing an FSH to denote 'menopausal' is as untelling as just looking at a TSH for thyroid. In other words...make sure once you are starting to be sufficiently treated for hypothyroidism (no matter what type) that the doctor does estradiol, progesterone and free testostosterone..not FSH...that's a really cheap test, like the TSH is...you are going to need a doctor well versed in thyroid, pituitary and other hormones. It 'might' be an endocrinologist..OR..may even be an MD or a DO...or even naturopathic...the site that is recommended at stop the thyroid madness has lists of good doctors all over...most of us travel up to two hours one way or more for a good thyroid doctor...I know I had to when first starting my treatment (now, all these years later...my own GP just writes my Rx for Armour thyroid..I'm well stabilized now).
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Old 03-18-2013, 05:52 PM   #11
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I second the low Vit D! That's way to low with all that's going on...I have to take 10,000u a day in winter to keep mine in the 70's.
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Old 03-20-2013, 06:15 AM   #12
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Thanks for the latest responses... my work has been super busy the past few days, not much time to post. Unfortunately, I don't have a lot to add yet, since my follow up endo appointment isn't until next Tuesday.

At that first appointment with him back on March 8 (prior to getting these latest blood test results), he made an impression on me that he would be one of the "good guys" - not someone who only pays attention to TSH, etc. But, as for my ex-gynecologist... I fired her - ha ha! But my endo was the one that suggested an MRI of my pituitary, even when the older blood work he was reviewing showed that my prolactin was just slightly out of range high. I think he saw even then that my medical history (which he called "....interesting!") pointed to a pituitary issue. He also said that, if it turned out that my problem was low T3, he'd certainly prescribe T3 or a combo of T4/T3 (meaning, he's not a Synthroid slave). He answered so many of my questions "right" that I already started celebrating in his office...before I knew what any of my blood test results were going to be. I went in there with the mindset of putting him to the test with all these questions I had picked up from various hypothyroid websites and books, and unless I overlooked something, he passed with flying colors. I guess the only complaint I would have is that when I suggested the salivary cortisol test... he wavered a little, saying something about it being "controversial" whether that was better than the blood test. I can always ask again next Tuesday, or even order the test myself.

We also discussed how my low carb diet could be the culprit for low T3. So I'm sure we'll discuss the option of tweaking my diet for a while to see how it affects T3 rather than going straight to a prescription. As always, I am curious about how strong of an influence other factors (like diet) have on the blood test results. Meaning...would a low carb diet alone cause my T3 to be at the bottom of the range, or is it a combination of that plus something else? Also, I was wondering about how much anti-depressants could be responsible for the elevated prolactin. My endo said that the small amount of sertraline (Zoloft) I take each day should never have elevated my prolactin; plus, I take bupropion (Wellbutrin) and that should have offset any potential effect of the sertraline. I also found a scale online that finally clarified for me that the "effect of drugs" would only have elevated prolactin a bit.... when it's over 150, the chances of a prolactinoma are very great. I believe I read that 200 or more indicates a nearly 100% chance of a prolactinoma, and mine was 191.3. Anyway, I'd also love to better understand the relationship between having a prolactinoma and hypothyroidism.

Emmaline, I'll add Vitamin D to my list of questions for next week's appointment. I guess it's the scientist part of my brain that doesn't want to start tweaking any variables until I get some kind of diagnosis.... or else I'd be buying some supplemental Vitamin D right now. This is also the reason why I'm sticking to the nutritional ketosis diet at the moment, even though I've been feeling so lousy for so long. Apparently, I'd rather be a dispassionate observer, treating myself like an experimental subject in a clinical trial, than try to feel better as soon as humanly possible. Ha ha ha.
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Old 03-20-2013, 09:51 AM   #13
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All of the studies on lowcarb diets 'causing' T4 to T3 binding are that it can affect up to .2 (yes, POINT 2). Um...no...a lowcarb diet doesn't affect like that...oh my..jeez...but if you are eating under 1000 cals a day, and exercising a lot...in other words..if you aren't eating enough, that can affect up to a whole point on the lab range.

So...that was using ONLY Total T's. That's WHY we do Free T4 and Free T3...it shows what's 'usable' to the body.

Yeah...research is part of my occupation...so I'm kind of a 'medical geek/nerd' about stuff too..love the research...and we patients are lucky...we have WAY more time than our doctors to research (but...um...leaving them saying stuff like 'just eat less food' to lose weight and 'oh, I read lowcarb (or Dr. Oz says) inhibits T3 production'.

If it is a small pit tumor..there are tons of peeps who don't EVER get them removed...they just find really good, savvy doctors to give them T4 and T3...without going by the TSH results, rather they use FT's.

