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Old 08-14-2014, 04:06 PM   #1
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Is there such a thing as a Thyroid for Dummies?

Just got a call from my Dr. I am hypo. The results are from regular lab test with my physical. I didn't go in with any symptoms. Sure I can be tired sometimes but it is usually attributable to staying up too late or eating crappy food. I am heavy but I don't always make the best food choices. LC works for me and I feel great when on plan.

So, new here and trying to learn. Any points in the right direction will be appreciated. I am going to dive into the stickies and see what I can learn.

My TSH was 14.46 by the way. A friend said she wonders how I ever get up with that number.

TIA for any help.

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Old 08-14-2014, 04:12 PM   #2
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Wow, that's quite a TSH.

There is a website and book called Stop the Thyroid Madness. There is a lot of good information on About.com too. I have another book that is pretty good called The Thyroid Solution (I think, it's at home and I'm at work).
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Old 08-14-2014, 04:23 PM   #3
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Without any severe symptoms, you should have your doctor re-check for lab error with a TSH that high. My doctors tell me that lab error is rampant.

However, my niece was recently diagnosed as hypothyroid at age 21, with a TSH of 13--and no severe symptoms. Her 'moodiness' and fatigue were also considered normal college-student issues--until the lab results from a standard physical (like yours), so I guess your situation isn't all that unusual.

I would caution you about internet sites for thyroid and recommend a book by a doctor. You can check reviews on Amazon.

I am hypo and keep up with the literature, and I find too much hysteria and misinformation on the internet.

Since this is a condition that will be with you for the rest of your life, my advice is to find a good thyroid doctor with whom you feel rapport because you need to be pro-active about your care but also know you can rely on your doctor.
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Old 08-14-2014, 05:54 PM   #4
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Thanks for the tips. That is a good thought about lab error. I have not had lab work in years so it is hard to compare anything. I kept canceling appointments and would only go when I had an issue which has been a few times in the last 10 years - eek! I had a toe that got infected and went a month ago. Dr. said I absolutely had to come back for a physical soon. So, I did.

I do have and have had for a year plus an odd pressure in my throat right where the thyroid is. I had been wondering if it was a goiter? There is no visual appearance of a bulge just the weird feeling. I wonder if it is related?

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Old 08-14-2014, 06:58 PM   #5
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Leo, now you have me scared a little after reading here. LOL - I am wondering if I shouldn't take the meds tomorrow but call the Dr. first and raise the issue of potential lab error and ask to be retested? My defense is that at such a high number wouldn't I surely have more symptoms or greater severity of one or two symptoms?
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Old 08-14-2014, 07:58 PM   #6
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When I was diagnosed back in college - every question they asked could be explained away "as normal" - tired? uh, college student after finals - yes. irritable? again, no sleep yes. etc etc etc. I didn't realize that what I felt was normal was in fact, not.

I had a goiter - that was what caught my doctor's attention and caused him to have me tested. How I wish my doctor had thought to do it when I was a teen. Thankfully - with the meds, the goiter went away pretty quickly.

When I am good about taking my meds regularly on time, without interaction with any food/calcium drinks - I feel good! I have a much more energy - less moody - easier time managing my weight.

Good luck!
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Old 08-15-2014, 01:59 AM   #7
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You didn't mention that you already had Rx to take.

I didn't mean to alarm you about lab error. In your situation, I might ask the doctor to recheck, but if you are sensing tightness in your throat, that may be a symptom, and all is OK with taking the Rx.

Everyone has different symptoms. Mine began with a goiter, which my primary doctor had checked and told me I was 'normal,' but I now know it was the first indication of my Hashi's. And my symptoms escalated so gradually that they were only obvious much later. For years, I accepted that my fatigue, etc. was 'normal aging' when it was my slowing thyroid.

So it's possible that your labs reflect more than you're feeling, similar to the way my own labs were the opposite--apparently 'normal' when I wasn't.

