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Do I or do I not take the medication if weight is my biggest symptom?
I will briefly post my situation here just so nobody has to go back and dig through to find what I am talking about :))) I realize that I don't really "FEEL" that bad, even though I do get cold super-easy and have dry skin and hair, it's more the fact that I have gained about 6-7 pounds that don't seem to come off and I worry about gaining MORE that makes me wonder if I should go ahead and move forward with the medication my doctor has told me she would put me on if I choose to take it. Up until this year (I am 48), I had been the SAME weight for 25+ years and now all of a sudden I have put this on and can't get it off, and worried that it will keep climbing (though it's been only 6 pounds since May pretty consistently).
Here are my labs (I realize that while they are in the normal range, that the T3 is still somewhat low and that the others could be improved with medication).
TSH 1.57 (normal range .4 - 4.5)
Free T3 of 2.8 (normal range of 2.3 - 4.2)
Free T4 of 1.2 (normal range of 0.8-1.8)
Antibodies tested for autoimmune and are FINE.
I don't like taking any meds if I don't need them, especially something that once started I will have to take indefinitely. Is it worth it to take meds JUST for weight issues if everything else is really somewhat 'tolerable'????
Lady
Here are my labs (I realize that while they are in the normal range, that the T3 is still somewhat low and that the others could be improved with medication).
TSH 1.57 (normal range .4 - 4.5)
Free T3 of 2.8 (normal range of 2.3 - 4.2)
Free T4 of 1.2 (normal range of 0.8-1.8)
Antibodies tested for autoimmune and are FINE.
I don't like taking any meds if I don't need them, especially something that once started I will have to take indefinitely. Is it worth it to take meds JUST for weight issues if everything else is really somewhat 'tolerable'????
Lady
Forgot to say that I have been an avid exerciser since I was 18 and currently work out 5X a week - 5x cardio for 30-40 minutes and 2x weight. I also log my calories and never go over 1400, which is really low for my height (5'6" and age). I had my metabolic rate tested and it is 22% lower than expected for my age and height. I should have included this info. above in my original post, as I am doing all of the right things yet STILL had the weight gain.
Your metabolic rate test, combined with the symptoms you have, and your test results all say that you are hypothyroid. Since your TSH is also low in its range, that points to central hypothyroidism, which is a malfunction in the hypothalamus/pituitary areas that is resulting in too little TSH from the pituitary.
In the words of a good thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."
It is very good that you have a doctor that was willing to prescribe thyroid meds, for you, even though your tests were within the so-called "normal" ranges. Many doctors have the "Immaculate TSH Belief" and use "Reference Range Endocrinology", and would not have offered to do so. You see 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 always be the most important, not just test results.
So I suggest that you should go ahead with your doctor's offer for thyroid med. Be aware that as you start on the med you may have to re-test and increase ever 4-5 weeks in order to raise your Free T3 and Free T4 levels. Many members say that symptom relief required Free T3 in the upper part of its range and Free T4 around the middle of its range. each patient can have slightly different optimal levels, so that is why clinical treatment is best.
One other thing is that hypo patients are also frequently too low in the range for Vitamin D, B12 and ferritin. So it would be a good idea to test those as well.
In the words of a good thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."
It is very good that you have a doctor that was willing to prescribe thyroid meds, for you, even though your tests were within the so-called "normal" ranges. Many doctors have the "Immaculate TSH Belief" and use "Reference Range Endocrinology", and would not have offered to do so. You see 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 always be the most important, not just test results.
So I suggest that you should go ahead with your doctor's offer for thyroid med. Be aware that as you start on the med you may have to re-test and increase ever 4-5 weeks in order to raise your Free T3 and Free T4 levels. Many members say that symptom relief required Free T3 in the upper part of its range and Free T4 around the middle of its range. each patient can have slightly different optimal levels, so that is why clinical treatment is best.
One other thing is that hypo patients are also frequently too low in the range for Vitamin D, B12 and ferritin. So it would be a good idea to test those as well.
