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Newbie here: wondering about my test results?
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Newbie here: wondering about my test results?

Hi everyone,
After a few years of serious hair loss, fatigue..a host of other problems, and being told Thryroid is normal I finally asked for my test results.
I see my physician in a few days and want to be prepared. I am a 46 YO female

B-12: 220 (Range 148-1500)
Ferritin: 49 (Range 15-340)
TSH: 8.76 (Range 0.6 -6.0)    HIGH
FreeT3: 4.0 (Range 3.2-5.6)
FreeT4: 12.0 (Range 11-24)

Anti Thyroglobulin (TG): 17  (Range Less than 60)
Anti Thyroperoxidase (TP0): 1810 (Range less than 60)   HIGH

Cholesterol: 5.99  (Range 3.60-5.19)       HIGH
LDL Cholesterol: 3.44 (Range 0.00-3.39)    HIGH

Can someone give me some guidance?
Do I push for Synthroid or Armour?

Thanks in advance.

Tags: test, Thyroid
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Your TSH is definitely high, so I would push for one of those meds.  I don't really know anything personally about Armour (although many women on this board are on it and happy with it)...I am on synthroid and do just fine on it.

I don't know anything about the rest of your labs.  Good luck!
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Read the comments with interest.  I didnt even know that thyroid problems could ever be life threatening.  I have just had hospitalisation after the worst episode in my life.

Undiagnosed thyroid for years.  Terrible symptoms 18.96 panic attacks paranoia fear, weight gain and feelings of going mad.  Four health professionals did not diagnose until i was at near collapse.

3 weeks later on thyroxine my levels have come down.  My doctor is away until July just got results back with antibodies  showing thyroglobulin *81.4 and thyroid peroxidase >964.0   TSH back down from 18.986 to 0.09 Free thyroxine 19.8 and Free T3   5.0.

Havent a clue what anything means but found your forum and you guys seem to be ahead of me in knowlefge stakes.  Any one able to help me I am very confused.  Many thanks.  Hope you all get well.
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WordGamer - Are you saying that Armour is better for EVERYONE?  Do you recognise that some people DON'T do well on it?  Just as some people don't do well on the synthetics?  Please recognise both sides are not wrong; neither side is absolutely 100% superior than the other.  Different solutions apply for different people.  



TO ALL;
I do not have a problem with Armour or other brands of desicatted thyroid (pig thyroid preparations) - but I DO have a problem when I see people saying that it is the ONLY way to go.  It is possible to be sucessfully treated on synthetics, have no symptoms and have full quality of life - I am living proof and I have no thyroid at all, so all the T3 I get is converted in my kidneys and liver.  And I am certainly not the only one out of the many millions of people taking this medicine.  And I am happy to acknowlege that it takes a lot of time to get here (optimal treatment) with fine dose adjustments - and I think that this is one point that both treatments share (they both take time and patience to get dosage levels tweaked).  

T3 is a faster acting thyroid hormone - this is why when you take Cytomel or Armour OFTEN (not always) doses may be split and spread out over the day.  Sometimes an initial increase in wellness ebbs and flows leaving the person feeling flat after the effects of T3 have worn off.  Others have described this as a T3 high - but I don't believe this is a fitting description because of the associations we have with street drugs; it is nothing like this.  

T3 can have negative effects very quickly because it is fast acting - most of these effects are cardiovascular, they effect your heart causing tachycardias (fast heart rates over 100 beats per minute, overworking your heart) and/or palpitations.  While these effect may be only short term until the T3 wears off (or doses are adjusted)  SOME people never adjust and find they are too sensitive to warrant use of Cytomel or Armour.

I don't have a problem with WordGamer saying that this has been the best solution for him/her BUT he/she should not say without regard that this will be the best treatment for you (KonamerraGirl) or anyone else.  Certainly wouldn't you like to be the one to judge for yourself which treatment you do better on?  

