Aa
Dr reluctant to medicate
Sent by Katharineparr 42 minutes
Hi I have had hypothyroid symptoms for 3 yrs with varying low t3 and t4 levels plus positive ANA at 1.40 (testing for lupus).
My dr says my levels are not serious to warrant meds. If I post my exact results, could someone advise pls? Many thanks in advance.
Hi I have had hypothyroid symptoms for 3 yrs with varying low t3 and t4 levels plus positive ANA at 1.40 (testing for lupus).
My dr says my levels are not serious to warrant meds. If I post my exact results, could someone advise pls? Many thanks in advance.
I think I need t check on the coeliac diagnosis. Sounds odd I know, but I was definately told I was borderline..I believe I still have the report I'll check it out. I'll also look into vitamin a with regards to diet and supplements.
Thanks very much again red star.
Thanks very much again red star.
I had vitamin D resistance due to severe magnesium deficiency. Malabsorption is the primary reason for vitamin D deficiency in Celiac disease (which is likely you have this autoimmune disease).
I have had very poor healing (4 months for a cut to heal) which i found improved a lot when i corrected my vitamin B12 levels. I've had acne due to hypothyroidism (i believe this may be due to poor conversion of beta carotene into vitamin A). Malabsorption of vitamin A sounds a likely reason for facial cysts.
"People with severe cystic acne, the type for which Accutane is typically prescribed, are often told that they have no alternative to taking Accutane if they want to cure their acne. Truth be told, the active ingredient in Accutane is simply a synthetic form of vitamin A. Rather than take the synthetic form, acne sufferers would be better off researching natural, carotene forms of vitamin A that are safe and non-toxic." - Accutane acne drug dangerous for your health?
I have had very poor healing (4 months for a cut to heal) which i found improved a lot when i corrected my vitamin B12 levels. I've had acne due to hypothyroidism (i believe this may be due to poor conversion of beta carotene into vitamin A). Malabsorption of vitamin A sounds a likely reason for facial cysts.
"People with severe cystic acne, the type for which Accutane is typically prescribed, are often told that they have no alternative to taking Accutane if they want to cure their acne. Truth be told, the active ingredient in Accutane is simply a synthetic form of vitamin A. Rather than take the synthetic form, acne sufferers would be better off researching natural, carotene forms of vitamin A that are safe and non-toxic." - Accutane acne drug dangerous for your health?
Thanks red star, I am low in b12 and v low in vitamin d ( dr gave me some weekly high doses for now of D) and the sub-lingual route is a good suggestion, thanks.
If my bloods show that the vitamin D level hasn't risen, is that significant in any way that you know of?
I have had slow to heal (even with antibiotics) facial cysts which are the deep and scarring type also, is this something you've had experience of?
If my bloods show that the vitamin D level hasn't risen, is that significant in any way that you know of?
I have had slow to heal (even with antibiotics) facial cysts which are the deep and scarring type also, is this something you've had experience of?
My lab is called QML pathology. I live in Queensland, Australia. I have three autoimmune diseases and my ANA states negative (as i mentioned, QML considers anything under 1:80 as negative). I have read one study that found 47% of Hashimoto's thyroiditis patients had a positive ANA. 60% of those with a positive ANA showed a titer of 1:40. So the ANA needs to be assessed along with other symptoms.
It is possible to take megadoses of a vitamin or mineral and a small % be absorbed if you have absorption issues. This also depends on how bad the absorption is however. An example is the FDA warning for PPI's (proton pump inhibitors which lower stomach acid). In about 25% of cases reviewed, magnesium supplements alone did not sufficiently raise low magnesium levels and the PPI needed to be discontinued.
You can bypass the gut using sublingual (under the tongue) products. I use sublingual vitamin B12 spray for autoimmune pernicious anaemia.
It is possible to take megadoses of a vitamin or mineral and a small % be absorbed if you have absorption issues. This also depends on how bad the absorption is however. An example is the FDA warning for PPI's (proton pump inhibitors which lower stomach acid). In about 25% of cases reviewed, magnesium supplements alone did not sufficiently raise low magnesium levels and the PPI needed to be discontinued.
