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Thyroid (Expert Forum)
Hypothyroid, Adrenals, or mix?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
Hypothyroid, Adrenals, or mix?
by SaveSecondBase, Mar 15, 2008 02:38PM
Hello - I recently had lab work done, and am waiting for a follow up to discuss with my endo. In the mean time, I'm looking for other insights, and would greatly appreciate any help. I have no thyroid tissue left after two doses of RAI (5 years ago), and after stable treatment on Levothyroxine since 2004, I recently started having many hypo symptoms. TSH in December was around 5.5, then down to 1.5 in January after an increase from .125 to .15 in Levothyroxine (fasting, no meds), and my recent results are below. I had already taken my levothyroxine that day (5 hours prior to labs). I'm also on long term corticosteroids (15+ years), and birth control pills. I'm 33/Female/not pregnant.
My question is, although TSH is in normal range, I'm still experiecing many hypo symptoms - is it my thyroid, or adrenal fatique, or something entirely different? Thanks in advance for any help you can provide.
TSH: 1 (.4 - 4.5 range)
T4, Free: 1.6 (.8-1.8 range)
T3, Free: 293 (230-420 range)
Prolactin: 3.9 (3.0 - 30 range)
DHEA Sulfate: 144 (40-325 range)
Vitamin B12: 290 (200 - 1100 range)
ACTH, Plasma: 13 (5-27 range)
Ferritin: 13 (10-154 range)
Cortisol (at 12:15PM), total, serum: 12.2 (4-22 range)
My question is, although TSH is in normal range, I'm still experiecing many hypo symptoms - is it my thyroid, or adrenal fatique, or something entirely different? Thanks in advance for any help you can provide.
TSH: 1 (.4 - 4.5 range)
T4, Free: 1.6 (.8-1.8 range)
T3, Free: 293 (230-420 range)
Prolactin: 3.9 (3.0 - 30 range)
DHEA Sulfate: 144 (40-325 range)
Vitamin B12: 290 (200 - 1100 range)
ACTH, Plasma: 13 (5-27 range)
Ferritin: 13 (10-154 range)
Cortisol (at 12:15PM), total, serum: 12.2 (4-22 range)
Doctor's Answer
My current doctor told me (and I believe her) that even while in range (nutritional status and the range is broad, as you notice) that people do experience symptoms in low normal ranges. As she would also state, "There is much we do not understand, yet." I agree.
Pernicious anemia and Celiac Sprue are common amongst those with Hashimotos. I think a look into other labs (for which, I would think were also drawn) need be considered.
Never-the-less, I think adding in extra B-12 may be beneficial.
The recommendation made to me, was B-12 sublingual (Methylcobalamin). B-12 is a water soluble vitamin and as such, excess is excreted through your urine (is not stored up in your body).
That said, Vitamin D (and Calcium) is another good one to look into. While I am in the reference range (D), I am low normal. My doctor recommended that I add in extra D (not surprising, I have darker skin and live North: Alaska)
Good luck to you,
~Kate