Doctors are not the gods that tradition has made them - they don't nearly know everything and many doctors are not well educated in thyroid matters.  KonamerraGirl may well need to find another doctor - but I''ll leave that judgement up to her.  A referral to a endocrinologist is still highly recommended as they are specialists in this area (hormones).

All I had tried to do was give a  breif overview of things that have been my (and many others experience) - I think if you read my post you'll find that I acknowledge that some people prefer Armour and did not present it in a negative light.  Already my inital post was long - and we could go back and forth relating the intricacies of different methods of treatment for many many threads (it's been done before).  To cover every single componet of thyroid treatment and how the thyroid works would take a book!  I did not set out to cover everything.  

In the end it is up to KonamerraGirl to weigh up the pro's and con's of each treatment on offer.  I don't believe anyone should tell another person that definately one way or the other is the ONLY way to go.  Especially given that you and I (the person giving the advice) have no responsibility if the person   does not do well or has an adverse reaction to your recommendations.

I pray that KonamerraGirl has a healthy dose of skeptism - it is your best protection in life. The stopthethyroidmadness site is patient moderated so always carefully weigh up the information offered there (and here) - if you chose one day to go down the Armour road I am sure you will find much support and guidance there.  I personally do not agree with some of the sentiment there - as I have explained I do not think it is wise to say unequivocally that T4 only treatments are rubbish, IT IS NOT TRUE.  There is no conspiracy going on - the medical field have very good reasons why synthetic T4 is the preferred treatment for the majority of patients.   T3 conversion problems are VERY rare (much rarer across the population than one would be lead to belive at the STTM site).



Wordgamer - I can't imagine why with a TSH of 3.71 that you were told you had 3 to 6 weeks to live?  Either you have other stuff going on that this was related to (which you also should have acknowledged) or this is just plain bullsh_t.  As a medical profession I can say with 100% certaintly that a TSH of 3.71 alone IS NOT life threatening, in fact it is in the normal range (or not far out of the revised reference range for normal.)  Scare tactics like this don't reflect well on your credibility.


I don't wish to go back and forth playing tit for tat with you Wordgamer - I respect that Armour is the right treatment for you, and I respect that you want to share that with KonamerraGirl and others BUT please give more consideration to the ethics of how you choose to share that information.  

~Jen
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There IS a difference between Armour and synthetically made thyroid replacement. And some people will never get well nor feel well on the synthetic replacement and will need supplementation with Cytomel (T3).

I would suggest reading about thyroid hormone synthesis and secretion at:

http://www.thyroidmanager.org/Chapter2/2-frame.htm

There you'll find exactly how the body's thyroid hormone functions. Briefly it states that thyroid (the naturally occurring one in your body) contains two hormones, L-thyroxine (T4) and L-triiodothyronine (T3). Iodine is an INDISPENSABLE COMPONENT of the thyroid hormones, comprising 65% of T4's weight, and 58% of T3's. The thyroid hormones are the ONLY iodine-containing compounds with established physiologic significance in vertebrates.

Also I would suggest reading chapters 8 and 9 on Hashimoto's Thyroiditis and Adult Hypothyroidism. Although very technical, as it is written for doctors who treat patients for thyroid disease, the text has invaluable information. I found the list of symptoms in chapter 9, Manifestations, very informative. Every system of the body is covered in great detail.

Finally, I would suggest reading about Armour vs. synthetic replacement. The number one difference you'll find is that Armour, Nature-Throid, and West-Throid all have both T4 and T3 hormones in them. Whereas synthetic replacement has only T4.

http://www.rxlist.com/cgi/generic/armourthyroid.htm
Armour contains both T4 and T3.

http://www.rxlist.com/cgi/generic/liothyronine.htm
Cytomel contains only T3.

http://www.rxlist.com/cgi/generic/synthroid.htm
Synthroid contains only T4.



It doesn't take a rocket scientist to figure out that your body would do better on Armour or Nature-Throid or West-Throid than synthetically made replacement such as Synthroid, Lexoyl, or Levothyroxine. It's only logical. Your body needs both T4 and T3. That's why your testing for thyroid functioning should include Free T3, Free T4, TSH.

