Aa
Hypothyroidism
My doctor recently did some blood tests. One of the results was that my T3 and T4 levels are normal, but my TSH level is elevated (5.5). Do you know what would cause this? Also, will levothyroxine actually help this issue?
I went to my appointment. He said he was very sure I'm not hypo, he said my July results are perfect.
Thyroxine (T4) Free 1.08 0.61 – 1.76
TSH 1.150 0.450 – 4.500
Triiodothyronine (T3) 123 85 - 205
Notice, no results for FT3. My symptoms are, hairloss, fatigue, depression, very hard to lose weight, can't sleep very long, puffy face, double chin, brain fog, horseness, high cholesterol, dizzy, hungry all the time, muscle aches, can't concentrate, achy, digestive problems and allergies (mold, pollen, ragweed corn stalks, and trees.)
He said, my Supraclavecular is swollen. He said this could be caused by the allergy meds I'm using, especially symbicort. He said I might have fibromyalgia. He had me drink water while he examined my neck.
He said I might have to see a neuroligist or a rheumatolgist. I'm not sure why the neuroligist. He was at the computer the whole time I was there and I had a hard time understanding his strong accent.
The tests he ordered are
Vitamin B12
25-Hydroxy Vitamin D
Thyroid Peroxidase AB
Thyroglobulin AB
TSH
T4 Free
T3 Free (finally)
Sedimentation Rate
CBC
Compr Metab Panel
Cortisol
Cortisol 24 Hr Free
Creatinine 24 Hr UR
Testosterone Free
DHEAS-Sulfate
Methylmalonic
Hemoglobin AIC
Insulin
He said I should stay away from carbs and I should exercise. He said my sleep problems may be due to sleep apnea or restless leg syndrome. I don't think I have either. My blood pressuse is fine 120/70.
Thyroxine (T4) Free 1.08 0.61 – 1.76
TSH 1.150 0.450 – 4.500
Triiodothyronine (T3) 123 85 - 205
Notice, no results for FT3. My symptoms are, hairloss, fatigue, depression, very hard to lose weight, can't sleep very long, puffy face, double chin, brain fog, horseness, high cholesterol, dizzy, hungry all the time, muscle aches, can't concentrate, achy, digestive problems and allergies (mold, pollen, ragweed corn stalks, and trees.)
He said, my Supraclavecular is swollen. He said this could be caused by the allergy meds I'm using, especially symbicort. He said I might have fibromyalgia. He had me drink water while he examined my neck.
He said I might have to see a neuroligist or a rheumatolgist. I'm not sure why the neuroligist. He was at the computer the whole time I was there and I had a hard time understanding his strong accent.
The tests he ordered are
Vitamin B12
25-Hydroxy Vitamin D
Thyroid Peroxidase AB
Thyroglobulin AB
TSH
T4 Free
T3 Free (finally)
Sedimentation Rate
CBC
Compr Metab Panel
Cortisol
Cortisol 24 Hr Free
Creatinine 24 Hr UR
Testosterone Free
DHEAS-Sulfate
Methylmalonic
Hemoglobin AIC
Insulin
He said I should stay away from carbs and I should exercise. He said my sleep problems may be due to sleep apnea or restless leg syndrome. I don't think I have either. My blood pressuse is fine 120/70.
Thanks again Nanci I just printed out your post.
I have never taken thyroid medication. I'm definetly not concerned about stopping any of my medication. I like what you call medication "snake oil."
I am thankful that I don't have any life threatening diseases that I know of. And I do feel somewhat better since I stopped the medications and have started taking vitamins. I just realized I don't have constipation that often anymore. The hair loss isn't as bad. The brain fog is still bad and depression.
I did a quick search for foods with Gluten. Does that mean I shouldn't eat whole wheat breat and pasta? I read another article about goitrogens. They suppress the thyroid. Those include: brocolli. cauliflower, cabbage, soy, pine nuts, peaches, and spinach, sweet potatoes. I love all of these healthy foods and I eat a lot of them. Especially wheat products, spinach and brocolli. What the **** am I supposed to eat? The other problem is I don't eat dinner until 7:00 p.m. My husband doesn't get home until 7 or after.
On the brighter side, the testing I'm having done is being done by Diagnos-Techs, Inc. I'm being tested for Estrone, Estradiol, Progesterone, Testosterone, and Dihydrotestosterone. I could only afford these at this time. I'm glad to know that the lab has an excellent reputation.
I don't plan to take any thyroid medication until I know more about what is going on with me. Although the person at the compound pharmacy that suggested the saliva testing, said she could make up a formula for me after we get the results back.
I just hope the endocrinoligist will agree to the testing I want. We will see!!!! All I know is if I hadn't joined this forum I wouldn't even know that (I'm sorry but I have to say it)my dumb family doctor didn't order the right testing that I asked for which was FT3 and FT4. She only order FT4.
Jena
I have never taken thyroid medication. I'm definetly not concerned about stopping any of my medication. I like what you call medication "snake oil."
I am thankful that I don't have any life threatening diseases that I know of. And I do feel somewhat better since I stopped the medications and have started taking vitamins. I just realized I don't have constipation that often anymore. The hair loss isn't as bad. The brain fog is still bad and depression.