You can bypass the gut using sublingual (under the tongue) products. I use sublingual vitamin B12 spray for autoimmune pernicious anaemia.
Ok thanks Red Star. What does QML refer to? Tried googling..
And I presume you're saying noT everyone is healthy with a low positive Ana.
Sounds like a silly question, but if you have poor absorption of vitamins in food, I presume no amount of supplements would change that...
And I presume you're saying noT everyone is healthy with a low positive Ana.
Sounds like a silly question, but if you have poor absorption of vitamins in food, I presume no amount of supplements would change that...
I would prefer QML to measure low positive ANA. No everyone is healthy with low positive ANA. I did read a medical article stating "False positive ANA tests may be found in patients with untreated celiac disease." Interesting. Poor wound healing can be due to numerous factors but includes low protein and vitamin and mineral deficiencies. Medscape states the presence in TgAb without TPOAb is not sufficient to establish the diagnosis of Hashimoto's thyroiditis.
Thanks redstar. So if I'm looking for physiological evidence of hashis, the TGab isn't 100% proof. A hypothyroid diagnosis is based purely on the culmination of symptoms and Blood thyroid levels, of which mine do not appear to be evidence enough.
Not to say I want to be diagnosed with hypothyroidism, but my feeling is that the mono findings don't explain the constant symptoms of the last few years.
I feel as though I'm pretty much running on empty hence the mono reactivation; my system isn't very strong, even scratches, blemishes etc take forever to heal.
If I haven't grasped your posts fully in any way,please do let me know..this is all very new to me.
Not to say I want to be diagnosed with hypothyroidism, but my feeling is that the mono findings don't explain the constant symptoms of the last few years.
I feel as though I'm pretty much running on empty hence the mono reactivation; my system isn't very strong, even scratches, blemishes etc take forever to heal.
If I haven't grasped your posts fully in any way,please do let me know..this is all very new to me.
A 1:40 titer is stated to be the lowest positive. My lab (QML) states under an ANA under 1:80 is negative so they doesn't bother with low positive results. The reason being that about 25% to 30% of healthy people have a positive test with a titer of 1:40, 10% to 15% at a titer of 1:80, and 5% at a titer of 1:160 or greater.
The vast majority with Hashimoto's thyroiditis will show high thyroid peroxidase antibodies (TPOAb) but there may also be thyroglobulin antibodies (TgAb) present as well.
TgAb antibodies are more likely to appear after thyroid gland swelling (inflammation) or injury. My TgAb has dropped back to normal levels again. In a small percentage of Hashimoto's thyroiditis cases, thyroid antibodies are negative. The study "Seronegative Hashimoto thyroiditis with thyroid autoantibody production localized to the thyroid" concludes...
"These studies show that lymphocytes capable of producing antithyroid antibodies can be present in the thyroid glands of patients with Hashimoto disease without evidence of a peripheral immune response, thus indicating that Hashimoto disease can exist as an organ-restricted autoimmune disorder." - Ann Intern Med. 1988 Jan;108(1):26-30.
The vast majority with Hashimoto's thyroiditis will show high thyroid peroxidase antibodies (TPOAb) but there may also be thyroglobulin antibodies (TgAb) present as well.
TgAb antibodies are more likely to appear after thyroid gland swelling (inflammation) or injury. My TgAb has dropped back to normal levels again. In a small percentage of Hashimoto's thyroiditis cases, thyroid antibodies are negative. The study "Seronegative Hashimoto thyroiditis with thyroid autoantibody production localized to the thyroid" concludes...
"These studies show that lymphocytes capable of producing antithyroid antibodies can be present in the thyroid glands of patients with Hashimoto disease without evidence of a peripheral immune response, thus indicating that Hashimoto disease can exist as an organ-restricted autoimmune disorder." - Ann Intern Med. 1988 Jan;108(1):26-30.
With Hashi's, it usually always shows as positive on either or both of those tests. I think any other result would be a rarity.
I understand how things work in a small community, but I see no reason for avoiding having a discussion with your doctor about information at variance with some of his conclusions. You can mention the existence of info that seems to point that the ranges are too broad, because of the way they were established, and that patients in the low end of the ranges often find they have hypo symptoms as a result.
