Low Thyroid Numbers but Normal Antibodies

[kris10_2]

I am a 35 year old female and when I FINALLY went to the doctor after months of hip pain and then recent back pain my doctor ordered a full blood work up just because it had been a while.  They called me the next day and said that my thyroid numbers were low and so they were going to request they do an antibodies test.  I don't know the first thing about all of this medical stuff and have a severe, probably unreasonable fear of "results" so I tend NOT to go to the doctor.  They called me after my antibodies came back normal and scheduled me for a thyroid ultrasound.  A little history of my symptoms might help so I'll tell you that I quit smoking seven months ago.  I gained 8-10 pounds gradually over about a 3 or 4 month period which I expected.  However...over the last 3-3 1/2 months, I have gained 18-20 pounds.  I have also felt extremely tired, have had lots of joint pain (that made me wonder if I could have arthritis), and have had an overall "yucky" feeling....like my body feels similar to what it has felt like when I've had the flu or some similar illness.  I'm absolutely terrified of the result of this test that I have to go get Wednesday and would love to know if anyone has experienced this same thing and if you might be willing to share their results.  I know I probably shouldn't worry YET but my biggest fear is going to the doctor and getting some terrible news.  I didn't think that at the age of 35, I would have to be worrying about something like this.  I do hope and pray that once the test is over, they find it's something that is completely treatable and will fix all that has been making me feel so uncomfortable, exhausted and irritable.  Thank you in advance for your assistance.

[gimel]

Here is a good link to use to check for additional hypo symptoms.

http://thyroid.about.com/cs/basics_starthere/a/hypochecklist.htm

The levothyroxin is a very commonly used  T4 type thyroid medication.  What dose did the doctor start you on?  Also, please post whatever thyroid test results and reference ranges you have, so that members can help interpret.  If you don't have the results, it is always a good idea to get a copy and keep it for future reference.  The doctor is required to give you a copy upon your request.

[openheart]

I just came from my doc,s appointment and i was told i have low thyroid. I was shocked because i don't even know the symtoms. I have been sleeping alot more and haven't felt myself . Can someone tell me about this medicine he put me on it is levothyroxin? I also would like more about the symstom because I didn't think I had any . I do wake up every morning with a sore thoath but it goes away after I am up for a while. I know nothing about low thyroid I haven't put weight on. Thanks for any help I can get about this!   openheart

[kris10_2]

OH NO THAT ***** when that happens!!!!  So do you not have to take Thyroid medicine?  I believe they want to start the Synthroid because of the T3.  My only question is that if I'm low on T3 then why not take that other one that is for reduced T3?  I'm going to ask when they call about the antibodies.

[ChitChatNine]

OH NO .. I just lost my entire post by hitting the wrong key....!!!!

I guess I was typing suggesting that you askyour Dr about taking the synthroid if it is the only reason why  they are suggestingit based on your TSH #'s alone  or if it has to do with the T3,etc.  If on the TSH alone I'd be concerned, too about going hypER if you feel better on the Vit D.  All my symptoms on the Vit D were HypO  and ALLwent away on my hefty dosage which is like yours.

Keep us posted .. feel better!

C~

[gimel]

Just look down the list of posts until you see one from Sunshine_67.  On the right side you will see a list of responses.  Click on my name to see my response.  

[kris10_2]

I'm definitely going to ask them about it when they call me next week with the antibodies.  Maybe I WOULD benefit from Armour too?  The nurse that calls me is SUPER nice and very willing to ask questions. They really seem to know what they are doing and I love that I don't feel rushed off of the phone and that they listen to my concerns and my questions.  I'm a little nervous about synthroid...or any pills I guess because I do NOT want to go hyper.  That terrifies me.  I sure dont want to start having panic attacks and heart palpitations.  Hopefully they'll start me off pretty low.

I'm having trouble finding your post to Sunshine_67 though.  Haven't quite figured out how to find stuff like that.

