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Confused about Thyroid!!!
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Confused about Thyroid!!!

Hi

I have recently received my blood tests back for my Thyroid, I was called in by the doctor as it was slighty high. I beleive he stated my TSH was 13.9 and my T4 was normal. I have no idea was any of this means and was hoping that someone would be able to explain it to me in the simplest terms possible.

I have, for a while now, been experiencing extreme tiredness, slight depression, I don't go to the toilet for nearly 2 weeks sometimes, have irregular periods and have been gaining weight, amongst other things. The doctor told me I have subclinical hypothyroidism and has presribed me 50mg of Thyroxine. I am going back for new blood tests in January next year.

Please would someone be able to explain this to me a bit better as I'm very confused!

Many Thanks!
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Avatar_m_tn
First, I'd like to point out that TSH is a pituitary hormone that is only an implied value for T4 and T3, which are the actual thyroid hormones.  In actuality it does not correlate very well with either, or with hypo symptoms.   TSH is affected by so many variables, that at best it is an indicator, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T3 and Free T4 (not the same as Total T3 an Total T4).  Of these FT3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not correlate.

All that said, your TSH, along with those symptoms,  is high enough to indicate hypothyroidism.  So, taking Thyroxine is in the right direction.  The next issue will be getting you to the right levels of Free T3 and Free T4 to alleviate symptoms.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief must be all important to you, not just test results.  You can gain some good insight into clinical treatment from reading this letter written by a good thyroid doctor for patients that he consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

For the future, you should request to be tested for Free T3 and Free T4, along with the TSH, every time you go in for testing.  If the doctor resists then you should insist on it and don't take no for an answer.  Since hypo patients are frequently low in other areas, you should also request testing for Vitamin D, B12, iron/ferritin, zinc, and selenium.  To find out if Hashimoto's Thyroiditis is the basic cause of your being hypo, you should also be tested for the thyroid antibodies, TPO ab and TG ab.  

When test results are available, please get a copy and post results and their reference ranges and members will be glad to help interpret and advise further.  
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Avatar_m_tn
First, I'd like to point out that TSH is a pituitary hormone that is only an implied value for T4 and T3, which are the actual thyroid hormones.  In actuality it does not correlate very well with either, or with hypo symptoms.   TSH is affected by so many variables, that at best it is an indicator, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T3 and Free T4 (not the same as Total T3 an Total T4).  Of these FT3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not correlate.

All that said, your TSH, along with those symptoms,  is high enough to indicate hypothyroidism.  So, taking Thyroxine is in the right direction.  The next issue will be getting you to the right levels of Free T3 and Free T4 to alleviate symptoms.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief must be all important to you, not just test results.  You can gain some good insight into clinical treatment from reading this letter written by a good thyroid doctor for patients that he consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

For the future, you should request to be tested for Free T3 and Free T4, along with the TSH, every time you go in for testing.  If the doctor resists then you should insist on it and don't take no for an answer.  Since hypo patients are frequently low in other areas, you should also request testing for Vitamin D, B12, iron/ferritin, zinc, and selenium.  To find out if Hashimoto's Thyroiditis is the basic cause of your being hypo, you should also be tested for the thyroid antibodies, TPO ab and TG ab.  

When test results are available, please get a copy and post results and their reference ranges and members will be glad to help interpret and advise further.  
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1928571_tn?1329325428
Thank you for your help!!

I have taken my first tablet today and I am due to have my next blood tests in 6 weeks time so will post my results then. I will also state how I am feeling and if I feel thaty anything has improved etc.

Again many thanks for your help and look forward to speaking to you soon!
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649848_tn?1357751184
gimel pretty well covered everything; I'd just like to ask if you have an actual result and reference range for the T4 test that was done, and do you know if it was for Free T4 or Total T4?

It's a good idea for you to write on each lab report the medication you're on, along with the dosage and your symptoms.  This will make it easier to find your optimal levels, so you'll know which numbers to target down the road.
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1928571_tn?1329325428
I have just received my blood tests back this morning and will be seeing the doctor tonight to talk over things with him. I dont have a full lab report of my results bu I do have a summary.

Apparently my TSH is in normal range after taking a daily dose of 50mg Levothyroxine and my TPO antibodies have come back high showing that it is likely I have auto immune hypothyroidism. Again, I am not overly sure what most of that means however I have a lot of questions to ask the doctor tonight.

With regards to my TSH, the results are now in normal range however I am extremely tired all the time, my skin has gone incredibly dry and is cracking especially on my face and I still do not go to the toilet very often. I read somwehere online that the best range for your TSH levels to be is between 1 - 2 although the 'normal' range accepted by most doctors is wider.

Could you help me please as I want to be able to say and ask the doctor the correct things tonight?
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Avatar_m_tn
TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate for diagnosing and medicating a thyroid patient.  At best it is only an indicator to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, which are Free T3 and Free T4 (not the same as Total T3 and T4).

Doctors use TSH because it is supposed to accurately reflect the levels of Thyroid hormone; however, it cannot be shown to correlate adequately with either Free T3 or Free T4, much less with the more important, hypo symptoms.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just blood test results.  I mention this about resultant TSH because frequently patients taking thyroid meds find that as their dosage is increased, (as will be required with your Hashi's), their TSH level becomes suppressed below the range.  This does not mean hyperthyroidism, unless it is accompanied by hyper symptoms, due to excessive levels of Free T3 and Free T4.  

YOu can get some good insight from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.  

http://hormonerestoration.com/files/ThyroidPMD.pdf


When you go to the doctor you should request to be tested for Free T3 and Free T4, along with TSH.  If the doctor resists, then you should insist on the importance of these tests and don't take no for an answer.  A copy of this for your doctor might help sway the doctor's decision.  Also, while there you should ask if the doctor is going to be willing to treat you clinically,as described in the letter.  Also ask if the doctor is willing to prescribe T3 meds if needed.   If either answer is no, then you will need to find a good thyroid doctor that will do both.  

You should also ask about testing for Vitamin  A, D, B12, and a full panel of tests for iron anemia.




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649848_tn?1357751184
Please post actual lab results, along with reference ranges.  Many of us, here on the forum, have little faith in "normal" values, because they often leave patients inadequately treated.  This seems to especially prevalent in UK, with the NHS.
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Avatar_f_tn
I am new to this forum..searching online for others in the same boat...I was on 60mg of armour and was taking too much (with my primary dr.)...palpitations...my GYN discovered after blood work..reduced armour to 15-30mg...then blood work showed 5.6 too low...GYN now has me on 50mg of time-released compounding thyroid...very tired and slow ..sometimes no bowel movement...this scares me...want my joy back and bowel movements normal (too much constipation)... will repeat blood work in 6 weeks...

Does anybody know how long to get back to normal?  I want to feel better with all symptoms very soon...thanks for any advice...I'll have to give by GYN time...but wonder if I should see an Internist...

Thanks for any help...
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Avatar_m_tn
I have a number of questions for you.  Is your doctor only testing and adjusting your meds based on TSH?  If so, that doesn't work because TSH is a pituitary hormone that is affected by so many variables that it does not adequately reflect even the thyroid hormones, Free T3 and Free T4, much less symptoms, which are the most important.

Have you had any other thyroid related tests besides TSH?  If so, please post results and reference ranges shown on the lab report.  

When did you start taking the Armour?  What dose did you start with?  When do you take it?
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