Would do FNA biopsy of nodule if >1-1.5cm, repeat TSH, check antibodies and likely start thyroid hormone treatment.
Go see an endrocinologist. I was also just diagnosed this week with a TSH of 10.5. You echo my feelings. My regular doctor just prescribed Synthroid and said come back in a month. He did no other tests even though I asked. I went to an endrocynologyst after that experience and several follow up tests including the ultrasound. I am waiting for the results, but I can tell you this...the experience was much better and I feel more confident that I will be treated with a more specific mix of thyroid hormones to address both T4 and T3 levels. My doctor also did a cortisol test. Anyway, go see another doctor who specializes in throid problems. My thought is that you shouldn't mess around with an incompetent doctor who doesn't understand how bad you have felt for so long. It's not your fault.
Your TSH along with your symptoms suggest T4 deficiency/hypothyroidism.
Although the FTs are important to relate thyroid disorders,
TSH is the best test to relate whether a person is hypo or hyper.
Serum FT4 measurement is a more reliable indicator of thyroid status than TSH when thyroid status is unstable. When thyroid status is stable and hypothalamic-pituitary function is intact, serum TSH measurement is more sensitive than free T4 (FT4) for detecting mild (subclinical) thyroid hormone excess or deficiency.
As previously suggested, go to an Endo who deals with a lot of thyroid issues. Have TSH, both FTs, full antibodies and the nodule revisited. No use getting up set with your doctor for something you can not control, other then going to a new doctor peferably an Endo. Getting up set only casues stress which is not good for thyroid, TED, weight gain/loss, etc. or general health.
well thanks everyone for your input it was really helpfull..i am going to make an appointment with an endo doctor..the nodule is only 13 mm..i am assuming that is very small...i forgot to say that the family doctor is ordering some type of iodine test for nodule to see if it is benign...what is an antibody test?
It's a blood test to determine whether or not you have Hashimoto's or Graves (autoimmune thyroid disorders).
13mm is 1.3cm -- I usually biopsy these. The iodine scan is not helpful at this stage and CANNOT distinguish benign vs cancer. It is NOT indicated for a nodule with a high TSH. Cancel this until you see a thyroid expert.
thank you very much i will cancel the test and i am going to call an endo doctor that my brother in law goes to..he has graves disease...the doctor is over 2 hours away but he's suppose to be good his name is Dr. Alan B. Schorr he's in langhorne pennsylvania.
Hi. You made the comment: "When thyroid status is stable and hypothalamic-pituitary function is intact, serum TSH measurement is more sensitive than free T4 (FT4) for detecting mild (subclinical) thyroid hormone excess or deficiency."
What would constitute the hypothalamic-pituitary function NOT being intact? I believe that I have adrenal issues (low cortisol, low DHEA and low ACTH) -- would this affect the thyroid tests? What tests would be best for me? My TSH has fluctuated from 0.9 to 1.58 (ref range 0.5-5.5) but my Free T4 has remained constant at 1.1 (ref range 0.8-1.8). Don't have Free T3 (prim doc and endo both poo-poo it -- ugh!), but my Total T3 was just below mid-range...
I still have all the symptoms but the tests don't "prove" it. U have made every lifestyle change I can -- I eat fruits, veggies, whole grains, protein, all organic (milk, too); I exercise 4-5 x a week (pilates, don't have stamina yet for my low-impact aerobics), get plenty of sleep, drink plenty of water, don't drink alcohol or soda (drink one cup coffee couple times a week), etc., etc., etc.
Anyway, I'd mostly like to remedy the unrelenting fatigue and irritability. It would be great not to have dry hair, skin and not be constipated. I'd be happy if I could sleep through the night and be refreshed in the morning. I'd love to not be cold all the time (my bbt is 97.2-97.8, and does fluctuate during the day...)
Any thoughts? How do you feel about self-treating? If a possibility (want to be safe), what would you recommend?