[gimel]

T4 is the storage form of thyroid hormone.  It is supposed to be converted to T3 as needed.  Most all of both T4 and T3 is bound up with protein and thereby inactive.  Only the small portion that is unbound (free) is the active portion.  If your body is converting adequately then the FT3 and FT4 should be fairly well balanced.  In this case a T4 med can provide enough of both hormones.  If unbalanced, and you are low in T3 then a combo T4/T3 med can be used to provide the additional T3 required to help alleviate symptoms.  I have a strong belief that the reference ranges for the "Frees" are too broad, since they have never been adjusted like the one for TSH.  This is a logical explanation for why we hear of so many patients who have FT3 and/or FT4 within the lower part of the reference range, yet they still suffer from hypo symptoms.  If you want to read more about  this, check my post to Sunshine_67 written 12 hours ago.

[kris10_2]

Is the free T3 the one that is stored and converted to free T4?  If that's the one I am lacking...isn't Armour the drug that replaces that or does Synthroid do the same thing? Thanks for the link.  I'm going to save it to favs and go read on it.

[gimel]

Just to add my two cents to this discussion, I noticed that the FT3 result was well below the midpoint of its range.  Since FT3 is four times as potent as FT4, and correlates best with hypo symptoms,  that looks to be significant to me.  I think the relatively low FT3 needs to be addressed by your doctor.  You might find some interesting info in this article.

http://www.hormonerestoration.com/Thyroid.html

[kris10_2]

I am hoping that my good feeling about this doctor is good and hoping it won't take long to get me to normal levels.  I mostly want my joints and body to stop hurting so I can go back to running every other day.  I stopped getting on the scale at 18 pounds so I don't know truly how much I've actually gained over this period of time.  The nurse that talked to me Friday when she called to give me my results said that the vitamin D supplement should help make my body feel better but it could take a couple of weeks.  I can handle that.  I used to do Weight Watchers and was very successful on it.  I did it without exercise though so I'm thinking that this time when I start it back up because my metabolism is compromised by the thyroid stuff, I'm going to have to be diligent about exercising too.  I don't mind walking and running with my music anyway.  It's kind of a stress reliever so as soon as my joints start feeling better I'm going to get back into it slowly and gradually.

I've heard about "parathyroids" and one of my co-workers had hers removed and never had any other problems.  I think I'll bring that up when I hear from the nurse about my antibodies.  

My throat has been hurting the last couple of days too.  It could be totally unrelated so I think I'll just keep an eye on it for a couple of days and if it gets worse, just go to my PCP and get him to take a look.  With all the flu junk floating around these days it could likely be something like that I guess.

[Barb135]

Usually once a person is on thyroid med, they have to stay on it for life.  I have heard of people going off med, but they usually end up back on it again.  

If you take med and get your levels into the normal range, some people think they are "cured" and that isn't the case.  The only reason the levels are "normal" is BECAUSE of the med.  

Also, don't be disappointed if you don't start losing weight right away.  Sometimes people on synthroid DO lose weight, but then there are those of us who don't.  I gained about 30 pounds in approximately a 3 month period.  I've been on thyroid med for about 18 months and have just recently gotten my levels to a point that will allow me to lose weight.  The thing you need to concentrate on first is getting your body healed and well, then worry about the weight.  

Vitamin D and magnesium are necessary in order to absorb calcium.  Lack of calcium could cause osteopenia/osteoporosis.  You should talk to your doctor about taking supplements.  I take 1200 mg/day.  

Has anyone thought about looking into your parathyroids?  

[kris10_2]

If my Calcium is normal, should I still take a supplement maybe?  I mean, if I did, is there any chance of overdosing on it or anything like that?  I don't know how long I've been D deficient but couldn't that cause bone problems if I have been deficient for quite some time?  Maybe adding Calcium would be helpful.  I used to take Magnesium and also Primrose Oil for something else so maybe I'll start taking them again.  I never know how much of them to take though.  Usually just taking what's on the bottle doesn't seem to help anything.

