Aa
Can you help me see the problem?
Hi there. I am new to this forum. But, finally I am going to an ND and she ran blood tests, but I don't see her for two more weeks. I'm confused with my results as I have so many hypo symptoms: Weight gain, extreme fatigue, thinning hair and eye brows, loss of sex drive, swelling hands and feet, can't lose a pound no matter what program I go on, goiter and two nodules on the thyroid one on left and one on right. etc. etc... here are my results:
Tsh high sensitivity 1.74 range 0.45-4.50 mu/L
T4 Free 0.9 range 0.8-1.7 ng/dL
T3 Free 2.4 range 2.0-4.8 pg/mL
Reverse t3, LC/MS/MS 18 range 8-25 ng/dL
symptoms I don't have is cold feeling. On the contrary I am overheated most of the time. Any suggestions as to what I may here when I go in. I am terrified to hear "oh you're blood results are normal, there is nothing else to do" since that is what I have heard for the last 10 years. Thank you in advance for any thoughts you may have.
Tab
Tsh high sensitivity 1.74 range 0.45-4.50 mu/L
T4 Free 0.9 range 0.8-1.7 ng/dL
T3 Free 2.4 range 2.0-4.8 pg/mL
Reverse t3, LC/MS/MS 18 range 8-25 ng/dL
symptoms I don't have is cold feeling. On the contrary I am overheated most of the time. Any suggestions as to what I may here when I go in. I am terrified to hear "oh you're blood results are normal, there is nothing else to do" since that is what I have heard for the last 10 years. Thank you in advance for any thoughts you may have.
Tab
COMMUNITY LEADER
Hi... You Free T4 is way too low, yet and your Free T3 still has room for improvement, as well.
The recommendation (where most of us feel best) is for Free T4 to be about mid range (yours is only at 11% of range) and for Free T3 to be in the upper half to upper third of its range. While your Free T3 is at 54% of range, it can still go higher, as long as you have symptoms, but you really need to get your Free T4 up, too.
It's not really uncommon to have Free T4 low in the range when on a desiccated hormone. Many have to add a separate T4 medication in order to accomplish this. You might ask your naturopath to add a small dose of levothyroxine to your WP med.
You also need to be supplementing vitamin D, if you aren't already because your D is below the reference range and to be optimal, it needs to be about 60-70.
Both the low Free T4 and vitamin D can contribute to your weight issues, but make sure you're following a good diet and exercise routine, as well.
The recommendation (where most of us feel best) is for Free T4 to be about mid range (yours is only at 11% of range) and for Free T3 to be in the upper half to upper third of its range. While your Free T3 is at 54% of range, it can still go higher, as long as you have symptoms, but you really need to get your Free T4 up, too.
It's not really uncommon to have Free T4 low in the range when on a desiccated hormone. Many have to add a separate T4 medication in order to accomplish this. You might ask your naturopath to add a small dose of levothyroxine to your WP med.
You also need to be supplementing vitamin D, if you aren't already because your D is below the reference range and to be optimal, it needs to be about 60-70.
Both the low Free T4 and vitamin D can contribute to your weight issues, but make sure you're following a good diet and exercise routine, as well.
2 Comments
Thank you :) I am supplementing with Vit. D (50,000iu) weekly. I just read that I should be taking it in the evening with some fat to help me absorb it. I will talk to her about adding the t4. and maybe increase the WP Thyroid. I was hesitant to add to it without talking to her, but still on one grain. Thank you so much, your insight helps me talk with my Dr. so that I can get on the right course of treatment. :)
Yes, vitamin D is fat soluble and should be taken with a meal that contains fat. I'm not sure what the difference is, but I, too, have read that it should be taken with the evening meal containing fat. If you can't take it, then, though, I'd think any meal that contains fat would be sufficient, but I could be wrong...
Typically, people usually start out with a low dose of T4. Usually around 25 mcg. Talk to your doctor about it. It will take several weeks for it to reach full potential, then you should retest and you may have to increase the dosage.
You should never make more than one change at a time, such as adding the T4 and increasing your WP... a lot of people get into trouble by making multiple changes at once. Always make one change and let it take effect before making another.
