Hi, I was diagnosed with hypothyroidism almost three years ago. For the past five years though I have been having trouble with my memory, I am only 23 years old so it's not related to my age. According to all my blood work I am healthy with the exception of my thyroid. The levels aren't terrible but they aren't perfect either. I have tried exercise, diet, omega fatty acid supplements, vitamins (for long periods of time) but none of it has helped my memory. It only helped improve my lab results. Generally it is just very foggy and I can't remember detail, or I completely can't remember an event or someone saying something. It's really annoying and I'm tired of living with this problem. It is interfering with almost every aspect of my life on a daily basis. I really need some advice from someone about this. I decided not to take the medication from my endocrinologist last time I went because I wasn't going to have insurance to follow up. But I have saved the money and plan to get my results read and am hoping that the medication he gives me will improve my memory. To be perfectly honest I'm not exactly sure what all these results mean, but here are my most up to date labs I have older test results available if it'll help):
Free T4 0.9
Tsh Third Generation 3.7
T3 Uptake 36
Free T4 1
Tsh Third Generation 2.01
Tsh Third Generation 2.35
I also have eight nodules which were checked with an ultrasound and seem to be fine.
Brain fog and memory problems are typical symptoms of hypo.
Your labs are pretty old and incomplete. FT3 should be being tested as well as FT4, and the latest lab is just TSH.
The two FT4 readings you show are both way too low. Many people find that FT4 has to be at least midrange (I'm assuming a range of approximately 0.8-1.8, but you should verify that from your lab report) before symptoms are relieved. In addition, we don't know if you convert well or not since there is no FT3.
Were these labs while taking thyroid meds? How long ago did you stop and what dose were you taking before discontinuing?
It's very important for you to have your levels tested again now. Seven-month-old labs are useless in evaluating your current condition.
Thanks for the info, I figured they were too old. I found it odd also that there was only TSH on the last lab and not the others...I will have to ask my endo when I go back why that was. Three years back when I got my level down from 9 to a 2.11 my regular doctor said I was fine now and didn't need an endo. But my mother insisted, and he said I needed medication. I was on it for about six months from summer of 09 until about December of 09. First levothyroxine 25 mcg and than levoxyl 50 mcg I believe, but I was also on another medication which I think was throwing the labs off. I've since stopped both meds. I didn't think that the levels being around 3 were terrible. I've always read that they need to be like 5 or over to be really bad and actually need medication. But I guess it varies from person to person. I am going to ask for the meds once more and see if I feel any better.
So, your endo wanted you to go back on meds the last time you saw him (when?), but you decided not to?
TSH is a pituitary hormone, and it's often not a really good indicator of thyroid status. FT3 and FT4 are much better. That being said, the range for TSH currently recommended by AACE is 0.3-3.0. As you said, we're all individually different, but many people have to be below the middle of the TSH range before symptoms go away. FT4 needs to be midrange or above, and yours were very close to the bottom.
It would be interesting to see current labs (FT3, FT4 and TSH). Once on meds again, you should have levels re-tested in 4-5 weeks and adjust as necessary until your FT3 and FT4 are higher in the ranges and your symptoms have been relieved. (I'm completely convinced your brain fog and poor memory are thyroid related. From the labs you did post, your FT4 has never been as high as it should be.)
Has a cause of your hypo ever been identified? If not, you might consider having TPOab and TGab tested to see if you have autoimmune thyroid disease.
I've had no memory for many years - my thyroid tests - tsh were in the normal range.
Now I am on replacement Eutrosig 100mcg and I am having good times with my memory (sometimes I think to myself I wont have recall and I do - I am still nervous about this) and then sometimes it is still slow. However my medication is not stabilized - it's early days for me. My tsh level was just over 4 - I have to wonder whether blood tests mean anything at all (I've had 40 years of only being only partly present) - surely if you are well then that has to be important. My feelings.
