Confusing TSH results w/ Hashimotos

[aireamdh]

Been diagnosed since 10/05, been quite the battle since.
November 1 TSH was 1.543/ Ft4 1.68 At this time a metabolic panel was also done. I had been on .125 mcg synthroid for only 3 weeks,having gone up from .112. Test was done early due to mix up
November 2nd I underwent GYN surgery: hysteroscopy to remove uterine polyps, and D & C . Had a very difficult time with nausea/vomiting about 2 hrs after waking, lasting into the next day. Soon after this I noticed "hyper" symptoms increasing, along with an increase in what I can only describe as "dread" feelings with adrenaline rushes in the early ayem. This relieved by getting up and moving around.
Results of metabolic/iron panel showed low values in all Iron areas. Iron=39 (ref range 45-145), %SAT=9(ref range 20-55%) Hemoglobin 11.8 (ref range 12.0-15.0)Ferritin=6 (ref range 10-291). Internist wrote then he believed the am "restlessness" symptoms and nightmares were result of these low levels. Tried the recommended Iron supplements but was unable to tolerate. Slow-Fe is better tolerated. Since I had been having an increase in hyper symptoms; worsening insomnia, anxiety, to name a few, he agreed I might be overmedicated and repeated TSH last week. The results have me baffled: TSH=4.034/ FT4=1.65.He said in note these results were fine when all along I had been told he wanted me somewhere around 1. I dont understand why I am having these supposedly opposing symptoms when it turns out the tsh is actually higher.

[Mark Lupo, M.D.]

May be that the symptoms are not related to thyroid OR that you are one that gets anxiety/insomnia when the thyroid is low (ie higher TSH).  Iron supplements may bind thyroid hormone (decreased absorption) so take synthroid early am and iron at least 1 hour later but preferrably at lunch/dinner.

[CouldBe]

Aireamdh,

Can you give us the normal range values for your TSH and T4?  Depending on what those are, could you be going hypo? It seems as though your TSH values changed awfully quickly.

Have you had a FT3 done?  

I am still learning about all this, but one thing I do know--you can definitely have symptoms of hyperthyroid when your actual problem is hypo.  And it can be quite severe.  My understanding is that your FT3 results might tell you more than the TSH results about what is going on in your body.

CouldBe

[aireamdh]

The "normal" ranges for this lab are outdated, but are TSH :0.350-5.500,

Free T40 0.89-1.80

Last time my T3 was tested was 6/06 Values are 60.00-181.0 and mine was 129.

I am thinking, as graveslady suggested in the other forum, that the recent surgery might have spiked this latest result. I only wish the doc had explained, as he usually does, instead of my big surprise in the mail ;)

I know patience is needed with all this , but I was so shocked to see that TSH go higher, instead of the possibly too low value even the internist expected.

Right now I am feeling like "meself", but that does tend to veer a bit of late. What I call the "fire ant feet" is back, and the sleeping/waking problems seem exacerbated right now, even with ambien or ambien CR.  I have an RX for lorazepam, I take no more than what is prescribed but am sure will have to be weaned from that one of these days.

Thanks for your answer and for the support found here.

[zapped77]

A related discussion, Low tsh with normal T-4 was started.