If you want, I can provide you some further info that you can give the doctor, and request a trial of meds to raise your Free T3 and Free T4 levels and monitor the effect on your symptoms. You should also mention the possibility of having secondary hypothyroidism, due to a pituitary issue causing low in the range TSH, in the face of very low in the range FT3 and FT4.
Again, are you located in the UK, or Canada, or Australia?
I understand how things work in a small community, but I see no reason for avoiding having a discussion with your doctor about information at variance with some of his conclusions. You can mention the existence of info that seems to point that the ranges are too broad, because of the way they were established, and that patients in the low end of the ranges often find they have hypo symptoms as a result.
If you want, I can provide you some further info that you can give the doctor, and request a trial of meds to raise your Free T3 and Free T4 levels and monitor the effect on your symptoms. You should also mention the possibility of having secondary hypothyroidism, due to a pituitary issue causing low in the range TSH, in the face of very low in the range FT3 and FT4.
Again, are you located in the UK, or Canada, or Australia?
Thanks gimel. Being in a small community has its disadvantages with regard to referrals and second opinions- is that what you were getting at?
One more thing- in the case of Hashis, would you always have a positive TPOab and TGab result?
One more thing- in the case of Hashis, would you always have a positive TPOab and TGab result?
Hi Gimel, thanks for your post. I did read the letter that you sent me the link to, it was very interesting. I haven't heard back re the Ana results to see if they were still positive, although this is something not uncommonly found apparantly with mono as well as hypothyroid sufferers..
I will try on Monday to suggest the TPOab and TGab again (and not RT3 and FT3?) and see if there is willing.
I could print the letter and take it in but not sure that wouldn't cause bad feeling which is better to avoid for my own sake.
Yes, It is a very small community (I can pm you if I can work out how)
I am so so exhausted - oh for some energy!
I will try on Monday to suggest the TPOab and TGab again (and not RT3 and FT3?) and see if there is willing.
I could print the letter and take it in but not sure that wouldn't cause bad feeling which is better to avoid for my own sake.
Yes, It is a very small community (I can pm you if I can work out how)
I am so so exhausted - oh for some energy!
Judging by your symptoms and your low in the range levels of Free T3 and Free T4, your doctor is wrong in assuring you that you are not hypothyroid.
Have you had a chance to read the link I gave you just above? Also, what about the question regarding where you are located?
Have you had a chance to read the link I gave you just above? Also, what about the question regarding where you are located?
I think my dr may have been testing my ESR for evidence of lupus perhaps after my positive ANA?
Whatever I have that is causing my symptoms and Positive ANA, it is pretty constant and I am not sure that mono causes constant symptoms....
Nothing in the bloods i have had have ruled out hypothyroidism, however, perhaps my system is generally struggling causing the mono to reactivate...?
Thank you again so much. I seem to be looking for something else because my dr assures my I'm not hypothyroid..
Whatever I have that is causing my symptoms and Positive ANA, it is pretty constant and I am not sure that mono causes constant symptoms....
Nothing in the bloods i have had have ruled out hypothyroidism, however, perhaps my system is generally struggling causing the mono to reactivate...?
Thank you again so much. I seem to be looking for something else because my dr assures my I'm not hypothyroid..
ESR and RF are not needed for a diagnosis of hypothyroidism. However, ESR may be elevated due to many conditions including thyroid disease.
95% of adults have been infected with EBV. EBV can reactivate at any time but usually there are no symptoms. If you have symptoms of glandular fever/mono they are flu like symptoms including sore throat, low grade fever, fatigue, malaise, swollen lymph nodes (especially neck glands), poor appetite.
95% of adults have been infected with EBV. EBV can reactivate at any time but usually there are no symptoms. If you have symptoms of glandular fever/mono they are flu like symptoms including sore throat, low grade fever, fatigue, malaise, swollen lymph nodes (especially neck glands), poor appetite.
As you posted above.