Thanks, Gimel. She did test me for those things and I *am* deficient in all three! Or WAS............she put me on supplements and after re-testing, I am in the right ranges, so at least I am making progress with that. If weight is my ONLY concern, though, is it worth it to go on the meds just for that? It almost sounds trivial, especially since it is only 6-7 pounds. I've heard some people say that they have gained tons of weight on the meds, so I would potentially be making the one problem I had worse than I would if I just left it alone. Am I misguided on my thinking?
Like Gimel said. With KNOWN slow metabolism and all the excercise you do and the sudden weight gain after prolonged period of extremely stable weight for years suggests that "something" is different. And it all points to the idea that it is thyroid. I think it would be reasonable to conclude that if the weight is NOT comig off after some period of time which it seems is the case, that indeed it would seem to make sense that the weight gain IS from low thyroid.
Did you have a metabolic test prior which was normal, and now suddenly the 22% below the expected rate? In any event the fact that a person do ing as much excercise for as long as you would expect if anything a higher than normal metabolism as excercise ususally speeds it up. The fact that you are now low suggest something that regulates your metabolism is messed up. And thyroid is the key hormone that establishes metabolism.
Bottom line is that a starter dose as a clinical trial to see if it helps would seem to make sense. But it is totally upto you. If you don't feel horrible then what you decide to do is your choice.
When you say antibodies are fine? DO you have the rest result? Did they test BOTH TPO ab and TGab? if they only tested one of these then you may still have Hashimoto's. Hashis only needs at least one of those two to be elevated.
As far as B-12 you want to be well above 50% of the range. In fact most people seem to need to be towards the very upper end to eliminate fatigue. But with the excercise you do and you are not complaining about fatigue that may not be an issue for you. But if you have the test results for the antibodies and for the other vitamins if you could post them here it would be a help.
It I were you, I'd start on a small dose of T4. But that decision is toatally up to you.
Just my thoughts.
Did you have a metabolic test prior which was normal, and now suddenly the 22% below the expected rate? In any event the fact that a person do ing as much excercise for as long as you would expect if anything a higher than normal metabolism as excercise ususally speeds it up. The fact that you are now low suggest something that regulates your metabolism is messed up. And thyroid is the key hormone that establishes metabolism.
Bottom line is that a starter dose as a clinical trial to see if it helps would seem to make sense. But it is totally upto you. If you don't feel horrible then what you decide to do is your choice.
When you say antibodies are fine? DO you have the rest result? Did they test BOTH TPO ab and TGab? if they only tested one of these then you may still have Hashimoto's. Hashis only needs at least one of those two to be elevated.
As far as B-12 you want to be well above 50% of the range. In fact most people seem to need to be towards the very upper end to eliminate fatigue. But with the excercise you do and you are not complaining about fatigue that may not be an issue for you. But if you have the test results for the antibodies and for the other vitamins if you could post them here it would be a help.
It I were you, I'd start on a small dose of T4. But that decision is toatally up to you.
Just my thoughts.
COMMUNITY LEADER
While I agree with gimel and flyingfool that your FT levels are too low in the ranges, I'd also like to point out that part of the reason your metabolic rate is so low is, likely, because you are taking in too few calories for your size and exercise level.
Your body requires a certain amount of calories every day, just to fuel involuntary processes, such as heart rate, digestion brain, kidney and other organ functions, plus you're adding exercise 5 X/week. If you don't provide enough calories, your metabolism will slow down in an effort to preserve existing fat stores. You should calculate your actual calorie needs, based on your weight, height, age and activity level.
That said, all of your symptoms together, weight gain, cold intolerance and dry skin/hair would warrant starting thyroid med to prevent them from becoming worse or for new ones from starting. It's always best to start med before symptoms become uncontrollable and you're lucky to have a doctor who is willing to start you on med, even with levels in the normal ranges.
Your body requires a certain amount of calories every day, just to fuel involuntary processes, such as heart rate, digestion brain, kidney and other organ functions, plus you're adding exercise 5 X/week. If you don't provide enough calories, your metabolism will slow down in an effort to preserve existing fat stores. You should calculate your actual calorie needs, based on your weight, height, age and activity level.
That said, all of your symptoms together, weight gain, cold intolerance and dry skin/hair would warrant starting thyroid med to prevent them from becoming worse or for new ones from starting. It's always best to start med before symptoms become uncontrollable and you're lucky to have a doctor who is willing to start you on med, even with levels in the normal ranges.
