New labs

[jtms]

TSH/0.64  (0.47-4.68)
T4 free/1.1ng/dl (0.8-2.2)
T3 free/2.9 pg/ml (1.7-3.7)
Thyroid Peroxidase/<1.0 IU/ml (0.0-5.5)
Sleep study and neck CT scheduled next week.

[Barb135]

I'm sorry; can you provide us with a bit of background?  Are you on thyroid med?  Which one/dose.

Your FT's are both too low in the ranges, which can cause sleep and/or neck issues.

Looks like doctors might be reacting to TSH.

[jtms]

Oh sorry, this is follow up to my previous posts. This is my third doctor, including an endo who says my thyroid is" perfectly normal". This doc however is amenable to full investigation. I have most of the hypo symptoms and u/s showing multi nodular goiter. New doc also tested me for Sjorgrens which was negative. I will be having a neck CT as I originally went to the doctor due to a feeling of pressure at the lowest point of my throat mostly at night but through the day as well and despite the multinodular goiter they don't believe it is causing the discomfort. The other symptoms I consider drastic at this point are extreme fatigue and hot flashes which are accompanied by what I can only describe as a surge of adrenaline and the list goes on. My mother had RAI for malignancy in the 1950s, her sister had thyroidectomy 2 yrs ago, and a cousin with hypo. The endo doesn't believe there is any relevance there. I am not returning to that endo but can't get in to the new one til January so my new FP will have to do for now. My TSH is always at the very bottom of the range no matter which lab ranges are used. This is the first free T3 that I have seen. I am not currentlt on any meds and I'm not sure that this doc will trial any until I see the new endo.

[Barb135]

I knew this was a follow up post; just couldn't remember all the background.  FYI, sometimes it's best to go back to your original post, so all the info is there and we don't have to ask for it again.  

I had a rather lengthy response all typed and ready to send, when MedHelp went into their "maintenance" phase - why they do that in prime time Sat night, is beyond me - but anyway the response I posted, didn't post....... I'll have to recreate it, but it's getting late in my world, so I'll have to try to do it tomorrow.

I'm very sorry -- yell at MedHelp.

[jtms]

I look forward to hearing from you.....I need all the guidance I can get at this point....;)

[Barb135]

Okay, I can't remember everything I had typed, so you'll get the "Reader's Digest" version......lol

Actually, at them again, your thyroid levels, especially FT3 and TSH look pretty good.  Your FT3 is at 60% of its range, which is about where we recommend.  Your FT4, on the other hand is only 21%, but considering that it appears that your thyroid is still working, you may not need your levels as high as those of us who are on medication.

I would recommend that you get antibody tests - Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) - if you haven't already, to confirm/rule out Hashimoto's.  If you have Hashimoto's, thyroid function will continue to decline and you will definitely become hypo, at some point.   The low FT4 could be an indication that that may be happening.

As for the fatigue and hot flashes, I'd ask if you've had any nutrient testing done.  The tests I'd recommend for fatigue are Vitamin B12, D, iron, calcium and magnesium, but particularly, vitamin B12.  B12 deficiency can cause absolute unbearable exhaustion.  

For the hot flashes, you might want to get some tests done on reproductive hormones.  Don't know your age, but you may be in perimenopause, or menopause.  Even if not, imbalance of reproductive hormones can cause hot flashes.  Additionally, adrenal issues can cause hot flashes, as well.  Talk to your doctor about that.

[jtms]

Thanks Barb....I am post meopausal (about1 1 1/2 yrs) @ 55 all of the docs so far make the menopause assumption except for this last one, she said she has never seen anyone restart with the hot flashes, etc after a year of absence of symptoms. I was so thrilled when the symptoms stopped I was praising on high for the relief. When the hotflashes restarted I could only say NO, NO, NO! These are definitely not the same, mostly I feel ill with them as opposed to menopause where they were a nuisance and uncomfortable. I had a hyste @ 23 (total not complete/no oophrectomy). Perimenopausal @44 so after 10 years was exhausted but I didn't feel ill. After my tests this week I will be following up with my new dr, will request the antibodies and adrenal issues (I think we are doing a 24 hr cortisol) I will keep you posted.

[Barb135]

I started menopause at about 41, and had horrible hot flashes/night sweats.  I ended up with a hysterectomy at 46 and the hot flashes/night sweats never did go away; in fact at 63, I still have them.  Some of them are simply uncomfortable, some make me feel ill, but not horrible.

One thing you might want to think about is blood sugar, if you are actually getting ill with these flashes.  Low blood sugar (hypoglycemia) can make you hot and sweaty and it can also make you very ill.  You might want to look into that, as well.  You should make sure you eat at regular intervals throughout the day, in order to keep your blood sugar steady.  Sudden dips can be very uncomfortable and they are not like the menopausal hot flashes.  

[jtms]

So, since  my last post a lot has happened. Everything thyroid is still questionable but my new doc is monitoring with repeat labs in 3months. The last round of labs following a bone density scan revealed a significant Vit D deficiency. I only have  a verbal report and will post the  range when I get the written report but the result was 20....the Dr recommended 800 IU p/day but I am seeing reputable sources say 2000  IU with optimal range at 40-50. My bone density showed definite osteoporosis at the lumbar spine @4.6...yikes, standard treatment prescribed. Any feedback on tHe Vit D would be much  appreciated, I have pretty significant joint and muscle pain that  has been unexplained and from my research might be relieved with adequate level off  Vit D 3...thanks to all in advance.

[Barb135]

Vitamin D at 2000 IU/day is generally safe.  Optimal range is often 50-80.

Are you taking calcium to help counteract the osteoporosis?  I've had osteopenia for years and by implementing a regimen of calcium, magnesium and vitamin D, and exercise, was able to actually rebuild lost bone.  Magnesium and vitamin D are necessary for the proper absorption of calcium.

You might want to have calcium levels tested, along with magnesium, since magnesium deficiency can also contribute to muscle/joint pain.

[jtms]

My calcium level is 9 which is to my understanding where it should be. I will check my last labs for magnesium but I don't recall seeing it. Anothwr of my moms sisters was just diagnosed with parathyroid issues although I don't have all of the details yet. Will keep you posted on all new developments.