Does this seem right? New to this! Help

[MarieNic]

My daughter, 23 yr, had bloodwork done and was diagnosed with a Hyperthyroid. All the work came back normal except the  TSH, 3rd GENERATION...it was 6.57 H   Reference Range: 0,40 - 4.50 mU/L

The PCP prescribed Synthroid  (sp)  .25mg.  Im confused because I thought THAT was given for a HYPO thyroid!

Her T4, FREE is 1.1  Reference Range:  0.8  -1.8 NG/DL

She has hair loss in a quarter or more size on her crown, which prompted this bloodwork. Also, fatigue, heart palpitations, some finger tingling, leg cramps...

She is seeing a dermatologist on Dec 8 and her gyne on Dec 21..also. We are new to this and should I get her in to see an Endocrinologist also? I just want the best right now.

She has ALWAYS been heathly, no problems. She just started as a new RN Nurse with rotating shifts since June so she is adjusting to THAT as well...

Any information will be so appreciated!
thank u!  

[goolarra]

Yes, high TSH indicates hypo (LOW thyroid hormones) and low TSH indicates hyper (HIGH thyroid hormones).

TSH is a pituitary hormone.  The pituitary puts out TSH (thyroid stimulating hormone) to stimulate the thyroid to produce T3 and T4.  When the pituitary senses T3 and/or T4 levels getting too low, it puts out more TSH and vice versa.  Because TSH is a pituitary hormone, it can be affected by many issues besides T3 and T4 levels (like pituitary and hypothalmus issues, among others).  Therefore, TSH is not the most reliable indicator of thyroid status.  FT3 and FT4 tests measure the levels of T3 and T4 actually available to your body.  FT3 and FT4 are the key to diagnosing and treating thyroid conditions.

Stella's right...the entire endocrine system is interrelated.  So, any endocrine hormone can affect the others, e.g. reproductive hormones can effect thyroid hormones and vice versa.

Best of luck in sorting this out.      

[stella5349]

I wrote back to you and I see now she is one birthcontrol. TAHT could be the issue - along with stress on why she failed the test. See the lab work above for proper testing.

[MarieNic]

Thank you so much for the information! Its so confusing when your trying to figure out all of this!  I want to go back to the PCP and have her discuss these with us. So your saying that if your TSH is HIGH is actually hypo? She is also on birthcontrol Sprintec!

[goolarra]

Your daughter is hypOthyroid, not hyper.  Her TSH is above range (TSH is counterintuitive - high TSH indicates hypo, low hyper), and her FT4 is in the very low part of the range, both indicating hypo.  You are correct, Synthroid is used to treat hypo.  Her symptoms are also typical of hypo.  

The choice of whether to see an endo is a personal one.  A PCP can manage many thyroid conditions if he is well-informed regarding thyroid.  On the other hand, many endos are only interested in diabetes, so seeing an endo doesn't necessarily guarantee a thydoid expert.  Hypothyroid is usually a life-long condition, so it is best to find someone who is competent in managing the disease and with whom you can work well.  

Hairloss is a symptom of hypo.  Once on a proper, therapeutic dose of thyroid meds, hair will grow back.  Make sure both her derma and ob/gyn know that she has just begun thyroid treatment and the meds have not yet had sufficient time to work.  Both doctors should want to see what happens once thyroid levels are corrected before pursuing any symptoms that could be thyroid-related.  

Next time you have bloodwork, ask for FT3 as well as FT4 and TSH.  It is the most biologically active of the thyroid hormones and the one that correlates best with symptoms.