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Can you be Hypothyroid without the antibodies?
I have been diagnosed with mild hypothyroidism and my prolactin levels are a little high. I was tested for hashi's because at times I have symptoms of hyper but low free t4. My test came back today for the antibodies and both tests were low end normal so I do not have hashimotos disease. But I am wondering is that normal to have hypothyroid without Hashimotos? I know I have something else going on whether its adrenal insufficiency or possibly pituitary related. But I am so confused by all my blood work :( any advice is welcome.
Good morning. I have the same type of nonsense going on and it is frustrating. You learn that doctors, even specialists, aren't all that learned in their field and that you are really on your own as regards diagnosing your issues. I do not have any answers. I do have a few suggestions:
1. If your doctor is consistently blocking your care, move on. Ask them to put their refusal to treat in writing with the reasons, request a copy of your ENTIRE medical record from their office (incuding all referrals, which is where they may badmouth you to other doctors), and get a second opinion. Continue getting second opinions until you find someone who doesn't hate women & mistreat young mothers. I'm guessing they've already made the suggestion to get on antidepressant/antianxiety meds? That is the standard "I hate women and I'm really fricking lazy" doctor's answer to everything. Don't waste your time on them (or - and this is just my opinion - their meds, unless you are actively thinking of harming yourself or others).
2. With your new doctor, EDIT THAT RECORD you got from your previous doctor. Do not just let doctors transfer your records around without reading them first. You'll be shocked by what you see. Send your own records, labs only. "I already received his opinion. I'm here for yours." You could even state that you do not wish him/her conferring with the previous physician. Don't sign a release.
3. walkinlabs.com If you have a LabCorp or Quest near you, you can order any testing you like, except imaging. It's not cheap, but cheaper than you'd think. Sometimes, one or two tests really clears things up for you and you can argue more effectively for your care. Warning: Lazy doctors hate when patients find things they didn't bother to look for. They will act offended that you don't trust them. It's your body. You make the choices.
4. Be willing to travel. I fought for two years in Maine and Boston to get my hyperparathyroidism diagnosed. Two years of consistently high PTH with all the frigging symptoms. It was thought my calcium wasn't high enough to cause the myriad of symptoms I have/had, because it hadn't gone over 11 yet. They were wrong. Very wrong. Two HUGE parathyroid adenomas and another 8% bone loss in my hips over those two years of arguing. I finally gave up on local care and went to Tampa, FL. One of those tumors was over an inch long and half again as wide. These things are supposed to be the size of an uncooked grain of rice.
5. SPECIFIC TO YOUR CASE:
a. Did you lose a lot of blood in childbirth? There is something called Sheehan's syndrome which can affect your pituitary function that might be relevant. It causes low pituitary function. I would ask for a pituitary panel, beyond the female hormones that are obviously out of whack for you right now. I'm confused as to why they did your cortisol at noon? Usually, that's a morning thing when cortisol is highest, along with ACTH, another pituitary hormone. An MRI with a focus on pituitary and hypothalamus would really cut to the chase, but you likely need to convince them with blood work. Unless you had that documented significant loss of blood, something that really dropped your BP post-birth, may have even resulted in fluids being pushed via IV. Then, they really should look.
b. Get your family history, if you can. You will not believe the amount of stuff your parents and grandparents never shared that might be relevant to your case. It's pretty clear that my dad has hyperparathyroidism, for example. You might save a lot of time.
Another note: I may sound a little harsh on the "lazy docs and psych meds" thing, but I have reason. You go down that path and psychological diagnoses are always going to be the answer for every little symptom you have. I stopped going to the ER for chest pain, palpitations, racing pulse and trouble breathing because I got sick of hearing "How much stress are you under, dear?" I had succumbed to the psychiatry trap for years and they really never drop that, even after you've tapered off all their crap and been off all of it for years. Finally, I had to give in and go to the ER for several palpitations, trouble breathing & disorientation after avoiding it for two years. I'd been having symptoms off and on the entire time. The latest EKG indicated a "possible myocardial infarction" sometime in those past two years. I had to insist on a stress test, which found a 4.8 cm ascending aortic aneurysm. Their bias against patients with a mental health history of anxiety & depression (Starting in the post-partum/early motherhood period. Sound familiar?) could have gotten me killed. Don't be their next statistic.