Hi, everyone and thank you for your comments and feedback. Just a few things:
Barb - YES, I have been trying to gradually increase calories over a three month period (a body building technique that body builders use to burn fat), but to no avail...............I have mixed it with increasing exercise, decreasing exercise, and different combinations. I have been logging it all through myfitnesspal app so I know exactly what I am doing each day. My stats show that I should be eating closer to 1800 - 2000 calories, and it just isn't happening when I get near that level that scales creep up.
Flying - I had never had a metabolic test done prior to May because I never had any problems. Ate pretty much whatever and it didn't matter because I was exercising and active, but I am sure it was over 2,000 per day that I was eating and burning. Just never had a reason to have it checked. I low resting metabolism one of the things they use to diagnose thyroid issues? I hadn't heard of that. I just went because I was continuing to have problems with these pounds just creeping up out of nowhere. I went back and looked and I was only tested to the TPO, NOT the GAB. Should I ask for this? Why would she test me only for one and not the other??
She gave me a prescription to start Armour (15 mg. 2x a day), BUT, I told her I wanted to try to treat the progesterone deficiency first (which was the only other thing 'off'). Don't know if THAT might be part of the problem, but from things I have read, it's possible and that it does impact the thyroid. I am going to stick with that for a few months along with my increasing calories and continuing exercise and if it isn't 'fixed' by those thing by the end of February, I am going to make myself go on the Armour.
MY PROBLEM?? I AM TERRIFIED of the thyroid meds! I have heard that thyroid meds are serious meds AND if I take them, my thyroid may NEVER work again and I will have to rely on these meds FOR LIFE! And honestly, if the weight is my issue, and I read about people who are on the meds and gain even MORE weight, then why bother taking them? I guess I am both TERRIFIED and CONFUSED about the thyroid meds. Can anyone share more about this in particular??? I have no doubt my levels are low, but if the progesterone doesn't fix my problems, then I'll have to look at the meds and that just scares me :((.
Barb - YES, I have been trying to gradually increase calories over a three month period (a body building technique that body builders use to burn fat), but to no avail...............I have mixed it with increasing exercise, decreasing exercise, and different combinations. I have been logging it all through myfitnesspal app so I know exactly what I am doing each day. My stats show that I should be eating closer to 1800 - 2000 calories, and it just isn't happening when I get near that level that scales creep up.
Flying - I had never had a metabolic test done prior to May because I never had any problems. Ate pretty much whatever and it didn't matter because I was exercising and active, but I am sure it was over 2,000 per day that I was eating and burning. Just never had a reason to have it checked. I low resting metabolism one of the things they use to diagnose thyroid issues? I hadn't heard of that. I just went because I was continuing to have problems with these pounds just creeping up out of nowhere. I went back and looked and I was only tested to the TPO, NOT the GAB. Should I ask for this? Why would she test me only for one and not the other??
She gave me a prescription to start Armour (15 mg. 2x a day), BUT, I told her I wanted to try to treat the progesterone deficiency first (which was the only other thing 'off'). Don't know if THAT might be part of the problem, but from things I have read, it's possible and that it does impact the thyroid. I am going to stick with that for a few months along with my increasing calories and continuing exercise and if it isn't 'fixed' by those thing by the end of February, I am going to make myself go on the Armour.
MY PROBLEM?? I AM TERRIFIED of the thyroid meds! I have heard that thyroid meds are serious meds AND if I take them, my thyroid may NEVER work again and I will have to rely on these meds FOR LIFE! And honestly, if the weight is my issue, and I read about people who are on the meds and gain even MORE weight, then why bother taking them? I guess I am both TERRIFIED and CONFUSED about the thyroid meds. Can anyone share more about this in particular??? I have no doubt my levels are low, but if the progesterone doesn't fix my problems, then I'll have to look at the meds and that just scares me :((.
Based on all the info so far, it is unlikely that you have Hashimoto's, so the additional tet for TG ab would be wasted. Regarding low progesterone, I read the following:
"Estrogen dominance causes the liver to produce high levels of a protein called “thyroid binding globulin”, which, as its name suggests, binds the thyroid hormone and decreases the amount of thyroid hormone that can be assimilated into and utilized by the cells.