KonamerraGirl, if you don't get satisfaction out of one doctor, find another and don't waste your precious time or health. I made that mistake and nearly paid for it with my life. By the time I saw a better doctor, this last Wednesday, June 13, I was told that I had about 3 to 6 weeks to live on my former dose of 88 mcg and that my current dose of 112 mcg was slowly killing me because it was simply inadequate and under treatment. I was on Levothyroxine. And because my thyroid is going into complete failure the lack of T3 replacement was hastening my demise. My doctor suggested putting me on T3. I asked for Armour and she said 'that would be my preference in your condition which is serious, severe under treated hypothyroidism.'

My TSH was 3.71 (.98 - 5.74) and my T4 was .98 (.58-3.74) I was on the fast and slippery slope to death on 88 mcg.

When I first got treated for hypo T my TSH was lower than yours, at the top of the range of normal. Yet I was in serious condition and my doctor didn't know it. That was 2003 and I continued to be under treated since then. My doctor believes I've had hypothyroidism most of my life. I can go back to 1975 when I started having allergic reactions and responses to medications which were atypical. And I can go back to age 14 when I had such severe menstrual cramps I required Aspirin with Codeine #2 and later #3. My hair was falling out back then!

Also check out the web site:

http://www.stopthethyroidmadness.com

There's info on what questions to ask your doctor.

Take care.
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Hi everyone;

I just checked this thread and was a little surprised at all this information.
Being that I have been researching thyroid (Hashimoto's) quite a bit, this is exactly what is confusing me.

I guess everyone is just so different and there are just so many varying opinions and I appreciate both of your replies and respect your differences.
Who knows until my appointment next week what this particular doctor recommends.I have felt so bad for so long without obtaining test results until now, that it seems I am so ready to try something, but these meds (synthetic or dessicated) seem to take so long to adjust, and I feel so desperate to do it right the first time.

I've been on STTMadness site many times as well as pro-synthetic sites. Sigh - very confusing. I do not even know if this doctor has or ever will prescribe *THYROID (Canadian Version of Armour). I live in a small place where we have no endocrinologist and he apparently is the doctor who is the most knowledgeable apparently (thyroid management is his thing). I did, however check a larger pharmacy in town and *THYROID brand (made by Erfa) is definitely on their drug database for availability.

So I shall keep absorbing the information and I do have a fairly open and inquisitive mind.

I guess everyone involved is anxious to tell their own personal story and beliefs, which is human nature, so I balance things in my mind fairly well when I absorb it, so no worries there.

If you ask 10 different people, I'm sure you'll get 10 different answers and personal recommendations as to what is the best alternative.

I appreciate all the info regardless in this new, strange and highly complex Thyroidism world!

I will definitely post back after I see my physician and let you know how we managed - I just want to go with an informed mind and between he and I we'll hopefully come up with an answer. Unfortunately, my scheduled Ultrasound doesn't take place until next month, after this appointment, so that's another time issue that is frustrating me. It's like once you know you have Hashi's you want to start treatment as soon as possible.

Thanks again - I shall let you all know what's going on and appreciate all of your input here.

KonamerraGirl
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Hi Herin,
Thyroid problems can be life threatening - when levels are at extremes of either end of the spectrum.  Both Thyroid Storm and Myxedema Coma are rare.  

THYROID STORM - Excessive amounts of thyroid hormone, usually TSH around 0.01
Signs & Symptoms;
-Increased metabolic rate
-Increased temperature, heat intolerance, sweating
-Tachycardia (fast heart rate >100 beats per minute)
-Widened pulse pressure
-Palpitations (irregular heart beats that come and go)
-Dysrhythmias (an irregular heart beat that can be life threatening)
-Agitation, delerium, psychoses
-Fine tremor
-Exagerated reflexes
-Difficulty breathing
-Increased respiratory rate

MYXEDEMA COMA - terribly low amounts of circulating thyroid hormone, usually TSH is greatly elevated >25
Usually relates to increased thyroid hormone utilisation and decreased thyroid hormone production which results in a crisis.  Even though the word Coma is used in the name of this condition the person may or may be conscious; but will definately have altered levels of consciousness.

