Aa
TSH 58 (way hypo) FreeT3 365 (Range 230 -420) , how?
New lab, and new lab ranges, new GP. My endo lab 1 1/2 weeks ago had a TSH of 24 and FT 3 was in lower range, now its 58.
Weird results.
On Nature Throid , If I increase, I get a burning sensation in my feet and face.
TSH says way hypo BUT FT 3 is in upper range. How is this possible. ***Is it Reverse T3?** Alergic to Nature Throid? And I know nothing about pituitary.
They did not do FT4, wish they did.
My thyroid is swelling some (can see it). I am not tired AT ALL. Hard to sleep. The high T3 is keeping me going I think despite high TSH
Calling my endo tommorow to ask for more testing or another specialist or the Mayo if I have too.
Moose
Weird results.
On Nature Throid , If I increase, I get a burning sensation in my feet and face.
TSH says way hypo BUT FT 3 is in upper range. How is this possible. ***Is it Reverse T3?** Alergic to Nature Throid? And I know nothing about pituitary.
They did not do FT4, wish they did.
My thyroid is swelling some (can see it). I am not tired AT ALL. Hard to sleep. The high T3 is keeping me going I think despite high TSH
Calling my endo tommorow to ask for more testing or another specialist or the Mayo if I have too.
Moose
Very old post from 2010. Please do not comment any more.
For those that do not know, this is what happened to many people when Armour stopped shipping in late 2009, then many switched to Nature Thyroid brand which then changed formulations. All the brands of natural thyroid will feel different and WILL have different lab results with the same doses. At this time frame it was very difficult to get any US made natural thyroid meds for more than one month supply - all were back ordered..
Please no more comments. This post is CLOSED, its from 2010.
For those that do not know, this is what happened to many people when Armour stopped shipping in late 2009, then many switched to Nature Thyroid brand which then changed formulations. All the brands of natural thyroid will feel different and WILL have different lab results with the same doses. At this time frame it was very difficult to get any US made natural thyroid meds for more than one month supply - all were back ordered..
Please no more comments. This post is CLOSED, its from 2010.
Now on ERFA I have no idea what my FT3 level is, ahh, so comforting not to know.
I am just lucky that these doctors (all of them) are open to letting me use ERFA. I made sure they all understood that this product is supposedly the closest thing to the old formulation of Armour currently available. And old Armour worked for me last spring - It was the old stuff, the new stuff I got in July, was obvious the time.
**Being hypo on a combo med feels so completely different than being hypo on a T4 only med, as the T3 kept me going the last three months**
With not much T4 stored up for conversion, I can really feel when the T3 in the dessicated gets used up. I am taking the ERFA 4 times a day to smooth the peaks and valleys till T4 gets in range.
I am just lucky that these doctors (all of them) are open to letting me use ERFA. I made sure they all understood that this product is supposedly the closest thing to the old formulation of Armour currently available. And old Armour worked for me last spring - It was the old stuff, the new stuff I got in July, was obvious the time.
**Being hypo on a combo med feels so completely different than being hypo on a T4 only med, as the T3 kept me going the last three months**
With not much T4 stored up for conversion, I can really feel when the T3 in the dessicated gets used up. I am taking the ERFA 4 times a day to smooth the peaks and valleys till T4 gets in range.
It is going to take the FT4 longer to come back. It doesn't matter where the T4 comes from (T4-only meds, dessicated, your own thyroid...remember the good old days?). It's the nature of T4, as the storage form of the hormones, to stay in your body for several weeks. So, levels change slowly no matter where it comes from.
Coulnd't you just choke them for not running everything? No FT4 on 3/18...what? It would be so nice to be able to see how it's changing. However, you're still ramping up, so you have a ways to go. I'm glad to hear you're no longer looking for the truck that just ran over you. So glad the ERFA is working out for you...
Coulnd't you just choke them for not running everything? No FT4 on 3/18...what? It would be so nice to be able to see how it's changing. However, you're still ramping up, so you have a ways to go. I'm glad to hear you're no longer looking for the truck that just ran over you. So glad the ERFA is working out for you...
Update on my "ERFA experiment". 2.5 weeks at 1 1/2 grain @ test time. 1 3/4 grain now.
Different Endo , different ranges again but close. No FT3 (thats right).
