what is this?

[kjarvis420]

I am currently not on any medicine and I have not been diagnosed with any thyroid problems, however I feel very sick. I have just about every hypothyroid symptom out there, and I have the WORST headaches nearly every day. I've tried pain and migraine meds and nothing works. They get so bad that I start to see colors, my vision blurs, I get shakey, and I feel nauseous, sometimes vomitting from the pain. Most mornings I wake up feeling hungover, but I don't drink the night before and as far as I know, I'm sleeping just fine. My most recent labs (5 days ago) were tsh at .41 and free t4 at 1.1. I know these are within normal range, but are they on the lower side? I'm especially concerned about my tsh because it keeps getting lower. The first tsh I had done was in June 09 and it was.72. In January 2010 my tsh was .64. All these tests were done around 8am. Are those changes very significant? And I thought that if tsh was low, free t4 should be high. This makes me wonder if there could be a pituitary problem? I also had my cortisol tested around 8am in January and it was at 5. I was given an ACTH stim a few days later, and at 8am base cortisol was at 11. I know this is within range, but still on the lower side for what is supposed to be the highest spike of the day. My adrenals did react to the stim, going from 11 to 27 to 33 every 30 minutes. That's great that my adrenals work so well, but I'm left wondering why my cortisol, tsh, and free t4 are all on the low end. (And there was no base ACTH serum taken.) My endocrinologist seems to want to try everything except looking at the pituitary. I also had an echocardiogram two days ago for a heart murmur and there was a small valve leak. I have been having some minor sharp shooting-type pains under my left breast area and right in the middle area of my left breast too (sorry, that's the only way I know to describe where the pain is). Can this all be connected? Do you think I should have the pituitary function addressed? I am really missing out on a lot of things I love to do because I feel so horrible lately. I'm in school for kinesiology for a career in the dance and fitness industry, but I can't even work out anymore and I'm gaining weight rapidly. If I run or dance for more than 30 minutes at a time, the next day I am sick. Any ideas about what is going on?!

[kjarvis420]

cool! thanks so much! i really appreciate it.

[LazyMoose]

Not to keep this going.........but you need the test that is called "Free T3", specifically, thats the form of T3 floating in your blood by itself..

Just the 'T3' only test also includes T3 bound to proteins I believe. If its bound to proteins it cant 'fit' into cell receptors, kind of useless.

[kjarvis420]

lazymoose, exactly! so t3 could really help complete the picture.

[LazyMoose]

The money they save insurance companies by skipping tests is washed out by patients returning  being undiagnosed.

You seem to be in tune with hormone chemistry. (?)  So I didnt give you the whole 'shpeel'.

Remember TSH is a messenger hormone for directing the thyroid (I suspect you understand this). TSH is not the hormone for the body cells. T4 is a storage hormone to be converted to T3 per an enzyme in the liver when needed. Not all of us convert correctly either - why the T4 meds can work different than any form of additional T3 (synthetic or Natural Dessicated (pork)) in some people.

[kjarvis420]

thanks lazymoose. i will def request that free t3. what is the big deal anyway about doing a full thyroid panel? sheesh. it's like pulling teeth to get a doctor to do much of anything...

[LazyMoose]

Having at least a prolactin test is well worth it.

Get a free T3 test, bet its way low from low t4 - it should be, and will make you feel terrible. T3 is what goes in your cells.

Some people here have really odd tsh levels while their frees are good from taking meds.

Otheres will chime in on the heart and pituitary stuff, weekends are slow.