Hypo Thyroid & Body Temp

I’ve been reading a lot of articles that with a thyroid problem keeping track of you body temp can tell you how well your thyroid (T4 ) is doing. My question is what thermometer would be the most accurate for this?

[gimel]

The best thermometer would be an old mercury type.  Lacking one of those, there are any number of digital types.  You can find info rating them for accuracy.  

Body temperature can definitely be an indicator of hypothyroidism.  But it is only one of many symptoms of being hypo.  For example, this is a list of 26 typical hypo symptoms.  There are even more.

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

If you have low body temperature, you will also have some of the other  symptoms as well.  The problem with body temperature or other hypo symptoms, you have to have a doctor that will even listen to your symptoms, rather than go strictly by blood test results.  A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 (not the same as Total T3 and Total T4), as necessary to relieve symptoms.  Symptom relief should be all important, not just test results.  


If the symptom list makes you think you may be hypo, then you should follow up with a good thyroid doctor, and make sure to get tested for the biologically active thyroid hormones, Free T3 and Free T4, as a start.  

[care610]

I have been keeping track of my basal body temp for pregnancy purposes and my basal body temp is very low! 95-96 range. Yet dr keep looking at my labs and say it should not be the hypo! Then... why is it so low?

[flyingfool]

I suspect you are indeed Hypo.

you need to get BOTH the FREE T4 and FREE T3 tests done.  Many people do not feel well until thier Free T4 is MID range AND their free T3 is in the UPPER 1/3 of the range.  Many Dr is thyroid tests come back anywhere within the range they call it "normal" and dismiss any other symptoms etc.  When simply being in range is NOT enough.

Every person varies. But the reference ranges for Thyroid are far to broad.  This is probably the single biggest misunderstood, misdiagnosed problem in the medical community.

Finding a Dr who will even test for Free T3 is difficult.  Then finding a Dr. who will actually listen to you and medicate you until you get symptom relief is even more difficult.

[Annie_777]

@care610, pls lmk what u find out.  My BBT is usu. 96.4-96.6 (except 96.8-97.2 during ovalution).  My temp right now is 98.6 - I cannot believe ppl say that's normal.  I feel chills, severe headache, nausea, sinus pressure and congestions.  I know I caught the virus from my colleague - she's running a 101 fever and stayed at home for most of this week.  I have the same symptoms but 99 is about as high as my temp goes.  Everytime when my temp raises above 38, I start to feel significant discomfort.  I cannot imagine my body to ever tolerate a 98.6 temperature.

[gimel]

Body temperature does vary from one person to another.  It doesn't have to be 98.6 for everyone.  Given that, yours does seem  low, which is often associated with being hypothyroid.  Do you suspect that you have hypothyroidism and that is why you were perusing a Thyroid Forum?  If so, members have a lot of info and experience they would be glad to provide.  Your call.

[care610]

I have been treated for hypothyroidism over the past few months. I was diagnosed during pregnancy and i lost the baby!  I was switched to Synthyroid from Levothyroxine which I have seen improvements but body temp is not one of them! My BBT does not rise so i am think I am not ovulating.

[onlyoneofme]

I have been on Levothyroxine for many years and still have the dry skin, hair, hair loss, constipation, etc....... dr. does the standard tests and no more....

My normal temp. is 97.1; the only time it goes much over that is if I am very ill w a high fever.  

I haven't asked dr. for the "free t3" tests, etc., bc I just started learning about them from these forums.  He just tells me to use lotion and Rogaine for my complaints.... I also haven't said anything about my 97.1 temp. and cold hands.....

I hate to go back to him and do the complaining (he's a good dr. and not impatient) bc I hate to sound like a hypochondriac when my recent lab tests show all is normal w thyroid.....

Should I give him a chance to run these extra tests or just move on to an endochronologist?

[gimel]

Moving on to an endo is no guarantee of being adequately tested and treated.  Many Endos have the "Immaculate TSH Belief", by which they only want to use TSH to diagnose and treat hypo patients.  That just doesn't work well.  TSH is a pituitary hormone that is affected by so many variables that it doesn't even correlate adequately with the biologically active thyroid hormones, Free T3 and free T4, much less with hypo symptoms.  Free T3 has been shown in scientific studies to correlate best with hypo symptoms, while Free T4 and TSH did not correlate.  

Many doctors that go beyond TSH use "Reference Range Endocrinology" by which they will tell you that any test result that falls within the so-called "normal" range is adequate.  This is also incorrect because the ranges are far too broad.  The ranges for Free T3 and Free T4 have never been corrected as was done for TSH over 8 years ago.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  Test results are valuable mainly during early diagnosis and afterward to track levels of FT3 and FT4 as meds are revised to relieve symptoms.  You can get some good insight into clinical treatment from the following 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.