I did a quick search for foods with Gluten. Does that mean I shouldn't eat whole wheat breat and pasta? I read another article about goitrogens. They suppress the thyroid. Those include: brocolli. cauliflower, cabbage, soy, pine nuts, peaches, and spinach, sweet potatoes. I love all of these healthy foods and I eat a lot of them. Especially wheat products, spinach and brocolli. What the **** am I supposed to eat? The other problem is I don't eat dinner until 7:00 p.m. My husband doesn't get home until 7 or after.
On the brighter side, the testing I'm having done is being done by Diagnos-Techs, Inc. I'm being tested for Estrone, Estradiol, Progesterone, Testosterone, and Dihydrotestosterone. I could only afford these at this time. I'm glad to know that the lab has an excellent reputation.
I don't plan to take any thyroid medication until I know more about what is going on with me. Although the person at the compound pharmacy that suggested the saliva testing, said she could make up a formula for me after we get the results back.
I just hope the endocrinoligist will agree to the testing I want. We will see!!!! All I know is if I hadn't joined this forum I wouldn't even know that (I'm sorry but I have to say it)my dumb family doctor didn't order the right testing that I asked for which was FT3 and FT4. She only order FT4.
Jena
The reason the reference ranges for the "Frees" are called "normal", is that they are based on a large population of patients' test results. From that data base they made the decision that about 2.5 % of people would fall out of this "normal" range because they were possibly hypo or hyper. From this decision they placed limits at plus and minus two standard deviations (which correlates with plus or minus 2.5%) from the overall average and called that the "normal" range, supposedly representing people who had no thyroid problems.
After many years of bad experience with this "normal" range for TSH, they finally acknowledged that there were a lot more patients out there with hypo and hyper problems, than previously accepted when they originally established the range.
After excluding from the data base those patients who were suspect for hypo and hyper, they again analyzed the remaining data base and established limits that included 95% of the total data base and called these new limits "normal". This changed the reference range from .5-5.0 down to .3-3.0, which is a huge change. Unfortunately this change hasn't yet been accepted or acknowledged by most labs and doctors.
Also, realize that the reference ranges for the "Frees" were established the same basic way. These ranges have never been reexamined and modified like the range for TSH. I am absolutely convinced that this is the reason why so many hypo people fall into the lower end of the ranges for FT3 and FT4 and are still told they are "normal".
In one my past lives I had a lot of training and experience in statistical analysis. Based on that experience, if I had to estimate what a revised range for FT3 would be if the data base were purged of suspect hypo and hyper people, then I would say it should change from 2.3-4.2 pg/dl up to about 3.2-4.3. And FT4 probably would change from .60-1.50ng/dl up to about 1.0-1.55. Quite a difference, huh? Think maybe that is why we hear from so many people that have hypo symptoms, yet they are in the "normal" ranges for the "Frees"? I'd bet my last dollar.
After many years of bad experience with this "normal" range for TSH, they finally acknowledged that there were a lot more patients out there with hypo and hyper problems, than previously accepted when they originally established the range.
After excluding from the data base those patients who were suspect for hypo and hyper, they again analyzed the remaining data base and established limits that included 95% of the total data base and called these new limits "normal". This changed the reference range from .5-5.0 down to .3-3.0, which is a huge change. Unfortunately this change hasn't yet been accepted or acknowledged by most labs and doctors.
Also, realize that the reference ranges for the "Frees" were established the same basic way. These ranges have never been reexamined and modified like the range for TSH. I am absolutely convinced that this is the reason why so many hypo people fall into the lower end of the ranges for FT3 and FT4 and are still told they are "normal".
In one my past lives I had a lot of training and experience in statistical analysis. Based on that experience, if I had to estimate what a revised range for FT3 would be if the data base were purged of suspect hypo and hyper people, then I would say it should change from 2.3-4.2 pg/dl up to about 3.2-4.3. And FT4 probably would change from .60-1.50ng/dl up to about 1.0-1.55. Quite a difference, huh? Think maybe that is why we hear from so many people that have hypo symptoms, yet they are in the "normal" ranges for the "Frees"? I'd bet my last dollar.
COMMUNITY LEADER
gimel, I'm with YOU here too - if my endo were going simply by my TSH, I'd probably be OFF thyroid meds by now in spite of having low FT4 and FT3 levels and still having symptoms. I was rather disappointed in Dr Lupo's reply as well about the TSH.
Nancib - to be perfectly honest with you, YOUR levels strike me as somewhat hypO-- Your TSH is elevated and your Free's are both barely in range.... I can't imagine that you wouldn't want to be treated......each to their own I guess. Hoping you the best of luck.
Nancib - to be perfectly honest with you, YOUR levels strike me as somewhat hypO-- Your TSH is elevated and your Free's are both barely in range.... I can't imagine that you wouldn't want to be treated......each to their own I guess. Hoping you the best of luck.
I have to agree with you here. If I had listened to my docs that my TSH of 2.74 was 'normal', then I would not have insisted I get the Hashi antibody test. Since my Anti-TPO is a 221, and anything over 35 indicates Hashimoto's, why then, is my TSH only a 2.74???
