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Need help with labs - first time ever posting anywhere!
Hi - Short and sweet (maybe). After I had my first child 10 years ago, I went severely hyperthyroid for 8 months. Did not go to hypo like they expected with post-partum. So since then I have had regular checks and my TSH bounces from 0.5 to 0.9. All antibodies are negative, ultrasound negative etc. This last test my Free T4 was 0.8 and my TSH was 1.2 (highest it has been in 10 years). I looked at old labs and a doctor had tested me 10 years ago and my Free T4 was .56 and my TSH was 1.4. My second to last lab (recent) was TSH .51 and Free T4 was 0.77. I am so tired! My muscles ache a lot (especially my legs) and my get up and go got up and went. Another dr. I see for something else thought my Free T4 was too low. I also have alopecia areata that started about 3 years ago and will not stop (better now) but some hair grows back kinky in places and a different texture. My cycle is a bit off but nothing major, I have eyebrows etc. I am on zoloft but have been forever. I take iron and am getting my ferritin up. I also take other vitamins. I am thin, don't feel depressed, just tired which I guess makes one feel a little down. Cortisol (ACTH) was tested and is normal. I went to an endo not too long ago and she said everything was fine. Strong family history of thyroid problems (seems like about 10 relatives, including mom). I was always told my thyroid was just burning itself out, but for 10 years? If everything is "normal" why am I so tired? Anyone have any suggestions? PS - Everything else about me is very healthy.
Your so so helpful! I am going to go to my regular doc as soon as I get an appt. and see if she can give me a trial of meds. Maybe my hair will come back :). You did not scare me, just informed me.
COMMUNITY LEADER
I'm going to scare you to death here, and I'm really sorry, but it has to be done........ low TSH will not make you hyper, because TSH causes no symptoms.
My TSH is < 0.01 and I've never been hyper at that level!!
There, that's done.... now I can move on.
TSH (Thyroid Stimulating Hormone) is a pituitary hormone that calls for the thyroid to produce hormones; if the thyroid doesn't respond, typically, the pituitary will keep sending out TSH in hopes of "prodding" the thyroid into action. Typically, when the thyroid doesn't react, the pituitary gets really torqued and TSH will continue going higher and higher....... what most people don't understand is that it's not the high TSH that causes symptoms, it's the lack of thyroid hormones (FT3 and FT4), because the thyroid isn't responding, that causes symptoms.
TSH should never be used as a diagnostic, even though that's what many/most doctors go by.
With your FT4 so low in the range, it would seem to follow that your FT3 would be similarly low, though FT3 often lags behind FT4...... your problem is that no one is testing FT3, so you don't know what it is.
FT3 is the actual biological hormone that you individual cells use. FT4 is a "storage hormone", which must be converted to FT3 before the body can use it........ sometimes, the conversion process doesn't work just right......
People who still have some thyroid function often don't have an issue with conversion (which mostly takes place in the liver), because the thyroid also produces a small amount of T3.
Your thyroid may not be totally "dead", but maybe it's close, so your thyroid is still producing some hormone, which hasn't put your pituitary into a frenzy just yet, which could explain why your TSH is still low - but don't forget the latest test was 1.2, which was your highest yet and while still well within the range, could be an indication that it will continue to rise, calling for thyroid hormones that your thyroid can no longer produce.
Standard therapy for hypothyroidism is a T4 medication. Some doctors will only prescribe synthroid, others say generic levothyroxine works as good (I found that to be true).... It's always best to start out at the very lowest dosage (sometimes having to split pills in 1/2 or 1/4) and move up very slowly; that's how we prevent the hypo to hyper effect. It takes any T4 medication approximately 4-6 weeks to reach full potential in the body. Starting low, also gives your body a chance to "acclimate" to having the hormones again; you'd need to move up very slowly - typically at 4-6 week intervals, by very small increments. Takes longer to get where you're going, but the journey is usually a lot less traumatic.
Not all of us convert FT4 to FT3, but that's a bridge that can be crossed if/when you meet it.
My TSH is < 0.01 and I've never been hyper at that level!!
There, that's done.... now I can move on.
TSH (Thyroid Stimulating Hormone) is a pituitary hormone that calls for the thyroid to produce hormones; if the thyroid doesn't respond, typically, the pituitary will keep sending out TSH in hopes of "prodding" the thyroid into action. Typically, when the thyroid doesn't react, the pituitary gets really torqued and TSH will continue going higher and higher....... what most people don't understand is that it's not the high TSH that causes symptoms, it's the lack of thyroid hormones (FT3 and FT4), because the thyroid isn't responding, that causes symptoms.
TSH should never be used as a diagnostic, even though that's what many/most doctors go by.
With your FT4 so low in the range, it would seem to follow that your FT3 would be similarly low, though FT3 often lags behind FT4...... your problem is that no one is testing FT3, so you don't know what it is.
FT3 is the actual biological hormone that you individual cells use. FT4 is a "storage hormone", which must be converted to FT3 before the body can use it........ sometimes, the conversion process doesn't work just right......
People who still have some thyroid function often don't have an issue with conversion (which mostly takes place in the liver), because the thyroid also produces a small amount of T3.
