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Subclinical underactive thyroid?
Hi,
I went to the Doc in Dec as I was exhausted, achy joints, thin ear, weight gain and lots of other things for the last few months.
Here are my bloods
11 March 2011 ( I felt good at this stage and was not on meds)
Free T4 10.0
TSH 1.94
Ft3 4.9
7 Dec 2011 (I felt like crap at this stage and was given 50mcg Levo)
Free T4 9.0
TSH 4.38
Ft3 3.9
4 Jan 2012 (feeling bit better)
Free T4 11.0
TSH 1.67
Ft3 3.8
After this last blood result I went back to doc as I was feeling great after being on Levo for three weeks but started feeling tired again so he has now put me on 100mcg and I feel really good... He said based on my results he cannot confirm that I have a underactive thryoid but possibly subclinical underactive thryoid? based on my symptoms and high TSH during the stage that I felt yucky.
I can only assume that because I feel better since taking the Levo that I do have subclinical underactive thryiod and the medication is helping me?
I get the impression that the doc is not that happy with me being on the medication but I certainaly feel better so it must be doing something!
I went to the Doc in Dec as I was exhausted, achy joints, thin ear, weight gain and lots of other things for the last few months.
Here are my bloods
11 March 2011 ( I felt good at this stage and was not on meds)
Free T4 10.0
TSH 1.94
Ft3 4.9
7 Dec 2011 (I felt like crap at this stage and was given 50mcg Levo)
Free T4 9.0
TSH 4.38
Ft3 3.9
4 Jan 2012 (feeling bit better)
Free T4 11.0
TSH 1.67
Ft3 3.8
After this last blood result I went back to doc as I was feeling great after being on Levo for three weeks but started feeling tired again so he has now put me on 100mcg and I feel really good... He said based on my results he cannot confirm that I have a underactive thryoid but possibly subclinical underactive thryoid? based on my symptoms and high TSH during the stage that I felt yucky.
I can only assume that because I feel better since taking the Levo that I do have subclinical underactive thryiod and the medication is helping me?
I get the impression that the doc is not that happy with me being on the medication but I certainaly feel better so it must be doing something!
gimel is right on. Also they "thyroid specialist" may inf fact "only" be an endocronologist. If so you still need to be prepared with letters and research. Gimel can help you out with that.
Many Endocrinologists deal with diabetes primarily and really don't know all that much about Thyroid. At least not as much as they should. There are TONS of evidence of that fact here with many people being mis treated, under treated or not treated at all by Endo's. on the other hand there are awesome Endo's. Also there are really good primary care Dr's who are good. The problem is they seem to all be just about as rare as Hen's teeth to find.
I'm just wanting to give you a heads up that just because you are going to a "specialist". to not get your hopes up too high or at least do not assume this will be smooth and easy. History shows this to be the exception not the rule.
The general rule is that a Thyroid patient MUST be a strong advocate for themselves or you will have a difficult time getting anywhere. That unfortunately just seems to be the state of the world we live in related to Thyroid conditions and Dr's.
I hope everything goes swimmingly for you.
Many Endocrinologists deal with diabetes primarily and really don't know all that much about Thyroid. At least not as much as they should. There are TONS of evidence of that fact here with many people being mis treated, under treated or not treated at all by Endo's. on the other hand there are awesome Endo's. Also there are really good primary care Dr's who are good. The problem is they seem to all be just about as rare as Hen's teeth to find.
I'm just wanting to give you a heads up that just because you are going to a "specialist". to not get your hopes up too high or at least do not assume this will be smooth and easy. History shows this to be the exception not the rule.
The general rule is that a Thyroid patient MUST be a strong advocate for themselves or you will have a difficult time getting anywhere. That unfortunately just seems to be the state of the world we live in related to Thyroid conditions and Dr's.
I hope everything goes swimmingly for you.
When you see the specialist, keep in mind the importance of clinical treatment, as opposed to "The Immaculate TSH Belief" or Reference Range Endocrinology".
We'll all look forward to hearing details of your appointment with the specialist.
We'll all look forward to hearing details of your appointment with the specialist.
He has said he will send me to a thyroid specialist and is sending me a letter of referral so that is good.
we need to know the reference ranges that the lab uses for those FT3 and FT4 test results. Test results and reference ranges will vary from one lab to another. We need to be able to see where the results fall within the range.
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A good thyroid doctor will treat a hypo patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can confirm what I am saying by this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance. The letter is sent to the PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
In the letter especially note this statement. "The ultimate criterion for dose
adjustment must always be the clinical response. I have prescribed natural dessicated thyroid for your patient (Armour or Nature-Throid). These contain T4 and T3 (40mcg and 9mcg respectively per 60mg). They are more effective than T4 therapy for most patients. Since they provide more
T3 than the thyroid gland produces, the well-replaced patient’s free T4 will be around the middle of its range or lower, and the FT3 will be high-“normal” or slightly high before the AM dose.'
So I think you need to go back and give your doctor a copy of the link and suggest that you would like to be treated clinically, in the manner described. If the doctor has a problem with clinical treatment, or prescribing T3 meds then you will need to find a good thyroid doctor that will do both.
In addition based on your history, I think that you need to be tested for the thyroid antibodies, Thyroid Peroxidase and Thyroglobulin. the tests are TPO ab and TG ab. In addition, you should test for Vitamin A, D, B12, and a full panel of tests for iron anemia.