Feel better. Still hypo, but less. TSH of 16 (last week) vs 58 (mid march)
Boat load of other tests that have good results. Its starting to seem more clear that Nature Throid was messing me up the whole time. Will know for sure when ERFA is at optimal dose.
Nature T. Time Caps Nature T. ERFA
sick better near dead better
different lab New Doc
different range
Lab Date 3-12-10 4-2-10 3-18-10 *4-16-10*
TSH ( .3 - 5.0) 24.5 21.2 58.18 (.4 - 4.5) 16 (.45 - 4.5)
FT4 (.71 - 1.85) .62 .57 FT4 not tested .6 (.7 - 1.5)
FT3 (2.3 - 4.20) 2.36 3.21 365 (230 -420) FT3 no test err!
Different Endo , different ranges again but close. No FT3 (thats right).
Feel better. Still hypo, but less. TSH of 16 (last week) vs 58 (mid march)
Boat load of other tests that have good results. Its starting to seem more clear that Nature Throid was messing me up the whole time. Will know for sure when ERFA is at optimal dose.
Nature T. Time Caps Nature T. ERFA
sick better near dead better
different lab New Doc
different range
Lab Date 3-12-10 4-2-10 3-18-10 *4-16-10*
TSH ( .3 - 5.0) 24.5 21.2 58.18 (.4 - 4.5) 16 (.45 - 4.5)
FT4 (.71 - 1.85) .62 .57 FT4 not tested .6 (.7 - 1.5)
FT3 (2.3 - 4.20) 2.36 3.21 365 (230 -420) FT3 no test err!
I should have rephrased that..... I didnt mean worse than the other lab times (this lab was better). I just meant that I would think I would feel worse than what I really do.
So with starting or increasing any combo T3/T4 med, The FT3 must show up faster on labs just like how you can feel it faster.
Hope that FT4 creeps up......must take longer, just like a T4 only med. I dont want any wierd T3/4 ratio. In the past my FT3 was at the top when FT4 was mid - that worked for me, and TSH was around 1.2 - 1.4. The doc is starting low and slow - could take awhile.
I feel like a Guinea pig, injected with a triple pig thyroid concoction.
So with starting or increasing any combo T3/T4 med, The FT3 must show up faster on labs just like how you can feel it faster.
Hope that FT4 creeps up......must take longer, just like a T4 only med. I dont want any wierd T3/4 ratio. In the past my FT3 was at the top when FT4 was mid - that worked for me, and TSH was around 1.2 - 1.4. The doc is starting low and slow - could take awhile.
I feel like a Guinea pig, injected with a triple pig thyroid concoction.
You're absolutely right...it's your FT3 keeping you going. And, yes, FT3 correlates best with symptoms. No, you shouldn't feel worse with the 4-2-10 lab because your FT3 is higher...lots higher. Hope it continues to work for you...
Update different lab
different range
Lab Date 3-12-10 ** 4-2-10 3-18-10
TSH ( .3 - 5.0) 24.5 21.2 58.18 (.4 - 4.5)
FT4 (.71 - 1.85) .62 .57 FT4 not tested
FT3 (2.3 - 4.20) 2.36 3.21 365 (230 -420)
Lab 3-12-10 was after a lowered dose of Nature Throid (around 1 1/2 grain)
Lab 3-18-10 was after even lower dose, but still I felt sick right after taking the NT
**Lab last week (4-2-10) was after 15 days of 1 1/2 grains of Time Caps dessicated, dont feel sick taking it, was able to increase. Felt better - that was test, since TC worked in the past.
So now I am on ERFA per the Doc, and he agrees its more close to old Armour, like the discontinued Time Caps. Starting out low. I've had so many brands and doses in me the last two months its amassing I can function as well as I can.
----------------------------------------------------------------------------------------------------------------------------
I cant believe I just said I felt better with a TSH of 21!! The FT3 must be what is keeping me functional - and I'm not really that tired! A little. So how tired you feel must all depend on FT3! ??.
In the past when hypo on a T4 med, I would be really tired -I'm guessing since there was no additional T3 to keep the body working.
Thyroid no longer hurts, vision is better, less shakey, hot / cold flushing almost gone - I dont get it, I should feel worse with that 4-2-10 lab. Then again labs have a lag time, maybe my 'real time' TSH is around 10 ??