Final note: Endocrinology is a tough field. It's wicked complicated and your endocrinologist can't know everything there is to know about the endocrine system. But a good endocrinologist knows the parts he or she knows really well and is secure enough in their expertise & intelligence to refer you or confer with colleagues on the stuff they are less clear on. If your endocrinologist says, "Huh. I don't know. Let me look that up." or, "Oh, you want Dr. Bob. Let me refer you," you probably have a good one.
Don't give up. You'll figure it out eventually.
1. If your doctor is consistently blocking your care, move on. Ask them to put their refusal to treat in writing with the reasons, request a copy of your ENTIRE medical record from their office (incuding all referrals, which is where they may badmouth you to other doctors), and get a second opinion. Continue getting second opinions until you find someone who doesn't hate women & mistreat young mothers. I'm guessing they've already made the suggestion to get on antidepressant/antianxiety meds? That is the standard "I hate women and I'm really fricking lazy" doctor's answer to everything. Don't waste your time on them (or - and this is just my opinion - their meds, unless you are actively thinking of harming yourself or others).
2. With your new doctor, EDIT THAT RECORD you got from your previous doctor. Do not just let doctors transfer your records around without reading them first. You'll be shocked by what you see. Send your own records, labs only. "I already received his opinion. I'm here for yours." You could even state that you do not wish him/her conferring with the previous physician. Don't sign a release.
3. walkinlabs.com If you have a LabCorp or Quest near you, you can order any testing you like, except imaging. It's not cheap, but cheaper than you'd think. Sometimes, one or two tests really clears things up for you and you can argue more effectively for your care. Warning: Lazy doctors hate when patients find things they didn't bother to look for. They will act offended that you don't trust them. It's your body. You make the choices.
4. Be willing to travel. I fought for two years in Maine and Boston to get my hyperparathyroidism diagnosed. Two years of consistently high PTH with all the frigging symptoms. It was thought my calcium wasn't high enough to cause the myriad of symptoms I have/had, because it hadn't gone over 11 yet. They were wrong. Very wrong. Two HUGE parathyroid adenomas and another 8% bone loss in my hips over those two years of arguing. I finally gave up on local care and went to Tampa, FL. One of those tumors was over an inch long and half again as wide. These things are supposed to be the size of an uncooked grain of rice.
5. SPECIFIC TO YOUR CASE:
a. Did you lose a lot of blood in childbirth? There is something called Sheehan's syndrome which can affect your pituitary function that might be relevant. It causes low pituitary function. I would ask for a pituitary panel, beyond the female hormones that are obviously out of whack for you right now. I'm confused as to why they did your cortisol at noon? Usually, that's a morning thing when cortisol is highest, along with ACTH, another pituitary hormone. An MRI with a focus on pituitary and hypothalamus would really cut to the chase, but you likely need to convince them with blood work. Unless you had that documented significant loss of blood, something that really dropped your BP post-birth, may have even resulted in fluids being pushed via IV. Then, they really should look.
b. Get your family history, if you can. You will not believe the amount of stuff your parents and grandparents never shared that might be relevant to your case. It's pretty clear that my dad has hyperparathyroidism, for example. You might save a lot of time.
Another note: I may sound a little harsh on the "lazy docs and psych meds" thing, but I have reason. You go down that path and psychological diagnoses are always going to be the answer for every little symptom you have. I stopped going to the ER for chest pain, palpitations, racing pulse and trouble breathing because I got sick of hearing "How much stress are you under, dear?" I had succumbed to the psychiatry trap for years and they really never drop that, even after you've tapered off all their crap and been off all of it for years. Finally, I had to give in and go to the ER for several palpitations, trouble breathing & disorientation after avoiding it for two years. I'd been having symptoms off and on the entire time. The latest EKG indicated a "possible myocardial infarction" sometime in those past two years. I had to insist on a stress test, which found a 4.8 cm ascending aortic aneurysm. Their bias against patients with a mental health history of anxiety & depression (Starting in the post-partum/early motherhood period. Sound familiar?) could have gotten me killed. Don't be their next statistic.
Final note: Endocrinology is a tough field. It's wicked complicated and your endocrinologist can't know everything there is to know about the endocrine system. But a good endocrinologist knows the parts he or she knows really well and is secure enough in their expertise & intelligence to refer you or confer with colleagues on the stuff they are less clear on. If your endocrinologist says, "Huh. I don't know. Let me look that up." or, "Oh, you want Dr. Bob. Let me refer you," you probably have a good one.