It was kind of funny at my sons football game because I thought it was going to be cloudy and rainy the whole time.  Well the sun came out nice and bright and hot and I had told my fellow team mom that I was D deficient and so I rolled my sleeves up as much as I could and kept saying throughout the game "yep, soaking up the D".  LOL!!!  

OH yeah..  Also...I thought in all of my reading that I read most people who go on Thyroid hormones had to pretty much stay on them forever?  I was talking to another team mom and told her what my doc had said and she said that I'll be able to start losing some of my weight once on the Synthroid because I would feel better.  She also said she did and then she didn't need it anymore after a while.  Is it possible to only have a temporary thyroid problem?

[Barb135]

Yes, you can speak your opinions on this forum - I thought I was agreeing with almost everything you said and explaining WHY I agreed.................lol.  

I'm not UP as much on the vit D as I'd like to be as I've not had a lot of time to research it.  Just basically what I've told you so far - that sometimes we just can't make it for whatever reason, such as skin type, age, etc and I'm sure there must be something within the body that could prevent us from producing it also.  If I'm low, as much time as I spend in the sun, there has to be something in my body that isn't working right, but I've no idea yet what that might be.  

I figured you might have meant that you didn't want to go hypER - yes, you are correct - that's when people "are bouncing off the walls", having heart palps, anxiety/panic attacks etc and often much worse.  I agree that you do not want that to happen.  I know there are some on this forum who have been hyper and went through he// with it.  Personally, I'd prefer to stay a bit hypO in order not to have to go through that.  

No, calcium doesn't help absorb vit D - it's the other way around - vit D helps absorb calcium, as does magnesium.  That's why a lot of calcium supplements also have vit D and magnesium in them.  

[kris10_2]

I apologize if I appeared to discount what you said because that was not my intention at all.  I am only speaking from my point of view and expressing my opinions based on what I've read and learned over the last two months. I thought that's what this site was for.

I meant I didn't want to go hyPER.  Isn't that where you are basically bouncing off the walls and people that have those symptoms can have heart palpitations, anxiety and panic attacks too?  I have read more on hyPO because that's what my symptoms point to than I have on hyPER.  Neither one can be fun and I know I hate the way I've felt for the last few months but for some reason, hyPER scares me more because of the things like heart problems and anxiety.  I've had enough issues with anxiety and panic attacks so I surely don't want to go the opposite of what I am now.  On the same token, I want to come out of this fuzz and discomfort I've been in for what seems like forever.

When it comes to Vitamin D deficiencies, are there typical things that can occur in one's body that causes that deficiency?  I am out in the sun for football practice in the evenings 2-3 times a week but it's getting dark earlier so I probably don't get as much at that time of night.  I am outside on Saturdays for 3-4 hours in the sun at the games but I guess my body is stubborn and doesn't want to produce it.  I have a friend that was diagnosed with a D deficiency and the put her on the prescription D but she doesn't have a thyroid problem or anything else that they could find.  I'm just curious what could cause someone to just not produce it correctly.  I also was curious as to calcium.  My doctor said my calcium level came back right in the middle of the normal range and didn't suggest taking calcium.  Doesn't calcium help absorb Vitamin D?  

I don't go on the Synthroid until two weeks from now so they can see if I do ok on the D.  I hope they start off low and go from there.  

[Barb135]

The most recent TSH range was set several years ago by the, I think it was, AACE - that range is 0.3-3.0.  Some labs are still using old ranges and they vary greatly.  For instance my lab uses 0.4 - 4.5........