Signs & Symptoms
-Decreased metabolic rate
-Decreased temperature, cold intolerance
-Distant heart sounds
-Bradycardia (slow heart rate <60 beats per minute)
-Pericardial effusion (accumulation of fluid around the heart, life threatening)
-Lethargy, somnolence (increased sleep requirements)
-Difficulty breathing on exertion
-Decreased respiratory rate at rest
-Slowed bowel movements
-Slow speech, course voice

*The TSH ranges given here for each condition are textbook; I have read reports of thyroid storm at 0.07 or Myxedema Coma at slightly lower levels than stated here; it is slightly variable and must be seen in context of each specific patient and the symptoms they are experiencing.  Some symptoms of each disorder may even be noticed in the opposite disorder eg.  Sweating in Myxedema coma.



Is the 18.96 your TSH?  If so your hospitalisation episode may have been boardering or getting close to myxedema coma.  I'm very sorry you have been so unwell.  Perhaps because these problems are rare many health professionals are not well versed on how to recognise them - I'm really sorry it took so long to get diagnosed and treated.

TSH stands for Thyroid Stimulating Hormone - it is a chemical messenger meant to tell your thyroid gland to release more thyroid hormone.  It is produced by a gland in your head involved in regulating thyroid levels (pituitary gland).  TSH is part of a feeback control mechanism.  So the higher your TSH the more thyroid hormone your body needs.  If TSH is too low then you have too much thyroid hormone circulating in your body.  

Here's a few websites that you can find more reliable information from;

http://www.thyroid.org/patients/brochures.html
American Thryroid Association

http://www.thyroidmanager.org/
(written by doctors for other doctors - helpful to have a medical dictionary open in another window)

http://www.mja.com.au/public/issues/180_04_160204/top10414_fm.html
Medical Journal of Australia - very informative article

http://www.endocrineweb.com/thyroid.html

http://www.mydr.com.au/default.asp?Article=567

http://thyroid.about.com/

http://www.thyroid-info.com/

http://www.mythyroid.com/optimalthyroid.html



Thyroid disorders can arise for many reasons - sometimes we never know just why it happens BUT sometimes we can attribute it to an autoimmune disorder.  Autoimmune disorders can be passed on, so it is important to note if anyone in your extended family also has had any type of thyroid disorder.  Thyroid Autoimmune disease is when the body gets it's wires crossed and starts attacking the thyroid gland as if it is a foreign invader - this causes inflammation and increased levels of thyroid antibodies.  The two main types of autoimmune thyroid disease are Graves disease and Hashimoto's.  You are sure to read more about these two on the links provided.  

I really recommend that you ask for a referral to an endocrinologist who deals with thyroid disorders (some only specialise in diabetes).  


Welcome to the forum and Best wishes on your journey!
~Jen

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This was my opening sentence to my posted comment:

"There IS a difference between Armour and synthetically made thyroid replacement. And SOME PEOPLE [my emphasis now] will never get well nor feel well on the synthetic replacement and will need supplementation with Cytomel (T3)."

That's NOT black and white thinking. It is the facts. I happened to be one of those people who needs the full deal, Armour.

As I said in another post here, everyone is different. Everyone responds in different ways to different medications. And that is even more so evident with untreated or under-treated hypothyroidism or hyperthyroidism. Both cause problems with idiosyncratic and/or allergic reactions to medications.


Please go back and read what I said.

Thank you.

------
As for TSH of 3.71 and being told I had 3 to 6 weeks to live? Another case of numbers not meaning zilch. In my case, the numbers are NOT telling the entire story but my body sure is.

And there you go with black and white thinking about my condition. I am speaking from my own experience and giving facts from credible web sites - Thyroid Manager. org and rxlist.com


Scare tactics? Toward whom? I was speaking of my own situation, not yours or KonamerraGirl's. There were no scare tactics.