What does this lead to? Low thyroid function and all of the negative side effects that come along with it."
So I understand your concern there. The only thing that doesn't add up is that if your low Free T3 and Free T4 are only due to low progesterone, why would your TSH also be somewhat low in the range. In response to the low FT3 and FT4, I would expect a higher TSH. That makes me wonder also if you cold have secondary hypothyroidism, due to a pituitary issue. So, something to keep in mind as you increase the progesterone level .
Also, there is no need to be terrified of thyroid meds. Thyroid meds are not drugs, they are replacement hormones. You can take thyroid meds and after achieving adequate levels of Free T3 and Free T4, if you get no benefit, you can always wean off the med and your system will return to prior. People who are on thyroid med and gain more weight are usually not adequately medicated. Often when first starting on thyroid med, the levels don't go up at the beginning and people think any continued weight gain is due to the med, when it is not.
"Estrogen dominance causes the liver to produce high levels of a protein called “thyroid binding globulin”, which, as its name suggests, binds the thyroid hormone and decreases the amount of thyroid hormone that can be assimilated into and utilized by the cells.
What does this lead to? Low thyroid function and all of the negative side effects that come along with it."
So I understand your concern there. The only thing that doesn't add up is that if your low Free T3 and Free T4 are only due to low progesterone, why would your TSH also be somewhat low in the range. In response to the low FT3 and FT4, I would expect a higher TSH. That makes me wonder also if you cold have secondary hypothyroidism, due to a pituitary issue. So, something to keep in mind as you increase the progesterone level .
Also, there is no need to be terrified of thyroid meds. Thyroid meds are not drugs, they are replacement hormones. You can take thyroid meds and after achieving adequate levels of Free T3 and Free T4, if you get no benefit, you can always wean off the med and your system will return to prior. People who are on thyroid med and gain more weight are usually not adequately medicated. Often when first starting on thyroid med, the levels don't go up at the beginning and people think any continued weight gain is due to the med, when it is not.
COMMUNITY LEADER
If you're increasing your calories and alternating your exercise, as needed, but still gaining weight, then I'm going to lean toward your weight gain being thyroid related.
You're right at the age, at which you would be starting peri-menopause, so your reproductive hormones could be "off".
That being said, I'd agree with gimel and the thought of secondary hypothyroidism, since we'd expect your TSH to be higher in the range, with such low thyroid hormone levels, if you had primary hypothyroidism (Hashimoto's). I also agree that the meds are not going to ruin your thyroid.
You're right at the age, at which you would be starting peri-menopause, so your reproductive hormones could be "off".
That being said, I'd agree with gimel and the thought of secondary hypothyroidism, since we'd expect your TSH to be higher in the range, with such low thyroid hormone levels, if you had primary hypothyroidism (Hashimoto's). I also agree that the meds are not going to ruin your thyroid.
Most advice and things I have read suggest that thyroid should be regulated, balanced and treated FIRST.
Then after thyroid is regulated do you start to consider replacement hormones for the other sex hormones such as progesterone.
Hormones all seem to interact with one another. So solving one at a time is important. The next consideration is the order to solve the out of balance hormone. Again I and my wife have been told by Dr's and others to first balance thyroid before attacking any others including adrenals and sex hormones.
In my wife's case, herTestosterone is in the tank. But the Dr won't even consider adding any Testosterone until her thyroid is all settled out with proper dosage.
Difinative testing for Hashi's as I understand it requires both TPOab and TGab antibodies to be tested. So only being tested for one of them is not completely conclusive. However Gimel makes a good point that it appears that it is more an issue or more likey that it is a central hypo than caused by Hashi's.
It really doesn't matter too much in the end. In either case the end result is that you need to add in thyroid hormone replacement.
Many people have found the target to shoot for to feel well is not only within the reference range, but well up into the reference range. Specifically to have BOTH of the following:
1) Free T4 (FT4) to be in the MIDDLE of the range or a bit more. Meaning 50% or a bit higher. You are testing out at 2.3% of the range!
