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Thyroid Function Tests
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Thyroid Function Tests

I had a TSH level test done to rule our any trouble with my thyroid since I have been having anxiety, panic attacks.  My TSH levels were at .32 which my doctor said was just under the lower of .34 which was considered low and since this was so close she did not think it was indicative of anything.  She had a little more of my blood to do another test so she had them run what she called a true test (I believe) which would be a better indicator.  She only told me that it was normal.  She said she would do the tests again in 8 weeks.  She also tested me or my estrogen levels because I am 45 years old and at "that age".  These were normal also.  My quandry is...I have been diagnosed with Barrett's Esophagus 1 cm.  I am on 20 mg. of prilosec for this because I could not tolerate 40 mg. of aciphex.  My quandry is.....all of my symptoms could be indicative of anxiety, thyroid, peri-menopause and the prilosec.   I have had palpitations or "skipped beats" especially after eatting, my hair has come out more (with the aciphex I took prior to prilosec), I sweat more at night, my right eye twitches all the time, I wake up a lot at night.  I am really trying to be patient because for one my anxiety over all of this could keep the symptoms alive....but how will I know what is causing this.  Is it okay to wait the 8 weeks for another thyroid test and will this be conclusive?  Thank you. MLS
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Avatar_n_tn
Thank you for your question and for visiting the Family Practice Forum.
A "low" TSH is indicative of "HYPERThyroidism". I agree your level is "borderline" but lets remember these blood tests are to be used as a "GUIDE" NOT to make a definitive diagnosis. You have other symptoms of HYPERThyroidism. These include hair loss, heart palpitations, diaphoresis, muscle twitching and anxiety. In my mind there is enough evidence of CLINICAL hyperthyroidism to warrant further investigation. This would include a T3, T4 (total T4, free T4,and Free T4 Index), "ultrasensitive TSH" and antithyroid antibodies. Hair loss and heart palpitations are not common side effects of Prilosec.
OK, now lets assume all the aforementioned blood tests for thyroid function are normal, the next step you need to take is to have an EKG to check these "skipped beats" and possibly a "holter monitor" (24 hour cardiac monitor - you wear at home).  
If all of these tests were normal I would begin to have an increased suspicion that your symptoms are related to acid reflux, menopause (or approaching menopause) and/or anxiety.
"Blood tests" for menopause are notoriously unreliable as MANY MANY MANY women will have symptoms as they "approach" menopause (also called "PERImenopausal") but will still have "normal" tests for hormones such as FSH, LH, Estrogen and Progesterone.
I have no reason to believe that there is going to be a change in your thyroid function in 8 weeks, in fact, I would highly doubt it.
I hope this helps you sort through this !
Dean M. Tomasello, M.D.
14 Comments
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Avatar_n_tn
Hi there! Well when I read your post I'd thought I wrote it. I have all the symptoms you state and then some. My thyroid test was the same as yous also, then on a second one it can back normal. According to the dr.( who also has a thyroid problem) he said it can do that-flucuate-and we'll just keep and eye on it.I'm fourty and the dr. prescribed HRT but I haven't started because my fear of possibly having a stroke. I also hve problems with pain moving from one place to another.My eye twitches have moved from one eye to the other and back.All have noticed twitches in my lower belly, and today have had them in my thigh.When you wake up alot are  you tossing and turning and feel really sore on the side your lying on? Do you have burning in that sides hip joint? Don't mean to be going on and on but maybe we could team up and figure out what's going on. Hopefully this dr. can kill two birds with one stone so to speak and help both of us. Shotsy

























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Avatar_n_tn
Talk about timing - I just found this place and the first topic was just what I came for.

My tsh is .63, down from .8 last year and l.5 the year before.  The eye twitches are such a bother.  I have night sweats, too and sometimes I'm so dizzy I think I'll pass out.


Do either of you have a goiter (enlarged thyroid)?


I'm going today to have a nodule on my thyroid biopsied.  I've had it done before and it was benign, but the thyroid has grown even larger and I feel it when I swallow.


Had an ultrasound in August and it showed the thyroid truly did grow more.


I swear, I wish they'd just get rid of the darn thyroid and put me on medication.


I took synthroid for years until I had my daughter, then my TSH levels became normal.  Now I wish I'd never gone off of it!


Never had that warm feeling in the hips though.


I would say that the 8 week lapse sounds reasonable.  At least the dr. isn't ignoring your symptoms.


