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Mistizoom 06-02-2013 07:42 AM

TSH test results
 
So I asked my gyn at my annual visit to check my thyroid, as I have developed Raynaud's syndrome (fingers go numb and white when exposed to cold) and one possibility is that it is a sign of hypothyroidism. My gyn said all my test results were normal, except for low vitamin D (I also had cholesterol and fasting glucose and insulin tested).

The thyroid test I had was:
THYROID STIMULATING HORMONE (TSH), WITH REFLEX FREE T-4
Range: 0.27-4.20 uIU/mL
Results: 4.15

On 6/3/11 the same test was 3.69.

Does this test mean anything? It seems regardless I am on the very high end of normal. I am going to see an internal med doc about the Raynaud's on Tuesday June 4 - are there other tests I should ask her to run? Is there any other info that can be gleaned from the test that they did run that they aren't telling me? From the name it sounds like they tested both TSH and T-4 but I only see one number so it is confusing. Thanks for any help!

Lokarbiebarbie 06-02-2013 11:54 AM

Yes. It means you need a doctor who may be a little better at taking care of thyroid. If you would like to start a new thread with 'Looking for thyroid doctor in/near _____" and put the nearest major city (most aren't found in our backyards...expect about an hour to two hour one way drive...but once you get taken care of it's only couple times a year).

any doctor who ONLY does a TSH test isn't up on thyroid care in this century :). You deserve a Free T4 and Free T3 test and perhaps a TPO antibody test. Most of us with hashimoto's autoimmune hypothyroidism have 'other' autoimmune problems too.

Mistizoom 06-02-2013 01:55 PM

Quote:

Originally Posted by Lokarbiebarbie (Post 16451580)
Yes. It means you need a doctor who may be a little better at taking care of thyroid. If you would like to start a new thread with 'Looking for thyroid doctor in/near _____" and put the nearest major city (most aren't found in our backyards...expect about an hour to two hour one way drive...but once you get taken care of it's only couple times a year).

any doctor who ONLY does a TSH test isn't up on thyroid care in this century :). You deserve a Free T4 and Free T3 test and perhaps a TPO antibody test. Most of us with hashimoto's autoimmune hypothyroidism have 'other' autoimmune problems too.

I can see my husband's internal med doctor if I am hypothyroid. She knows what she is doing and is working with him on getting to the right level of Amour. But I am seeing a different doc in the same practice on Tuesday, so I need to know what tests to ask for before that. I'll ask for the others you suggested, thanks.

Lokarbiebarbie 06-03-2013 03:08 AM

How wonderful to have a doctor near who does Armour! So happy for you..and yes...with THAT HIGH of a TSH (most women feel best UNDER a 1...and good docs don't use TSH to see if you have hashimoto's (TPO AB) and FT4, FT3 to see the levels of actual hormones. Most other docs..just do a TSH and call 'normal' anywhere in range.

Psmileyf 06-03-2013 05:02 PM

I agree...that is high. "Normal" but not optimal.

My TSH, FT4 and FT3 are all "normal" but none of them are in the optimal range.

I have met with a few doctors and they all seem to want to rule out other causes before they treat the thyroid, so you may go through a whole battery of test.
Do you have any other symptoms?

Mistizoom 06-03-2013 07:28 PM

Quote:

Originally Posted by Psmileyf (Post 16453634)
I agree...that is high. "Normal" but not optimal.

My TSH, FT4 and FT3 are all "normal" but none of them are in the optimal range.

I have met with a few doctors and they all seem to want to rule out other causes before they treat the thyroid, so you may go through a whole battery of test.
Do you have any other symptoms?

Thanks, I have PCOS which I just found out means I have a 4 times higher chance of having Hashimoto's, I am cold in general, the Raynaud's which is possibly a sign of hypothyroid (though it could be primary Raynaud's), I have had hairs turn white (saw this listed on a website), constipation which started before I went LC (though right now that's generally ok with magnesium supplements). We'll see...I don't really want to be hypothyroid but if I am I want it treated properly.

Mistizoom 06-04-2013 05:33 PM

More test results
 
I went to the internal med doc today, and talked her into having Free T4, Free T3, TSH, and anti-TPO antibody tests done. She essentialy said unless TSH is high she won't treat. I told her if there were any abnormalities I would go to see my husband's doc and she was fine with that.