AND- that means in addition
2) Free T3 (FT3) to be in the UPPER 1/3 of the range, certainly above 50% of the range. You are testing at 40%
From your test results, it appears that you are converting T4 into T3. That is good. You can see that your FT4 are low. By raising the FT4 level with conversion it should also raise your FT3 levels.
Therefore while I have no problem with Armour or any Natural Dessicated Thyroid (NDT) medication, it has a LOT of T3 in it. And I'm not sure you really need that. As a result, my opinion would be to go with a straight T4 medication starter dose and see how that reacts and results for you.
T4 medication takes 6 WEEKS to stabilize in your blood. it is a storage hormone and isn't used directly. Your body (on demand) converts the T4 when it senses the need and converts it into T3. it is the T3 that is ultimately used by your body's cells.
T3 is used up in HOURS. That is why your Dr recommended that you take Armour in two doses. The T3 peaks about 2 to 4 hours after taking it and then trails off. By taking the first dose in the morning and then a 2nd dose later allows the 2nd dose to start coming "online" about the time the first dose is all used up.
Bottom line is that it is up to you which way you decide to go, either Armour or synthetic T4 (Synthroid or other generic names).
Just my opinions/thoughts.
Then after thyroid is regulated do you start to consider replacement hormones for the other sex hormones such as progesterone.
Hormones all seem to interact with one another. So solving one at a time is important. The next consideration is the order to solve the out of balance hormone. Again I and my wife have been told by Dr's and others to first balance thyroid before attacking any others including adrenals and sex hormones.
In my wife's case, herTestosterone is in the tank. But the Dr won't even consider adding any Testosterone until her thyroid is all settled out with proper dosage.
Difinative testing for Hashi's as I understand it requires both TPOab and TGab antibodies to be tested. So only being tested for one of them is not completely conclusive. However Gimel makes a good point that it appears that it is more an issue or more likey that it is a central hypo than caused by Hashi's.
It really doesn't matter too much in the end. In either case the end result is that you need to add in thyroid hormone replacement.
Many people have found the target to shoot for to feel well is not only within the reference range, but well up into the reference range. Specifically to have BOTH of the following:
1) Free T4 (FT4) to be in the MIDDLE of the range or a bit more. Meaning 50% or a bit higher. You are testing out at 2.3% of the range!
AND- that means in addition
2) Free T3 (FT3) to be in the UPPER 1/3 of the range, certainly above 50% of the range. You are testing at 40%
From your test results, it appears that you are converting T4 into T3. That is good. You can see that your FT4 are low. By raising the FT4 level with conversion it should also raise your FT3 levels.
Therefore while I have no problem with Armour or any Natural Dessicated Thyroid (NDT) medication, it has a LOT of T3 in it. And I'm not sure you really need that. As a result, my opinion would be to go with a straight T4 medication starter dose and see how that reacts and results for you.
T4 medication takes 6 WEEKS to stabilize in your blood. it is a storage hormone and isn't used directly. Your body (on demand) converts the T4 when it senses the need and converts it into T3. it is the T3 that is ultimately used by your body's cells.
T3 is used up in HOURS. That is why your Dr recommended that you take Armour in two doses. The T3 peaks about 2 to 4 hours after taking it and then trails off. By taking the first dose in the morning and then a 2nd dose later allows the 2nd dose to start coming "online" about the time the first dose is all used up.
Bottom line is that it is up to you which way you decide to go, either Armour or synthetic T4 (Synthroid or other generic names).
Just my opinions/thoughts.
Gimel and Barb, my TSH isn't always that low.........sometimes it is has been as high as 2.8. The T3 and T4 have stayed pretty consistent. Knowing that, does that change what you both had shared? I agree about the age thing, and somehow think it is part of it.
Also, Flying, I thought my T3 was more out of line than myT4? When you say 2.3% of the range, does that mean I am 2.3% vs. 100% of what it should be OR that I am only 2.3% away from being where it should? I just thought from my interpretation of the results was that it was my T3 that was more out of line? I am sooo confused. Can you clarify?