That's another reason for my suggestion to be comfortable with your doctor. We all respond differently, and it's best to have a doctor that you can rely on rather than strangers who express opinions on the internet.
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Old 08-15-2014, 07:37 AM   #8
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My TSH was 26 and the only symptom that I noticed was weight gain. I went from a hyper phase where I had a myriad of symptoms to hypo in the span of about three months. For me, the hyper was a lot worse than the hypo as far as feeling bad.
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Old 08-15-2014, 12:54 PM   #9
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I went ahead and started today. I did send my Dr. an email to reference my visit to him 2 years ago about the tightness. I asked if that could be related to the new diagnosis of hypothyroid as the feeling is still present and could it be a goiter or something else? Heck, I will just copy my message here:

I came to see you summer 2 years ago, I think, with a tight feeling in my throat. You instructed me to take OTC Prilosec and quit smoking. I took the Prilosec daily for 2 months and cut the smoking way back but not complete cessation. The tightness never went away and is still present. With the new diagnosis of hypothyroid, is there a possibility that I have a goiter or something else related to this diagnosis? I thought I would just bring that up and see if anything more needs to be done regarding that. I would love to not have that feeling anymore.
Also, being a pessimist by nature, is it possible there was an error in the lab? Just a thought.
Thanks - Sarah

So, we shall see how he responds.

I read a bunch last night. A few symptom lists included some odd things that I do have but weren't on the majority of the other lists. One was tingling or numbness in fingers. I have that in my left hand and have for about a year. It comes and goes. I thought for awhile it was because I sleep on that side and my shoulder gets sore so maybe it was a pinched nerve or something? Who knows? I am rambling now. LOL

Thanks again for the help everyone. . It is time for my afternoon nap. I had an exhausting morning with a very chatty individual. He wore me out. LOL

I think I may have more symptoms than I was willing admit. Most 43 yo don't need a nap, do they? Eating lunch makes me tired afterward.

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Old 08-15-2014, 01:11 PM   #10
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Great e-mail; you covered all the bases. Please keep us posted on your doctor's response. Meanwhile, I remembered about the self thyroid neck check that I've read about in the past. If you're interested, here is it:

How to Do a Thyroid Neck Self-Check
This simple self-check may help identify if your thyroid is enlarged, one sign that you may need further examination by a doctor.

Difficulty Level: Easy Time Required: 5 minutes

Here's How:

1.Hold a mirror so that you can see the area of your neck just below the Adam's apple and right above the collarbone. This is the general location of your thyroid gland.
2.Tip your head back, while keeping this view of your neck and thyroid area in your mirror.
3.Take a drink of water and swallow.
4.As you swallow, look at your neck. Watch carefully for any bulges, enlargement, protrusions, or unusual appearances in this area when you swallow.
5.Repeat this process several times.

If you see any bulges, protrusions, lumps or anything that appears unusual, see your doctor right away. You may have an enlarged thyroid, or a thyroid nodule, and your thyroid should be evaluated.
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Old 08-15-2014, 02:45 PM   #11
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Here is the response from my Dr. That was a pretty fast response IMO. I sent it before posting it above.


Your TSH level was high enough that I do not think this was lab error or a mild transient increase. If you have any concerns we can always repeat the test prior to treatment.

Although I did not feel as if your thyroid was enlarged I will examine more closely at your follow up. Goiter's or thyroid nodules can cause symptoms of throat discomfort. It is reasonalbe to have a thyroid ultrasound with your symptoms. I will have my staff contact you to set this up.

JCA
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Old 08-15-2014, 02:51 PM   #12
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I like your doctor; he sounds like he listens to your concerns, he's responsive and he's thorough. My doctor doesn't always respond to my e-mails and when he does, it's in shorthand which I don't always understand.
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Old 08-16-2014, 05:55 AM   #13
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It's great that your doctor responded as he did. (None of my doctors use e-mail.)

It's usual to do an ultrasound to check for thyroid nodules, and you should not worry about this. I have 3, and my endo checks them annually because once you're medicated, they should not grow, and if they do, you have a biopsy. I've had one biopsy--to check for cancer. Over 85% of thyroid nodules remain benign, and mine haven't grown in about 6 years.

It's also possible that's the source of your throat discomfort and that your doctor didn't 'feel' them on examination. My own nodules are so deep that they can't be felt by the doctor, and when I had a biopsy, the pathologist had to be guided by the radiologist to 'find' them.

Your doctor sounds excellent, and you should be able to rely on him for great care.
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Old 08-16-2014, 10:59 AM   #14
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His practice encourages all patients to enroll in their online system. I had just enrolled so that I could print out my labs and "over" study them. LOL. An ultrasound does not scare me in the least. I have had two back surgeries so this is nothing.

