Aa
Hypo again
I don't mean to sound ignorant but I'm a little lost. And 2012 I had low TSH <0.03 with my T4/T3 bouncing around high, low. Took almost a year of my previous Endo changing the amount of
Methimazole where my TSH went to 8.28 with T4/T3 seemingly normal. He took me off completely and didn't really intend on testing me again. Basically said 'you're cured' . I insisted on blood tests for a bit and then waited 6 months. I felt fair but I'm also taking Prozac now, so maybe it masked some of my nuttiness for awhile. Now, 6 months since that test (TSH was down but still ok in Feb) my TSH is <0.01- my vision has become more blurry and my slight tremors are back. The former Endo is no longer in my medical group so I will be referred to someone else (yay) .. So, to my real issues/needs - currently TSH = <0.01.. Free T4 = 1.8 (slightly elevated) and total T3 = 152 ( just inside the normal/high side) The Endo previously said that I have graves but I was never 'tested' and I know that there are different causes. I am also a Desert Shield/Storm Vet and wonder about the issues GWS (Gulf War Syndrome) could be wreaking havoc with me so many years later. And, does age, gender and/or race play a part in all of this. ? Any info, ideas and suggestions are welcome. Thank you
Methimazole where my TSH went to 8.28 with T4/T3 seemingly normal. He took me off completely and didn't really intend on testing me again. Basically said 'you're cured' . I insisted on blood tests for a bit and then waited 6 months. I felt fair but I'm also taking Prozac now, so maybe it masked some of my nuttiness for awhile. Now, 6 months since that test (TSH was down but still ok in Feb) my TSH is <0.01- my vision has become more blurry and my slight tremors are back. The former Endo is no longer in my medical group so I will be referred to someone else (yay) .. So, to my real issues/needs - currently TSH = <0.01.. Free T4 = 1.8 (slightly elevated) and total T3 = 152 ( just inside the normal/high side) The Endo previously said that I have graves but I was never 'tested' and I know that there are different causes. I am also a Desert Shield/Storm Vet and wonder about the issues GWS (Gulf War Syndrome) could be wreaking havoc with me so many years later. And, does age, gender and/or race play a part in all of this. ? Any info, ideas and suggestions are welcome. Thank you
COMMUNITY LEADER
Pituitary function can be checked by testing other hormones that the pituitary controls as well. The endo might want to do that.
Sounds like your doctor is placing way too much emphasis on the TSH and not enough on other possibilities.
It sometimes takes a week or more for referrals to be done, but if you don't hear from the new endo, soon, you might want to call your doctor back and ask; it's possible that someone dropped the ball and forgot to, actually, make the referral. I've had that happen. I don't know where you're located, but with Monday being a holiday, I'd say give it till the end of the week.
Sounds like your doctor is placing way too much emphasis on the TSH and not enough on other possibilities.
It sometimes takes a week or more for referrals to be done, but if you don't hear from the new endo, soon, you might want to call your doctor back and ask; it's possible that someone dropped the ball and forgot to, actually, make the referral. I've had that happen. I don't know where you're located, but with Monday being a holiday, I'd say give it till the end of the week.
Thank you very much. The part that has been most frustrating is that my free T4/T3 weren't even very high in the past - the TSH was just extremely low, as it is now. His main concern seemed to be getting my TSH back up into a normal range. I'm still waiting for the new Endo to call me so that I can have the tests run to know more of the real deal. Thanks again for this info - I'll feel a little more 'armed' when I go in and make sure they complete the appropriate tests.
I'll be back. ☺
I'll be back. ☺
COMMUNITY LEADER
Methemazole wouldn't just put your TSH into hypo mode; it would also decrease your FT3 and FT4 levels.
I don't know why they would have run the T3, rather than FT3... typically, that's done by someone who doesn't really know thyroid all that well.
Fasting for thyroid blood work is not necessary.
You need to have all the antibody tests done... even if TPOab was negative previously, it should be done again, as there just may not have been a lot of antibodies then, plus you didn't have the TgAb, which is another marker for Hashimoto's... you must have them both to rule out Hashimoto's, though they don't both have to be done at the same time.
Since TSI is the definitive test for Graves, you need that, as well.
Rarely, a person can have both, Graves and Hashimoto's at the same time.
It's always possible that there's a pituitary issue, but it's more likely to be an autoimmune disease attacking the thyroid. That's where the antibody tests come in. Once you get those, you'll know what you're dealing with. Fortunately, both Graves and Hashimoto's can be dealt with.
I don't know why they would have run the T3, rather than FT3... typically, that's done by someone who doesn't really know thyroid all that well.
Fasting for thyroid blood work is not necessary.
You need to have all the antibody tests done... even if TPOab was negative previously, it should be done again, as there just may not have been a lot of antibodies then, plus you didn't have the TgAb, which is another marker for Hashimoto's... you must have them both to rule out Hashimoto's, though they don't both have to be done at the same time.
Since TSI is the definitive test for Graves, you need that, as well.
Rarely, a person can have both, Graves and Hashimoto's at the same time.
It's always possible that there's a pituitary issue, but it's more likely to be an autoimmune disease attacking the thyroid. That's where the antibody tests come in. Once you get those, you'll know what you're dealing with. Fortunately, both Graves and Hashimoto's can be dealt with.