My endo wanted me to stay on the meds, but because the levels were in the "lower" range he said it was okay but I needed to come back at the first sign of symptoms and always get them rechecked every six months. He really didn't want me to stop taking them though and tried to convince me otherwise. While I was on it I didn't notice any relief of my symptoms, everything just kind of stayed the same which is why he changed it to levoxyl. If you're interested I can always post up my current labs when I get them back. They only checked for T4 and TSH, once again I don't understand the lack of T3 testing. I was tested for these other labs: ANA Screen, ANA Titer, Thyroid AB (ATA, TPO), Thyroglobulin AB, Thyroid Peroxidase AB, Heterophile Screen and Titer
Thyroglobulin, Rheumatoid Factor, DNA AB (DBL Strangd/ Native), SM AND SM/RNP SM AB, EIA, SM/RNP AB...I do not know what all those are...but they were on the thyroid lab results. I just know the general facts and am trying to understand the whole thyroid itself so I know what is actually going on with my body. I remember asking my endo if it was caused by nutrition, etc, he said no that it would have eventually surfaced. It just happened to be really early for me.
Glad you found something to help you feel better and not like you live in a fog. It's hope that I can have the same someday. I am sure your meds will stabilize within you and you'll be better on the foggy days. I'm sure the bloods mean something, but it probably depends on the patient and how they feel.
I suspect you never had any relief of your symptoms because your FT3 and FT4 levels were never adjusted high enough. Just being in the lower ends of those two ranges is seldom good enough to relieve symptoms. FT4 should be somewhere around midrange or higher and FT3 in the upper half to third of the range.
Definitely post your current labs when you get them back. Request FT3 as well, and if they balk, insist. You're the customer here, you deserve to get what you need. FT3 testing can be tough to get. A lot of doctors don't "believe" in FT3 testing. They were taught that if FT4 was okay, FT3 was, too. However, we hear from way too many people with conversion problems to buy that line. If you don't convert well, your FT4 can be perfect, and your symptoms will remain as T3 is the only form of the thyroid hormones your cells can use.
Please, post the rest of those labs you list, especially interested in TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodes), but post them all if it's not too much trouble.
Relief of symptoms is what this is all about. Labs have value, IF they're interpreted properly. They can be used as a guide for meds adjustments, but with the knowledge that ranges are flawed and that we all have our personal comfort levels somewhere (but not everywhere) within those ranges.
I went to the hospital today and picked up a copy of my most recent labs from two weeks ago:
FT4 0.92 range [0.89-1.76]
TSH3G 2.55 rang [0.35-5.5]
I called my endo and they said that if he wanted FT3 it would have been on the paper, and that I would have to bring back the script. Only problem is that I already had the blood done so I can't do that. I will ask him for an additional script when I speak to him and hopefully he doesn't tell me no also.
Here are the results of the other labs, I'm going to post the most up to date ones I have rather than every one I've had. These are all from Summer of 09:
ANA Screen- Positive
ANA Titer- 1:160 Diffuse/ Homogeneous
Thyroid Peroxidase AB 414 H Range <35
Heterophile Screen and Titer Negative
Thyroglobulin 414 H Range <35
Rheumatoid Factor <15.0 range [0-25]
DNA AB (DBL Strangd/ Native) <1 Range <=4 Negative
SM AND SM/RNP SM AB, EIA <1.0 Negative Range <1.0
SM/RNP AB <1.0 Negative Range <1.0
Thyroglobulin 16 Range 2.0-35.0
Thyroglobulin Quant & ATA Thyroglobulin AB <20 Range <20
Thyroid Peroxidase AB 414 H Range <35
I am supposed to go back to my doctor on March 9th and am hoping I can be prescribed medication. How long does it really take to being working, is it different for every person? I am still reluctant to go on medication for this...but I just need to see if this is the cause of my memory problems. Is there anything I should ask my doctor additionally when I speak to him? It seems he's always in a rush and I feel like I am nagging him when I ask him questions. Not once did I even remember him actually explaining the process to me, rather just reporting the labs to me, and laughing at me when I mentioned that my levels got better when I changed my diet and was thinking it could be due to that. I think I should probably change doctors lol.