Once you add the T4 med, you should get some conversion from that, so your Free T3 level may increase, as well, so you could end up over medicated if you add the T4 "and" increase you WP at the same time. Slow, but sure, is, typically, the best way to go with thyroid meds. It takes longer to get where you're going, but the risk of reaction or over medication is much less.
Typically, people usually start out with a low dose of T4. Usually around 25 mcg. Talk to your doctor about it. It will take several weeks for it to reach full potential, then you should retest and you may have to increase the dosage.
You should never make more than one change at a time, such as adding the T4 and increasing your WP... a lot of people get into trouble by making multiple changes at once. Always make one change and let it take effect before making another.
Once you add the T4 med, you should get some conversion from that, so your Free T3 level may increase, as well, so you could end up over medicated if you add the T4 "and" increase you WP at the same time. Slow, but sure, is, typically, the best way to go with thyroid meds. It takes longer to get where you're going, but the risk of reaction or over medication is much less.
Hi Barb135 I do feel somewhat better. Sleeping better and my skin isn't so dry. Nails and hair are doing well. I just got my new labs after starting the meds and this is the result:
Tsh 1.09 range is .45-4.50
T4 Free 0.9 range is 0.8-1.7
T3 free is 3.5 range is 2.0-4.8
Vit D 28.3 range is 30-100
Is it normal that my t4 didn't raise up any? I am gaining weight like crazy and swelling up like a puffer fish. I am not willing to stop my meds as I do think I have more energy, but I am not sure where to go from here. My naturopath is very willing to help me, I just need to know whats next. I don't know if they looked at the hypothalamus or not. I've gained 12 pounds in a month!
Tsh 1.09 range is .45-4.50
T4 Free 0.9 range is 0.8-1.7
T3 free is 3.5 range is 2.0-4.8
Vit D 28.3 range is 30-100
Is it normal that my t4 didn't raise up any? I am gaining weight like crazy and swelling up like a puffer fish. I am not willing to stop my meds as I do think I have more energy, but I am not sure where to go from here. My naturopath is very willing to help me, I just need to know whats next. I don't know if they looked at the hypothalamus or not. I've gained 12 pounds in a month!
COMMUNITY LEADER
Just because the MRI came back unremarkable doesn't mean it's working properly. Did they also look at the hypothalamus? That's another gland that figures into the mix.
Is the medication helping you feel better? That's really what counts...
Is the medication helping you feel better? That's really what counts...
Ok-Just got news that my MRI of the pituitary and brain are "unremarkable" I'm like thanks doc, what now. So, what else would cause this???
Hello, I just got home from my NP and she believes it's a pituitary issue as well. She is still going to treat me with thyroid (Westhroid Pure) and then I will go in for an MRI. Four years ago, my doctor in Oklahoma was advised by my eye doctor to follow up on pituitary because I had swollen optic nerves. She didn't. That's why this dr. is going straight for the MRI to check for abnormalities. I'll keep you updated as I go along. Just happy she is still going to treat me in the mean time and I am hoping it will make me feel better.
2 Comments
Thank you for letting us know how your appointment went. I'm glad your NP is going to go ahead and treat you with thyroid hormones.
Did she, also, order other pituitary tests, as well? Anyone with pituitary issues may lack any of the hormones the pituitary produces.
You might also suggest that the hypothalamus be looked into, since the hypothalamus actually tells the pituitary what to do...
What dosage of Westhroid (WP) did your doctor prescribe? Did she tell you that it's typically better to take medications with T3 in 2 smaller doses, rather than one large dose?
Please do keep us posted.
Did she, also, order other pituitary tests, as well? Anyone with pituitary issues may lack any of the hormones the pituitary produces.
You might also suggest that the hypothalamus be looked into, since the hypothalamus actually tells the pituitary what to do...
What dosage of Westhroid (WP) did your doctor prescribe? Did she tell you that it's typically better to take medications with T3 in 2 smaller doses, rather than one large dose?
Please do keep us posted.
