Aa
TSH is 66 @ Tx Wk 16
I just left my doctor's office today and they called when I got home and said I must see an endo NEXT WEEK. If this can't get controlled immediately they are discontinuing my treatment. Anybody ever have this? The thing is I feel great and I hardly sleep at all since on treatment. According to my doctor, I should be lethargic and gaining weight. I am so confused and disappointed. I really want to get rid of this HCV!!!
Do you have any backup for this information about the pituitary for us to read?
TSH is produced in high quantity only if the pituitary is working at normal levels.
HCV patients have a much higher rate of pituitary insufficiency than the normal populace.
Why this is has not been definitively attributed to the HCV, but the lower function is well documented.
In which case, the extra TSH may not be made and hence the body's ability to self correct is limited.
My pituitary function is 20% of normal so this can be part of the problem. The truest tx for this is to correct the pituitary if the IGF-1 level is too low.
However, this is expensive, requiring daily injections of HGH, ergo most docs only correct for the thyroid and leave the pituitary untreated.
In fact most docs, including mine and several others of patients in this forum, don't even know that HCV and pituitary insufficiency are synonymous. They were trained to believe "it is extremely rare" and have not kept pace with the research.
mb
HCV patients have a much higher rate of pituitary insufficiency than the normal populace.
Why this is has not been definitively attributed to the HCV, but the lower function is well documented.
In which case, the extra TSH may not be made and hence the body's ability to self correct is limited.
My pituitary function is 20% of normal so this can be part of the problem. The truest tx for this is to correct the pituitary if the IGF-1 level is too low.
However, this is expensive, requiring daily injections of HGH, ergo most docs only correct for the thyroid and leave the pituitary untreated.
In fact most docs, including mine and several others of patients in this forum, don't even know that HCV and pituitary insufficiency are synonymous. They were trained to believe "it is extremely rare" and have not kept pace with the research.
mb
Here is some info about how the thyroid works that may help. First off, the thyroid gland is in the lower central neck and overlies the trachea (windpipe). It secretes thyroxine (T4) which is exactly the same substance as Synthroid and Levoxyl. It is bound to protein in the blood and isn't the active form of the hormone. At the tissue level it is converted to T3 which is the active form, which essentially regulates metabolism.
Another hormone, TSH (Thyroid Stimulating Hormone) is made by the pituitary gland at the base of the brain, enters the bloodstream and causes the thyroid gland to secrete T4. This T4 enters the bloodstream and does the job as described above. It also reaches the pituitary gland and turns off TSH secretion. It's pretty much how the heating system works in your house. The thermostat (pituitary gland) turns on the furnace (thyroid gland) which heats up the room and turns the thermostat (pituitary gland) off.
So, if your thryoid gland begins to fail the pituitary makes more TSH to try to force the thyroid to make more T4. Once the gland fails, the TSH skyrockets in an attempt to force the thyroid to do its job. This is classic hypothyroidism -- TSH is high and T4 is low. Hyperthryoidism (hyperactive thyroid) is just the opposite -- too much T4 and almost undetectable TSH. The most common cause of hyperthryoidism is autoimmune disease such as Grave's disease.
So how quickly should you spring into action about an elevated TSH? First off, when done alone it's a screening test. You need to know your T4 (usually free-T4) and T3 to get the whole picture. Assuming you are in a hypothyroid state, you probably haven't been that way too long. It takes 8 days for your body to get rid of half the T4 (i.e., half-life is 8 days) in your bloodstream, and it take about 5 half-lives, or 40 days, to get down to zero. That's 6 weeks, and it's highly unlikely that you became hypothyroid right after starting treatment. That's why I assume you haven't been in a severe hypothryoid state for a long time.
The bottom line is that having a TSH of 66 isn't usually a catastrophe and it's usually not too hard to get things back into some semblance of order. Your body has the ability to compensate for low levels of T4 early on in the disease. On the other hand, stress and illness (like being on INF and riba) can make hypothryoidism more serious, and you're older like me :-) so it's nothing to ignore either.
Like I said above, it's usually not too hard to get things close to normal with Synthroid, but that's not to say that you would be able to start treatment with Synthroid and be back to normal in a week. It can take some time to regulate TSH and T4 levels.
The usual disclaimer of saying that you need to talk to your doctor for medical advice applies here. I'm a physician, but nor YOUR physician, so you need to work out the details with your doctor.