Is your dr. an endocronoloist?
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Avatar_n_tn
Hi Anniewoo & SHOTSY,
Thanks for your reply.  First off, I'll answer the questions.  Yes, I do toss and turn some nights.  Not every night. I do exercise a lot and walk so this does help me sleep better but when I do wake up I do deep breathing exercises I have learened and talk positive to myself. I do not have a goiter and my doctor is not an endocrinologist although she said that if my levels remain low she would send me to one since this is not in her field.  Again, I do suffer from anxiety and panic disorder which I had 20 or so years ago and has just come back again due to work related stress and my worries about my health in general.  SHOTSY what is HRT?   Thanks for your replys.  Hopefully we will figure this out.
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Avatar_n_tn
Forgot to say I'm also close to being perimenopausal and am also 45.


I know you didn't ask me, but HRT is hormone replacement therapy.  We all have to decide whether to go that route or not.  It's so questionable!


Shotsy, have you tried soy?  My gyn nurse practitioner has me drinking soy milk - it's supposed to help symptoms but hasn't yet.


MLS, I get panic attacks, too, but have never taken anything.  I do as you do, calm myself down and I tell myself there's nothing life-threatening happening.


I started taking atenolol last June for high blood pressure and my heart doesn't race any more.


MLS, try to see an endocronologist.  

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Avatar_n_tn
I suffer the same problems you all do.  I'm also 45 years old.  I believe that I have a Vitamin B defiency.  It runs in my family, and what I've read about Vitamin B defiency, all these symtoms (symptoms) are caused by this.  The doctors don't seem to be real supportive to me, so where does one turn to?  You are not alone from the looks of your comments.  So I would say it could be our age, it would be nice if there was an easy answer to these questions.  Try taking a vitamin B supplement.  It sure shouldn't hurt you.
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Avatar_n_tn
Hi...at least I don't feel alone any more!!!  Anyway....the doctor said my estrogen levels are okay so far but I'm not sure what to do about HRT because I do have fibrocystic breasts and have trouble with breast lumps.  Will cross this road when I come to it.  I did start taking soy pills before each meal until I read that too much soy can aggravate the thyroid so I am on hold for this for awhile.  I do take vitamins thought a B complex, vitamin E, calcium and folic acid.  Hopefully the doctor will answer and lead us in the right direction.
MLS
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Avatar_n_tn
I'll go right out and get some B6, though I used to take a B complex vitamin and gave up.


But I'll try again.  I appreciate finding out there's others with the same problems and I'm not crazy!


Does B6 help the eye twitches?



My nurse practitioner knows about my thyroid and said I should still take the soy - what effects does soy have on the thyroid?


Thanks everyone!
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Avatar_n_tn
Hello, Ladies! I understand we're getting older, but I don't buy that is all of our problem. I've directly asked people about their aging and these aren't the symptoms. Yeah, there's some achiness and some degenerative processes that occur. But I never recall anyone saying "just wait till you get them eye twitches" or "Yeah that waking up all night long is a real bummer" etc. At any rate I've come to conclusion IF this is some sort of early stage of a disease or such, it'll probaly get worse then the dr.s will figure it out . In the meantime just do what you can to manage the problems. The dr. had stated my thyroid appears slightly enlarged but I can't tell. He's says he's in tune to it but he's not treating me for that. Plus fibramyalgia (sp) has been indicated but I've read the is no definitive test for it. The main stay is to manage symptoms. I call my problems eposodic, they get bad sometimes tnen other times just a minor nusiance. But seems like something is always going on. Oh and the thing I like the most is when a new symptom occurs . Please pardon the sarcasim. Have to do that to keep my atitude up. At least we know from the blood work we're not dying, at least as far as they tell us. So that's a good sign.Just keep fighting the good fight and we'll be alright.Right?
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Avatar_n_tn
Yes, I agree Shotsy, I don't think we'll die from any of this!!! And we'll get by.  I appreciate the support knowing there are others like me out there.  I really, really, really, appreciate that I was responded to by a Dr. and now I have something to show my Dr. and go by.  I hope she doesn't feel slighted that I would have this information...but...I am protecting MY best interests and I am only trying to help myself and she needs to realize this.  Anniewoo, I can't even remember where I read about soy but just remember that it stated that too much soy could affect the thyroid. I don't know what they mean by this, it didn't go into specifics. I just remember thinking, "oh darn, since I had just started taking this."  Take care everyone and keep me informed how you are doing.  MLS
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Avatar_n_tn
Hello everyone my name is Valerie,

I have a thyroid problem also.  I have hypothyroidism,Hashimotos Thyroiditis and I also have a multinodular goiter.

