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Hashimotos or not?
Hi everyone,
This past year I have gone through the wringer, health wise. In September, I was diagnosed with a pituitary tumor that has since then been removed. I took the semester off from college for my surgery and then for recovery. I started to feel normal again around January and decided to go back to school. Two weeks into classes and I crashed. My constant fatigue returned along with my terrible migraines, Lighted headness/ dizziness, depression, brain fog, and lack of concentration. I also began to experience new symptoms I had never felt before with my tumor, such as heart palpitations, cold semsitivities, dry skin, memory problems, and inability to find words, constipation, and swelling in my thyroid and neck area.
I went to my endocrinologist and she ran a thyroid panel. My tsh, t4, and t3 were all the the "normal" range except my TPO levels were elevated. She proceeded to call me an idiot for thinking I have something wrong or that my elevated TPO levels were an issue. I continued to jump from doctor to doctor trying to find a solution to this problem.
My latest results indicate my TSH and Free T4 levels are at 1.2. Free T3 at 3.2 and my TPO and TgAB levels continue to double. In my latest visit with the fifth endocrinologist Ive seen, the doctor did an ultrasound of my thyroid. She then told me that judging by my ultrasound, it indicates that I have Hashimotos. Also the thyroid nodule I did have, is no longer there. When she received my results from my latest lab test, the doctor told me to see a neurologist for my pituitary gland, even though my gland is in tact bc of my excellent surgeon and is completely functioning. She disregarded my symptoms and said I was fine. Obviously I am not. I was forced to take another medical leave from school as these symptoms are near debilitating. I feel worse then I did with my tumor, which is hard to believe.
From my extensive research, I believe to be a euthyroid Hashimoto's patient, yet all the doctors i see refuse to listen to what I have to say. If anything aren't my tsh levels low? The range (0.8 to 4.0) is so broad, I feel that you can fall anywhere on the spectrum and be labeled as normal. On top of that, my thyroid antibody levels continue to rise. I have a history of autoimmune disease in my family so this is a bit concerning to me.
I don't know what to do or where to go. If anybody has any advice or tips or anything, please feel free to reply.
Thank you for listening to my rant!
This past year I have gone through the wringer, health wise. In September, I was diagnosed with a pituitary tumor that has since then been removed. I took the semester off from college for my surgery and then for recovery. I started to feel normal again around January and decided to go back to school. Two weeks into classes and I crashed. My constant fatigue returned along with my terrible migraines, Lighted headness/ dizziness, depression, brain fog, and lack of concentration. I also began to experience new symptoms I had never felt before with my tumor, such as heart palpitations, cold semsitivities, dry skin, memory problems, and inability to find words, constipation, and swelling in my thyroid and neck area.
I went to my endocrinologist and she ran a thyroid panel. My tsh, t4, and t3 were all the the "normal" range except my TPO levels were elevated. She proceeded to call me an idiot for thinking I have something wrong or that my elevated TPO levels were an issue. I continued to jump from doctor to doctor trying to find a solution to this problem.
My latest results indicate my TSH and Free T4 levels are at 1.2. Free T3 at 3.2 and my TPO and TgAB levels continue to double. In my latest visit with the fifth endocrinologist Ive seen, the doctor did an ultrasound of my thyroid. She then told me that judging by my ultrasound, it indicates that I have Hashimotos. Also the thyroid nodule I did have, is no longer there. When she received my results from my latest lab test, the doctor told me to see a neurologist for my pituitary gland, even though my gland is in tact bc of my excellent surgeon and is completely functioning. She disregarded my symptoms and said I was fine. Obviously I am not. I was forced to take another medical leave from school as these symptoms are near debilitating. I feel worse then I did with my tumor, which is hard to believe.
From my extensive research, I believe to be a euthyroid Hashimoto's patient, yet all the doctors i see refuse to listen to what I have to say. If anything aren't my tsh levels low? The range (0.8 to 4.0) is so broad, I feel that you can fall anywhere on the spectrum and be labeled as normal. On top of that, my thyroid antibody levels continue to rise. I have a history of autoimmune disease in my family so this is a bit concerning to me.