Hypothalamic - Pituitary - Thyroid Axis in simple terms, influences the TSH levels. So if TSH level is out of Lab range renduring either hypo or hyper, the hypothalamic-pituitary function is not intact. Low thyroid normally is or can be, the cause of low cortisol, low DHEA and low ACTH . Not knowing if you have been treated and what for, hypo/hyper and if you are on meds. My doctor does and I recommend all three test, TSH and both FTs and T-3 is better than no 3. He dose a full blood/urin work up once a year. Antibodies if they haven't already been and for fatigue checked blood for iron. If you THINK you have adrenal issues, have them tested as well. Levels fluctuating may be due to many reasons, such as a nodule, time of day Labs are done (recommended Labs be done approx at or as close to the same time of day each time - (hypos PM and Hypers AM), what we eat, prolonged intake of refined carbohydrates and sweets, seasons, weather, how and when we take our meds, calcium,V-C, iodine, high fiber foods, other medications, etc., etc., etc., can interefere with meds absorption or make absorption more potent. Pulse, Blood pressure, Temperture, all three normally fluctuates through out the day and unless they are way out they are not too important. The symptoms of both hyperthyroidism and hypothyroidism are non-specific and can be mimicked by other health conditions. On the other hand, most of us have been hypo/hyper for a long time before bing dia., so it will take a long time for us to heal and feel better as well. If there is a health issue I do not believe in solely self-treating without medical, damgae can be done to the system (health)along with the natural thyroid process doing damage as well or worse. However, if you are under the care of a doctor for your thyroid, then any self help might be good, let your doctor know, and take into consideration that it might influance your levels either way. Sometimes our system gets out of wack and out of the habbit of functioning properly. To get it back into the habbit it needs help for a while, so try sleeping pills for a couple of months, then get the type that "works right away and as needed", so if you wake up during the night you can take it, it will put you right to sleep fast and you can have it on hand for those just incase nights. (never use during the day - just night time), after that you might not nned them at all. The same for bowls. This worked for me. I suffered 6 years with sleep and bowl problems until I became wise and got aids to help - all it took was a couple of months and now everything has been back to normal the last three years. Cold, I have always been a cold as a child and adult, its just a natural thing with me, maybe it is with you too....I have no clue. Self help such as good nutrition, vitamin/mineral supplements, no processed foods or as little as possible, exercise, stress control/therapy, regular medical check-ups and whatever else can be done to help and maintain a healthy body and mind as much as possible.
I don't know if this will be of any help since we all are different and our system react differently, but I hope you soon find wellness.
Hi, I just received blood tests once more for the 10th time in 10 years. My TSH is 4.76 and my T-4 is 8.2. My doctor says it is fine. I have been exhausted for years. No energy. Can't sleep at nite. Gets nite sweats. Body is filled with inflammation. Feet and legs swell to the point of almost breaking open. My sed rate is 76. I know some of my problems are my tyroid. Open for suggestions. I'm not sure if a specialists would need to see me but I know I need help.
Your THS suggest hypo. Get a second opinion from an endo. who deals a lot with thyroid. Have both F/Ts done with TSH and antibodies for Graves' and Hashi.
Get a hard copie of your test with Lab ranges. If Lab suggest, then treatment is warrented. Once on treatment with meds. you need to have Labs done at least every 6 weeks to 3 months until your levels are stable, then every 6 month until levels stay stable for a year and when stable for a year, once year is fine. This is not for Armour or T-3 replacement - you would need to go more often, like every 4 weeks but no more than every 6 weeks.
I posted my test results on a different thread and realized that this thread is probably more appropriate. I just received my blood work results and I can't seem to make sense of the FT3 result. Here they are:
Brief history: Hashi's, half thyroid removed with large nodule a week ago, been on various mcgs of Levoxyl for about a year, currently on 137 mcg. Do I need to add Cytomel (sp?) to my Levoxyl...or go on Armour? Or am I ok with the FT3 as it is? I can't seem to find anything about the FT3 number being in this range online. I'm positive it was my Ft3 that was tested though, I saw it filled out on the form and specifically asked for it to be tested. I know that my TSH is good...it was 28 at one time...yuck! That's about the extent of what I know though. =) anyone know what this reading means? Thanks!
Your FT-3 looks correct according to Quest Laboratory.
You might be having a conversion problem.
You could try supplements, selenium in small dose working up to 400 mcg but no more then 600 mcg with the same amount of chromium, and zinc working up to 50 mg per day. Or eat brazil nuts if you can afford the weight. I take the selenium route and sometimes eat the nuts as well regardless of the supplements. This route will take longer if its going to work than T-3/Armour which are chemicals that our body is not use to. Plus Armour is said to cause TED. I prefer the natural route, supplement first. It has been working for me, however we are not all alike.
Or check with doctor about adding T-3, if you have no heart problems of any sort. I think adding T-3 to your T-4 meds would be easier to regulate then Armour. But that is just my thought.
Best to check with or inform the doctor on all the above.
hmmm...I see Graveslady responded...but for some reason the post isn't showing up?
ok...NOW I see it. Hey! I just bought some Selenium. I was going to try that anyway...I had no idea just exactly what it did for the thyroid but had read that it can help and the Doc here said that they were conducting trials with some encouraging results...I think I just may go that route first. Um...no I can't afford the weight...so no Brazil nuts for me! =)
I do have a rapid heartbeat already...I don't have a heart condition...yet. It runs heavily in my family though. This is the one thing that makes me afraid of Armour etc...when I went hyper last month, it was just awful, my heart pounded and I hated the feeling in general. According to my endo's office all my labs look "perfect", and I feel decent (just had surgery so it's a little hard to know for sure). I'll read up on the Selenium...I will start slow...I do know you have to be careful with it. Thanks for responding...it's good to know my labs are finally getting to where they should be! Thanks!
