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Questions
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

Questions

by Sheri1963, Aug 28, 2007 11:46AM
really would like your opinion please...I have been hypothyroid for 15 yrs.  I have been unstable for the last 8 yrs.  The doctors have changed my dosing every 2 months as my levels are outrageous.  My last TSH was high at 13.0 and my T3 was 0.02 and my T4 was low (indicative of hyperthyroidism).  The doctor is running several tests including a thryoid u/s. I have had abnormal weight gain in the last 2 months (30 lbs, and I have had gastric bypass).  The doctors are puzzled as to why I cannot get regulated.  My exam on Thurs my doc said my heart was skipping beats and I guess he felt nodules because he told me get the u/s asap.  Any thoughts?  We are all at our wits end here.  I was on 250 mcg of Levothyroxine then lowered to 200 and now at 175.  This is all within the last yr and 1/2.  My tests are still all over the place.  

Sheri1963

08/26/07
  I was dx'd with Hashi's awhile back, so still not sure what is going on with me.  I also get EXTREME hot flashes, shakes flushed and woozy with palpitations.  I am sooooo confused as is my doctor.  

by Mark Lupo, M.D., Aug 29, 2007 06:21AM
Your tests consistently show too much levothyroxine (ie low TSH and high T4/T3).  Would continue to lower the dose.  You have hyperthyroidism due to over-treatment of your hypothyroidism (which is caused by your Hashimoto's).  You can certainly have diabetes independent of this and hyperthyroidism will increase insulin resistance (and therefore make sugar higher).
Member Comments (5)

by Sheri1963, Aug 28, 2007 05:25PM
To: Dr Lupo
I am sorry got my labs backwards:  TSH 0.02 (L), T3 36 (H)  AND T4 1.9 (h) date 08/06/07, on 05/24/07 T3 192 (h), T4 1.9 and TSH 0.01 (l), on 04/11/07 T3 193 (h), T4 2.1 (h) and TSH 0.01 (l), then on 03/16/07 TSH 0.02 (l).  I am also having what I think are symptoms of Type II diabetes and was wondering if you can Hashi's/Hyper and be diabetic?

by brbangle, Aug 29, 2007 10:13AM
To: Sheri1963
Sheri1963, Dr. Mark's comment about hyperthyroidism increasing insulin resistance is interesting. I take 1500 mg/day Metformin for insulin resistance -- it has successfully cleared up my acne and regulated my periods. Recently, however, I experienced hyperthyroid symptoms -- heart palps, shortness of breath, anxiety, etc. -- from Synthroid/T3 overtreatment, and it suddenly seemed like the Metformin just stopped working! After discontinuing the T3 and lowering my Synthroid dose, the hyperthyroid symptoms have lessened in frequency and severity, and the insulin resistance seems to be under control again with the same dose of Metformin. Maybe this is what was happening with you, too...

A TSH of 0.02 is, indeed, pretty low. You should be aiming for a TSH around 1.0. Good luck!  

by bunniemay, Aug 29, 2007 11:56AM
IN 1989 after the birth of my last child I began having issues with thyroid. Within 2 years I was diagnosed with Hashimoto's and Papillary Carcinoma of the right lobe of my Thyroid. I had 2 surgeries to remove both lobes and had my 6 week wait for radioactive iodine isotope. 1st yr follow up great, 5 year follow up great (but systems went crazy and was hospitalized)....now here we are almost 16 years later...Last June I began having problems with my TSH being elevated, my endo from previous yrs had always said my TSH was never to be any higher than .01 and I always had yearly Thyroid globulin tests. SO TSH last June was at 10 (I think)...I know for sure tooo high. I struggled and argued (as I have no health insurance) with docotrs from the "free clinic". Recently I had been out of my Levoxyl and had grown so tired of being told I don't know diddly about my own body. In just 4-5 weeks my TSH went to 180.17....I also had a WBC of over 17,0000 which seemed to be from a neglected bladder infection that went into my kidneys(I kept asking for help about my urine being so bad but was ignored) anyway I was hospitalized and assigned to a doctor who is argued with me and absolutely REFUSED to DAW my LEVOXYL as I am not able to take synthroid or any other generics out there (been there done it and it wasn't good!) Finally another doctor took over the Levoxyl issue and I was given it DAW.....I have been on that for 16yrs ! My question is when they did blood work they did a TgAb and  not having a thyroid I am assuming that there should be no antibodies around for the thyroid....the level came back at 20 and I have huge concerns that antibodies are present as they are genetically altered from my Hashimotos....Could my cancer be back?? I have gone 6 weeks for body scans without my Levoxyl and my TSH has never been that high....I am very concerned.....actually very scared, this is a female issue on my paternal side also 2 other cousins have had the same cancer since I have. I would appreciate any help as I am just out of the hospital and have to wait until 9/11 to see my new doctor...HELP please!!!! This time has really flared my fibromyalgia into extremes also...pain in my spine is unbelievable....Please help!

by bunniemay, Sep 01, 2007 11:21AM
  I don't require an answer as I have researched this myself.....my new GP and I will discuss this on 9/11 and the treatments will follow that.....it would have been nice to have an answer from a professional.....however, this is not a "normal situation"

  Good luck to you all
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