My credibility as what? A professional? My doctor is the one who diagnosed me with pre-Myxedema NOT me. And yes I am THAT serious at 3.71!!! It's only a number, not a symptom and not what a person looks like and not what a person feel like. At this point in my life, I can sit, stand, sleep, fix simple meals for myself, but not without extreme fatigue, SOB, chest pain, and exhaustion. I can't handle ANY exertion. I have several complications including bradycardia, first degree heart block, cardiomegaly, and Stage II Hypertension.


Talking about scare tactics ... Armour and T3 are used with caution WHEN there is serious concurrent heart conditions. Here are the specific warnings regarding concurrent heart conditions:

Thyroid hormones should be used with great caution in a number of circumstances where the integrity of the cardiovascular system, particularly the coronary arteries, is suspected. These include patients with angina pectoris or the elderly, in whom there is a greater likelihood of occult cardiac disease. In these patients therapy should be initiated with low doses, i.e., 15-30 mg Armour Thyroid. When, in such patients, a euthyroid state can only be reached at the expense of an aggravation of the cardiovascular disease, thyroid hormone dosage should be reduced.

And here are warnings about other conditions:
Thyroid hormone therapy in patients with concomitant diabetes mellitus or diabetes insipidus or adrenal cortical insufficiency aggravates the intensity of their symptoms. Appropriate adjustments of the various therapeutic measures directed at these concomitant endocrine diseases are required. The therapy of myxedema coma requires simultaneous administration of glucocorticoids.

Notice it doesn't say Armour is contraindicated but needs to be closely monitored with the above concomitant diseases and conditions.


I don't wish to go back and forth neither, however, I wish in the future that you would read what a person is saying, NOT what you believe they are saying. None of my statements are black and white thinking OR all or nothing statements. And I did start off from the very beginning saying that "some" people don't do well on synthroid alone. And that is the truth, not one sided. Notice: I didn't say all.

Okay, done, finished.
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173351_tn?1201217657
I was addressing the part of your post where you specifically said (and I quote):

"It doesn't take a rocket scientist to figure out that your body would do better on Armour or Nature-Throid or West-Throid than synthetically made replacement such as Synthroid, Lexoyl, or Levothyroxine. It's only logical. Your body needs both T4 and T3. That's why your testing for thyroid functioning should include Free T3, Free T4, TSH."

You really do like word games don't you?

No further correspondence on this topic will be entered into.
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Hi there,

I agree with Nicki1433 that your TSH is high indicating hypothyroidism.  One big obstacle that you may already be coming across is that traditionally hypothroidism is not generally treated until TSH gets close to or over 10.0 - That's when the hypothyroidism typically arises from within self according to the old guidelines so many doctors still use - (it's a totally different ball park after a total thyroidectomy when doing complete replacement, can be confusing).  Although I'm sure there are some good doctors out there who have initiated treatment earlier - as there are many on this board who would testify to.  But unfortunately for you it sounds like your doctor is from the old school.

Maybe you could approach it by saying something like this;

Some schools of though would classify these results as hypothyroid, my TSH is clearly HIGH - could you supervise me trying some thyroid hormone to see if it helps my symptoms?  

**From experience I never try to 'tell' my doctor something he/she should already know, not good for their ego (he he!).  Rather I try to suggest things or ask his/her opinion "how about so and so..."

Most doctors also only accept Synthroid (or other synthetic brands such as Levoxyl, Levothroid etc) as treatment for hypothyroid.  Armour is not readily accepted by the mainstream medical field.  So it might do your plight better not to mention it.  

The reasons for Armour not being accepted universally are controversial and complex.  It is made from ground up dry pig thyroids.  I don't really want to go into this again - if you want to, you can search Armour in this forum either under "Search Medhelp" or by browsing the archives of this forum.

No one can say that definately Sythroid or Armour would suit you better - you never know until you have tried it and persisted for some time to get levels right.  It is fine for someone to say that one or the other suits them better - but it might not be the same for you.  My opinion is start simple - go the accepted route first, learn about this condition and if you are not happy in 12 months time on Synthetic maybe then think about trying Armour.  But realise many have had a quite a fight on their hands to get their doctors to prescribe it.