You are welcome! I hope it works for you as well as it did (is) for me. I also take mega vitamins and minerals. Here is a little more info. But first, Retraction - Correction: Armour is natural desiccated pig or beef thyroid drugs.
Selenium is an anti-oxidant and important for proper thyroid function and selenium is also an important heavy metal chelator, among a few other things.
If you don't mind me asking...how big was the nodule you had on your thyroid?..Mine is 1.3 cm..i have an appointment with an endo on 6-19-06..my tsh is 6.88.
You would think I would know that huh? (I'm going to find that out...several people have asked me this already and I should know) I actually have no idea, I can tell you that my surgeon said it was big and rock hard. It was visible to the naked eye...so I'm guessing it was fairly big. Do you have Hashimoto's? Can you see or feel yours yourself?
i don't know yet because i don't have my first endo visit until 6-19-06..my family doctor only ran tsh and some other thyroid test which i found out by reading posts was not even a good test to run...the family doc ordered the ultra sound that is how they found the nodule...so i am assuming that the endo will order the appropriate tests so that i can get a diagnosis..i am very depressed over this whole thing..i have gained alot of weight..that i am not use to having..i have digestive problems such as bloating..i don't feel like eating but i am gaining weight!..i have shortness of breath...muscle aches...joint aches..night sweats..i feel like i have something in my throat all the time...i could go on and on lol...i feel like a flippin
hypochondriac (spelling). i also have hepatitis c which i was treated for about 4 years ago...but i didn't clear the virus...i now found out that the medicine they gave me for the hepatitis c can cause autoimmune thyroid disease!...so i am not assuming this is how i got this thyroid problem...biggest mistake i made was in letting them treat me with peg-intron therapy for the hepatitis c...it was a living hell while on the treatment..and now i am still suffering from it!...sorry to go on and on..thanks for listening.
You poor thing! You've really been through it.
I'm assuming your endo will test your antibodies and that should give a clearer picture about the Hashi's (which is an auto immune disease). I know what you mean about the weight. I went about a year undiagnosed and gained a lot of weight. It's not easy. Hopefully your endo is a good one and will get you feeling better...I know it seems so bleak right now. Your TSH is high and certainly you have a ton of the hypo symptoms. It makes sense that you don't feel well. I was so sick before treatment. It did take a while, but I'm just now starting to really feel better. I did feel better before the surgery, but they wanted to be sure my nodule wasn't cancer, so they went ahead and removed half of my thyroid and the nodule. It came back benign. The whole "getting regulated" process was hard (especially with Hashi's)...I'm feeling like there's a light at the end of the tunnel now. I do hope you'll feel that way soon too. You're going in the right direction. Anyone who's been hypo knows you're not a hypochondriac...it's funny...I've heard a few hypo people say that. I said it too. I wonder if it's because we don't have "sick symptoms"...you know, like sneezing or coughing...I don't know! I know I just felt like I thought people were looking at me as if I were "faking" or something. Just find it interesting that a lot of people seem to feel like hypochondriacs with this disease. Don't be hard on yourself though, being hypo stinks and it's not your fault your thyroid freaked out on you! I'm still a little in shock that this all happened to me...it just came out of nowhere it seems. I hit forty and fell apart! =)
Yea i understand that 40 thing and falling apart..i am 49 and i don't have as much energy as my 72 year old mother..i am sick of feeling sick!..i feel bad for my husband cause to be honest with you i have had no sexual drive what so ever...i freak out alot on him for no reason..but he's still here so thats good..i'm sure evenutally i will feel better also...people like you give me hope... thanks!
Funny, my 70 something year old parents are full of energy too. I always think "if THEY can do it..."! Once you get your energy back you'll be back to your old self...all of a sudden I just found myself being "normal"...like watering the plants wasn't overwhelming anymore. It's so funny, just folding laundry would be hard...my arms felt so heavy. It's TOTALLY different now. Low sex drive is a common symptom of being hyper too...and I'm happy to report it DOES come back. ;)
I know how hard it is. At least you have an appt. with an endo and are taking action. That alone will start to make you feel more positive.
hello just found out today that my thyroid leveels are 10.5 im assuming this is not really good but what is a normal leveland what is the diffrence between a low and high thyroid
A 10 would indicate a definite hypo and require thyroid medication. I would suggest having a full thyroid panel done - TSH, both FTs and all the antibodies.
Each Lab has their own method of testing where one Labs range will differ from another Labs range, so what might seem a high or low range, really is not by that Labs method.
However as a reference: According to Quest Lab who uses a premier endocrinology laboratory, the Nichols Institute in San Juan Capistrano, CA, as their reference laboratory for 18yrs up:
THS 0.6 - 4.6