As far as this Dr., I am willing to see how he performs. He has been somewhat of a godsend to me dealing with my dad and his dementia/decline. I think he knows that I am pretty level headed and not a freak out type. My dad sees him every few months and he has helped me wade through all types of medical issues on my dad's behalf.
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Old 08-18-2014, 03:43 PM   #15
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Ultrasound on thyroid is scheduled for early Oct. In the meantime, I have not had a cig since Saturday morning. The pressure in my throat feels so much better. There is still a feeling but much decreased.

I am grouchy and hiding in the bedroom to be away from SO, he smokes, while this ick feeling passes. I have been pretty snappy with him.
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Old 08-18-2014, 04:11 PM   #16
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Originally Posted by Puppy View Post
Ultrasound on thyroid is scheduled for early Oct. In the meantime, I have not had a cig since Saturday morning. The pressure in my throat feels so much better. There is still a feeling but much decreased.

I am grouchy and hiding in the bedroom to be away from SO, he smokes, while this ick feeling passes. I have been pretty snappy with him.
I do hope your mood lifts. Perhaps the pressure in your throat has eased due a combination of taking the meds and not smoking? Please keep us posted on your ultrasound.
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Old 08-18-2014, 04:31 PM   #17
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He is used to me being snappy. LOL! The stink is killing me. I already didn't like the smell of cigs and it is worse now. When he comes in from outside he smells like a smoke bomb. I used to smell it on him more than me anyway but now it is like WHAM!

I am hoping I wear off on him but he has to decide on his own. Me coercing him will end badly. Believe it or not, I am keeping my mouth shut. He did say he is happy my throat feels better. It got really bad Friday which led me to think about how I didn't want to live with that feeling and to, at least, control the things that I can control. I have been wanting to quit for awhile now but haven't. I have smoked about 30 years. Started around 15 and will be 44 next week. That is really scary to me. My mother has begged me to stop. I am going to try very hard. So far so good. If I avoid my triggers, I think I will be successful. Coffee and cigs was a morning ritual. I am now making a cup and taking it back to bed instead of outside where I would smoke. I am going to avoid wine for awhile too - another trigger. It will be good for weight anyway.

OK, enough babbling.

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Old 08-18-2014, 04:39 PM   #18
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That's wonderful that you're stopping especially while you're still young. There are so many benefits to stopping smoking, including better health now and in the future, cleaner environment, cleaner clothes, smelling better, more money in your pocket. Hang in there!
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Old 08-18-2014, 06:44 PM   #19
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"cleaner clothes and smelling better" for sure! I have been washing clothes and bedding all day. Even though we don't smoke in the house there is a residual smell that gets in.
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Old 08-20-2014, 12:59 PM   #20
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I need your expert opinions please. I sent my Dr. a message asking if he retests at the follow up appt. and if so, what does he test? The following is his reply:

Quote:
Typically with a milder elevated TSH I will also check the Free T4 prior to starting medications. Yours was elevated enough that I felt we did not need you to return for repeat testing.

I do usually recheck the TSH as well as the free T4 at your follow up visit although we rely more on the TSH for the appropriate dose. I typically do not routinely check the T3 for monitoring.

Let me know if the leg pains continue.

I hope this is helpful.

JCA
Everything I have been reading suggests testing Free T4, Free T3, Total T3 and then the antibody stuff that I still don't really understand. His approach seems to be lacking but i feel like he could be swayed to do as I ask as long as I back it up.
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Old 08-20-2014, 02:17 PM   #21
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T3 is what your cells actually use. Your body must convert the T4. It is possible to have good levels of T4 and not be converting properly- that's why free T3 should be tested, but many doctors don't do it. If your free T3 is OK and you still feel bad, reverse T3 should be tested. Even fewer doctors do that.
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Old 08-20-2014, 02:41 PM   #22
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T3 is what your cells actually use. Your body must convert the T4. It is possible to have good levels of T4 and not be converting properly- that's why free T3 should be tested, but many doctors don't do it. If your free T3 is OK and you still feel bad, reverse T3 should be tested. Even fewer doctors do that.
Yay - I knew that. Thanks so much for putting it so succinctly. I will be referring to it again and again until I know it like my dang SS#. Thanks for the succession of if this then ... I was a little lost on the the reverse T3. I am sure I will have more questions but thanks for now.
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