Here are today's results:

ANTI-TPO ABS (THYROID PEROXIDASE), 10.4 (H), range 0.0-9.0 IU/mL
FREE - TRIIODOTHYRONINE, 2.30 (L), range 2.57-4.43 pg/mL
FREE T4 (THYROXINE), 1.11, range 0.92-1.57 ng/dL
THYROID STIMULATING HORMONE, 2.74, range 0.27-4.20 uIU/mL

my prior TSH result was for "THYROID STIMULATING HORMONE (TSH), WITH REFLEX FREE T-4" and doesn't show up under "past results" when I click on today's TSH test, so I think today's test is slightly different.

Here is the note from the doctor along with the test results:

"Your Anti-TPO antibodies did return positive meaning you likely do have some autoimmune thyroid disease. Your Free T3 returned low, but this is not a reliable test as we discussed. I would not treat you with thyroid replacement hormones at this time, but rather monitor the TSH and treat based on that. You are certainly welcome to a second opinion on treatment as we discussed previously."

??? Any thoughts? I think I should schedule an appointment with DH's doc (the one who prescribes Amour, this doctor doesn't) to see what she thinks.

I also had mildly elevated B12, not sure if that means anything. I'll probably change my multivitamin to one with less B12.

Hot Potato 06-05-2013 12:15 AM

I am in Australia and I have recently been put on 50mg thyroxine daily due to my TSH levels being around 4.5 - 5.

My understanding is that the new accepted upper range is 3.

Lokarbiebarbie 06-05-2013 03:30 AM

Having a 'little autoimmune thyroid disease' is like having a 'little bit of pregnancy'. :)

You don't titrate incoming hormone nor treat using a TSH test.

I'd want treatment, personally. You do what you want, keeping in mind that there are plenty of us who could not get a good doctor.

tcayuela 06-05-2013 09:11 AM

I would certainly seek treatment and elsewhere. Any doctor that treats based on TSH is behind the times. And your doctor said the Free T3 test is useless....that's one of the most valuable tests we go by! To me your T3 is very low and an indication of hypothyroidism. I'm not an expert on Hashi's but the comment above about having a 'little bit of autoimmune disease is like a little bit of being pregnant' is absolutely right! What you find is that you may be at the beginning of stages of thyroid disease and as you go untreated, you will see your numbers get worse.

Best to you!
Tammy

watcher513 06-07-2013 04:50 PM

"Your Free T3 returned low, but this is not a reliable test as we discussed."

Yep, hockey puck to that. TSH loving doctor. Geez, it's not even IN the range! Definitely to go your hubby's doc and take these results with you. So, under range FT3 and a 4+ TSH, I'd be asleep!

Mistizoom 06-07-2013 05:06 PM

Thanks all. I think am going to read the 2 thyroid books my husband has before I go see the other doc. They are in the same practice but I think night and day in the way they do things. DH's doc is into integrative medicine/holistic approaches. She told him not to go to any of the other docs in the practice because they don't know anything about Amour. The one I went to (only because I could get in to see her fast as she's new) graduated from med school in 2009 but it seems like her info is very outdated...sad. She even mentioned the possibilty of subclinical hypothyroidism, but it sounds like she isn't willing to treat it even though she acknowledges it exists.

Question - I also forgot to mention I have low vitamin D - 16 (L), range is 20-80 ng/ml. Will supplementing with vitamin D help my thyroid function at all? I'm currently taking 2000 IU/day, not sure if I should increase that. My vitamin B12 was a tad high, so I've stopped my multivitamin for now as that had large amounts of B12 in it. I need to find a new mutli. I wonder if being cold/having Raynaud's would be helped by thyroid treatment. Those are the main symptoms that are bothering me. I feel pretty good and am losing weight otherwise.

Hot Potato 06-07-2013 06:26 PM

My naturopath said that the latest research shows that to reverse a vitamin d deficiency you need to take 1000 IU/day per 10kgs of body weight (I think that's 22pds).

You might want to up your dosage for a couple of months :)

Mistizoom 06-07-2013 07:07 PM

Quote:

Originally Posted by Hot Potato (Post 16460767)
My naturopath said that the latest research shows that to reverse a vitamin d deficiency you need to take 1000 IU/day per 10kgs of body weight (I think that's 22pds).

You might want to up your dosage for a couple of months :)

Ok, so that would be around 10,000 IU or so a day...I will look into that, thanks.

watcher513 06-08-2013 01:47 AM

When my Vit. D was low a few years ago (19 on a 30-100 range at the time), I was told to take 1000 iu D3 pills 2x/day. It took 3 months to get up to 32. 1000 iu was all they had then as far as I know. I know there are 2,000 and 5000 iu pills now, probably gel caps. Definitely monitor it though. Too high can be bad too but it's better in my opinion to take the D3 OTC than the D2 prescription.