Has your doctor told you that you have Hashimoto's thyroiditis (Hashi's)? Your TPOab (thyroid peroxidase) is elevated, which indicates Hashi's. Hashi's is an autoimmune diease. Your immune system is attacking your thyroid and impairing its function. Hashi's is the most prevalent cause of hypo in the developed world, so many of us have it. Often, in the early stages especially, the thyroid function can swing back and forth. Sometimes your thyroid produces a little more hormone, sometimes a little less. So, it's not unusual for things to be a bit unstable for a while. Also, because it's a degenerative disease, meds increases have to be made frequently to keep up with the diminishing function of the thyroid.
Your FT4 is very low; it's almost on the floor of the range. It should be much closer to midrange. I'm sure that you'd feel much better on meds once they're adjusted properly and your FT3 and FT4 levels are higher in their ranges.
It takes a while to get levels adjusted properly. We're usually put on a starting dose. Then we have to wait 4-5 weeks before we can re-test and re-evaluate symptoms. It takes that long for the meds to build up in your body. After that, this process has to keep being repeated until we are symptom-free. Some of us find our optimal dose realatively quickly, some struggle with it.
Seriously, you might consider changing doctors. It was not at all nice of him to laugh at you, and he should be answering your questions. Also, it sounds like your levels were never adjusted propery (to the point where your symptoms went away). However, since your appointment with your current endo is relatively soon, you can probably at least get a starting dose from him since he's already said he wantted you to stay on meds.
Once you get that, you might try to find a doctor you can work with better. Hashi's is for life, so it's worthwhile to find a good doctor to help you manage it.
Although it's best to have FT3 tested every time, your FT4 is so low currently that it's going to be a bit of a non-issue anyway. If he'll order it, fine, otherwise I think it can wait until your next blood test, which should be 4-5 weeks after re-starting meds.
Thank you so much for all the info. My doctor never told me I have Hashimoto's but I am going to bring it up at our visit. But you're definitely right about my levels not stabilizing on the meds. I just have this strange fear that if I go on the medication and ever end up stopping it that my body will just collapse without it. I guess the way I looked at it in the past is that if you're on hormones than your thyroid will become weaker and always need an increase. Whereas not being on it you will probably slowly lose function but maybe not as much. I think I am looking at it backwards. Thanks again though you've been a great help.
It is true that once you're on thyroid meds, it's usually for life. Whether you take meds or not, those hungry little antibodies are going to munch your thyroid up eventually! The difference is that you'll be a lot more comfortable on the meds. The meds don't make your thyroid weaker (it's the antibodies that do that), they just supplement the hormone that your thyroid is producing. Eventually, when all thyroid function is destroyed, you are on 100% replacement.
My doctor put me on injections of B12 and on 70mg of Vyvannse which helped greatly improved all functions.....i originally started on provigil but not much success....i'm not ADHD....so the Vyvannse accelerates all brain activity and the B12 improved the fatigue for me...
Thanks, I'll make an update after i speak to my endocrinologist.
I've been taking a B-Complex but I'm sure it's probably not nearly as potent as a shot. Idk about the vyvannse, from what I read it could cause anxiety like side effects. I suffer from anxiety so I'd be weary to take it myself lol.
B-12 injections will help with fatigue if you have pernicious anemia. B-12, however, is not a treatment for thyroid disease. B-12 levels are important, and B-12 should be supplemented as needed, but an underlying thyroid issue must also be addressed separately.
So many anxiety and depression symptoms are actually caused by thyroid. Many people find they don't need meds for those once thyroid levels are atabilized.