Because, as Gimel has stated, TSH is 'old hat'.
BTW, my FT4 is now a 0.8, down from 1.3 last spring when my previous endo said I was 'normal'.
My FT3 is a 262.
My frees are in the supposedly 'normal' range. IMHO, they are low, and I will not settle for those levels, nor will I listen to any doctor who relies on the TSH as the gold standard.
Take care...
:) Tamra
Because, as Gimel has stated, TSH is 'old hat'.
BTW, my FT4 is now a 0.8, down from 1.3 last spring when my previous endo said I was 'normal'.
My FT3 is a 262.
My frees are in the supposedly 'normal' range. IMHO, they are low, and I will not settle for those levels, nor will I listen to any doctor who relies on the TSH as the gold standard.
Take care...
:) Tamra
...almost forgot. :) My reply is posted here:
http://www.medhelp.org/posts/Thyroid/TSH-levels/show/1031140?personal_page_id=120716
http://www.medhelp.org/posts/Thyroid/TSH-levels/show/1031140?personal_page_id=120716
Thanks, Jena. :) By the way, have you taken any thyroid meds at any time during those years?
I hear you loud and clear when you say you've lost interest in everything and don't do any of the things you used to love to do. I also relate big time to you not wanting to get out of bed in the moring to face the day--and, oh-my-head, the hair loss...don't even wanna go there! :( I'll only say this about that: For me, hair loss began in a major way a few months AFTER I began taking thyroid meds.
Some have said that whether or not the hair will grow back depends upon the length of time the hair loss has gone on. I refuse to believe that. If I don't believe it, it won't be true for me. ;) Your hair loss has not gone on for long....and, though it's no doubt difficult, the way you might want to look at it is that your hair loss was actually the impetus to get you to begin your research...a VERY positive thing! :))
Please don't let your present health get you completely down....I know that's not an
easy thing to do--it was not even an easy thing to say. But you CAN pull yourself up out of what seems like an abyss. You've stopped taking a lot of "snake oil." That's an excellent start!
Don't be concerned about stopping the cholesterol medicine--it has done people far more harm than good. Ditto, regarding anti-depressants, sleep meds, and laxatives. There are natural alternatives to all of these. People just aren't patient--they want quick fixes.....as do doctors. You don't have hyperglycemia. That's good. You're still way ahead of the game; you don't have diabetes, cancer, or heart disease ...much to be thankful for!
The most important thing for you to do right now is to take a deep breath, sit down, make a plan for your optimal health, and stick to it. This will take all the patience you can muster, but "patience" is definitely the name of the game at this point. There ought to be a lab test for levels of patience...no doubt it would show that most people's values are sub-SUB normal. :\
First and foremost, make a plan for your "diet."
Speaking of diet, I forgot to mention one of the best things you can do for your diet--the one thing, I might add, which appears anathema to most people. Stop-eating-gluten, com-PLETE-ly!!!! NOW!!!
Gluten is implicated in sooooo many health problems. You don't even need to be checked for it since most humans are gluten-intolerant to some degree. Being a "little" gluten intolerant is like being a little pregnant. It matters! Many health problems can be traced to gluten intolerance. Even a tiny BIT of gluten in your diet will probably impede your quest for wellness.
(Check out "Pamelas" products, esp. the "Baking & Pancake mix;" you can make EVERYTHING with it, and I promise you won't even miss gluten--I suffered through a lot of BAD gluten-free products before I found this one.)
So, first, work on diet and elinmination of gluten. By the way, it's good that you're eating 5 meals a day--your adrenals will thank you. :) One thing, though, you seem to be eating very few calories for your height and weight. It might be a good idea to add a 6th snack, to get a few more calories...1800 would not be too much, as long as it's nutritious and low in sugars. Be sure to have a small amount of protein with each meal/snack. Eat your last snack no later than 7:00 P.M., and make it a small one. This is also good for the adrenals. The added benefit of this extra meal (at 7:00) is that not only will it increase your metabolism--important for weight loss and whatever else ails us--but it will put your cortisol in a better place during the night, which will enable you to sleep. :) This may not happen "immediately," but it will happen--all you need is patience.
I have a ton of suggestions to what I consider a good health plan--it's the one I'm following. Of course, a lot of it depends on your hormone levels--I certainly hope adrenal hormones were included in the saliva test you had. :)
WhatEVER ones health problems are, you can be sure there is adrenal involvement, and therefore "thyroid" involvement. Even if you find that you truly are hypothyroid, Do NOT allow the "drug pushers" to prescribe thyroid medications before first knowing the status of your adrenals.
The best way to know this is through an ASI, an Adrenal Stress Index. It is a saliva test which will tell you how well or how poorly your adrenal function is. Also, Included in the ASI is your Gliadin ab, SIgA (degree of gluten intolerance), DHEA, Progesterone, and Insulin status (whether or not you are insulin resistant). The excellent lab which does this saliva testing is Diagnos-Techs, Inc. (I'm not saying other labs are not good, I'm just saying this one has an excellent reputation, and this is what they test for.)