Bottom line? If your thyroid feeds back info to a pit that's been harmed by virus (yes, that's VERY common..more common that a tumor) and the pit says 'Um...what? duh...' than the thyroid channels that response into a lower TSH (which erroneously tells a TSH worshipping doctor that 'all is well, go home now')...than the next tests are FT's..if the FT's are FT4 just barely within bottom parameter and FT3 same...than that tells the doctor you aren't making any....so you need some particularly if you don't feel well, and have allllllll the symptoms of hypothyroidism.

That's the 'Thyroid Cliff Notes' version anyway.
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Old 03-25-2013, 06:46 PM   #14
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Just checking in to give a quick (ish) update. I saw my endocrinologist this morning - kind of a short appointment compared to my last one, but he probably had a lot less to say. Basically, he thought that everything in my lab results except my prolactin was okay. I didn't get the chance to ask every question I might have wanted to, because he seemed a little rushed. I did specifically ask whether he thought my free T3 and free T4 were "optimal," and although he never answered this directly, he certainly didn't think the numbers indicated a problem. The prolactin was really the only thing he wanted to talk about, because he said the other results ruled out other possible pituitary issues.

He went ahead and prescribed bromocriptin, which is the "prolactinoma shrinking drug" but I am not supposed to get it filled until after my MRI pituitary scan (luckily, first thing tomorrow morning). So the MRI should let us know whether or not there's a tumor for real, and how large it is. I hope I find out the results right away, but regardless, I am supposed to start taking the medicine after the MRI. And then, I will have more blood tests done seven weeks later, followed by another endo appointment one week after that. I assume he will want to see if the prolactin levels have already started to decrease after seven weeks of taking of bromocriptine.

I am not sure how to feel at the moment, because I was pretty sure that the thyroid numbers would have been worth looking at more closely...not to mention the elevated cortisol. I have not found any info online that clearly indicates that a prolactinoma can cause all the hypothyroid symptoms I'm having, so I am afraid to put too much hope in the idea that taking this drug will alleviate them. I have seen hypothyroidism mentioned as being associated with somewhat elevated prolactin levels, but the context indicates that hypothyroidism is somehow the cause of elevated prolactin rather than a tumor....and apparently TSH would also be elevated in those cases (mine is not - if anything, it's low). But, as is usually the case lately with my fuzzy thinking, I could have read and/or understood that wrong.

I will check in here again after I find out something definite from the MRI and/or if I start feeling some effects from the medicine, whichever comes first.
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Old 03-26-2013, 03:43 AM   #15
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That's about 'standard care' for most non thyroid specialist endocrinologist. Very old school, we're all made from the same cookie cutter.

Carry on in your research...make sure you go to thyroid website like the stop the madness site and about and read about others with same conditions and labs.
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Old 03-26-2013, 04:27 PM   #16
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Yeah, I was afraid my endo would disappoint me at some point...he almost seemed too good to be true at my first appointment!

The MRI was done this morning, and they gave me a CD of all the images afterward, but I have to wait for someone to interpret them and give a report before I really know anything. I have analyzed the images until I'm sick of looking at them (haha) but I can't tell if anything is off or not. I've seen tons of examples of normal and abnormal pituitary MRIs online but I just can't tell. Guess I don't have a hidden talent for amateur radiology. I will just wait until I hear something from my doctor....would be awesome if that could be tomorrow, but I'm not getting my hopes up.

I have taken my first bromocriptine dose with dinner and haven't felt any weird side effects yet. I feel tired/sleepy, but then again, I almost always do!

Thanks for reminding me about the stop the thyroid madness website - I've been there before but not lately, and there is probably some good info I've missed.

Good night!
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Old 03-28-2013, 02:24 PM   #17
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I just heard the results of my MRI and have read the report from the radiologist. Everything is "normal" and "unremarkable." I guess I should be relieved, but now I'm just confused.

The instructions from my endo are to keep taking the bromocriptine and get my blood tested again a week before my next appointment two months from now. If the bromocriptine works, it should lower my prolactin. Whether that means my symptoms will improve, I have no idea. I have yet to see any information that directly correlates hyperprolactinemia with all these hypothyroid symptoms - just the acknowledgement that high prolactin sometimes happens in people with hypothyroidism. But apparently I don't have hypothyroidism according to my endo.

So I have no satisfactory reason for my high prolactin levels and no concrete diagnosis of anything, but I do have a prescription for bromocriptine. Sure, it will be great if that gets my prolactin levels down, but what do I care about that if it doesn't resolve the symptoms. We'll see... I've only taken it for two days. At least I haven't had any side effects yet. I continue to be sleepy almost all the time, but I can't tell if that is worse than it usually is.

How weird is it to feel disappointed that I don't have a tumor?!? Maybe not disappointed... I guess just frustrated at the vagueness of whatever is going on.
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Old 03-28-2013, 02:27 PM   #18
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you need to find another dr as those labs in the original post are low and if you feel hypo might want another opinion.

check with compounding pharmacies in your area and where you are willing to drive. Tn is hard.
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