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Bloodwork/Scan Results
Okay, since you guys are the experts, I'd like to run this by you!
I contacted my doctor earlier this month becaue I was feeling "off". Tired, lethargic, hoarse voice, brittle nails, and feeling like I was in a fog (among other things). All symptoms of hypothyroid. Occasionally, I will alternate and have symptoms of hyperthyroid - feeling super excited, trouble sleeping, having lots of energy. At the moment my feet will not stay still!
He ran the following labs (a couple times to confirm what the levels were) and these are the results (pointing to hyper):
TSH 0.06 (Range .40-4.50)
Free Thyroxine T4 1.5 (Range 0.8-1.8)
Free T3 3.1 (Range 2.3 - 4.2)
INTERPRETATION: TSH result is low, FT4 is normal, FT3 normal or low. Consistent with subclinical hyperthyroidism, secondary hypothyroidism due to pituitary or hypothalamic disease or nonthyroidal illness (euthyroid sick Syndrome).
So he sent me for a radioactive uptake scan. The results came back saying that my thyroid is inflamed, causing the elevated levels of thyroid hormone in my blood. They said that it typically self corrects, but I need to be monitored by having my blood checked monthly to make sure levels are in the normal range.
I'm honestly not buying this diagnosis, with the wait and see approach. I feel like crud and I want to be better!
Is it possible to be hypo, and the inflammation is coming from this, causing me to be hyper as well, or having me alternate between the two? Has anyone else experienced this?
I contacted my doctor earlier this month becaue I was feeling "off". Tired, lethargic, hoarse voice, brittle nails, and feeling like I was in a fog (among other things). All symptoms of hypothyroid. Occasionally, I will alternate and have symptoms of hyperthyroid - feeling super excited, trouble sleeping, having lots of energy. At the moment my feet will not stay still!
He ran the following labs (a couple times to confirm what the levels were) and these are the results (pointing to hyper):
TSH 0.06 (Range .40-4.50)
Free Thyroxine T4 1.5 (Range 0.8-1.8)
Free T3 3.1 (Range 2.3 - 4.2)
INTERPRETATION: TSH result is low, FT4 is normal, FT3 normal or low. Consistent with subclinical hyperthyroidism, secondary hypothyroidism due to pituitary or hypothalamic disease or nonthyroidal illness (euthyroid sick Syndrome).
So he sent me for a radioactive uptake scan. The results came back saying that my thyroid is inflamed, causing the elevated levels of thyroid hormone in my blood. They said that it typically self corrects, but I need to be monitored by having my blood checked monthly to make sure levels are in the normal range.
I'm honestly not buying this diagnosis, with the wait and see approach. I feel like crud and I want to be better!
Is it possible to be hypo, and the inflammation is coming from this, causing me to be hyper as well, or having me alternate between the two? Has anyone else experienced this?
No problem. :) Just wanted to add this from Sensible Alternative - Thyroid Disease...
"Thyroid antibodies cause symptoms even when thyroid reading is normal
"...it raises the possibility that optimal doses of thyroid hormone will not completely ameliorate all symptoms" - Dr Emerson (editor of journal Thyroid)
New research has shown that Hashimoto's patients with high thyroid antibodies report more symptoms than patients with low thyroid antibodies, even if their thyroid function test is normal. In other words, thyroid replacement is not enough to ameliorate symptoms of autoimmune thyroid disease. (5)
(5) Ott, Johannes et al. Hashimoto's Thyroiditis Affects Symptom Load and Quality of Life Unrelated to Hypothyroidism: A Prospective Case-Control Study in Women Undergoing Thyroidectomy for Benign Goiter.Thyroid, 2011; 21 (2): 161 DOI: 10.1089/thy.2010.0191"
"Thyroid antibodies cause symptoms even when thyroid reading is normal
"...it raises the possibility that optimal doses of thyroid hormone will not completely ameliorate all symptoms" - Dr Emerson (editor of journal Thyroid)
New research has shown that Hashimoto's patients with high thyroid antibodies report more symptoms than patients with low thyroid antibodies, even if their thyroid function test is normal. In other words, thyroid replacement is not enough to ameliorate symptoms of autoimmune thyroid disease. (5)
(5) Ott, Johannes et al. Hashimoto's Thyroiditis Affects Symptom Load and Quality of Life Unrelated to Hypothyroidism: A Prospective Case-Control Study in Women Undergoing Thyroidectomy for Benign Goiter.Thyroid, 2011; 21 (2): 161 DOI: 10.1089/thy.2010.0191"
Thank you both so much for your insight! That was some excellent information you both gave me!
I asked my dr. to run my antibodies, but he has basically refused, saying that I CLEARLY don't have hypothyroidism, and if my antibodies were off it wouldn't change anything anyway. Um, okay! I guess he'd rather see what happens after 3 months of blood work to see if the levels change...but that means I'm stuck waiting til late October to plan a course of action. Ugh!
I asked my dr. to run my antibodies, but he has basically refused, saying that I CLEARLY don't have hypothyroidism, and if my antibodies were off it wouldn't change anything anyway. Um, okay! I guess he'd rather see what happens after 3 months of blood work to see if the levels change...but that means I'm stuck waiting til late October to plan a course of action. Ugh!
Let me start with TSI. Although the reference range for TSI is <140, the fact of the matter is that people who don't have Graves' (autoimmune hyperthyroidism) have TSI of <2. 140 is the level at which symptoms usually become apparent. So, since your TSI is elevated above 2, it would indicate that you do have Graves', but it's not yet at the stage where you “should” have symptoms from it.
Your FT4 is a little high, but not a concern yet. However, your FT3 is quite low. Yours is at 42% of range, and target for FT3 is upper half to upper third of range. Furthermore, the balance of FT3 to FT4 is off. FT3 should be higher in its range than FT4 is in its, and yours is the other way around.