Don't give up. You'll figure it out eventually.
You could take all I know about those pituitary tests and put it in a thimble; however, from the reading this has caused me to do, I think that your FSH, LH and Prolactin tests are indicative of low/sluggish pituitary function. This is also consistent with your low free T4 result.
Just a couple of questions come to mind right now, and hopefully other members with direct experience/knowledge of pituitary problems will join the discussion. What type of symptoms were you having before taking the Levothyroxine? What amount did the doctor prescribe to start with?
Just a couple of questions come to mind right now, and hopefully other members with direct experience/knowledge of pituitary problems will join the discussion. What type of symptoms were you having before taking the Levothyroxine? What amount did the doctor prescribe to start with?
One other thing I have which I don't know if it is related I have major pressure behind my eyes and was diagnosed with papilledema. I see spots and floaters ALOT. I thought I may have a pituitary tumor, but with these lab results all checking out I don't know what it could be. I have also had an MRI 2 years ago I had the same symptoms and it was normal. So I am very very confused...
Okay I am back once more with more recent lab work. I am still fighting to get more adrenal testing done with my doctor, however I have some tests that I had done recently for pituitary function AND thyroid antibodies test done, let me give you my results. I will even give the results of my TSH and Free t4 to show that I have low thyroid function.
TSH 1.97 (normal range)
Free T4 0.68 (0.71-1.66) Low
hormones:
FSH 4.4 mIU/ml (4.0-13.0)
LH 3.6 mU/mL (1.0-18.0)
Prolactin 23.0 ng/mL (5.2-26.5)
Thyroglobulin Antibodies <0.3 (0-14.4)
Thyroid Peroxidase Antibodi <0.5 (0-3.9)
Cortisone Serum 1.8 mcg/dL A.M. 1.2-3.5
P.M. 0.6-2.8
I had the cortisol test done at noon. I am just confused if my Pituitary tests check out normal, and antibodies are normal, why am I hypothyroid? My Doctor isn't being very helpful right now. I don't know if my adrenals maybe causing the thyroid to be low...? I am going in on Tuesday to get him to do more adrenal tests done, but I am just still confused as to where my hypothyroid comes in. I also am still lactating and have been for 2 years and had my son 2 years ago. I just don't understand why my doc won't treat me if I have an obvious symptoms but the labs are within "normal" range. Hating my life right now!!!! He gave me levothyroxine and it didn't help I felt like I was going hyper even though my t4 was still showing hypo. I feel like all doctors are idiots! HUGE idiots and I hate them all right now. Sorry to vent that wasn't my intent with this I am just searching for viable answers.
TSH 1.97 (normal range)
Free T4 0.68 (0.71-1.66) Low
hormones:
FSH 4.4 mIU/ml (4.0-13.0)
LH 3.6 mU/mL (1.0-18.0)
Prolactin 23.0 ng/mL (5.2-26.5)
Thyroglobulin Antibodies <0.3 (0-14.4)
Thyroid Peroxidase Antibodi <0.5 (0-3.9)
Cortisone Serum 1.8 mcg/dL A.M. 1.2-3.5
P.M. 0.6-2.8
I had the cortisol test done at noon. I am just confused if my Pituitary tests check out normal, and antibodies are normal, why am I hypothyroid? My Doctor isn't being very helpful right now. I don't know if my adrenals maybe causing the thyroid to be low...? I am going in on Tuesday to get him to do more adrenal tests done, but I am just still confused as to where my hypothyroid comes in. I also am still lactating and have been for 2 years and had my son 2 years ago. I just don't understand why my doc won't treat me if I have an obvious symptoms but the labs are within "normal" range. Hating my life right now!!!! He gave me levothyroxine and it didn't help I felt like I was going hyper even though my t4 was still showing hypo. I feel like all doctors are idiots! HUGE idiots and I hate them all right now. Sorry to vent that wasn't my intent with this I am just searching for viable answers.
Yes you can be Hypo without having Hashi, it would mean there is something else causing your Hypo/ Hyper, have they looked at your pituitary gland if your levels are high? As gimel suggests post your blood work so more can give you an idea..
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