If your adrenal function is not good, if it's depressed, do NOT take thyroid meds until it is optomized, no matter what anyone says! To do so can damage your thyroid, when it may not have been damaged to begin with.
Doing all the right things for our health is difficult enough when we're feeling GOOD, but when we feel lousy, it rises to an entirely new level of difficulty. No one knows this better than I. But, what this all boils down to is survival. Both you and I know that no one is going to do it FOR us.
Given that they tend to be fed up with our "belly-aching," we're lucky to get even minimal support from our FAMILIES, much less the medical people who most DEFINITELY could not care less if we get well......that is, as long as we are still well enough to keep our next appointment. (I'm always amazed at the number of patients who think doctors really care!)
Also, it's a good idea to keep in mind that Lab tests are just numbers on pieces of paper, which, if we're supremely lucky, may just be able to tell us a little something we can use. (Operative word, "WE.")
Take care now--please stay in touch......and, be patient! :)
Nanci
I hear you loud and clear when you say you've lost interest in everything and don't do any of the things you used to love to do. I also relate big time to you not wanting to get out of bed in the moring to face the day--and, oh-my-head, the hair loss...don't even wanna go there! :( I'll only say this about that: For me, hair loss began in a major way a few months AFTER I began taking thyroid meds.
Some have said that whether or not the hair will grow back depends upon the length of time the hair loss has gone on. I refuse to believe that. If I don't believe it, it won't be true for me. ;) Your hair loss has not gone on for long....and, though it's no doubt difficult, the way you might want to look at it is that your hair loss was actually the impetus to get you to begin your research...a VERY positive thing! :))
Please don't let your present health get you completely down....I know that's not an
easy thing to do--it was not even an easy thing to say. But you CAN pull yourself up out of what seems like an abyss. You've stopped taking a lot of "snake oil." That's an excellent start!
Don't be concerned about stopping the cholesterol medicine--it has done people far more harm than good. Ditto, regarding anti-depressants, sleep meds, and laxatives. There are natural alternatives to all of these. People just aren't patient--they want quick fixes.....as do doctors. You don't have hyperglycemia. That's good. You're still way ahead of the game; you don't have diabetes, cancer, or heart disease ...much to be thankful for!
The most important thing for you to do right now is to take a deep breath, sit down, make a plan for your optimal health, and stick to it. This will take all the patience you can muster, but "patience" is definitely the name of the game at this point. There ought to be a lab test for levels of patience...no doubt it would show that most people's values are sub-SUB normal. :\
First and foremost, make a plan for your "diet."
Speaking of diet, I forgot to mention one of the best things you can do for your diet--the one thing, I might add, which appears anathema to most people. Stop-eating-gluten, com-PLETE-ly!!!! NOW!!!
Gluten is implicated in sooooo many health problems. You don't even need to be checked for it since most humans are gluten-intolerant to some degree. Being a "little" gluten intolerant is like being a little pregnant. It matters! Many health problems can be traced to gluten intolerance. Even a tiny BIT of gluten in your diet will probably impede your quest for wellness.
(Check out "Pamelas" products, esp. the "Baking & Pancake mix;" you can make EVERYTHING with it, and I promise you won't even miss gluten--I suffered through a lot of BAD gluten-free products before I found this one.)
So, first, work on diet and elinmination of gluten. By the way, it's good that you're eating 5 meals a day--your adrenals will thank you. :) One thing, though, you seem to be eating very few calories for your height and weight. It might be a good idea to add a 6th snack, to get a few more calories...1800 would not be too much, as long as it's nutritious and low in sugars. Be sure to have a small amount of protein with each meal/snack. Eat your last snack no later than 7:00 P.M., and make it a small one. This is also good for the adrenals. The added benefit of this extra meal (at 7:00) is that not only will it increase your metabolism--important for weight loss and whatever else ails us--but it will put your cortisol in a better place during the night, which will enable you to sleep. :) This may not happen "immediately," but it will happen--all you need is patience.
I have a ton of suggestions to what I consider a good health plan--it's the one I'm following. Of course, a lot of it depends on your hormone levels--I certainly hope adrenal hormones were included in the saliva test you had. :)
WhatEVER ones health problems are, you can be sure there is adrenal involvement, and therefore "thyroid" involvement. Even if you find that you truly are hypothyroid, Do NOT allow the "drug pushers" to prescribe thyroid medications before first knowing the status of your adrenals.
The best way to know this is through an ASI, an Adrenal Stress Index. It is a saliva test which will tell you how well or how poorly your adrenal function is. Also, Included in the ASI is your Gliadin ab, SIgA (degree of gluten intolerance), DHEA, Progesterone, and Insulin status (whether or not you are insulin resistant). The excellent lab which does this saliva testing is Diagnos-Techs, Inc. (I'm not saying other labs are not good, I'm just saying this one has an excellent reputation, and this is what they test for.)
If your adrenal function is not good, if it's depressed, do NOT take thyroid meds until it is optomized, no matter what anyone says! To do so can damage your thyroid, when it may not have been damaged to begin with.