Jeff
Facta non Verba
Another hormone, TSH (Thyroid Stimulating Hormone) is made by the pituitary gland at the base of the brain, enters the bloodstream and causes the thyroid gland to secrete T4. This T4 enters the bloodstream and does the job as described above. It also reaches the pituitary gland and turns off TSH secretion. It's pretty much how the heating system works in your house. The thermostat (pituitary gland) turns on the furnace (thyroid gland) which heats up the room and turns the thermostat (pituitary gland) off.
So, if your thryoid gland begins to fail the pituitary makes more TSH to try to force the thyroid to make more T4. Once the gland fails, the TSH skyrockets in an attempt to force the thyroid to do its job. This is classic hypothyroidism -- TSH is high and T4 is low. Hyperthryoidism (hyperactive thyroid) is just the opposite -- too much T4 and almost undetectable TSH. The most common cause of hyperthryoidism is autoimmune disease such as Grave's disease.
So how quickly should you spring into action about an elevated TSH? First off, when done alone it's a screening test. You need to know your T4 (usually free-T4) and T3 to get the whole picture. Assuming you are in a hypothyroid state, you probably haven't been that way too long. It takes 8 days for your body to get rid of half the T4 (i.e., half-life is 8 days) in your bloodstream, and it take about 5 half-lives, or 40 days, to get down to zero. That's 6 weeks, and it's highly unlikely that you became hypothyroid right after starting treatment. That's why I assume you haven't been in a severe hypothryoid state for a long time.
The bottom line is that having a TSH of 66 isn't usually a catastrophe and it's usually not too hard to get things back into some semblance of order. Your body has the ability to compensate for low levels of T4 early on in the disease. On the other hand, stress and illness (like being on INF and riba) can make hypothryoidism more serious, and you're older like me :-) so it's nothing to ignore either.
Like I said above, it's usually not too hard to get things close to normal with Synthroid, but that's not to say that you would be able to start treatment with Synthroid and be back to normal in a week. It can take some time to regulate TSH and T4 levels.
The usual disclaimer of saying that you need to talk to your doctor for medical advice applies here. I'm a physician, but nor YOUR physician, so you need to work out the details with your doctor.
Jeff
Facta non Verba
I understand it to be that if you have Hashimoto's disease you have thyroid antibodies. So if we have no thyroid antibodies, we stand a greater chance of our thyroid returning to normal post tx.
I love you too.
"66 man oh man. That is so high, you must be pretty damn strong to deal with it and not be floored! Treatment is hard enough on people but with something like that - wow! I respect the amount of work you are doing BIG TIME!"
I just loved your post above. You say what is on your mind, you say it straight out. WE NEED YOU!
"66 man oh man. That is so high, you must be pretty damn strong to deal with it and not be floored! Treatment is hard enough on people but with something like that - wow! I respect the amount of work you are doing BIG TIME!"
I just loved your post above. You say what is on your mind, you say it straight out. WE NEED YOU!
I am not that good at this stuff either, but I do know that when my TSH was elevated (only to 7.3 which is nothing compared to skersj's 66), they said it was good that my T4 was normal.
I read this on a Swedish site (internetmedicin.se):
"HYPOTHYROIDISM
STAGES OF DISEASE:
Autoimmune thyroid disease without symptoms:
TPOab detectable. TSH, (free) T4 and T3 are normal.
(20-25% of healthy female population)
'Subclinical' hypothyroidism:
TPOab detectable in most cases. TSH elevated. (Free) T4, T3 are normal.
About 25% of this group have mild, unspecific symptoms.
Mild hypothyroidism:
TPOab detectable in most cases. TSH elevated. (Free) T4 lowered. (Free) T3 normal. Mild symptoms.
Pronounced hypothyroidism:
TPOab detectable in most cases. TSH elevated. (Free) T4 and T3 are lowered.
Pronounced symptoms."
I read this on a Swedish site (internetmedicin.se):
"HYPOTHYROIDISM
STAGES OF DISEASE:
Autoimmune thyroid disease without symptoms:
TPOab detectable. TSH, (free) T4 and T3 are normal.
(20-25% of healthy female population)
'Subclinical' hypothyroidism:
TPOab detectable in most cases. TSH elevated. (Free) T4, T3 are normal.
About 25% of this group have mild, unspecific symptoms.
Mild hypothyroidism:
TPOab detectable in most cases. TSH elevated. (Free) T4 lowered. (Free) T3 normal. Mild symptoms.
Pronounced hypothyroidism:
TPOab detectable in most cases. TSH elevated. (Free) T4 and T3 are lowered.
Pronounced symptoms."
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