Lokarbiebarbie 06-08-2013 04:05 AM

Prescription Vit. D3 comes in 10,000 IU

watcher513 06-08-2013 05:26 PM

Nice! Less pills to take.

Lemming 06-09-2013 07:09 AM

When I got my TSH (2.9), FT4 (just under range) and FT3 (just within range) results 3 years ago, my doc immediately diagnosed my as hypo and started me on meds. I had been having symptoms for 2 years but none of my lab results were below range until this particular test (which he ran while troubleshooting something else--increased frequency of PVC's, a benign heart arrhythmia. By that point I had given up on thinking the thyroid was the cause of my symptoms, because docs kept telling me that, since my labs were (barely) in range, I was "fine.") At any rate, he had no problem diagnosing hypothyroidism with only one of the labs out of range--and getting on meds has made a HUGE difference for me! And, I might add, my TSH has never been above 2.9. So if you have symptoms, and one or more lab value out of range--don't let them tell you you're "fine!" (and as someone said, most docs now use 3 as the upper TSH range, so you are even out of range on that!)

Hot Potato 06-09-2013 06:56 PM

Lemming, can I ask are PVCs like when your heart kind of skips a beat, or does like a big double beat kind of thing???

Thanks :)

Lemming 06-24-2013 12:19 PM

Hot Potato, they feel like a "skip" in my pulse (if I'm taking my pulse when they happen), but can feel like anything from a 'thump" to a "flutter" in my chest. If you have a "weird" feeling that you think might be a heart arrhythmia, go to the doc! They can have you do a portable EKG (either a Holter monitor or an event monitor) so they can "catch" the arrhythmia when you're not in the Dr's office. PVC's are harmless, but there are some other arrhythmias that aren't...so always good to check them out!

Lokarbiebarbie 06-24-2013 02:37 PM

Quote:

Originally Posted by Mistizoom (Post 16455433)
I went to the internal med doc today, and talked her into having Free T4, Free T3, TSH, and anti-TPO antibody tests done. She essentialy said unless TSH is high she won't treat. I told her if there were any abnormalities I would go to see my husband's doc and she was fine with that.


Here are today's results:

ANTI-TPO ABS (THYROID PEROXIDASE), 10.4 (H), range 0.0-9.0 IU/mL
FREE - TRIIODOTHYRONINE, 2.30 (L), range 2.57-4.43 pg/mL
FREE T4 (THYROXINE), 1.11, range 0.92-1.57 ng/dL
THYROID STIMULATING HORMONE, 2.74, range 0.27-4.20 uIU/mL

my prior TSH result was for "THYROID STIMULATING HORMONE (TSH), WITH REFLEX FREE T-4" and doesn't show up under "past results" when I click on today's TSH test, so I think today's test is slightly different.

Here is the note from the doctor along with the test results:

"Your Anti-TPO antibodies did return positive meaning you likely do have some autoimmune thyroid disease. Your Free T3 returned low, but this is not a reliable test as we discussed. I would not treat you with thyroid replacement hormones at this time, but rather monitor the TSH and treat based on that. You are certainly welcome to a second opinion on treatment as we discussed previously."

??? Any thoughts? I think I should schedule an appointment with DH's doc (the one who prescribes Amour, this doctor doesn't) to see what she thinks.

I also had mildly elevated B12, not sure if that means anything. I'll probably change my multivitamin to one with less B12.

I'm sorry...about the Hashi's....but gee whiz...does this same doctor say to his pregnant patietnts "You likely do have a little pregnancy'. Goodness. This doctor isn't savvy on thyroid treatment. Do you see your FT3 is UNDER the lab range? If you know a doctor who does Armour...I'd be RUNNING to that person.

Mistizoom 06-24-2013 04:54 PM

Quote:

Originally Posted by Lokarbiebarbie (Post 16485237)
I'm sorry...about the Hashi's....but gee whiz...does this same doctor say to his pregnant patietnts "You likely do have a little pregnancy'. Goodness. This doctor isn't savvy on thyroid treatment. Do you see your FT3 is UNDER the lab range? If you know a doctor who does Armour...I'd be RUNNING to that person.

I know....my husband's doctor prescribes Amour. I just need to call and get an appointment with her, just keep forgetting to do it.

Mistizoom 09-16-2013 06:23 PM

Update:

So I went to see Dr. Nisly (at UIHC in Coralville, for those who are local to the IC area). It was for a "second opinion" visit. She was running about 45 minutes late, so got right to business. She said based on my previous thyroid results I will likely develop hypothyroidism...some day. She does not want to diagnose/treat me based on low free T3 and slightly elevated anti-TPO alone. I told her though, that I do want to stick with her because when/if my thyroid (seriously) tanks I want to be on Amour. She agreed to that. I am fine with not being treated at this point, as I feel fine right now.