Doing all the right things for our health is difficult enough when we're feeling GOOD, but when we feel lousy, it rises to an entirely new level of difficulty. No one knows this better than I. But, what this all boils down to is survival. Both you and I know that no one is going to do it FOR us.
Given that they tend to be fed up with our "belly-aching," we're lucky to get even minimal support from our FAMILIES, much less the medical people who most DEFINITELY could not care less if we get well......that is, as long as we are still well enough to keep our next appointment. (I'm always amazed at the number of patients who think doctors really care!)
Also, it's a good idea to keep in mind that Lab tests are just numbers on pieces of paper, which, if we're supremely lucky, may just be able to tell us a little something we can use. (Operative word, "WE.")
Take care now--please stay in touch......and, be patient! :)
Nanci
Your reply is so informative. Where is this posted? You have been through so much. I can very much relate because I have had many of my symptoms for at least 10 years they have become worse in the last 2 years. I've lost interest in everything. I don't do any of the things I used to love to do. I don't want to get out of bed in the morning to face the day.
I have told doctors about my symptoms, and he or she just wants to prescribe another medication. I've been on them all, ant-depressants, sleep meds, high cholesterol meds, laxatives, and more. I stopped taking these. I have allergies so I do take sudefed and use flonase. I also have an stomach ulcer and I take aciphex for that. I stopped taking everything else about 3 months ago.
I have to beg for all of the tests that I have had done. I was tested for hyper glycemia. I was told I'm not. I'm 5' 7" and weigh about 162. I know I need to lose weight but it is almost impossible. I can't exercise because it makes me feel worse. I do have a regular sleep schedule, although I can't sleep most of the time I'm in bed. I eat on the average of five times a day, small amounts, not too small. I'd say I eat about 1200 - 1500 calories a day.
I plan to ask the doctor on Tuesday to test FT3, and Antibodies Tests (TPOAB), (TgAb) and (TRAB). And I read about a test to find out the effect that the thyroid hormones have on your body or is that the THS, FT4 and FT3.
It took my hair loss to start researching. That started April 2008.
I'm doing my saliva test on Monday, I mail it out and I was told the results take about 7 days. And the doctor on Tuesday. I'll keep you posted.
I have told doctors about my symptoms, and he or she just wants to prescribe another medication. I've been on them all, ant-depressants, sleep meds, high cholesterol meds, laxatives, and more. I stopped taking these. I have allergies so I do take sudefed and use flonase. I also have an stomach ulcer and I take aciphex for that. I stopped taking everything else about 3 months ago.
I have to beg for all of the tests that I have had done. I was tested for hyper glycemia. I was told I'm not. I'm 5' 7" and weigh about 162. I know I need to lose weight but it is almost impossible. I can't exercise because it makes me feel worse. I do have a regular sleep schedule, although I can't sleep most of the time I'm in bed. I eat on the average of five times a day, small amounts, not too small. I'd say I eat about 1200 - 1500 calories a day.
I plan to ask the doctor on Tuesday to test FT3, and Antibodies Tests (TPOAB), (TgAb) and (TRAB). And I read about a test to find out the effect that the thyroid hormones have on your body or is that the THS, FT4 and FT3.
It took my hair loss to start researching. That started April 2008.
I'm doing my saliva test on Monday, I mail it out and I was told the results take about 7 days. And the doctor on Tuesday. I'll keep you posted.
Personally, I'm disappointed that Dr. Lupo apparently still believes in the "Immaculate TSH", since he said " The TSH is clinically the single most useful test for thyroid - there is little debate in the academic thyroid world regarding this." On the other hand as an example, we hear second hand that Emory Univ. Med School is teaching that TSH is old hat, and that the active thyroid hormones, FT3 and FT4 are more important. And many of us know how useless TSH has been in diagnosing and helping our thyroid problems.
I'm also dismayed that he said " Usually we start treatment when TSH is >10."
I'm also dismayed that he said " Usually we start treatment when TSH is >10."
Oops, meant to say sub or HIGH normal testosterone or estrogen levels could be a problem. Sorry. :)
I am saying to think long and hard about taking thyroid medication because I did not, and should have.
No, I'm not talking about Armour. Although Armour is considered to be natural, it isn't any more natural than taking Synthroid--chemical molecules are chemical molecules. The reason people consider Armour to be natural must be because Armour is derived from another sentient being.
As far as nutritional supplements (vitamins & minerals), if you ARE hypothyroid you will not be utilizing the RDA of vitamins and minerals to any great extent. I doubt that you're taking TOO many since the government's recommended requirement is barely what is needed to keep one's head above water, healthwise. Keep taking them--it's a good thing, hypothyroid, or not....especially cholecalciferol, at least 1000 iu :)
All three of your lab values look good to me--I would love to have mine even close. They would "strongly" suggest to me that you are not hypothyroid.
As far as your symptoms go, they sound like they COULD be hypothyroid symptoms; BUT, they could also be caused by many other things, such as hypo or hyper adrenal problems; weight issues; hypo or hyper glycemia; sub-normal testosterone or estrogen levels; low iron (ferritin); low iodine; not sleeping regular hours; not eating regular meals; sub-standard diet with too many--or not ENOUGH--calories; ETC.