May 2013
T4 5.42 (5.53-11.0) flagged Low
Ft3 2.89 (2.77-5.27)
TSH 1.350 (0.465-4.680)
Ft4 (0.83 (0.78-2.19)
You were told it would do harm to medicate for hypothyroid symptoms when you have normal bloods. First, that is not really true. If you got no improvement from a therapeutic trial of thyroid med, you could stop and there would be no permanent effect on your body. Second, I don't read your results as "normal". I wondered if you have a pituitary/hypothalamus issue that is causing your TSH to remain relatively low, even though your Free T3 and free T4 are very low in their ranges. And, by the way, those ranges are far too broad because of the way they were established. Functional ranges for healthy adults wold look more like the upper half of the listed ranges.
So I think your doctor is looking at your TSH, and overlooking everything else, such as the low levels of FT3 and FT4 and your symptoms. A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
From the way you referred to your test results, I wondered if you are located in the UK, Canada, or Australia?
May 2013
T4 5.42 (5.53-11.0) flagged Low
Ft3 2.89 (2.77-5.27)
TSH 1.350 (0.465-4.680)
Ft4 (0.83 (0.78-2.19)
You were told it would do harm to medicate for hypothyroid symptoms when you have normal bloods. First, that is not really true. If you got no improvement from a therapeutic trial of thyroid med, you could stop and there would be no permanent effect on your body. Second, I don't read your results as "normal". I wondered if you have a pituitary/hypothalamus issue that is causing your TSH to remain relatively low, even though your Free T3 and free T4 are very low in their ranges. And, by the way, those ranges are far too broad because of the way they were established. Functional ranges for healthy adults wold look more like the upper half of the listed ranges.
So I think your doctor is looking at your TSH, and overlooking everything else, such as the low levels of FT3 and FT4 and your symptoms. A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
From the way you referred to your test results, I wondered if you are located in the UK, Canada, or Australia?
Sorry, there was an autocorrect- "deactivation" should read "reactivation".
Thanks so much again.
Thanks so much again.
Hi again. Further to my last post I saw my doctor to discuss the blood tests I had to investigate the positive ANA.
The follow up ANA is not back yet (unsure as to whether it was indeed done)
The Lymes Disease was negative.
I had an Epstein Barr virus evaluation which has 'infection' in small letters on it and I was told the markers show that I had it in the past and its a deactivation.
EBV nuclear antigen igg antibodies >=1.80 ref range <1:5
As I say, I didn't find it easy to read..nor the following...
Rheumatoid factor <8.6 Negative <12 normal Units iu/ml
ESR was 3.0 mm/hr <20.0
Does this have any bearing on hypothyroid diagnosis?
I was told that this was good news as now we know why I had a positive ana and hypo symptoms but does mono make you feel like this all of the time? I do have bad flares when I feel worse but the symptoms are always there...
I was also told that it would do harm to medicate for hypothyroid symptoms when I have normal bloods.
I did ask for the TPOab and TGab also RT3 and FT3, as suggested, I hope that was the right thing to do.
If you have the time please let me know your thoughts on this progression (?).
Many thanks again.
The follow up ANA is not back yet (unsure as to whether it was indeed done)
The Lymes Disease was negative.
I had an Epstein Barr virus evaluation which has 'infection' in small letters on it and I was told the markers show that I had it in the past and its a deactivation.
EBV nuclear antigen igg antibodies >=1.80 ref range <1:5
As I say, I didn't find it easy to read..nor the following...
Rheumatoid factor <8.6 Negative <12 normal Units iu/ml
ESR was 3.0 mm/hr <20.0
Does this have any bearing on hypothyroid diagnosis?
I was told that this was good news as now we know why I had a positive ana and hypo symptoms but does mono make you feel like this all of the time? I do have bad flares when I feel worse but the symptoms are always there...
I was also told that it would do harm to medicate for hypothyroid symptoms when I have normal bloods.
I did ask for the TPOab and TGab also RT3 and FT3, as suggested, I hope that was the right thing to do.
If you have the time please let me know your thoughts on this progression (?).
Many thanks again.
For your discussion with the doctor, you might be able to make good use of this link, written by a good thyroid doctor.
http://hormonerestoration.com/files/ThyroidPMD.pdf
http://hormonerestoration.com/files/ThyroidPMD.pdf
Ok it's going to take me a while to absorb (ha ha) all of your information, but I would just like to take the time to say how incredibly grateful I am to you all for taking the time to consider my situation. I have never used a forum before but desperation drew me to it as a last resort.