You are absolutely correct, without any doubt whatsoever that TSH is NOT the way diagnose a thyroid issue.  AND you are absolutely correct that not everyone is alike and should be treated the same.  That's why you will find such varying treatments on this forum - because we have all figured out that we can't be treated the same.  There are some guidelines for initial treatment, but once we start coming back to health, we all have to figure out what's right for us.......Some of are on synthroid, some on generic levo, some on cytomel, Armour, or varying combinations of meds- we all have to get to a point where we do what's right for US, not what everyone thinks we should do.  BUT having said that, I must also point out that *I* would never have learned enough without the great people on this forum helping me, to have gotten to where I am now because the doctor who diagnosed me refused to do anything except prescribe synthroid and THAT isn't what I needed........without the people on this forum, I would not have known what to look for in a doctor, what tests to ask for or anything........So yes, you have to do what's right for you, but don't discount the help of other people either.  You take each opinion and weigh it to see if there is information there you can use.......usually there is, if only a few words of encouragement, which goes such a long way toward helping us get well.  

As far as your vitamin D - experts say that 10-15 min/day in the sun without sun screen should be sufficient - for some of us it isn't --- as I said in my earlier post, I am in the sun for 3-8 hrs daily without sunscreen and I'm deficient.  I also drink milk, which is fortified with vit D, plus I eat fish, etc that are loaded with it.......So again, you are right - YOUR deficiency may not be because of lack of sunshine.  It could have to with your skin - remember, I said the darker the skin the less rays you absorb - or it could be because you don't eat the right things OR it could be because there is something going on in your body that either can't produce it or USE it.......

I'm not sure what reactions/side effects you are referring to from synthroid, but there shouldn't be too many, except that it will help you feel better.  If for some reason you don't do well on synthroid - there are other meds to try, including generic, natural, etc.  Synthroid will help you keep from being hypo or did you mean you don't want to go hypER?  You will have to monitor your symptoms, along with regular testing to prevent it.  

[kris10_2]

I live at the beach but I don't go very often anymore.  I used to get way more sun time than I have the past two years or so.  I might have gone and stayed a couple hours at the beach a total of 5 times in the last two summers.  Part of it this year is the weight I've gained.  I don't usually wear sunscreen because after the first time or two in the sun, I tan well.  There are risks associated with sunning too in the form of cancer and after my mom worshipped the sun for so many years and having to get 3" of her leg dug out from a stage three melanoma, I'm not willing to risk it anymore.  I don't know that me not being in the sun though is the cause of my Vitamin D deficiency.

Regarding the Sinthroid...I'm a little leary to try it because I don't really like the idea of some of the reactions and side effects to it.  I feel confident that my Endo isn't going to prescribe me high levels of it though to start.  I may benefit from just a low dose of it.  Whatever he does, I do NOT want to go Hypo either.  Ive read about anxiety/panic attacks and I've had those before so I do NOT want to have those either.  They scare me so bad.

There seem to still be many debates about that range and what should be the correct one.  How do we know that just because one side says this 0.3-3.0 is the correct range to use that it IS really the correct one?  After all the reading I've done, I take the TSH ranges with a grain of salt. I believe that the TSH test is only a jumping off point for digging deeper.  It seems that some people function normally at one range while another group of folks function normally at a completely different range.  I'm just not convinced by that test.  I'm also not sure that these ranges really indicate anything.  Who decides what's normal for one person or another?  I don't think that every person is created equal thus can't always be treated equal but deciding with numbers. Who knows.  It's all crazy and I know that I want to feel better so I'm willing to try anything.  :-)  I feel a little relieved just knowing that there is SOME answer about why I feel so uncomfortable all the time.

I also hope that whatever they do...it clears up my brain because it feels like there is a huge fuzz ball soaking up it's power.  I'm such a major ditz lately.  If my posts ever sound dingy...well...there's my excuse.  LOL!

[Barb135]

Everyone DOES have antibodies - the problem is that sometimes the antibodies, which are supposed to attack foreign things (like flu, colds, etc) sometimes start attacking parts of our bodies because for some reason they think that part shouldn't be there - these are called autoimmune diseases.  There are several of them, including Hashimoto's Thyroiditis, Graves Disease, which are both thyroid related.  