I am already feeling a little less fearful should I have to take the Armour for several reasons that each of you have pointed out. I have to say I truly was terrified (and still am a little scared) about taking it, but it IS a hormone, it obviously IS needed, and the point taken about the weight gain reported by many is likely NOT because of the drug..........I am feeling a little better just hearing what you all have to say. Just the thought of having to take it forever and not knowing what would do if I had to quit should I have a reaction to it or something, is what got me. I am feeling a bit better, so THANK YOU, friends!
Also, Flying, I thought my T3 was more out of line than myT4? When you say 2.3% of the range, does that mean I am 2.3% vs. 100% of what it should be OR that I am only 2.3% away from being where it should? I just thought from my interpretation of the results was that it was my T3 that was more out of line? I am sooo confused. Can you clarify?
I am already feeling a little less fearful should I have to take the Armour for several reasons that each of you have pointed out. I have to say I truly was terrified (and still am a little scared) about taking it, but it IS a hormone, it obviously IS needed, and the point taken about the weight gain reported by many is likely NOT because of the drug..........I am feeling a little better just hearing what you all have to say. Just the thought of having to take it forever and not knowing what would do if I had to quit should I have a reaction to it or something, is what got me. I am feeling a bit better, so THANK YOU, friends!
PS, Flying, I wanted to say that my doctor has taken the OPPOSITE approach.........wanted to fix everything BUT the thyroid first. I worked on getting the adrenals and the testosterone fixed along with the Vitamin D, and now she wants to try the progesterone first before going for the thyroid issues (to see if the progesterone is what is causing the thyroid). Very interesting that they have two totally opposite approaches! :))
Pituitary - I looked up symptoms and couldn't find anything that matches mine. I definitely did look and want to pursue all avenues, though, as I want to make sure I am not treating the thyroid if there is something else MAKING the thyroid malfunction - I would rather fix what is CAUSING the problem and let the thyroid fix itself. Does this *really* sound like pituitary? It will take forever to get an appointment and get seen about pituitary (I am sure they would have to do an MRI or something) and I have already been dealing with this for soooo long :(((
Pituitary - I looked up symptoms and couldn't find anything that matches mine. I definitely did look and want to pursue all avenues, though, as I want to make sure I am not treating the thyroid if there is something else MAKING the thyroid malfunction - I would rather fix what is CAUSING the problem and let the thyroid fix itself. Does this *really* sound like pituitary? It will take forever to get an appointment and get seen about pituitary (I am sure they would have to do an MRI or something) and I have already been dealing with this for soooo long :(((
Your symptoms would not show as being directly caused by the pituitary because the pituitary effect we are talking about results in the low TSH, and relatively low Free T4 and Free T4. I think you can gain some good insight from this quote from a good thyroid doctor.
"TSH is a measure of how
much the hypothalamic-pituitary system is attempting to stimulate the thyroid gland. A "normal" TSH tells us only that the
person doesn't have failure of the thyroid gland. It does not tell us that they have sufficient levels of thyroid
hormone. A normal TSH does not "rule out" hypothyroidism. Many, and possibly most people with various degrees of
hypothyroidism have normal TSH levels. Their hypothalamic-pituitary system is dysfunctional and not making sufficient TSH to give
them optimal thyroid levels. The hypothalamic-pituitary secretion of TSH is every bit as fallible as the secretion of any other
pituitary hormone or neurotransmitter. Indeed, the hypothalamus is part of the brain and is affected by its connections to all parts
of the brain. It can be dysfunctional due to genetic alterations, neurotransmitter imbalances, toxins, stress, aging, drugs, etc. A
person who has symptoms of hypothyroidism with freeT4 (FT4) and/or free T3 (FT3) levels in the low end of the laboratory
reference ranges and a "normal" TSH has, by definition, central hypothyroidism. In fact, when both T4 and T3 are in the lower third
of their population ranges, the person can be severely hpothyroid, regardless of the TSH level."