I could buy subclinical hyper (hyper is almost always Graves'), but secondary hypo…no...your FT4 is too high for that. TPOab and TGab are elevated with Hashimoto's thyroiditis (autoimmune hypo, which can swing hypo to hyper in early stages). To cover all the bases, they're worth testing, since contradictory as it sounds, you can have both Hashi's and Graves'. However, once again, I think your FT4 is too high and your TSH is too low to indicate Hashi's.
FT3 is the test that correlates best with symptoms. Since your FT3 is a bit low, it's consistent with your hypo symptoms.
Your FT4 is a little high, but not a concern yet. However, your FT3 is quite low. Yours is at 42% of range, and target for FT3 is upper half to upper third of range. Furthermore, the balance of FT3 to FT4 is off. FT3 should be higher in its range than FT4 is in its, and yours is the other way around.
I could buy subclinical hyper (hyper is almost always Graves'), but secondary hypo…no...your FT4 is too high for that. TPOab and TGab are elevated with Hashimoto's thyroiditis (autoimmune hypo, which can swing hypo to hyper in early stages). To cover all the bases, they're worth testing, since contradictory as it sounds, you can have both Hashi's and Graves'. However, once again, I think your FT4 is too high and your TSH is too low to indicate Hashi's.
FT3 is the test that correlates best with symptoms. Since your FT3 is a bit low, it's consistent with your hypo symptoms.
Hello. :) I would recommend having these antibodies tested for sure. A good article on this is by Jim Lowrance - "Hypothyroid & Hyperthyroid at the Same Time"...
"With Hashimoto's thyroiditis, which typically causes hypothyroidism (low thyroid hormone) some patients can have fluctuations from hypothyroid to hyperthyroid and this can be due to having high levels of thyroid antibodies.
The antibodies that are tested for, when Hashimoto's is being determined, are the anti-TPO (thyroidperoxidase) and the anti-TG (thyroglobulin) antibodies (either or both testing positive helps confirm it) however, some Hashimoto's patients also test positive for antibodies called the TSI antibodies (thyroid stimulating immunoglobulins). This antibody is what usually contributes to Grave's Disease or "autoimmune hyperthyroidism" however, some Hashimoto's patients have these antibodies as well as the TPO and/or TG ones, that typically cause Hashimoto's and is why they may experience spells of Hashitoxicosis or "intermittent hyperthyroidism". You almost could say they are suffering from Grave's and Hashimoto's, simultaneously.
Even without having the TSI antibodies present, Hashimoto's patients can potentially experience flares of thyroiditis, which can also cause mild hyperthyroid type symptoms that are not as severe as those caused by Hashitoxicosis but are still concerning.
Some patients who have both Hashimoto's and Grave's antibodies that cause continuingly unstable thyroid hormone levels are placed on a treatment called "block and replace". This is where they will block the stimulation of the thyroid with an anti-thyroid medication (slows hormone production) and then replace the patient with thyroid hormone therapy (replaces the diminished hormone levels).
Some Hashimoto's patients have been known to actually transition over to Grave's Disease, when having both types of antibodies and they become progressively hyperthyroid. Other Hashimoto's patients will have hyperthyroid phases but will still become progressively hypothyroid afterward. It may also be encouraging for patients with this condition to know that many Hashimoto's patients have the hyperthyroid spells more-so during the early onset of the disease but after time, the hyperthyroid spells subside and give way to progressive hypothyroidism."
"With Hashimoto's thyroiditis, which typically causes hypothyroidism (low thyroid hormone) some patients can have fluctuations from hypothyroid to hyperthyroid and this can be due to having high levels of thyroid antibodies.
The antibodies that are tested for, when Hashimoto's is being determined, are the anti-TPO (thyroidperoxidase) and the anti-TG (thyroglobulin) antibodies (either or both testing positive helps confirm it) however, some Hashimoto's patients also test positive for antibodies called the TSI antibodies (thyroid stimulating immunoglobulins). This antibody is what usually contributes to Grave's Disease or "autoimmune hyperthyroidism" however, some Hashimoto's patients have these antibodies as well as the TPO and/or TG ones, that typically cause Hashimoto's and is why they may experience spells of Hashitoxicosis or "intermittent hyperthyroidism". You almost could say they are suffering from Grave's and Hashimoto's, simultaneously.
Even without having the TSI antibodies present, Hashimoto's patients can potentially experience flares of thyroiditis, which can also cause mild hyperthyroid type symptoms that are not as severe as those caused by Hashitoxicosis but are still concerning.
Some patients who have both Hashimoto's and Grave's antibodies that cause continuingly unstable thyroid hormone levels are placed on a treatment called "block and replace". This is where they will block the stimulation of the thyroid with an anti-thyroid medication (slows hormone production) and then replace the patient with thyroid hormone therapy (replaces the diminished hormone levels).
Some Hashimoto's patients have been known to actually transition over to Grave's Disease, when having both types of antibodies and they become progressively hyperthyroid. Other Hashimoto's patients will have hyperthyroid phases but will still become progressively hypothyroid afterward. It may also be encouraging for patients with this condition to know that many Hashimoto's patients have the hyperthyroid spells more-so during the early onset of the disease but after time, the hyperthyroid spells subside and give way to progressive hypothyroidism."
Hi Red_Star!
To my knowledge, those were not tested. What would those tests show? This is something I should ask for, eh?
To my knowledge, those were not tested. What would those tests show? This is something I should ask for, eh?
Inflammation of the thyroid gland (thyroiditis) can be due to a number of conditions but fluctuations of hyper and hypo can be see with Hashimoto's thyroiditis. Did you have your thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) tested?
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