Your body does make vitamin D from sunlight, but there are some of us who apparently "malfunction" there too.  My job keeps me in the sun for anywhere from 3-8 hrs/day but a recent test showed that I'm deficient.  One thing is whether or not you use sun screen -- if you do, the rays can't get through, so your time in the sun doesn't do anything for you - vitamin D wise, that is.  Another thing is the color of your skin - the darker your skin, the less rays you absorb to make vit D from.  Aging is another factor - the older we get, the less efficient our bodies are at making vit D.  Personally, I have sort of medium olive skin, which burns once in the spring, then tans famously but apparently that tan is what contributes to my low vit D levels.  Another contributing factor is my age -- I recently turned 60, so you have that advantage.  I do not use sunscreen so my face/upper neck and arms are exposed to the sun most of the time I'm outside.........oh, woe is me --- I'm waiting for an appt with my pcp on the 23rd to see what kind of journey this is going to take me on...

Judging from the labs you posted above, your TSH is mid range (the lab is using an outdated reference range - the new one is 0.3 - 3.0); your FT3 is very low in the range; under most circumstances I would say your FT4 is good.  Sometimes, those of us with Hashimoto's benefit from having our TSH suppressed more, so I can see where you might benefit from synthroid.  One thing I'd ask you to make sure of is that you start at a very low dose, then work up slowly and retest in a few weeks.. You don't seem to be that far out of line and I'd hate to see a large dose all at once to send you completely hyper.  

[kris10_2]

I FINALLY heard back from my awesome Endo.  I'm SOOOO glad I decided to switch from the original Endo I was referred to and go to this one who was highly recommended by a co-worker.

I got some info on my blood work though they are still waiting on antibodies.

I forgot to ask the level and range for my Vitamin D but they said it was extremely low and are starting me on 50,000iu's of it now.  I will take it twice a week for 8 weeks to get it back up to normal range.  I think they will test it again then.  The nurse said that it's probably why I've been feeling so terrible too so hopefully it'll kick in pretty fast.  She said my calcium was right in the middle of the healthy range.  I wonder if I should still take some Calcium anyway?

TSH = 1.9 (.45 - 4.5)
Free T3 = 2.7 (2.3 - 4.2)
Free T4 = 1.23 (0.6 - 1.7)

They said that I would benefit from the Vitamin D AND after two weeks of being on that, they want to start Synthroid too.  They just want to make sure I don't have any kind of reaction to the Vitamin D first.  

I asked her what the numbers above mean and she said she really couldn't say yet because the antibodies won't be back until Tuesday next week but on a preliminary result she said there was evidence of them being active?  Not really sure if that means too much yet because I thought everyone had antibodies...that were active.  Maybe she thought they looked too active but are waiting on the antibodies to come back to confirm.

So....I feel a little better just knowing they are going to try these two things out and not make me go on living feeling so horrible.  I really like this doctor so far.  I hope that within the next 2-4 weeks, I'll start to resemble what I THINK I should really feel like.

[kris10_2]

How much Vit D should one have in their body's?  I am in the sun 3-4 afternoons a week and now coming up, will also be on Saturdays as football season has started back.  Isn't the sun where you get Vit D?  I watched a show one time that said the majority of the general population don't typically get enough Vit D.  Should I just go buy some and start taking it to see if it helps or is there risk of having too much?  I've read about Calcium too and though I take fish oil vitamin w/ three kinds of oils and a Complex B12 w/ folic acid and Vit C in it, I haven't noticed any difference.  Well...I take that back...a day or two after I started taking it, I did notice a difference in my need for sleep over the weekend and I didn't feel as exhausted during the day but that didn't last.  I'm still taking those but still feel extrememly fatiued daily and my joints...especially my back, hips, knees and ankles hurt like crazy.  My endo said my symptoms could be rheumatoid related too so hopefully he requested that test also.  I think I'll call them today and see if they can add the Vit D and Calcium just so I'll know.  

