Think I'm Hypo No where to Turn

[Sassy51486]

I've been showing signs of hypothyroidism that are progressively getting worse yet no doctor wants to listen after seeing my TSH level of 2.69-They simply say its normal but just about everything i've read online says otherwise...i have been doing a lot of research in effort to get help. Has this happened to anyone else? I am in a tough predicament and just want to get treated but these so called "professionals" are basically telling me its all in my head. (These symptoms i'm having). I just need someone to back me up here and tell me im not crazy. Maybe if we discuss what's going on with me it can be confirmed

[goolarra]

Many people experience a feeling of tightness or "fullness" in the thyroid.  You might try taking selenium for that.  Be sure to follow label directions, however, as selenium can be toxic in very high doses.  Brazil nuts are also very high in selenium; you only have to eat about one to get your RDA.

Have you had a thyroid ultrasound?

[Sassy51486]

Even when i talk occasionally, mainly accompanies raising my voice

[Sassy51486]

I apologize for not getting back to you  with a response sooner, i've been thinking about everything you guys said and agree that what i need to do is focus on one thing at a time. Im working on correcting my vitamin D problem. I just started on 2000 units a day, as instructed by my doctor. I realize it may take a while before i start feeling better but at least i am headed in the right direction.Although something is concerning me, a new symptom..I've actually been having pain in the neck area, right around my thyroid. It feels like it swollen and sore. It hurts when i stretch my neck, yawn or strain my neck in any way. Sometimes swallowing and if i cough or sneeze but its definitely not throat soreness that i'm experiencing.

[goolarra]

I don't see anything in your labs to indicate a pituitary issue.  I think your TSH is consistent with your FT3 and FT4 level.

Your low FT4 bears watching.  As deb said, you "might" benefit from a low dose of T4.  However, it's FT3 that correlates best with symptoms.  Also, you need vitamin D to properly synthesize thyroid hormones.  I've read that D should be in the 50-60 range for proper thyroid hormone synthesis.  If you correct your D deficiency, your FT4 might just correct itself...

Also, vitamin D must be present in cells in order for thyroid hormone to get into the nucleus.  So, you can feel hypo, even with perfectly good serum thyroid hormone levels, if it can't get into your cells.    
  

[deb62gee]

Just my opinion, and you've been given some great information here, but I would start doing some checking for problems with gluten. Vitamin/mineral deficiencies can cause a lot of the problems you have described, and since you are D3 deficient, you should also check for the B vitamins being deficient. With your fT3 being up there and your FT4 low and your TSH nearing 3, you "might" benefit from having a little bit of T4. You would have to work with a doctor willing to listen to your symptoms and start you out very low and work up slowly if needed. I have known people who have done way better by just adding as little as 32 mcg T4. But, if you take it and it raises your T3 too much or you feel hyper, then you don't need any more T4. We are all really different and the ranges are just ranges where people have felt no overt symptoms of disease. We can all have different levels and still feel fine and be perfectly healthy.

You might want to also consider getting a "nutritional status" iron testing done. That would include the saturation percentage, TIBC and iron and ferritin. some doctors just look at hemoglobin or ferritin, but you can be iron deficient with those numbers being in the normal ranges. If your TIBC is low and you take iron, that could make you feel sick.

[Sassy51486]

Thank  you for helping me grasp this better. I will try to find one of those links for you, they seemed to be reliable sources. Anyway what does my low t4 tell you about my thyroid health?? Can there still be something wrong even though the T3 is in perfect range? Could it be the pituitary ??

[goolarra]

I'm no expert on the finer points of D deficiency, but I'm fairly certain that it's D3 that you want to take.  D3 is safer and more bio-available than D2.

By and large, multivitamins aren't really good for a lot.  You're much better off addressing any deficiency by buying a high quality supplement of a single (or combination as in the case of D and calcium) item.  Typically, multivitamins contain the cheapest form of what's in them.  Bio-availability is often sacrificed.

As far as TSH is concerned, I think you (or the articles you've read) are putting way too much emphasis on it.  TSH is a pituitary hormone, and as such, it's an indirect measure of thyroid status.  It's influenced by many factors other than thyroid hormone levels.  Just to mention one factor:  TSH has a circadian rhythm and can vary as much as 70% intraday, just depending on what time the blood was drawn.  If we look at the AACE recommended range of 0.3-3.0, 1.65 would be the middle of the range.  So, someone testing at 1.65 could actually have a TSH of anywhere from 0.5 to 2.81 at another time of day.