Your thyroid may not be totally "dead", but maybe it's close, so your thyroid is still producing some hormone, which hasn't put your pituitary into a frenzy just yet, which could explain why your TSH is still low - but don't forget the latest test was 1.2, which was your highest yet and while still well within the range, could be an indication that it will continue to rise, calling for thyroid hormones that your thyroid can no longer produce.
Standard therapy for hypothyroidism is a T4 medication. Some doctors will only prescribe synthroid, others say generic levothyroxine works as good (I found that to be true).... It's always best to start out at the very lowest dosage (sometimes having to split pills in 1/2 or 1/4) and move up very slowly; that's how we prevent the hypo to hyper effect. It takes any T4 medication approximately 4-6 weeks to reach full potential in the body. Starting low, also gives your body a chance to "acclimate" to having the hormones again; you'd need to move up very slowly - typically at 4-6 week intervals, by very small increments. Takes longer to get where you're going, but the journey is usually a lot less traumatic.
Not all of us convert FT4 to FT3, but that's a bridge that can be crossed if/when you meet it.
Hi - I did find an old,old (2000) that showed Anti Thyroglonb at 1.1 (0-1 value) but all ones since were normal (showed <2, no number value given)
Tested for all antibodies. Negative. I think you are right about just needing something for my low t4 levels. 30 years??! Ugh. I am afraid if they put me on meds I will go hyper. Is there a med that ups ft4 and ft3 (if necessary) what will not make me hyper with my TSH already on the low side? Thank you!
COMMUNITY LEADER
You should be getting FT3 checked every time there's a TSH and FT4, so you know what your values are.
I wouldn't be thinking pituitary, at this point. I simply think you're tired because you don't have enough thyroid hormones to keep you going. Sometimes thyroid symptoms can begin long before the labs will confirm.
While the FT3 from '09 is too old to be useful now, it, too was low in its range.
"I was always told my thyroid was just burning itself out, but for 10 years?" Yes, if that's what's happening, it can take 10 yrs. I think mine took closer to 30 yrs. Have you been tested for thyroid antibodies to see if you have Hashimoto's Thyroiditis? That would be the next step. If you test positive, some doctors would be willing to give a trial med just to see if it helps.
Antibody tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyrglobulin Antibodies (TGab).
I wouldn't be thinking pituitary, at this point. I simply think you're tired because you don't have enough thyroid hormones to keep you going. Sometimes thyroid symptoms can begin long before the labs will confirm.
While the FT3 from '09 is too old to be useful now, it, too was low in its range.
"I was always told my thyroid was just burning itself out, but for 10 years?" Yes, if that's what's happening, it can take 10 yrs. I think mine took closer to 30 yrs. Have you been tested for thyroid antibodies to see if you have Hashimoto's Thyroiditis? That would be the next step. If you test positive, some doctors would be willing to give a trial med just to see if it helps.
Antibody tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyrglobulin Antibodies (TGab).
Lab values are 0.7-1.8 for FT4 taken this month (my FT4 was 0.8)
June '11 my FT4 was 0.77 (lab values 0.6-1.25) - TSH at that time was 0.5
In '09 I had my one and only FT3 test. It was 2.71 (value 2.0-3.7)
June '11 my FT4 was 0.77 (lab values 0.6-1.25) - TSH at that time was 0.5
In '09 I had my one and only FT3 test. It was 2.71 (value 2.0-3.7)
On Zoloft because I was depressed :). I think Zoloft works ok. I have been on anti-d's for many years. Pretty much since I started having weird thyroid stuff. I am no so much depressed as tired. I have always felt it was something else. I go from tired, to jittery to whatever. It is hard to explain. I used to be someone who got the job done right away and well...now I just don't seem to really care but I am not in the corner crying. Does that make sense? Thanks for your feedback. That is what I was thinking - FT 4 is low and has been for years. The weird thing is that my TSH usually hangs out from 0.5 to 0.8. with same numbers for Free T4. The last test I had at the beginning of the month had my TSH at 1.2 - the highest it has been in about 10 years but with the Free T4 still low. I am actually thinking maybe pituitary? The problem now is finding a good doctor.
COMMUNITY LEADER
What are the reference ranges for those FT4's. Ranges vary from lab to lab, so if you didn't have all the tests done by the same lab, there would be variations.
What's important is where your levels fall within (or outside) the ranges. Your FT4 levels seem to be awfully low. Nearly all of your symptoms indicate hypothyroidism and it's entirely possible to be hypo with so-called "normal" labs. You should also be getting tested for the biologically active hormone, Free T3.
"I am thin, don't feel depressed, just tired which I guess makes one feel a little down." Why are you on Zoloft, if you don't suffer from depression? Depression can be a classic symptom of hypothyroidism.
What's important is where your levels fall within (or outside) the ranges. Your FT4 levels seem to be awfully low. Nearly all of your symptoms indicate hypothyroidism and it's entirely possible to be hypo with so-called "normal" labs. You should also be getting tested for the biologically active hormone, Free T3.
"I am thin, don't feel depressed, just tired which I guess makes one feel a little down." Why are you on Zoloft, if you don't suffer from depression? Depression can be a classic symptom of hypothyroidism.
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