Had other blood tests - no results yet.
different range
Lab Date 3-12-10 ** 4-2-10 3-18-10
TSH ( .3 - 5.0) 24.5 21.2 58.18 (.4 - 4.5)
FT4 (.71 - 1.85) .62 .57 FT4 not tested
FT3 (2.3 - 4.20) 2.36 3.21 365 (230 -420)
Lab 3-12-10 was after a lowered dose of Nature Throid (around 1 1/2 grain)
Lab 3-18-10 was after even lower dose, but still I felt sick right after taking the NT
**Lab last week (4-2-10) was after 15 days of 1 1/2 grains of Time Caps dessicated, dont feel sick taking it, was able to increase. Felt better - that was test, since TC worked in the past.
So now I am on ERFA per the Doc, and he agrees its more close to old Armour, like the discontinued Time Caps. Starting out low. I've had so many brands and doses in me the last two months its amassing I can function as well as I can.
----------------------------------------------------------------------------------------------------------------------------
I cant believe I just said I felt better with a TSH of 21!! The FT3 must be what is keeping me functional - and I'm not really that tired! A little. So how tired you feel must all depend on FT3! ??.
In the past when hypo on a T4 med, I would be really tired -I'm guessing since there was no additional T3 to keep the body working.
Thyroid no longer hurts, vision is better, less shakey, hot / cold flushing almost gone - I dont get it, I should feel worse with that 4-2-10 lab. Then again labs have a lag time, maybe my 'real time' TSH is around 10 ??
Had other blood tests - no results yet.
Wow! Australia is the lucky country then like they say.
I asked for a CT scan and got it.
Had the paper at home for a few months before I went and had it done.
And this is public health too...not private.
All bulk billed to Medicare.
I asked for a CT scan and got it.
Had the paper at home for a few months before I went and had it done.
And this is public health too...not private.
All bulk billed to Medicare.
I did have a decent prolactin test 10 months ago, so that is my doctors first step for
finding Pituitary issues. Still, I will ask some more.
The way the health care system works in this country, you just cant demand an expensive test and get it, not until your almost dead. Thanks to all the people that are making massive profits over this kind of thing.
You might have heard our health system is about to change over the next four years, did this make world news? For better or worse, we dont know what it will be like.
finding Pituitary issues. Still, I will ask some more.
The way the health care system works in this country, you just cant demand an expensive test and get it, not until your almost dead. Thanks to all the people that are making massive profits over this kind of thing.
You might have heard our health system is about to change over the next four years, did this make world news? For better or worse, we dont know what it will be like.
My FT3 and FT4 were within range and a comfortable one for me....and also as you know, I'm not on dessicated so who knows?
I think though that LM should go through an 'elimination process' ....checking things one by one.
A Pit. Tumour will NOT kill you......
Let me make that clear to everyione.
All it does is stuff up your TSH and other levels.
You do have a point Stella.......
I have heard of so many people who have changed different brands of dessicated , only to find the formulas are all different and this alone, can knock anything 'out of whack'.
My so-called sister told my brother in the UK a few weeks ago that I wasnt 'quite right in the head'.
I laughed at her (even though it hurt me)....and said ...Nah Linda, I got a brain tumour!
She backed off straight away.
Then when I went to the Docs on Thursday this week, I told him what she said.
He said to me (quite matter of factly)....
"Of course your not quite right in the head Debs, because if you were ...that would make you as dumb and nasty as her".
Ya shoulda seen the smile on my face lol.
I thought to myself....Bloody Brilliant! :o)
I think though that LM should go through an 'elimination process' ....checking things one by one.
A Pit. Tumour will NOT kill you......
Let me make that clear to everyione.
All it does is stuff up your TSH and other levels.
You do have a point Stella.......
I have heard of so many people who have changed different brands of dessicated , only to find the formulas are all different and this alone, can knock anything 'out of whack'.
My so-called sister told my brother in the UK a few weeks ago that I wasnt 'quite right in the head'.
I laughed at her (even though it hurt me)....and said ...Nah Linda, I got a brain tumour!
She backed off straight away.
Then when I went to the Docs on Thursday this week, I told him what she said.
He said to me (quite matter of factly)....