We're all different and have different set points when it comes to levels.  Some of us would feel very hypo at 1.65, and some of us would be hyper.

If you have a link to one of your articles, I'd like to read it.

  

[Sassy51486]

Ok so its D2 that I need mostly since im obviously not getting enough in my diet. Do you think I could have a problem with absorption though because i've been taking multivitamins that contain vitamin d and my calcium level is fine although I don't drink that much milk....Also, doesn't iron have a connection with vit D, like if there's a deficiency in one you develop a problem w/ the other??

In regards to thyroid, (When it comes to tsh specifically) everything ive read has said that anything over two raises a red flag and is indicative of possible thyroid failure, or just means its starting to slow down. And that in order for someone to be feeling their best it should be 1 or less, 1.5 being the cutoff. Any normal healthy person should fall within that range, otherwise symptoms arise. Especially for becoming pregnant it's a concern

[goolarra]

So, your FT4 is quite low at 20% of range.  However, your FT3 is right where it should be at 63% of range.  You have to use the range from your own lab.  Part of what goes into making up the reference range is the methodology and test kits that the lab buys.  2.3-4.2 is a pretty "standard" range.  A range that starts at 3.5 and goes to 6 or 7 is probably not in the same units.  I think you'll find your lab's range is in pg/ml, and the 3.5-6 or 7 range is pmol/L.

Yes, your vitamin D is below range, so you're deficient.  Anything below about 50 should be considered deficient, and some people need it higher than that.  Vitamin D deficiency isn't only common it's rampant, especially since we've all been told to avoid the sun.  However, all that means is a lot of people are probably suffering silently with it.  Vitamin D is necessary both for the synthesis of thyroid hormones in the thyroid and for the metabolism of thyroid hormones in cells.  So, if D is deficient, you can feel hypo secondary to vitamin D deficiency.  I, personally, would work on that with my doctor and correct it before I did anything else.  

[Sassy51486]

Reference*

[Sassy51486]

The range they had was 0.8-1.8 for ft4 and ft3 was 2.3-4.2  but i have seen a variation of references ranges (For T3) which I dont quite understand. I've found that a popular one online starts at 3.5 and goes to 6 or 7 and that would mean mine is borderline. Is this accurate? About the vitamin D, would that classify me as deficient?? I wonder why my doctor wouldn't contact me regarding it, is it fairly common to lack it that much in the winter time ?

[goolarra]

What are the reference ranges on your FT3 and FT4?

Your vitamin D is more than a little low.  The lower part of the vitamin D range is distinctly questionable.  D should be in the 50-70 range for the proper synthesis and metabolism of thyroid hormones.  You should ask your doctor about supplementing.  People with D as low as yours sometimes start out supplementing at 50,000 IU per week until levels start to rise.  After 4-6 weeks, that's scaled back until it's time for a maintenance dose.  Of course, don't supplement that aggressively without talking to your doctor first.  This could explain your fatigue.

Why are you so concerned that your TSH be below 2?

[Sassy51486]

Oh, and the t4 was actually 1.1

[Sassy51486]

Forgot to mention those were 'Free' Tests listed

[Sassy51486]

Interesting finding, i was not aware. Well mine came back negative once again-The results are in and are as follows:

T3  3.5
T4  1.0
TSH  2.09
Peroxidase Antibodies <10
Thyroglobulin <20
Also my vitamin D level ended up being low;slightly out of range at 28 (Total) And D2 less than 4

I don't really know what to make of any of these except that tsh is too elevated for my liking, a little better than the last reading but still above 2

[goolarra]

Yes, there's a difference.  Some people with Hashi's have a positive ANA, some don't.  TPOab and TGab are the specific antibodies that cause Hashi's.  They attack the thyroid and nothing else.  I just read a study that said only 37% of the participants, all of whom had Hashi's, were ANA positive.  

[Sassy51486]

Alright i'm a little confused, is there a difference between the test for antibodies and the ana??? Because a month ago i had that test and the result was negative which means i don't have an autoimmune disease...Right? There weren't any numbers given for this test, when they test for thyroid antibodies is that more of a specific result or is it the same thing basically as the ana

[goolarra]

I thought that this site had cured its issues with the less-than and greater-than signs...apparently not.  A lot of text got blown away.

Last sentence of paragraph 1 should read:

For example, if the range is  less-than 40, they might report a result as less-than 20; at the higher end, they might say enough is enough and report as greater-then 3,000.

