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Question about TSH

My husband has a lot of hypothyroidism so we ask the PCP to order thyroid test. We ask for the TSH, FT3 and FT4. He said he had had a lot of people mention the FT3 and FT4 but he's never found a need for it so he just ordered the TSH test.  This is what came back:
TSH 1.362  lab reference ranges 0.350-4.840
Calcium 9.8 reference range 8.6- 10.8
Vitamin D  51  reference range  30-80
He's in the low range of normal on the TSH and I'm sure the PCP isn't going to treat it for it or run the FT3 and FT4 unless we insist on it. Not sure even then.
He's had these symptoms for several years but they have gotten to the point where he's almost nonfunctional. He's 71, not overweight has things he wants to do and places he wants to go and he's too young at heart to just sit on the porch in terrible pain waiting to die.
He's diabetic but was controlling it with diet and exercise until recently when he's gotten too weak to go for a daily walk. His recent A1C was 7.1.
He's had xray's and an MRI and there's nothing showing up that's serious enough to cause the pain he suffers daily. He has a little arthritis in his knees but not enough to cause the pain he has. There's no heat or swealing.
He takes oxycod/acetam 10-325 4 times a day for back pain but doesn't get much relief. The MRI didn't show enough damage in his back to cause the pain he has either. He has symptoms of a vitamin D deficiency that's the reason for the vitamin D test but it was normal. He also has a lot of symptoms of hypothyroidism. Is his TSh low enough to cause real problems?
We are searching for an answer for what's going on with him so hopefully it can be fixed. Your input will be appreciated.
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1756321 tn?1547095325
Here is some info from Dr Hyman's article Magnesium: The Most Powerful Relaxation Mineral Available...

"Stop Draining Your Body of Magnesium

• Limit coffee, colas, salt, sugar, and alcohol

• Learn how to practice active relaxation

• Check with your doctor if your medication is causing magnesium loss (many high blood pressure drugs or diuretics cause loss of magnesium)

Eat Foods High in Magnesium

Include the following in your diet as often as you can:

• Kelp, wheat bran, wheat germ, almonds, cashews, buckwheat, brazil nuts, dulse, filberts, millet, pecans, walnuts, rye, tofu, soy beans, brown rice, figs, dates, collard greens, shrimp, avocado, parsley, beans, barley, dandelion greens, and garlic

Take Magnesium Supplements

• The RDA (the minimum amount needed) for magnesium is about 300 mg a day. Most of us get far less than 200 mg.

• Some may need much more depending on their condition.

• Most people benefit from 400 to 1,000 mg a day.

• The most absorbable forms are magnesium citrate, glycinate, taurate, or aspartate, although magnesium bound to Kreb cycle chelates (malate, succinate, fumarate) are also good.

• Avoid magnesium carbonate, sulfate, gluconate, and oxide. They are poorly absorbed (and the cheapest and most common forms found in supplements).

• Side effects from too much magnesium include diarrhea, which can be avoided if you switch to magnesium glycinate.

• Most minerals are best taken as a team with other minerals in a multi-mineral formula.

• Taking a hot bath with Epsom salts (magnesium sulfate) is a good way to absorb and get much needed magnesium.

• People with kidney disease or severe heart disease should take magnesium only under a doctor's supervision."
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Avatar universal
How much magnesium do you recommend he take?
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1756321 tn?1547095325
I'd recommend magnesium supplements just in case.

Excerpt from Hospital Laboratory Testing Fails to Detect Most Magnesium Deficiencies by Kerri Knox, RN...

"...the vast majority of magnesium in the body is not IN the bloodstream but in the cells and the fluid surrounding the cells. Our blood has an amazing ability to keep a balanced magnesium level at all times, and therefore is the last storage area of magnesium in the body. So when a hospital test shows a magnesium deficiency, then it's likely to already be severe and dangerous- with up to 99% of the body's magnesium having already been depleted."

"A serum magnesium test is actually worse than ineffective, because a test
result that is within normal limits lends a false sense of security about the
status of the mineral in the body. It also explains why doctors don't recognize magnesium deficiency; they assume serum magnesium levels are an accurate measure of all the magnesium in the body."
Dr. Carolyn Dean from 'The Magnesium Miracle'"


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Avatar universal
Had his magnesium level checked recently and it was 2.2 reference range is 1.6-2.6
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1756321 tn?1547095325
An HbA1c value above 7% is poorly controlled diabetes.  When blood glucose/insulin is high, magnesium levels are being affected. How long or how low magnesium levels need to be to cause a vitamin D deficiency I'm not sure about but I know from experience magnesium deficiency causes pain (my doctor thought I had fibromyalgia).

"Magnesium deficits and increased urinary magnesium excretion can occur in people with insulin resistance and/or type 2 diabetes [24,25]. The magnesium loss appears to be secondary to higher concentrations of glucose in the kidney that increase urine output [2]." - Excerpt from NIH - Magnesium.

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Avatar universal
I have the name of a member recommended doctor in Columbus.  Sending name by PM.  Just click on your name and that takes you to your personal page.  Then click on messages.  
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Avatar universal
Our beloved doctor of quite a few years left the area last year so we've only had this doctor for about a year and still haven't made up our minds about him yet but this last visit really has us wondering! At the last visit I told the doctor my husband doesn't have a life anymore. He works for the local hospital which we think very little of and he always has a scribe with him and I don't like that either.
Like you, I feel my husband will never get the treatment he needs from this doc. About a year ago the doc sent him for nerve testing on his legs and would you believe he still hasn't received a report on that as of Monday when we were there.
A doctor in the Columbus area would be good.
I had a TT in May because of cancer and I have an endo in Columbus but I think she requires a referral. I haven't really made up my mind about her yet. yet.
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Avatar universal
Your husband is yet another victim of the 'Immaculate TSH Belief", by which doctors think that TSH is all they need to know to diagnose and treat hypothyroid patients.  That is very wrong.  TSH is a pituitary hormone that is supposed to accurately reflect thyroid status; however, TSH cannot be shown to correlate well with either Free T4 or Free T4, the biologically active thyroid hormones, much less correlate well with symptoms, which should be the main concern.  

TSH doesn't cause symptoms, it is only an indicator, and a poor one at that.  In addition, there are lots of hypothyroid patients who have what is called central hypothyroidism, in which there is a problem with the  hypothalamus/pituitary output which controls TSH.  The result is a low, seemingly normal TSH, but the patient is accordingly also low in the actual thyroid hormones, Free T3 and Free T4, but the doctor would never know that if he only tests for TSH.  Ridiculous, I know.  

You should emphasize all your husbands symptoms and insist that the doctor test for Free T3 and Free T4.  If he resists, then be more insistent.  The alternative is to find a good thyroid doctor.  A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

If you will give us your location within Ohio, perhaps we can recommend a good thyroid doctor  in your area.  Even if the doctor relents and agrees to test your husband, I have serious doubts that he will ever get the treatment needed.  
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