Help With Hashimoto's

[Amy2776]

I have been diagnosed with Hashimoto's disease since 2008 and am not sure my Labs are where they should be.  My TSH shows that I am more Hypo yet my Free T4 shows that I am more Hyper.  I have horrible Panic attacks that come and go.  I went a year without any attacks and now they are back full swing.  My lab results are below.

Thyroid Autoantibody
   Thyroglobulin  AutoAB    <20         Range  0-40
   Thyroid Perox AutoAB    187H       Range 0-34
TSH      0.62         Range 0.27-4.20
Free T4  0.58        Range 0.71-1.85
Cortisol   0.69       Range 2.30-25.40

[Barb135]

I think you might still be confused about the test results and what they indicate.  

High TSH and low FT4 and/or FT3 indicate hypothyroidism.  Therefore, based on your TSH, typically, nothing would have been done, since it's at a very good level.

The fact that your FT4 is at the very bottom of the range, does raise a red flag, though, and you should have had an FT3 done.  

You might well have benefited from a low dose of replacement hormones.

[Amy2776]

Thank you all so much for your responses.  I have one more question...

Back in 1996 I had a TSH and Free T4 done and the levels were as follows:

TSH   1.02   Range 0.38 -4.7
Thyroxine, Free    0.87  Range 0.8 to 1.8

Since the levels were within "Normal" nothing was done...if both lab tests are on the Low range would this have been an inclination of something was Not right? or since they are normal all is well?

[Barb135]

Often autoimmune diseases have a genetic link; other times, they "come out of the blue" - for instance, my son was diagnosed with type I diabetes (autoimmune) at age 10.  The doctor told us that, for whatever reason, he thought that it might come from my side of the family; however, we had no diabetes at all in my family that we knew of.  We treated his diabetes for many years, then, lo and behold, I had a nephew who is older than my son, diagnosed, then later still, my oldest sister was diagnosed at close to 70 yrs old.  

In regards to thyroid issues, again, in my case, we've never had any; however, less than a year before I was diagnosed hypo/Hashi's, my sister who is 2 yrs older than me, was diagnosed.  

My point is: even if you don't have a family history, there's always got to be a place to start...... additionally, maybe you had family members who DID have thyroid issues and didn't know it, just like apparently, my family has had diabetes (and thyroid) issues, but we didn't know it.  Remember, years ago, people died and no one knew why - often it was put down to "consumption", which could have been anything, including diabetes, thyroid issues, cancer, etc and they didn't have the means to test for it, like we do today.

In regards to the chlorine issue - I'd have to say, that's rather unlikely. Water treatment is my "line of work";  I am a licensed water treatment operator and I deal with chlorine on a daily basis.  While there are some compounds produced when chlorine reacts with organics in the water, I've never heard of this being an issue specifically with thyroid.

Additionally, the EPA sets specific limits on the levels of chlorine allowed in your drinking water - if you suspect that those levels are too high, you need to contact the supplier of your potable (drinking) water.  If you are on a private well, this would not be an issue, unless you chlorinate the water as it's pumped to your house, or pour chlorine into the well.    

All of that said - I agree with gimel.  The cortisol issue needs to be addressed, with a very high priority.

[gimel]

I know that there is supposedly a heredity factor with hypothyroidism/Hashi's.  Beyond that I know there are lots of theories about the cause, none statistically validated as far as I know.  I also wanted to point out that we did not discuss the cortisol test result.  That is also something that needs to be addressed by your doctor, with perhaps a higher priority than the thyroid issues.  I have no experience with that, so hopefully other members can provide some input on that area.

[Amy2776]

Thanks gimel for the article,  it seems I should have been treated all along.  I have Labs back from 1996 that were off and were dismissed because I wasn't complaining.

I know Hashimoto's is supposed to be genetic but I have no genetic history at all if this.  So why me?  I have been reading Articles that Hashi's can be caused by environmental toxins and possibly chemical exposures, including high amounts of chlorine.  Has anyone heard anything on this?

[gimel]

When searching for an Endo, be aware that not all are good thyroid doctors.  Many specialize in diabetes.  Many have the "Immaculate TSH Belief", and do not pay attention to the more important tests for free T3 and free T4.  

When trying to find a good thyroid doctor, I have found a good approach.  I call the office and say that I'm looking for a good thyroid doctor but before making an appointment I have a few questions I'd like to ask of one of the nurses.  This has never failed to get a nurse on the phone with me.  Then I ask if the doctor is willing to test and adjust free T3 and free T4 with whatever meds are necessary to relieve symptoms, without being constrained by resultant TSH levels.  I also ask if the doctor is willing to prescribe meds other than the T4 only types.  If the answer to either question is no, then don't bother with an appointment, just keep on looking.

Relative to your doctor saying to come back only when you are having real problems,  I think you will find this article to be of interest.

http://thyroid.about.com/od/hypothyroidismhashimotos/a/preventative.htm

[Amy2776]

Thanks so much for your posts...it gets frustrating when you are trying to tell a Dr. that you aren't feeling well and they throw you on Anti Depressants because it is all in your head.  I will be searching for an Endocrinologist,  even if I have to travel so I can finally get the help that I need,  and verify that I am not crazy!  Great to have this to know that I am not alone and there are other people out there with the same symptoms.

[Barb135]

No - vaccinations do not trigger Hashimoto's....... Hashimoto's Thyroiditis is an autoimmune disease in which your body produces antibodies that "see" your thyroid as a foreign thing; the antibodies, then begin to "attack" your thyroid and will eventually destroy it, so it can no longer produce adequate hormones.  

In your case, with both TSH *and* thyroid hormones (FT3 and FT4) being low, it could be that you might have a pituitary issue. Your thyroid is not producing enough hormones, but your pituitary may not "know that", so isn't sending out the TSH (Thyroid Stimulating Hormone) to tell your thyroid to produce hormones.......

You need to find a doctor who will take your symptoms into account first, then evaluate your FT3 and FT4 values, along with the low TSH.  You could have more than one issue going on.........

[Amy2776]

I also want to point out that I have not been on Synthroid or anything like that.

[Amy2776]

No meds what so ever.  I am trying to get evaluated by a different Endocrinologist seeing that the other one said I only need to come back if I start to really have problems.  The Panic attacks were dismissed as stress.  

T3 Free was <1.10    Range 1.45 to 3.48   So Low

I never had any issues until after I was about 20 years old.  Can something trigger Hashimoto's.  Like Adult Vaccinations?

[Barb135]

It can get confusing, but your thoughts are backward.  High TSH indicates hypo, low TSH indicates hypER.  Low FT4 indicates hypO, meaning that your thyroid is not producing enough hormone;  High FT4 indicates hypER, meaning that your thyroid is producing too much hormone.  

Your TSH is "in range", some would say "perfect";  while your FT4 is below range, indicating that you are hypo because your thyroid is not producing enough hormone.  That said, however, you need to have an FT3 done as well, as FT3 is the hormone that correlates best with symptoms.

Are you currently on any thyroid med?  If so, what med(s) and what dosage?