"TSH is a measure of how
much the hypothalamic-pituitary system is attempting to stimulate the thyroid gland. A "normal" TSH tells us only that the
person doesn't have failure of the thyroid gland. It does not tell us that they have sufficient levels of thyroid
hormone. A normal TSH does not "rule out" hypothyroidism. Many, and possibly most people with various degrees of
hypothyroidism have normal TSH levels. Their hypothalamic-pituitary system is dysfunctional and not making sufficient TSH to give
them optimal thyroid levels. The hypothalamic-pituitary secretion of TSH is every bit as fallible as the secretion of any other
pituitary hormone or neurotransmitter. Indeed, the hypothalamus is part of the brain and is affected by its connections to all parts
of the brain. It can be dysfunctional due to genetic alterations, neurotransmitter imbalances, toxins, stress, aging, drugs, etc. A
person who has symptoms of hypothyroidism with freeT4 (FT4) and/or free T3 (FT3) levels in the low end of the laboratory
reference ranges and a "normal" TSH has, by definition, central hypothyroidism. In fact, when both T4 and T3 are in the lower third
of their population ranges, the person can be severely hpothyroid, regardless of the TSH level."
I would agree with the others that starting on a low dose of thyroid hormone would probably help. Keep in mind that increases are very gradual on these medications as you have to re-test every 6 weeks or so to see the impact they are having.
My question to you is - how / where does one get a metabolic test?
Thanks!
My question to you is - how / where does one get a metabolic test?
Thanks!
So, Gimel, if my TSH usually ranges from 1.5 - 2.8, that is NOT considered low which would indicate pituitary? What would be considered low?? Thank you for those other details. I am still learning!
Bearika, I went to a registered dietitian when all of this started thinking it was my eating. She has a metabolic testing machine called the MEDGEM which is what universities and laboratories use (she is affiliated with a university). If you are interested, you could check one of the larger medical academic places where you are. I'm sure there are other methods, this was the one that I had heard was really the best for determining metabolic rate simply without having to do a more intensive laboratory sort of test.
Bearika, I went to a registered dietitian when all of this started thinking it was my eating. She has a metabolic testing machine called the MEDGEM which is what universities and laboratories use (she is affiliated with a university). If you are interested, you could check one of the larger medical academic places where you are. I'm sure there are other methods, this was the one that I had heard was really the best for determining metabolic rate simply without having to do a more intensive laboratory sort of test.
Doctors usually don't pay much attention to a TSH unless it is above the range; however, as quoted above, " A TSH within the "normal" range does no rule out hypothyroidism. Manypeople with various degrees of hypothyroidism have normal TSH levels. That means that their hypothalamic-pituitary system is dysfunctional and not making sufficient TSH to give them optimal thyroid levels."
If you look at the listed possible causes for such a situation (genetic alterations, neurotransmitter imbalances, toxins, stress, aging, drugs), obviously there is not much that can be done directly to alleviate that situation. So, instead, thyroid meds are used to offset the lower production of natural thyroid hormone. Does that make it any clearer?
If you look at the listed possible causes for such a situation (genetic alterations, neurotransmitter imbalances, toxins, stress, aging, drugs), obviously there is not much that can be done directly to alleviate that situation. So, instead, thyroid meds are used to offset the lower production of natural thyroid hormone. Does that make it any clearer?
Yes, it does :))) thank you, Gimel. I appreciate your sharing and taking time to help me understand :))))
I had a typo. The FT3 was not 2.3% but rather the correct calculation is 26.3%. And the rule of thumb target for FT3 is between 50% to 67%.
So you can see there is still plenty of room for improvement.
Your FT4 is 40% of range with the rule of thumb target at about 50% or a bit more.
yes it is interesting that Dr's have 180 degree opposite desires to "fix" hormones.
It may have something to do with how familiar and comfortable a Dr is with the hormone. If comfortable with treating thyroid, they will probably focus there first. The opposite could be true for another Dr. Maybe the most important point is that they have a plan and progressively continue to fix the problem no matter which direction they come from to solve the overall problem. IDK.
So you can see there is still plenty of room for improvement.
Your FT4 is 40% of range with the rule of thumb target at about 50% or a bit more.
yes it is interesting that Dr's have 180 degree opposite desires to "fix" hormones.
It may have something to do with how familiar and comfortable a Dr is with the hormone. If comfortable with treating thyroid, they will probably focus there first. The opposite could be true for another Dr. Maybe the most important point is that they have a plan and progressively continue to fix the problem no matter which direction they come from to solve the overall problem. IDK.
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