I don't know what to do or where to go. If anybody has any advice or tips or anything, please feel free to reply.
Thank you for listening to my rant!
The rule of thumb is for FT4 to be 50% of the range and you are a little low at 40%. The rule of thub for FT3 is to be at least 50% and upwards to 67% of the range. Of which you are only at 47% of the range.
So you may want to try a small starter dose of T3 medication maybe Armour or other natural dessicated thyroid to see if that helps.
GImel gave great advice and other things to test for. The symptoms of low Cortisol also seem to be on the mark and worth getting tested. Ideallly you would want a cortisol test that is saliva or urine that are taken like 4 times during the day as cortisol varies throughout the 24 hour cycle and could be high or low at different times of the day.
So you may want to try a small starter dose of T3 medication maybe Armour or other natural dessicated thyroid to see if that helps.
GImel gave great advice and other things to test for. The symptoms of low Cortisol also seem to be on the mark and worth getting tested. Ideallly you would want a cortisol test that is saliva or urine that are taken like 4 times during the day as cortisol varies throughout the 24 hour cycle and could be high or low at different times of the day.
Just to supplement the good info from goolarra, I was thinking about your pituitary issue and wondered if iw might be possible that as a result you could have low cortisol.
The symptoms of low cortisol, or hypoadrenalism, include:
Mental and psychological ailments such as depression
Faintness and dizziness
Weakness and fatigue
Heart palpitations
Emotional hypersensitivity
Inability to cope with stress
Social anxiety
Muscle weakness
Headache, scalp ache, or general body ache
Severe or dull lower back pain
Extremely sensitive skin
Nausea, diarrhea, and vomiting
Abdominal pain and hunger pain despite an empty stomach
Extreme craving for salty foods
Anxiety and jitters
Clumsiness and confusion
Motion sickness
Insomnia and dark circles under the eyes
Low bladder capacity and symptoms of IBS
Irregular or non-existent menstrual period
Of course, these symptoms won’t all occur simultaneously, or immediately. Some people suffering from low cortisol will experience a couple of these symptoms, perhaps one after another. If you experience any one of these, or a combination of them, severely enough that it is affecting your day to day quality of life, you should consult a doctor or health expert right away.
In addition, low cortisol can interfere with the transport of Free T3 into cells, resulting in insufficient tissue thyroid effects. It might be worthwhile to get tested for diurnal saliva (free) cortisol, which is done at four different times of day. Doctors usually resist ordering this test and instead order the morning serum (total) cortisol test, which is not nearly as revealing.
Also it would be a good idea to test for Vitamin D, B12 and ferritin. Low levels can cause symptoms that mimic hypothyroidism. D should be about 55, B12 in the upper end of its range and ferritin should be about 70. If you can get those tested you can supplement as needed to optimize.
The symptoms of low cortisol, or hypoadrenalism, include:
Mental and psychological ailments such as depression
Faintness and dizziness
Weakness and fatigue
Heart palpitations
Emotional hypersensitivity
Inability to cope with stress
Social anxiety
Muscle weakness
Headache, scalp ache, or general body ache
Severe or dull lower back pain
Extremely sensitive skin
Nausea, diarrhea, and vomiting
Abdominal pain and hunger pain despite an empty stomach
Extreme craving for salty foods
Anxiety and jitters
Clumsiness and confusion
Motion sickness
Insomnia and dark circles under the eyes
Low bladder capacity and symptoms of IBS
Irregular or non-existent menstrual period
Of course, these symptoms won’t all occur simultaneously, or immediately. Some people suffering from low cortisol will experience a couple of these symptoms, perhaps one after another. If you experience any one of these, or a combination of them, severely enough that it is affecting your day to day quality of life, you should consult a doctor or health expert right away.
In addition, low cortisol can interfere with the transport of Free T3 into cells, resulting in insufficient tissue thyroid effects. It might be worthwhile to get tested for diurnal saliva (free) cortisol, which is done at four different times of day. Doctors usually resist ordering this test and instead order the morning serum (total) cortisol test, which is not nearly as revealing.
Also it would be a good idea to test for Vitamin D, B12 and ferritin. Low levels can cause symptoms that mimic hypothyroidism. D should be about 55, B12 in the upper end of its range and ferritin should be about 70. If you can get those tested you can supplement as needed to optimize.