She started me on one grain. No, she didn't say to separate the dose, but I will if I should? How far apart in dosing? She isn't running the other tests yet. She wants to see if there is a tumor first since my other dr. had let it go for four years. I think her line of reasoning is that if there is a tumor, I will have to see a specialist and then go from there, but she would continue to treat me. She did run another test for DHEA because mine was high in the saliva test. That was a concern for her, but she also said that if my pituitary isn't working correctly, it could raise my DHEA also.
COMMUNITY LEADER
Please be sure to let us know how your appointment goes and don't be afraid to ask further questions, if you have them between now and your appointment.
1 Comments
I will and thank you.
COMMUNITY LEADER
Yes, your antibody levels are in the normal ranges, indicating that you don't have Hashimoto's. That leaves a pretty strong argument for Central, also called Secondary, hypothyroidism.
You can go ahead and see an eye doctor, but I'm not sure that a pituitary issue of this nature would cause eye problems. It wouldn't hurt to make sure.
You will want your doctor to order other pituitary hormone tests though, because if there isn't enough TSH to stimulate the thyroid, there's a good chance there aren't enough other pituitary hormones to do their jobs either...
You'll want to get prolactin, FSH, Luteinizing hormone, Growth Hormone, ACTH, etc because these affect female and adrenal hormones, as well, and can be responsible for many symptoms, too.
Your ND should be willing to order these tests.
You can go ahead and see an eye doctor, but I'm not sure that a pituitary issue of this nature would cause eye problems. It wouldn't hurt to make sure.
You will want your doctor to order other pituitary hormone tests though, because if there isn't enough TSH to stimulate the thyroid, there's a good chance there aren't enough other pituitary hormones to do their jobs either...
You'll want to get prolactin, FSH, Luteinizing hormone, Growth Hormone, ACTH, etc because these affect female and adrenal hormones, as well, and can be responsible for many symptoms, too.
Your ND should be willing to order these tests.
1 Comments
Thank you! At least I feel like I am on the right track now. I appreciate your help. I will write down the tests and ask her about them.
COMMUNITY LEADER
Hi and welcome to the forum... Well, your results are "normal", but normal doesn't mean adequate and it's certainly easy to see why you have symptoms of hypothyroidism... Both your Free T4 and Free T3 are on the floor of the ranges.
It's, typically, recommended that Free T4 be about the mid range point; yours is only at 11% of its range. It's also recommended that Free T3 be in the upper half to upper third of its range and yours is only at 14% of its range. You have a long way to go to get both of them where they need to be.
With your thyroid hormone levels being as low as they are, we'd expect your TSH to be higher than it is, since the pituitary produces TSH to stimulate the thyroid when thyroid hormones are low. It would appear that your thyroid might working just fine and the actual problem might be in the pituitary/hypothalamus axis, in which there isn't enough TSH to stimulate the thyroid. If the ND you're seeing is a good thyroid doctor, they will recognize this.
No matter what the cause of hypothyroidism, it's still hypothyroidism and must be treated with replacement hormones. The goal is to alleviate symptoms and a good doctor will do just that...
Have you had any thyroid antibody tests done to rule out Hashimoto's Thyroiditis?
It's, typically, recommended that Free T4 be about the mid range point; yours is only at 11% of its range. It's also recommended that Free T3 be in the upper half to upper third of its range and yours is only at 14% of its range. You have a long way to go to get both of them where they need to be.
With your thyroid hormone levels being as low as they are, we'd expect your TSH to be higher than it is, since the pituitary produces TSH to stimulate the thyroid when thyroid hormones are low. It would appear that your thyroid might working just fine and the actual problem might be in the pituitary/hypothalamus axis, in which there isn't enough TSH to stimulate the thyroid. If the ND you're seeing is a good thyroid doctor, they will recognize this.
No matter what the cause of hypothyroidism, it's still hypothyroidism and must be treated with replacement hormones. The goal is to alleviate symptoms and a good doctor will do just that...
Have you had any thyroid antibody tests done to rule out Hashimoto's Thyroiditis?
1 Comments
Thank you. Yes, I forgot to put that on there. My TPO said <10 range is <34 and the Thyroglobulin Anitbodies said <20 with a range of <40 so I am guessing that is normal? I was concerned about the Pituitary because I have had vision issues as well. Should I see an eye doctor as well?
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