For Physicians of Patients Taking Thyroid Hormones
I have prescribed thyroid hormones for your patient because his/her symptoms, physical signs, and/or blood tests suggested that he/she had inadequate levels for optimal quality of life and long- term health. If there were clear improvements, I maintained the thyroid supplementation. Mild-to- moderate thyroid insufficiency is common and an unrecognized cause of depression, fatigue, weight gain, high cholesterol, cold intolerance, atherosclerosis, and fibromyalgia. Thyroid supplementation to produce higher FT3 and FT4 levels within the reference ranges can improve mood, energy, and alertness; help with weight control, and lower cholesterol levels.
Your patient’s TSH may be low or undetectable, even though their free T3 and free T4 are within the reference ranges. Why? We are taught that the TSH always perfectly reflects a person’s thyroid hormone status, supplemented or unsupplemented. In fact, we have abundant evidence and every reason to believe that the hypothalamic-pituitary axis is NOT always perfect. In clinical studies, the TSH was found not useful for determining T4 dose requirement.i The diagnosis of thyroid insufficiency, and the determination of replacement dosing, must be based upon the patient’s symptoms first, and on the free T4 and free T3 levels second. The TSH test helps only to determine the cause. Even here, “normal” may not be good enough. The labs’ reference ranges for free T4 and free T3 are not optimal ranges; but only 95%-inclusive statistical population ranges. The lower limits are below those seen in studies of healthy adults. They define only 2.5% of the population as “low”, but hypothyroidism is more prevalent than that.
T4-only therapy (Synthroid, Levoxyl), to merely “normalize” the TSH is typically inadequate as the H-P axis is often under-active to begin with, is more sensitive to T4, and is over-suppressed by the once-daily oral thyroid hormone peaks. TSH-normalizing T4 therapy often leaves both FT4 and FT3 levels relatively low, and the patient symptomatic. Recognizing this, NACB guidelines call for dosing T4 to keep the TSH near the bottom of its RR (<1) and the FT4 in the upper third of its RR; but even this may not be sufficient. The ultimate criterion for dose adjustment must always be the clinical response. I have prescribed natural dessicated thyroid for your patient (Armour or Nature-Throid). These contain T4 and T3 (40mcg and 9mcg respectively per 60mg). They are more effective than T4 therapy for most patients. Since they provide more T3 than the thyroid gland produces, the well-replaced patient’s free T4 will be around the middle of its range or lower, and the FT3 will be high-“normal” or slightly high before the AM dose.
Excessive thyroid dosing causes many negative symptoms, and overdosed patients do not feel well. I suggest lowering the dose in any patient who has developed insomnia, shakiness, irritability, palpitations, overheating, excessive sweating, etc. The most serious problem that can occur is atrial fibrillation. It can occur in susceptible patients with any increase in their thyroid levels, and is more likely with higher doses. It should not recur if the dose is kept lower than their threshold. Thyroid hormone does not cause bone loss, it simply increases metabolic rate and therefore the rate of the current bone formation or loss. Most older people are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies. The solution is not life-long hypothyroidism or bisphosphonates; one should correct the hormone deficiencies.

Fraser WD et al., Are biochemical tests of thyroid function of any value in monitoring patients receiving thyroxine replacement? Br Med J (Clin Res Ed). 1986 Sep 27;293(6550):808-10





You might want to talk with your current doctor about clinical treatment and see if he is willing to test and adjust Free T3 and Free T4 as necessary to relieve your hypo symptoms.  If you show him a copy of this info, it might open his eyes and influence him to do so.

[onlyoneofme]

Thanks for the information and for the follow-up.  I just had a lab test a couple of weeks ago (annual one); had to call nurse to have dr. order "full thyroid panel" which I thought meant everything (I didn't know about the free t3 and free t4 then.)  Nurse called back saying I was fine, continue on the Lev. dosage (.125)  

I like my dr. but since he has listened to my complaints of not feeling well all these years (mentioned occasionally) and not suggested a more thorough test, I doubt asking him to run a free T3 and free T4 would work.... I don't think he's up on this.  I doubt if he'd take seriously an article from the internet no matter how accurate.....

I am going to ask my gynecologist and perhaps dermatologist about doing these tests to see if they are up on this.  If no help there, I'll go back to gp; if all else fails, I'll try a thyroid specialist (I googled one in nearby city.)

Thanks!

[flyingfool]

Another option is to order the lab test online.  We had to resort to this for my wife as she was never able to talk her Dr into a free T3 test.