She was a bit more concerned about my recently developed Raynaud's syndrome (fingers go numb and white when exposed to cold) since that doesn't typically crop up in a woman in her 40s without an underlying issue. So she ran tons of tests, I didn't even know what all she was doing. She re-ran all the thyroid test except for anti-TPO (I guess if it was positive once there is no need to check that again? - not sure about that). Good news is my vitamin D is much better, bad news is I have a positive anti-nuclear antibody test, which may indicate an autoimmune condition. That test plus the Raynaud's means a referral to Rheumatology. I have an appointment with them on Wednesday. All my other tests were normal.

Here are my thyroid test results:

Name
Standard Range.....................6/4/13...........9/4/13

FREE - TRIIODOTHYRONINE......2.30..............2.25
2.57-4.43 pg/mL

TSH
0.27-4.20 uIU/mL...................2.74..............3.40

FREE T4 (THYROXINE).............1.11..............1.03
0.92-1.57 ng/dL

ANTI-TPO ABS........................10.4..............not tested
0.0-9.0 IU/mL

watcher513 09-17-2013 03:45 AM

I find it really odd that you're below range for FT3 and she doesn't think that's a problem. You're also over 2.0 and 3.0 respectively for TSH and that's not a problem? Many of us feel better around and Under 1.0.

I can't comment on the Raynauds because I don't know anything about it. It's not necessary to test TPO Antibodies again (this soon anyway - save your $$). They fluctuate. I was in the 400's one year and 3-4 years later in the mid 300's. Originally, 14-15 years before the 400's I was in the 300's (back in 1998).

I'd be really dragging with FT3's like that. Asleep probably.

Mistizoom 09-17-2013 07:10 AM

Quote:

Originally Posted by watcher513 (Post 16607668)
I'd be really dragging with FT3's like that. Asleep probably.

I've heard other people say that but I feel fine. I am alert during the day and sleep well at night. I have plenty of energy and I'm losing weight. If I felt like I had hypo symptoms I would push it, but I don't feel the need to right now.

However, it does seem that Nisly is not as alternative/complementary as I had hoped. So for anyone who lives in my area looking for an alternative, I am not sure she is it. Though she does prescribe Amour.

KeirasMom 09-17-2013 11:04 AM

RE: Raynaud's -- I was diagnosed with it as a teenager, but it never gave me any problems until last year, coincidentally after my TD diagnoses. I honestly had forgotten I have it, because other than just cold hands or feet sometimes, I never had any other problems. I got chilblains last winter and they were so bad they ulcerated. I was referred to a Rheumatologist because 3 different doctors couldn't figure it out (my anti-nuclears were negative, though), and the Rheumatologist asked me about family history of Raynaud's. :doh: When I told him I had a diagnosis years before, he knew right away that it was chilblains and not RA.

Anyway, TD can definitely affect Raynaud's and exacerbate your condition, and I suspect being untreated even though you feel well, could affect it as well. Be sure to share every little bit of information you can think of with your Rheumatologist. Good luck!

catkan 10-16-2013 12:51 PM

Hi Mistizoom,

Have you ever heard of Rachel Headings, NP in Iowa City? I saw her on a good dr list and was wondering if you have heard of her?

Thanks

Mistizoom 10-17-2013 07:03 AM

Quote:

Originally Posted by catkan (Post 16646095)
Hi Mistizoom,

Have you ever heard of Rachel Headings, NP in Iowa City? I saw her on a good dr list and was wondering if you have heard of her?

Thanks

No, I haven't. I found the website for the Kylemore Center were she's at. Looks interesting.

ETA: Looks like they promote a grain-free, sugar-free diet for patients. Very cool...

catkan 10-17-2013 12:43 PM

Quote:

Originally Posted by Mistizoom (Post 16647137)
No, I haven't. I found the website for the Kylemore Center were she's at. Looks interesting.

ETA: Looks like they promote a grain-free, sugar-free diet for patients. Very cool...

I hadn't thought of a website. I figured she was with the hospital there. So I looked for the website. They do promote paleo. However, one of the recipes they have on there uses canola mayo. I stay away from canola.

They talk about functional medicine, but I see a lot of supplements and vitamins on that website too. Hard to tell if they could help or not.

Thank you Mistizoom for your input! Would love to find a good thyroid doc in Iowa.


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