I just wanted to update my situation. I went to my endocrinologist today and he said that my levels are within the normal range and that I'm not hypothyroid. I explained all my symptoms and my memory issues. But he said that the medication really wouldn't most likely do much because I am chemically normal. If I was a worse case than it would definitely help he said. The only reason he would suggest going on the medication would be to keep the nodules I have from growing, or to slow their growth. As far as he can tell they have no grown but I need to get another ultrasound in a few months. I asked him for a prescription and he gave me Synthyroid .05 I'm not sure if I am going to take it or not. I might try it out for a few months to see if my memory gets better...but he really seemed to think it's not related to this. I also asked him about why he didn't test for T3 and he said that it's not really necessary because my TSH levels were not abnormal and it wouldn't be accurate to make any diagnoses based on it. Which is what I believe you said. So anyway....not sure where to go from here...I guess just try to figure out what could be causing me this problem. Thanks for all the help
Just because your FT4 is in range and you are "chemically normal" does not mean that you are going to feel well, All of us have our own personal range where we feel our best. Your FT4 is at the very bottom of the range. If it were higher, and your FT3 were adjusted properly, too, you'd get a lot more symptom relief. What we want is for you to be "clinically normal" (no symptoms).
Meds could also help shrink your nodules.
I think it's a great idea to try the Synthroid for a few months and see how you feel.
What I said was just the opposite, actually. FT3 is the test that correlates best with symptoms. TSH is a pituitary hormone and not a reliable indicator of thyroid status. The FT3 est will tell you if you convert T4 to T3 well.
I wouldn't go any further trying to find what's causing this problem. I think it's your thyroid since memory problems are a common symptom. If I were you, I'd take the meds you were given. In 4-5 weeks, you should have labs run again. At that time, request FT3 as well to make sure you are converting T4 to T3 properly. This doctor is going to keep you sick. You're way too young to let him do that. Find a new doctor that knows more about thyroid.
Ah yes you said T3 not TSH, sorry about that. I am definitely going to look for a new doctor and hopefully I get some better answers. My only problem is a lack of insurance so I can't get the labs redone in 4-5 weeks because I'd need to go back to my endo for another prescription and they'll charge me. But I am going to keep on top of this and see what I can do. I really do hope my symptoms are from this...it seems odd that it would be anything else considering all my problems are a side effect of hypo. I'll be getting my prescription today and starting it tonight. Thanks again.
Don't forget to be sure to take your meds on an empty stomach...nothing to eat or drink for 3-4 hours before and 1/2-1 hour after. A lot of people like to take it first thing in the morning when their stomachs are empty. Also, any other meds or supplements should be taken at least 4 hour away from when you take your Synthroid. Do the best you can to get re-tested as soon after 4 weeks as possible, and best of luck...
Pretty funny...my endo told me not to worry about taking it on an empty stomach and to take it with breakfast if I want because my levels aren't bad. I wasn't gonna follow that advice anyway. I was planning on taking it at night before going to bed and not eating for about an hour or two before. Thanks again.
I read your posts I've had Hashi for five years now and been having issues with meds again and had to increase twice in the past 6 months still working on it.It takes time and everyones different. Apparently I'll have to adjust ever so often as the thyroid dies *****!
I've been using econolabs for the last two years- Google them... No prescriptions needed and you can do pretty much any blood test at a nice discount . They email you the results works through LAB Corp
Hope this helps..
You have to get rid of this doctor. Food can interfere with absorption of meds something fierce. You really want to not eat for longer than an hour or two before taking Synthroid. Can you take it in the morning? You know, get up, swallow your pill immediately, shower, etc., then eat. Fiber interferes the most, protein the least.
I'm another one have low thyroid the high and low. Have had many changes in meds. Have much difficulty with memory. Not at all depressed. I am 49 and sure I have hasimoto disease as well. I can't seem to get anyone to do much. Went to endocrinologist and she did nothing different from my PCP. I have a nodule also. Just tired of all the ex that go with it and feel like I'm getting nowhere
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