I found all this out one day in August 2001. I just went to the doctor compaining about acid refulx and being tired.

Although I did have some bone pain and swollen ankles in 1999 and I took tests for Rhumetoid Arthritis, Lupus and Lyme disease.  I also had an ESR or Sed rate of 44 and she didn't know why (ESR is a test for inflamation (inflammation)).  She didn't take any other blood tests.  After 3 months the pain went away and I didn't bother to look into it.

In Augst when I went to my doctor she did a TSH test and it came back 6.52 which is concidered high but isn't too high.  Was put on Synthroid 5mg.  
Told to see Endocrinologist.  Went to her in September and she said with a TSH of 6.52 I shouldn't be having so many symptoms
1. Tired (hard to get up in the morning)
2. Throat (hoarsness and hard to swallow)  everyone keeps askin me if I have a cold.
3. My concentration has not been too good.  (when I am having a conversation can't remember what I am talking about)
4. I have gained plenty of weight I use to weigh 105 then 125 now 137 and I am only 5 feet tall.
5. I get upset easily
6. My menstrual cycle is weird now it's every 42 days
7. When it is hot I am too hot, when it's cold I am so cold.
8. Feels like my muscles are jumping
9. Bone pain especially when sleeping and on the right side.  Wrists hurt also (hard to open bottles)

Well she put me on 75mcg of Synthroid.
I feel a little better maybe a little more energy but I now have an ESR of 55 (Inflamaiton rate) normal is 0-30. They still don't know why.  

I am 37 years old and have three children and have always been active but now I don't know how I am going to feel.  I have to see from day to day.

I have also been on a site that talks about Thyroid Problems and it is about.com  

Now I found this one and it is great also.  Just think about it doctors that can actuall answer your questions.
Val
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Avatar_n_tn
I think the TSH tests are not very reliable.  I had one 7 wks ago to be normal.  I am 42 and now I have NO period, high anxiety has alway splagued me, and my nails, hair is brittle and I have all the synptoms.  I realize I may be premenopausal but I just feek it is thyroid--had the trouble at age 14.  Anybody has TSH to be normal and ti "jump track" in less than 8 wks?  Should I have another one??
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Avatar_n_tn
Girls. 44 years old and in menopause.  Was sssoooo tired, but after began estrogen patch felt much better.  Thyroids have been tested 3 times since beginning of estrogen usage.  They have continued to go down but doc said he doesn't think this is the reason for fatigue.  They are still in "normal" range, but slipping.  Anyone else with this problem.  Also on Zoloft and have MVP.
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Avatar_n_tn
About fifteen years ago I was told by an eye doctor that I should have some tests done on my thyroid because he could see evidence by examining my eyes that I had some thyroid problems. My tests came back normal, according to my doctor.  About five years ago another eye doctor told me the same thing and insisted I get some blood tests. It was okay. Today I went to another eye to have a tests for diabetes of the eyes and he said it was fine for that but he was concerned because it looked like I had thyroid problems. I told him what happened before and my own doctor has tested me several times. He says it is possible I am one of those rare ones that it will not show up in a blood tests and I should see a specialist who works with nothing but they thyroid.  I am concerned about this because he is the third eye doctor who said they could see it while examining my eyes but it does not show in the tests. How can that be?
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Avatar_n_tn
Dear Girls,
I feel like you are all talking about me! My thyroid would go up and down in my 30's, but was never put on meds. At 47 I jumped my weight by 20 lbs in 2 mos. My FP checked my Tsh it was 12. He started my on a low dose dessicated thyroid called Armour. I was then followed by a one time visit to an endocrinologist. The endo did blood work and said my antibodies were elevated. He also told me that I had "garden variety hypothyroidism" and that my Armour should be increased slowly over a year or so, and the increase should follow my clinical appearance, and the TSH. He also told me that it was a shame no one put me on Thyroid in my 30's as it was probably that is why I was infertile. My cholesterol is elevated. I have odd symptoms as I have burning sensations at times, but also have Fibromyalgia (mildly) I chalk everything up to perimenopause and "nerves", but, it's beginning to "GET ON MY NERVES". My symptoms almost sound like hyperthyroidism at times, but am still on 60mg of Armour. I just thought I would add my two cents worth. My periods just stopped last month as well. So, is THIS what we get to "look forward" to in our "golden" years??? HA :) I also have some ankle swelling, slight. I am extremely cold in cold weather, and too hot in hot weather.......oh please.....
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A related discussion, Are these reesults normal thyroid function? was started.
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