Synthetic thyroid replacement (eg. Synthroid, Levothroid, Levoxyl) are T4 only.  Your body converts some of the T4 into T3 in your liver and kidneys.  (T4 and T3 are the main thyroid hormones).  Synthetic thyroid hormone is chemically exactly the same as what your body would make if it was able - it is made by recombinent DNA technology.  Basically how they do it is by taking a special bacteria cell and putting some human DNA into it - the specific strand of DNA which contains the recipe/instructions of how to make thyroxine (T4).  So these bacteria cells are converted into little thyroxine factories.  Neat huh?
So even though replacement medications contain T4 only they do replace both T4 and T3.

It's too early to think about changing doctors just yet - but if you don't get anywhere with this doc that may be what you need to do in future.  First give him a chance to do the right thing.  If still no joy then ask for referral to an endocrinologist (hormone specialist) - try to get one who deals with a lot of thyroid patients as many just specialise in diabetes.


Have you recently had a baby?

Are you getting close or experiencing menopause?

*These ^^^ types of hormonal changes often trigger underlying thyroid problems in many women - very common.

Do you have others in the family (close & extended) who have experienced ANY type of thyroid problem?

Your HIGH anti TPO could indicate autoimmune thyroid disease such as Hashimoto's but this must be looked at in context of your entire situation - for example if you just had a baby this could just indicate the inflammation that goes along with postpartum thyroiditis which usually resolves itself within 12 months (give or take).  

A really good source of reliable information is the American Thyroid Association - be careful where you get your information from, make sure doctors and professionals give the information NOT patients.  Dot org websites are good as a rule of thumb - dot com websites need careful consideration as may not be reliable.

http://www.thyroid.org/patients/brochures.html

Your B12 and ferritin are both within normal range and some would say they are okay - BUT others would say that you could get benefit from an increase in both of these numbers.  Only way to tell really is to try supplementing and judging for yourself - no harm will come of this as you have plenty of room to move up the reference ranges for both.  You don't need a prescription for either B12 or iron supplements and they are not expensive.  Generally though B vitamins work synergistically (ie. better when working together) with the other B vitamins - so try to get a B complex formula that contains all the B vitamins from B1 through to B12.

Please make sure you are doing all the simple and sensible things to aid your health.  Stuff like getting a well balanced healthy diet full of fresh fruit and vegetables, drinking 1.5 to 2.5 litres of water everyday, moderate exercise on a regular basis (hard when you are tired - I know, but it pays off when you can muster the effort),  and getting enough relaxation and good quality sleep (at least 6 or 7 hours every night).  These things become extra important when you have thyroid problems.

I've rambled on enough for today - you have a task ahead to get your head around all this stuff.  You've found a good site where many have walked a similar path to the one you've found yourself on.  Remember the only silly question is the one you don't ask!  (we don't have all the answers but usually someone know's something about whatever)
Welcome to the forum and Best wishes on your journey!
Cheers
~Jen
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Avatar_n_tn
Thank you so much for taking the time to try to help me.
How kind and considerate of you.

You are ahead of me on this one.  I am still licking the wounds of a very weird experience and trying to get a handle on it. Certainly not easy when my doctor is away til july and no one wil explain the pathology readings on my latest results.
Total thyroxine (T4) is now to  128
TSH                                      0.90 (down from 18.96 three eeks ago)
Free thyroxine ?                   19.8
Free T3                                5.0                

Thyroglobulin Antibody          *81.4     This is the section i am concerned about because it seemsw well off the recommended scales.
Thyroid peroxidase Antibodies  *>964.0

If asnyone readin understands the meaning of this I would be very grateful as not knowing is worse than understanding.

Your forum is such a great idea.  I am reading lots and trying to inform myself as the lack of understanding on this issue by health professional in the countryside where i live is worrying.

Many thanks JP for helping me.

Herin
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