Typo again- the endo said that the amount of the methimazole is what made my TSH in 'hypo' range and as soon as he lowered it again my level dropped .. Sorry for the typos.
Wow, that was a typo- I meant Hyper Again.
Thank you for responding- I have had the Thyroid Peroxidase test ( but it was back when my hyper T was first established ) <10 ..
I'm very confused as to why the T3 was run rather than the Free T3. And everything that I've read regarding the free T4 says that you fast prior to testing it- but they didn't have me fast for my recent tests . My previous endo told me that the amount of methimazole is what caused my TSH to show hyper and as soon as he lowered the dose my level dropped again.
My GP has put me back on my 'last' dosage amount of methimazole from last year while we wait for the medical group to farm me out to a new endo.. (I'm picking up the prescription today after work)
I'm very uncomfortable not knowing what it causing this. Could there be an issue with my pituitary gland instead of it actually being the thyroid?
Thank you for responding- I have had the Thyroid Peroxidase test ( but it was back when my hyper T was first established ) <10 ..
I'm very confused as to why the T3 was run rather than the Free T3. And everything that I've read regarding the free T4 says that you fast prior to testing it- but they didn't have me fast for my recent tests . My previous endo told me that the amount of methimazole is what caused my TSH to show hyper and as soon as he lowered the dose my level dropped again.
My GP has put me back on my 'last' dosage amount of methimazole from last year while we wait for the medical group to farm me out to a new endo.. (I'm picking up the prescription today after work)
I'm very uncomfortable not knowing what it causing this. Could there be an issue with my pituitary gland instead of it actually being the thyroid?
COMMUNITY LEADER
You aren't hypo, you're hyper.
TSH is a pituitary hormone that stimulates the thyroid to produce more thyroid hormones, so it's counter intuitive - when it drops very low it's usually because thyroid hormone levels are high (thyroid is over active or hyper) and when the thyroid is under active (hypo - thyroid levels are low) TSH rises in an effort to get the thyroid to produce hormones. Your TSH is low and thyroid hormones are high, so you're hyper.
You not only need to be tested for Graves Disease, which is always associated with hyperthyroidism, you need to be tested for Hashimoto's, which can cause you to swing back and forth between hyper and normal or hyper and hypo, which it seems you've done.
With Graves, the thyroid often has to be removed to stop over production of thyroid hormones which leaves you permanently hypothyroid. With Hashimoto's, the antibodies eventually destroy healthy thyroid tissue so it no longer produces thyroid hormones and you end up permanently hypothyroid. Either way you take replacement thyroid hormones.
You could also have nodules on your thyroid that are producing hormone independently of the thyroid. You should ask for a thyroid ultra sound.
You should be getting Free T3 tested, instead of Total T3, which is considered obsolete and of little value.
The definitive test for Graves Disease is Thyroid Stimulating Immunoglobulin (TSI). The 2 tests for Hashimoto's are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).
Studies indicate that there may be a link between some environmental factors and thyroid disease. Smoking has been linked to thyroid disease. We're more likely to have thyroid conditions as we age, but all ages can get all thyroid diseases. Women are more susceptible to thyroid conditions than men, but a lot of men do get thyroid conditions. I've never heard of a connection of any race getting thyroid conditions more than another.
Both hyper and hypothyroidism are know to cause depression, anxiety and other mental issues, so it's possible that you might have needed thyroid medication instead of (or in addition to) prozac for some time.
TSH is a pituitary hormone that stimulates the thyroid to produce more thyroid hormones, so it's counter intuitive - when it drops very low it's usually because thyroid hormone levels are high (thyroid is over active or hyper) and when the thyroid is under active (hypo - thyroid levels are low) TSH rises in an effort to get the thyroid to produce hormones. Your TSH is low and thyroid hormones are high, so you're hyper.
You not only need to be tested for Graves Disease, which is always associated with hyperthyroidism, you need to be tested for Hashimoto's, which can cause you to swing back and forth between hyper and normal or hyper and hypo, which it seems you've done.
With Graves, the thyroid often has to be removed to stop over production of thyroid hormones which leaves you permanently hypothyroid. With Hashimoto's, the antibodies eventually destroy healthy thyroid tissue so it no longer produces thyroid hormones and you end up permanently hypothyroid. Either way you take replacement thyroid hormones.
You could also have nodules on your thyroid that are producing hormone independently of the thyroid. You should ask for a thyroid ultra sound.
You should be getting Free T3 tested, instead of Total T3, which is considered obsolete and of little value.
The definitive test for Graves Disease is Thyroid Stimulating Immunoglobulin (TSI). The 2 tests for Hashimoto's are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).
Studies indicate that there may be a link between some environmental factors and thyroid disease. Smoking has been linked to thyroid disease. We're more likely to have thyroid conditions as we age, but all ages can get all thyroid diseases. Women are more susceptible to thyroid conditions than men, but a lot of men do get thyroid conditions. I've never heard of a connection of any race getting thyroid conditions more than another.
Both hyper and hypothyroidism are know to cause depression, anxiety and other mental issues, so it's possible that you might have needed thyroid medication instead of (or in addition to) prozac for some time.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