Thanks for the note.  I'm going to go get the tracker you mentioned too.

Guess I should fix up my profile.  I'll likely be spending a fair amount of time here. :-)

[ChitChatNine]

O I C the nodule is small.  Nothing you can do with them that small from what I'm told .. mine is a 4.0mm stable and my other ones removed via surgery that were atypical FNA were almost 2.0cm's and hypoechoic and turned out 100% benign.  I have to have my other side ultrasounded ev. year now for serial comparison with my one yr coming up next month.  Used to be ev. 6mos for which I liked better.

They usually can only biopsy > 1.0 cm

Vitamin D ... see if they can add that test to the bloodwork .. so many of us here on thyroid are low on Vit D and that, alone, can cause hypo-like symptoms.  Mine was a horrific 9 with normal being 32-100 ... and my hypo symptoms all went away with treatment.

C~
partial 1/07
synthroid 75mcgs

[ChitChatNine]

You can have hypO symptoms and be Hyper.  We use LabCorp, too, and my endo did repeat Vit D tests which he wanted to make sure were accurate.   My antithyroglobulin was 8 I think but since I had some small papillary tumors and did not receive RAI they are ok with the #.  And it's been stable for 2+ yrs.

How large are your nodules?  That is my main thougtht .. PM me to be sure I come back to your post and I'll watch list it, too!

C~

[kris10_2]

I went to the Endo I was referred to last Wednesday.  He seems to be very knowledgeable also.  He says "the thyroid is my passion".  LOL!  They did an US and found a nodule on the left lobe too which of course put me right back in my fear zone.  He did say however that they were too small to biopsy right now and wanted to watch them for 3 or 4 months.  My thinking on that is that if they COULD be cancerous, even though only a 10% chance, I don't want to wait dang it.  I don't want to let something like that grow in my body.  I said jokingly to him, can't you just take out my thyroid and give me a pill?  He laughed and said no.  I asked him if there WAS anything he could do that day and he said that because my blood work didn't really give him any answers, he pretty much had to start over.  He was not happy with LabCorp's range for antibodies and after much research and studying, they finally called them and asked them where they got the range of 0-40 as a healthy range.  They said from an internet website.  So....I'm not sure if I totally understood his reasoning but I believe he said that if your antibodies were up too much over 0, that they were doing something or fighting something thus requiring more research.  So...they took six vials of blood and said he was going to go do another "full blood work up".  He sent the thyroid testing to a lab in California that he is more comforatable with and the other to LabCorp...who I'd just rather not use after his comment about the healthy range being found online.  I'm terrified of these nodules but pray that the blood work points obviously to something that's fixed/treated easily.  I'm soooooooooo tired of feeling so horrible.

One question...is it still possible to be HYPO with a low TSH? I know other tests are really going to be the deciding factor but as a base line....TSH being raised usually indicates hypo.....not it being low....right?  Doc is doing Free T3 and Free T4!  Thank goodness!

[goolarra]

Thyroid issues can present in childhood.  Most of us are old farts, but not all!  As far as thyroid cancer is concerned, I'd relax...your US just doesn't support it.  Also, your antibodies are negative, which also does not support thyroid cancer.  Hope your endo can unravel all this for you.

[kris10_2]

Thanks guys for all of your comments.  I read an article today where someone had normal TSH levels but was still presenting with Hypothyroid symptoms.  The doctor did a TRH (Thyrotropin Releasing Hormone) test and it came back above ten which indicated that her thyroid was underactive.  It's mostly frustrating and a little scary right now for me.  My biggest...probably even unreasonable fear...is cancer.  I'm 35 years old and I just don't think I should have issue's like this at this time...though I've read that thyroid issue's can begin to present in the 20's.  Crazy.  I'm scared and will be until I get an all clear from my doctor.  It doesn't make sense why I feel so bad but yet there still is not an obvious reason for it.