Exercise is VERY important, but, with all your symptoms you may not feel up to it, yet. But, I'm sure you will. :)
I was interested in this question which Birdinia posed to Dr. Lupo:
TSH levels written to dr. lupo
by birdinia, Aug 20, 2009 01:14PM
I recently had some blood tests run. One of the results is that my T3 and T4 levels are in the normal range, but my TSH level is elevated (5.5). Can you tell me what would cause this? What are the health risks if I choose not to take levothyroxine? How much would levothyroxine actually help?
Dr. Lupo's reply to Birdinia:
by Mark Lupo, M.D., Aug 20, 2009 05:18PM
This is called subclinical hypothyroidism (ie mildly sluggish thyroid). Sometimes it is transient and does not need meds. I usually repeat levels in 2-3 months to confirm it is persistent unless the patient has significant symptoms. Treatment is not absolutely needed, so decisions must be individualized. Usually we start treatment when TSH is >10. The most common cause is Hashimoto's (test TPO and TG antibodies). If you have no symptoms, then there would be little benefit from levothyroxine. Even if there are symptoms we must remember that "thyroid symptoms" are so non-specific, the symptoms may be unrelated to this slight lab abnormality.
After Dr. Lupo's reply to Birdinia, I posted this to him:
by nancib, Aug 21, 2009 08:57AM
To: Dr. Lupo
Dear Dr. Lupo, you said in your reply to Birdinia that a TSH under 10 means that sometimes a thyroid is mildy sluggish, transient, and does not need medications.
I went to a doctor a little over 5 years ago with the single symptom of "tiredness." A blood test was done, and when myTSH was found to be elevated (8.5), the GP freaked and started me on 50mcg Synthroid; thereafter, he tested regularly, but only the TSH.
I told him I was becoming even MORE tired--not that he ever listened to me. Steadfastly going only by my TSH, he raised the dosage of Synthroid to 75mcg. My body practically came to a standstill. I went to a new doctor.
The next doctor became nervous when she noted my TSH was just a tad over 1.0, and said the 75 mcg was WAY too much and that I was now hyPERthyroid. She lowered the Synthroid from 75mcg to 25mcg--still no improvement. This is pretty much the way things have gone through the years as I've struggled to find a doctor to help me.
It's been an awfully bumpy road to be on for more than 5 years. The bumps have shaken me to the point where I feel nothing in my body is in the right place anymore.
I have been to countless doctors (MD,s & Endos), and have been given different combinations of thyroid meds (T3, T4, T3/T4) . Each doctor has taken the dosages up, then down and all over the place....all to no avail. During this time I have steadily worsened to the point where I NOW have practically every hypothyroid symptom on record.
Most of this time, aside from what I understand now to be "worthless" thyroid tests, the only testing done was for TSH (of questionable worth) which has ranged anywhere from below 1.0 to 17.0 and anywhere in between.
I've finally struck out on my own--a tough place to be, but no tougher than where I've been......I don't think.
My last lab tests, TSH, FT3 & FT4. were done on June 5, 2009, and are as follows:
TSH (third generation), 5.17 REF: 0.40- 4.5 mIU/L
FT3, 217 REF: 230-420 pg/dL
FT4, 0.9 REF: 0.8-1.8 ng/dL
I guess what I'm asking here is if there's any hope for me. I really think my thyroid "problem" might have been simply transitional, "a mildly sluggish thyroid." If this is true, it's a VERY tough pill to swallow right now. This would mean I've been sick and in solitary confinement (totally out of commission, life) for over five years all because I listened to doctors and took their thyroid meds, or should I say, "took their snake oil."
I'm beginning to believe the ups and downs my body has suffered over these years WAS caused by thyroid medications. This begs the questions: Has my thyroid now been so damaged that I now NEED to take the thyroid medications, and try to find the right combination and dosages, OR, is it possible at this late stage to wean myself off them? I'm afraid it may be too late for the latter?
People, beware of doctors bearing gifts of wellness!
(Sorry, Dr. Lupo; this does not necessarly include you.)
Nanci
by nancib, Aug 21, 2009 08:58AM
To: Dr. Lupo
P.S. I have no thyroid antibodies
Dr. Lupo then replied to my post:
by Mark Lupo, M.D., Aug 21, 2009 12:15PM
To: nancib
I usually don't respond to posts other than initial questions, but noticed your question.
The TSH is clinically the single most useful test for thyroid - there is little debate in the academic thyroid world regarding this. The problem is that thyroid symptoms are very nonspecific, so even with an abnormal TSH a patient may have many symptoms caused by problems other than thyroid.
You had a trial of thyroid hormone (many trials over 5 years actually) with no improvement in symptoms despite normalizing ("fixing") your TSH - in this case, unless the TSH is >10 w/o meds we usually observe without treatment. The medications did not damage the thyroid.
Hope that is helpful.
My last post to Dr. Lupo:
by nancib, Aug 21, 2009 02:03PM
To: Dr. Lupo
Thank you, Dr. Lupo.
Your response, that the medications did not damage my thyroid, was very comforting.