"Of course your not quite right in the head Debs, because if you were ...that would make you as dumb and nasty as her".
Ya shoulda seen the smile on my face lol.
I thought to myself....Bloody Brilliant! :o)
Deb, this is copied from my post in Magies Nature Throid thread.
Dropped Nature Throid, three days ago only and feel better already, hope it continues. Sleep, not wired, less muscle tightness, can breath.
I think it was NT doing this to me. Doc wont just do a CT or MRI says if it was pituitary other signs would be there. So hope he is correct. I will see him Friday.
On my super low labs, it appeared to make the FT4 and FT3 way more separated in their ranges compared to other natural brands. Its like my FT4 was gone and FT3 was more potent on NT. FT3 is what rules your med intake and maybe the ratio of t3 to t4 in your body from the med. Their powder must be from "super pigs" with higher T3 than regular pigs - obviously not a scientific observance on my part LOL.
NT might be better with me combining some synthroid with it - more complicated than what patients my endo has I think.
Yes, I only have limited Time Caps dessicated left. I went that route as a sort term test since it worked in the past and is OK with my current doctor.
I have ERFA in the freezer as a backup, never tried it..........it was not a script from this current endo, so I have to let him know. Just changing to a brand without his knowledge would not be a smooth move on my part.
Reformulated Armour worked better for me I think than NT.
So I realy hope NT works for most people, and anyone reading this should not freak out as we all have different outcomes with different meds.
Dropped Nature Throid, three days ago only and feel better already, hope it continues. Sleep, not wired, less muscle tightness, can breath.
I think it was NT doing this to me. Doc wont just do a CT or MRI says if it was pituitary other signs would be there. So hope he is correct. I will see him Friday.
On my super low labs, it appeared to make the FT4 and FT3 way more separated in their ranges compared to other natural brands. Its like my FT4 was gone and FT3 was more potent on NT. FT3 is what rules your med intake and maybe the ratio of t3 to t4 in your body from the med. Their powder must be from "super pigs" with higher T3 than regular pigs - obviously not a scientific observance on my part LOL.
NT might be better with me combining some synthroid with it - more complicated than what patients my endo has I think.
Yes, I only have limited Time Caps dessicated left. I went that route as a sort term test since it worked in the past and is OK with my current doctor.
I have ERFA in the freezer as a backup, never tried it..........it was not a script from this current endo, so I have to let him know. Just changing to a brand without his knowledge would not be a smooth move on my part.
Reformulated Armour worked better for me I think than NT.
So I realy hope NT works for most people, and anyone reading this should not freak out as we all have different outcomes with different meds.
Go see your Doc and get a CT scan done.
I am allergic to the dye so it was done without the dye and it picked up the tumour straight away.
You think I wasnt scared???
I was sh@tting myself!
I had a feeling I had this around xmas time and put it off due to death of Dad.
Then decided that I was sick of feeling 'strange'.
I knew it wasnt my levels as they were fine and have been consistant for some time now.
I also know the TSH can climb for reasons such as stress or illness.
But this feeling was different.
I didnt have all the signs of Hypo.....far from it.
I just knew something was 'going on' and couldnt avoid it any longer.
It went well and because anaestic doesnt like me too much, I had an epidural and was awake for it.
I have had surgery like this for a number of years now....with no groggy feeling afterwards.
Get it checked Hun....and start the 'elimination ' process.
Thats what I did.
(((hugs)))
I am allergic to the dye so it was done without the dye and it picked up the tumour straight away.
You think I wasnt scared???
I was sh@tting myself!
I had a feeling I had this around xmas time and put it off due to death of Dad.
Then decided that I was sick of feeling 'strange'.
I knew it wasnt my levels as they were fine and have been consistant for some time now.
I also know the TSH can climb for reasons such as stress or illness.
But this feeling was different.
I didnt have all the signs of Hypo.....far from it.
I just knew something was 'going on' and couldnt avoid it any longer.
It went well and because anaestic doesnt like me too much, I had an epidural and was awake for it.
I have had surgery like this for a number of years now....with no groggy feeling afterwards.
Get it checked Hun....and start the 'elimination ' process.
Thats what I did.
(((hugs)))
Sorry for taking a while to get back to you....applid for a job and got it.