It cost us $85 out of pocket.  Healthcheckusa.com I believe was the site.  My wife did have to drive to the nearest lab that they would use.  For us that was about 90 miles away.  But we finally got the test.  And low and behold she was not even mid range let alone in the upper 1/3.

Just another option.  At least to get the test.  you still have to convince a Dr. to actually prescribe a medication increase.

[gimel]

I am sending you a PM with a link to a site that I ran across recently.  I have found it to be the most comprehensive site that I have found.  It gives great info, plus it provides references to scientific studies that support the info given.  Copies of selected portions of this info might have a favorable effect on your GP.

[sissaphus]

Would you mind sending me  PM with the link as well?

Thanks!

[gimel]

Glad to do so.

[helyanna]

My oral temperature reaches 98.6 (or slightly over) only for a short time in afternoon. Now it is 97.8. My thyroid medication is ok (T3V 5.3 upper limit of reference 7.1). So if one has naturally low body temperature, thyroid medication does not change it.

[Barb135]

As stated in a post above, body temperature varies from person to person, so no, thyroid medication won't always change body temp if yours is naturally lower.  Mine is usually pretty low, also; only rising when I'm very ill, then not very high.  

[flyingfool]

Body temps for this really need to be basal body temps.

This is done to be most accurate with a mercury type thermometer. YOu place the thermometer at the side of your bed.  ASAP without getting up and staying as motionless as possible when you first awake.  Take the thermometer and place it under your arm.  Leave it remain there while you remain as rested as humanly possible for 15 minutes. Then take and read the thermometer.

Once you get up and start your day your temperature is all messed up and this is why you need to do it ASAP when you awake.  True reading is while you are asleep but that is not really possible without being hooked up to wires and such.  So taking the temp ASAP when you awake is about as good as we can get at home.

I believe Dr. Broda's Book stated that this temperature should be around 97.8 degrees plus or minus about one half of a degree.  If it is below 97 he suggested it is almost a 100% indication of being Hypo (low) thyroid.

[artfemme]

Dear All,

My body temp hovers around 97.1 most of the time, when historically it was 98.6. Really bothers me, as I get sick with respiratory illnesses all the time and fell like I can't "burn them off" as I used to.

That said, I'm also measuring with a digital thermometer, and even when I take an average of 3 readings, I don't think the results are accurate, and impossible to get a good reading under the arm in a.m. as is recommended for basal body temp. I nearly died when I dropped and broke my trusty old mercury thermometer last year....had it forever. Of course no drugstore has them anymore, but does anyone know of another source for them ? I believe the best were manufactured in Germany, and perhaps their laws re: mercury are not so strict. (And yet, go figure, it's in our lightbulbs now. So stupid.)

[flyingfool]

I would say that you need to have your Thyroid Free T4 and Free T3 tested ASAP.

With your history of having body temperature that is considerably higher than it is now would clearly indicate a slow down in your metabolism.

Thyroid is essentially fuel for your body's furnace.  Without fuel there won't be much heat coming out of your body's furnace.  So without proper Thyroid you won't have any fire in your furnace and your body temp drops.  Very macro view with that analogy but still generally accurate.

I think you can go to the dug store and ask for a basal body temperature thermometer.  Probably also digital but those really are not as good as the good old fashioned mercury ones.  They average the temp over time much better than the microwave society we have today that wants instant results.  When maybe instant is not as good.

Understand that under arm temps will not be as high as under the tongue.  If you have early morning 1st wake up under tongue temp of 97.1 I'd definitely say you have an issue that needs to be addressed and low Thyroid would be the 1st thing I'd think of!

[suddenly]

Well 1st of all I am a woman just turned 35 and having all the symptoms of Hypo. My voice has went deep and I sound  like a boy in puberty. I am short breathed. Constipation, hair massively falling out, very fatigue, weight gain drastic, dizzy, shaky and morning temp when I first wake up is 96.5-97.1 with a basal therm. My Dr said my levels are within range on labs but I do have all the symptoms. He is sending me to ENT per I have been diagnosed with Menieres Disease in both ears. Is the ENT the best route for me to go or should I see Endocrinologist? My grandmother also had Hypo issues and had a goiter. I dont have insurance at the moment so I have to pay visits out of pocket. Please advise. ty

[FTB4]

First of you have posted a question on an old thread from 2011, and to get a better response, you ahould go to the top of the page and hit the Red Bar that says "POST A QUESTION" and rewrite your question after the text box opens up. You Should ask your MD for Free T3 and Free T4 thyroid tests, along with TSH, When you repost, add these test results along with the reference ranges provided for each. An MD does noy have to be an Endo to order these tests.  Best Regards FTB4