Now that I'm on my own, rather than freaking out over just what my next step should be, I'm beginning to feel a little more courageous. I've decided to stop taking any more thyroid meds, while continuing to track my lthyroid lab values.
In the past, stopping the medications was never an option. Although I did suggest it to the last two doctors, I was warned that if I did NOT take the meds as instructed, I could find another doctor.
Thanks, again.
Regards,
Nanci
---------------
Good luck on the 25th, Jena.....keep us posted!
No, I'm not talking about Armour. Although Armour is considered to be natural, it isn't any more natural than taking Synthroid--chemical molecules are chemical molecules. The reason people consider Armour to be natural must be because Armour is derived from another sentient being.
As far as nutritional supplements (vitamins & minerals), if you ARE hypothyroid you will not be utilizing the RDA of vitamins and minerals to any great extent. I doubt that you're taking TOO many since the government's recommended requirement is barely what is needed to keep one's head above water, healthwise. Keep taking them--it's a good thing, hypothyroid, or not....especially cholecalciferol, at least 1000 iu :)
All three of your lab values look good to me--I would love to have mine even close. They would "strongly" suggest to me that you are not hypothyroid.
As far as your symptoms go, they sound like they COULD be hypothyroid symptoms; BUT, they could also be caused by many other things, such as hypo or hyper adrenal problems; weight issues; hypo or hyper glycemia; sub-normal testosterone or estrogen levels; low iron (ferritin); low iodine; not sleeping regular hours; not eating regular meals; sub-standard diet with too many--or not ENOUGH--calories; ETC.
Exercise is VERY important, but, with all your symptoms you may not feel up to it, yet. But, I'm sure you will. :)
I was interested in this question which Birdinia posed to Dr. Lupo:
TSH levels written to dr. lupo
by birdinia, Aug 20, 2009 01:14PM
I recently had some blood tests run. One of the results is that my T3 and T4 levels are in the normal range, but my TSH level is elevated (5.5). Can you tell me what would cause this? What are the health risks if I choose not to take levothyroxine? How much would levothyroxine actually help?
Dr. Lupo's reply to Birdinia:
by Mark Lupo, M.D., Aug 20, 2009 05:18PM
This is called subclinical hypothyroidism (ie mildly sluggish thyroid). Sometimes it is transient and does not need meds. I usually repeat levels in 2-3 months to confirm it is persistent unless the patient has significant symptoms. Treatment is not absolutely needed, so decisions must be individualized. Usually we start treatment when TSH is >10. The most common cause is Hashimoto's (test TPO and TG antibodies). If you have no symptoms, then there would be little benefit from levothyroxine. Even if there are symptoms we must remember that "thyroid symptoms" are so non-specific, the symptoms may be unrelated to this slight lab abnormality.
After Dr. Lupo's reply to Birdinia, I posted this to him:
by nancib, Aug 21, 2009 08:57AM
To: Dr. Lupo
Dear Dr. Lupo, you said in your reply to Birdinia that a TSH under 10 means that sometimes a thyroid is mildy sluggish, transient, and does not need medications.
I went to a doctor a little over 5 years ago with the single symptom of "tiredness." A blood test was done, and when myTSH was found to be elevated (8.5), the GP freaked and started me on 50mcg Synthroid; thereafter, he tested regularly, but only the TSH.
I told him I was becoming even MORE tired--not that he ever listened to me. Steadfastly going only by my TSH, he raised the dosage of Synthroid to 75mcg. My body practically came to a standstill. I went to a new doctor.
The next doctor became nervous when she noted my TSH was just a tad over 1.0, and said the 75 mcg was WAY too much and that I was now hyPERthyroid. She lowered the Synthroid from 75mcg to 25mcg--still no improvement. This is pretty much the way things have gone through the years as I've struggled to find a doctor to help me.
It's been an awfully bumpy road to be on for more than 5 years. The bumps have shaken me to the point where I feel nothing in my body is in the right place anymore.
I have been to countless doctors (MD,s & Endos), and have been given different combinations of thyroid meds (T3, T4, T3/T4) . Each doctor has taken the dosages up, then down and all over the place....all to no avail. During this time I have steadily worsened to the point where I NOW have practically every hypothyroid symptom on record.
Most of this time, aside from what I understand now to be "worthless" thyroid tests, the only testing done was for TSH (of questionable worth) which has ranged anywhere from below 1.0 to 17.0 and anywhere in between.
I've finally struck out on my own--a tough place to be, but no tougher than where I've been......I don't think.
My last lab tests, TSH, FT3 & FT4. were done on June 5, 2009, and are as follows:
TSH (third generation), 5.17 REF: 0.40- 4.5 mIU/L
FT3, 217 REF: 230-420 pg/dL
FT4, 0.9 REF: 0.8-1.8 ng/dL
I guess what I'm asking here is if there's any hope for me. I really think my thyroid "problem" might have been simply transitional, "a mildly sluggish thyroid." If this is true, it's a VERY tough pill to swallow right now. This would mean I've been sick and in solitary confinement (totally out of commission, life) for over five years all because I listened to doctors and took their thyroid meds, or should I say, "took their snake oil."