My Pit. tumour was picked up by CT scan.
Although my TSH was all over the place for 5-6 months.
BUT I felt different too.
I wasnt cold, I wasnt sluggish, I just 'felt' something else was going on.
I also had a sensation in the head at times...as if my head was being held in a 'vice'.
I had severe vertigo too around xmas time.
When the Free's came back as good and the TSH was only around 4.0, thats when I figured something else was going on.
The TSH just kept rising.
I had the Pit. tumour removed nasally and got the all clear y/day on the labs...benign.
I went into hospital in the early morning and was home by night time....had packing (gauze wadding) packed up my nose for 4 days.....
And start back at work next week doing 3 shifts a week (10 hr shifts).
I feel as if I am back to my old self now.
Labs are to be done again next week to watch the TSH.
Doc made a bet that they've would go down to probably 3.0.
Prior to op...TSH was over 7 within 4 weeks.
My Pit. tumour was picked up by CT scan.
Although my TSH was all over the place for 5-6 months.
BUT I felt different too.
I wasnt cold, I wasnt sluggish, I just 'felt' something else was going on.
I also had a sensation in the head at times...as if my head was being held in a 'vice'.
I had severe vertigo too around xmas time.
When the Free's came back as good and the TSH was only around 4.0, thats when I figured something else was going on.
The TSH just kept rising.
I had the Pit. tumour removed nasally and got the all clear y/day on the labs...benign.
I went into hospital in the early morning and was home by night time....had packing (gauze wadding) packed up my nose for 4 days.....
And start back at work next week doing 3 shifts a week (10 hr shifts).
I feel as if I am back to my old self now.
Labs are to be done again next week to watch the TSH.
Doc made a bet that they've would go down to probably 3.0.
Prior to op...TSH was over 7 within 4 weeks.
wow! your doctor talks to you on the phone?
You are either super lucky or very persistent.
My doctor is very open minded, a young super nice guy, considers FT3 test and give you T3 medicine and desiccated because he believes in them, but do not call and try to talk to him, he will never come to the phone or give his e-mail address.
His staff is not very nice and want me to make an appoinment for every single little thing I call for. He has a lot of patients and it is always running...but I like him anyway. I stopped calling him, well... except when I need an appoinment.
Good luck with your new endo.
You are either super lucky or very persistent.
My doctor is very open minded, a young super nice guy, considers FT3 test and give you T3 medicine and desiccated because he believes in them, but do not call and try to talk to him, he will never come to the phone or give his e-mail address.
His staff is not very nice and want me to make an appoinment for every single little thing I call for. He has a lot of patients and it is always running...but I like him anyway. I stopped calling him, well... except when I need an appoinment.
Good luck with your new endo.
Trying to get an appointment with another endo, one that doesn't assume things and is open to all meds and freeT3. Thats like a xmas list.
On the phone, the Doc insists its just hypo, even though the FT3 is more than 50% of range. The fact that NT makes me burn after taking it - he says its probablly the NT doesnt agree with me.
He says it cant be a pituitary since my january labs looked good, despite the fact that I did not feel well on the NT.
He says it cant be a pituitary since my january labs looked good, despite the fact that I did not feel well on the NT.
I'd think running the pit testing I replied to you on the message and checking the Hypothalamus labs would be first on the list to do..
Then abnormal pit or hypothalamus reading - move toward MRI - then... if all is well... looking at the NT
Then abnormal pit or hypothalamus reading - move toward MRI - then... if all is well... looking at the NT
just was doing more reading and had a thought regarding pit dysfunction and thyroid connection.
Here is a thought too.
hypothalamus
Region of the brain containing a control centre for many autonomic-nervous-system functions. Its complex interaction with the pituitary gland makes it an important part of the endocrine system. As a critical link between the body's two control systems, the hypothalamus regulates homeostasis. Nervous and hormonal pathways connect it with the pituitary, which it stimulates to release various hormones. The hypothalamus influences food intake, weight regulation, fluid intake and balance, thirst, body heat, and the sleep cycle. Disorders can produce pituitary dysfunction, diabetes insipidus, insomnia, and temperature fluctuations.
thyrotropin or thyroid-stimulating hormone (TSH), hormone released by the anterior pituitary gland that stimulates the thyroid gland to release thyroxine. The release of thyrotropin is triggered by the action of thyrotropin-releasing factor (TRF), a substance found in the hypothalamus of the brain. TRF, once released from the hypothalamus, travels in the bloodstream to the anterior pituitary, where it causes the release of thyrotropin.
male hypothlamus testing Testosterone <---(Testes)--- LH <---(Pituitary)--- GnRH
<---(Hyphothalamus)---- Testosterone
Now, if this is correct, is the objective of the GnRH test to inject GnRH
into the blood stream, and see if LH rises. If it doesn't there may be some
problem with the Pituitary, such as a benign tumour?