Well, it's true that all the ranges are very broad, and we all have a level where we each feel best. So, if your results fall at either end of the ranges, it's not unusual to have symptoms.
However, your FT3 and FT4 are a little low, but not in the area where most of us would be experiencing debilitating symptoms. FT4 is at 40% of range, and that should be about 50%. FT3 is 47% of range, and 50+% is the target for FT3.
AACE recommended a number of years ago that TSH range be changed to 0.3-3.0. Anything from 1-2 is considered midrange. TSH, a pituitary hormone, is the least important of the tests, although most doctors just about worship it.
Both TPOab and TGab are elevated, which indicates Hashi's, and your U/S confirmed that.
Antibodies are untreatable. It can take years, or even decades for them to do enough damage to cause symptoms. They also vary wildly, even intraday.
So, the real question becomes whether or not your FT3 and FT4 levels are causing your symptoms. Unless there's something else going on besides Hashi's and you are one of the very rare people who has to have FT3 and FT4 levels very high, your current numbers shouldn't be causing debilitating symptoms.
Do you have any previous thyroid labs to compare these to?
However, your FT3 and FT4 are a little low, but not in the area where most of us would be experiencing debilitating symptoms. FT4 is at 40% of range, and that should be about 50%. FT3 is 47% of range, and 50+% is the target for FT3.
AACE recommended a number of years ago that TSH range be changed to 0.3-3.0. Anything from 1-2 is considered midrange. TSH, a pituitary hormone, is the least important of the tests, although most doctors just about worship it.
Both TPOab and TGab are elevated, which indicates Hashi's, and your U/S confirmed that.
Antibodies are untreatable. It can take years, or even decades for them to do enough damage to cause symptoms. They also vary wildly, even intraday.
So, the real question becomes whether or not your FT3 and FT4 levels are causing your symptoms. Unless there's something else going on besides Hashi's and you are one of the very rare people who has to have FT3 and FT4 levels very high, your current numbers shouldn't be causing debilitating symptoms.
Do you have any previous thyroid labs to compare these to?
Please post the actual results and reference ranges for all your thyroid tests. Reference ranges vary lab to lab and have to come from your own lab report.
1 Comments
T4, FREE
1.2 ng/dL
(0.8-1.8 ng/dL)
TSH
1.27 mIU/L
(0.5-4.3)
T3, FREE
3.2 pg/mL
(2.3-4.2 pg/mL)
THYROGLOBULIN ANTIBODIES
298 IU/mL (HIGH)
(< or = 1 IU/mL)
THYROID PEROXIDASE ANTIBODIES
76 IU/mL
(<9 IU/mL)
1.2 ng/dL
(0.8-1.8 ng/dL)
TSH
1.27 mIU/L
(0.5-4.3)
T3, FREE
3.2 pg/mL
(2.3-4.2 pg/mL)
THYROGLOBULIN ANTIBODIES
298 IU/mL (HIGH)
(< or = 1 IU/mL)
THYROID PEROXIDASE ANTIBODIES
76 IU/mL
(<9 IU/mL)
First thing is that w need to have you post the reference ranges shown on the lab report for the Free T4 and Free T3 results.
1 Comments
T4, FREE
1.2 ng/dL
(0.8-1.8 ng/dL)
TSH
1.27 mIU/L
(0.5-4.3)
T3, FREE
3.2 pg/mL
(2.3-4.2 pg/mL)
THYROGLOBULIN ANTIBODIES
298 IU/mL (HIGH)
(< or = 1 IU/mL)
THYROID PEROXIDASE ANTIBODIES
76 IU/mL
(<9 IU/mL)
1.2 ng/dL
(0.8-1.8 ng/dL)
TSH
1.27 mIU/L
(0.5-4.3)
T3, FREE
3.2 pg/mL
(2.3-4.2 pg/mL)
THYROGLOBULIN ANTIBODIES
298 IU/mL (HIGH)
(< or = 1 IU/mL)
THYROID PEROXIDASE ANTIBODIES
76 IU/mL
(<9 IU/mL)
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