I'm beginning to believe the ups and downs my body has suffered over these years WAS caused by thyroid medications. This begs the questions: Has my thyroid now been so damaged that I now NEED to take the thyroid medications, and try to find the right combination and dosages, OR, is it possible at this late stage to wean myself off them? I'm afraid it may be too late for the latter?
People, beware of doctors bearing gifts of wellness!
(Sorry, Dr. Lupo; this does not necessarly include you.)
Nanci
by nancib, Aug 21, 2009 08:58AM
To: Dr. Lupo
P.S. I have no thyroid antibodies
Dr. Lupo then replied to my post:
by Mark Lupo, M.D., Aug 21, 2009 12:15PM
To: nancib
I usually don't respond to posts other than initial questions, but noticed your question.
The TSH is clinically the single most useful test for thyroid - there is little debate in the academic thyroid world regarding this. The problem is that thyroid symptoms are very nonspecific, so even with an abnormal TSH a patient may have many symptoms caused by problems other than thyroid.
You had a trial of thyroid hormone (many trials over 5 years actually) with no improvement in symptoms despite normalizing ("fixing") your TSH - in this case, unless the TSH is >10 w/o meds we usually observe without treatment. The medications did not damage the thyroid.
Hope that is helpful.
My last post to Dr. Lupo:
by nancib, Aug 21, 2009 02:03PM
To: Dr. Lupo
Thank you, Dr. Lupo.
Your response, that the medications did not damage my thyroid, was very comforting.
Now that I'm on my own, rather than freaking out over just what my next step should be, I'm beginning to feel a little more courageous. I've decided to stop taking any more thyroid meds, while continuing to track my lthyroid lab values.
In the past, stopping the medications was never an option. Although I did suggest it to the last two doctors, I was warned that if I did NOT take the meds as instructed, I could find another doctor.
Thanks, again.
Regards,
Nanci
---------------
Good luck on the 25th, Jena.....keep us posted!
Why are you saying to think long and hard about taking thyroid medication? I'm seeing an endocrinoligist on Tuesday August 25. I know I would rather go the natural route if I need meds. Do you mean Armour or vitamins? I'm just learning.
My thyroid lab results are:
Thyroxine (T4) Free 1.08 0.61 – 1.76
TSH 1.150 0.450 – 4.500
Triiodothyronine (T3) 123 85 - 205
I am also doing a saliva test for hormones, testosterone etc. from a compound pharmacy.
My symptoms are hair loss, depression, brain fog, can't sleep, puffy face, constipation, can't concentrate, muscle aches, high cholosterol, hungry all the time and more.
I have been feeling better since I have been taking numorous vitamins. I think I take too many. Everytime I read a new article about hair loss I start taking the vitamin they sugeest. I take saw palmetto, selenium, kelp zinc, evening primrose, biotin, maganese silica, flax seed oil, fish oil, C, multiple, B-Complex.
I can't continue taking all of these, its costly, but until I find out what is wrong with me I figured I would take them.
My thyroid lab results are:
Thyroxine (T4) Free 1.08 0.61 – 1.76
TSH 1.150 0.450 – 4.500
Triiodothyronine (T3) 123 85 - 205
I am also doing a saliva test for hormones, testosterone etc. from a compound pharmacy.
My symptoms are hair loss, depression, brain fog, can't sleep, puffy face, constipation, can't concentrate, muscle aches, high cholosterol, hungry all the time and more.
I have been feeling better since I have been taking numorous vitamins. I think I take too many. Everytime I read a new article about hair loss I start taking the vitamin they sugeest. I take saw palmetto, selenium, kelp zinc, evening primrose, biotin, maganese silica, flax seed oil, fish oil, C, multiple, B-Complex.
I can't continue taking all of these, its costly, but until I find out what is wrong with me I figured I would take them.
I disagree. 5.5 is a significantly higher than normal TSH value, indicative of possible hypothyroidism. In addition, with the way the so-called "normal" ranges for FT3 and FT4 were established, the ranges include many people who are hypo and some who are hyper. These ranges have never been adjusted, as TSH was, to exclude suspect hypo and hyper patients. As a result, the lower you go in the range, the greater the probability of being hypo and benefitting from thyroid meds. What we really need to know from birdinia, is an answer to my question about her symptoms. These are most important in determining further action to be taken.
5.5 is not a terribly elevated TSH. It sounds, as Dr. Lupo has said, like it may be just a transitional thing, a sluggish thyroid.....especially since your other thyroid values are normal.
Please think very long and hard before beginning thyroid medications....they MAY do much more harm than good. I hope you'll decide to use OTHER, more natural, solutions to any health problems you may have.
Please think very long and hard before beginning thyroid medications....they MAY do much more harm than good. I hope you'll decide to use OTHER, more natural, solutions to any health problems you may have.
Many of the regulars here on the Forum have come to hate the word "normal". I know that doctors use it to denote that the test results fell somewhere within the very broad range. This means very little relative to what is most important, which is symptoms. We really need to know about your symptoms and look at the actual test results and their reference ranges . If you will please post those, along with a description of your symptoms, our many experienced members can give you the best response.
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.