But, if this is the objective of the test, and it shows a normal Pituitary
function, can't there still be a problem if the Hypothalamus is not
functioning correctly. Can the reason why the T level is too low be that
the Hypothalamus is not be producing enough GnRH? and testing TRH
Here is a thought too.
hypothalamus
Region of the brain containing a control centre for many autonomic-nervous-system functions. Its complex interaction with the pituitary gland makes it an important part of the endocrine system. As a critical link between the body's two control systems, the hypothalamus regulates homeostasis. Nervous and hormonal pathways connect it with the pituitary, which it stimulates to release various hormones. The hypothalamus influences food intake, weight regulation, fluid intake and balance, thirst, body heat, and the sleep cycle. Disorders can produce pituitary dysfunction, diabetes insipidus, insomnia, and temperature fluctuations.
thyrotropin or thyroid-stimulating hormone (TSH), hormone released by the anterior pituitary gland that stimulates the thyroid gland to release thyroxine. The release of thyrotropin is triggered by the action of thyrotropin-releasing factor (TRF), a substance found in the hypothalamus of the brain. TRF, once released from the hypothalamus, travels in the bloodstream to the anterior pituitary, where it causes the release of thyrotropin.
male hypothlamus testing Testosterone <---(Testes)--- LH <---(Pituitary)--- GnRH
<---(Hyphothalamus)---- Testosterone
Now, if this is correct, is the objective of the GnRH test to inject GnRH
into the blood stream, and see if LH rises. If it doesn't there may be some
problem with the Pituitary, such as a benign tumour?
But, if this is the objective of the test, and it shows a normal Pituitary
function, can't there still be a problem if the Hypothalamus is not
functioning correctly. Can the reason why the T level is too low be that
the Hypothalamus is not be producing enough GnRH? and testing TRH
I sent you a reply on your message to me and I do have thoughts about checking the pitutiary out too. That is all spelled out in the reply.
There are people experiencing off symptoms with the new NT too - but with bad conversion issues - usually the TSH and FT3 tests will still respond correctly. Meaning, with the FT3 still being in the upper ranges as your is the TSH almost all the time is still responding lower - and this is where yours is not doing that.
Conversion issues happen more often in the FT4 and FT3 labs and out of whack ranges are seen with those to base a conversion issue theory. and in a reverse T3 issue - labs usually are low FT3 - high FT4 and higher TT3 and TT4. There is nothing in your report that would make me thing looking at RT3 - but this is complex too.
The selenium supplement may help with the sensation of the swelling. I wrote about that too in the reply message. the Aleve and ice is helpful too.
LM - I hear you are anxious over this and I am sure you are uncomfortable with the symptoms. Call your doctor this morning and see if you can get in to talk over some pit testing. It's better to checked that out and rule of - if possible.
There are people experiencing off symptoms with the new NT too - but with bad conversion issues - usually the TSH and FT3 tests will still respond correctly. Meaning, with the FT3 still being in the upper ranges as your is the TSH almost all the time is still responding lower - and this is where yours is not doing that.
Conversion issues happen more often in the FT4 and FT3 labs and out of whack ranges are seen with those to base a conversion issue theory. and in a reverse T3 issue - labs usually are low FT3 - high FT4 and higher TT3 and TT4. There is nothing in your report that would make me thing looking at RT3 - but this is complex too.
The selenium supplement may help with the sensation of the swelling. I wrote about that too in the reply message. the Aleve and ice is helpful too.
LM - I hear you are anxious over this and I am sure you are uncomfortable with the symptoms. Call your doctor this morning and see if you can get in to talk over some pit testing. It's better to checked that out and rule of - if possible.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