[goolarra]

You should get an exact number on the antibody tests.  However, the interpretation is basically positive or negative.  If you're above range, it's positive, no matter the actual number.  Sometimes, at the low and high ends of the spectrum, they will report as a less-than or greater-than value.  For example, if the range is <40, they might report a result as 3,000.

If you have Hashi's, iodine can be contraindicated since it can exacerbate the autoimmune reaction.  Also, more iodine isn't necessarily better.  If you have a deficiency of iodine, there might not be enough available to make thyroid hormones.  However, if your iodine level is sufficient, increasing it will unlikely have any effect.

[Sassy51486]

Oh, well thanks for clearing that up. Yes he do give me the antibody test, he wants to check them. Can that result either be positive/negative or do you get a number? Just curious. By the way i have been feeling horrible lately, the last 2 days especially... Since i've started taking these new prenatals that i noticed contain a lot of iodine-More than my body's used to. I feel like a zombie walking around, im terrible fatigued and have never felt exhaustion like this. Coffee won't even weak me up fully. Now that i am supplementing with iodine do you think that's what is causing it?? Im also colder than normal and just feel run down, like i'm getting  sick. My throat has been sore every morning upon waking up. I've had a persistant sore throat for a while now but it seems as if that along with everything else is exaggerated. All of my thyroid symptoms have worsened following the labwork and after i used iodine on my skin then added the supplement. How is this explained?? Does it make sense ?

[goolarra]

Iodine deficiency doesn't go hand in hand with hypo.  Iodine is one of the building blocks of the thyroid hormones, so a deficiency of iodine can cause you to be hypo.  Before WHO launched a massive campaign to eliminate iodine deficiency, it was the leading cause of hypo and still is in some parts of the world.  However, having thyroid dysfunction does not affect your iodine levels.  Iodine deficiency is the cause, not the effect, of thyroid disorder.

The patch test has pretty much be relegated to the realm of witch doctors.  You really have to have it tested to know what's going on.

Are your antibodies being tested as well?

[Sassy51486]

Ok, thank you for all of that input. I was able to get my doctor to investigate further, he ran a complete work up on me. I don't think he did the B vitamin but managed to get everything else (Vitamin D, thyroid panel and ordered a urine sample) For what i dont know? He gave me the ANA test even though i told him i recently had one done and it came out negative. (I suppose that can change over a short time?) Another thing, I suspect i could be iodine deficient which i know is not only linked to thyroid function but goes hand in hand with it. That didn't come up at the appointment and am almost certain im not being  tested for it. So i performed the simple at home 'patch' test and that showed there could be some extent of deficiency because the color faded after 8-10 hours. This leads me to believe my thyroid is without a doubt failing. I will post those results as soon as i get them back. In the mean time thank you for reading!

[flyingfool]

FYI - your profile which is the default indicates that you are male.

ALL your sysmptoms are consistent with Hypo.  I'm not sure about the light sensitivity though.

Also be sure to be tested for the following vitamins/minerals as they too can cause fatigue.

Vitamin D3

Vitamin B-12 ( you want to be WELL up in the range if not towards the top)  B-12 has a VERy wide reference range.  In the USA the lower part of the range starts lower than they do in Europe and Japan which start out at the bottom at about 500.  Often we'll see a lower range in the USA of 200. you will want to be around 700 or even 900.  Don't let them tell you that 250 or something is "normal" or sufficient. it is NOT.

Iron

Ferritin

[goolarra]

"What are the chances i'd be able to get him to comply and give them to me if I explain how i've been feeling and how this has affected me."

It depends on the doctor.  So many of them think TSH is the gold standard in thyroid testing.  A few know differently.  If it's not a financial burden, you might consider ordering those tests online.  Self ordered tests are self pay.  However, if you have results in hand before seeing the new doctor, it might make it a lot easier on you.  It's about $135 for FT3, FT4 and TSH (altogether).  I believe you can also order TPOab, but I don't know how much that is.

Once a thyroid dysfunction or disease is diagnosed, you should be treated based on symptoms.  However, I do have to appreciate the fact that the symptoms of hypo can be the symptoms of so many other things as well.  That's why it's so important to test FT3 and FT4 to see what the actual thyroid hormones are doing.

If your thyroid hormone levels are too low, and you're hypo, it can be difficult to conceive.  Miscarriage can also be the result of being hypo during pregnancy.  So, it's very important to make sure you're not hypo before you conceive, especially since pregnancy and childbirth can wreak havoc with even properly functioning thyroids.  Low maternal thyroid hormone levels can also impact fetal development.  Infertility isn't typically an issues...once the thyroid condition is corrected with meds, you should be able to conceive normally.