I just wanted to say thank you all so much. Just to know I'm not considered a time waster is invaluable.
Thanks guys.
I now need to consider how to approach my doctor further.
All the best and thanks again. I'll let you know how I make out and any more advice, I am grateful for, should you have any more thoughts.
I just wanted to say thank you all so much. Just to know I'm not considered a time waster is invaluable.
Thanks guys.
I now need to consider how to approach my doctor further.
All the best and thanks again. I'll let you know how I make out and any more advice, I am grateful for, should you have any more thoughts.
Thought i might fill in the blank wandering past :) ESS can be due to malabsorption syndromes (failure of normal intestinal absorption). Examples: Celiac disease, inflammatory bowel syndrome.
A good question. I think ESS for acute severe illnesses and CSS (Chronic Sick Syndrome) for chronic diseases. How about that? :P
Okay, blank it is!
"The body begins to make a type of thyroid hormone (reverse T3) that shuts the body down…to hibernate."
My point exactly. RT3 production increases when the body needs to scale back metabolism a little in response to (mostly) acute diseases, trauma, surgery, etc. It's actually more like torporing than hibernating (picky, picky).
So, do we really have a separate syndrome here, or are we looking at a "normal" (in the face of abnormality) bodily response?
"The body begins to make a type of thyroid hormone (reverse T3) that shuts the body down…to hibernate."
My point exactly. RT3 production increases when the body needs to scale back metabolism a little in response to (mostly) acute diseases, trauma, surgery, etc. It's actually more like torporing than hibernating (picky, picky).
So, do we really have a separate syndrome here, or are we looking at a "normal" (in the face of abnormality) bodily response?
_______ is the answer. LOL. I'm no expert on the subject but i did find this article which is interesting...
"Sick Euthyroid Syndrome (SES): a medical condition (not disease) where the patient exhibits many symptoms of hypothyroidism – fatigue, weight gain, insomnia, dry skin, depression, anxiety, decreased memory/concentration, low libido, muscle pain, etc – and yet have normal or low/normal levels of throid stimulating hormone (TSH), T3 and T4. (Dr. Massey video on SES, click here)
SES is the result of more stress than the body can handle and the body is trying to conserve resources. The body begins to make a type of thyroid hormone (reverse T3) that shuts the body down…to hibernate.
Most physicians do not believe that SES exists outside of the intensive care unit and that it is rare in the general public. However, recent medical research has demonstrated that symptoms of sick euthyroid syndrome is often found in patients with stressful, chronic illnesses such as cancer, diabetes and heart disease….if you look for it. Dr. Massey has also diagnosed SES in patients with severe, chronic stress without other diseases. Treating SES can restore energy and vitality. By definition, patients with SES also have adrenal fatigue.
There is no traditional medical therapy for sick euthyroid syndrome. However, integrative medicine combines the best of traditional medicine and complementary and alternative medicine…and has a solution. SES is not a disease and therapy is not a life-long process. Most patients with sick euthyroid syndrome, if properly treated, do very well in the short and long term.
ALT-MED integrative medicine approach it tailored to the specific patient and may include the following:
Tests to confirm SES and adrenal fatigue
Specific thyroid medication – short term
Specific supplements to help with adrenal function and stress
Intravenous vitamins
Lifestyle changes
Energy medicine to reduce stress and balance energy flow
Acupuncture to reduce stress, increase energy
Massage therapy to reduce stress, increase “relaxation” hormones"
Alt Med - Sick Euthyroid Syndrome
"Sick Euthyroid Syndrome (SES): a medical condition (not disease) where the patient exhibits many symptoms of hypothyroidism – fatigue, weight gain, insomnia, dry skin, depression, anxiety, decreased memory/concentration, low libido, muscle pain, etc – and yet have normal or low/normal levels of throid stimulating hormone (TSH), T3 and T4. (Dr. Massey video on SES, click here)
SES is the result of more stress than the body can handle and the body is trying to conserve resources. The body begins to make a type of thyroid hormone (reverse T3) that shuts the body down…to hibernate.
Most physicians do not believe that SES exists outside of the intensive care unit and that it is rare in the general public. However, recent medical research has demonstrated that symptoms of sick euthyroid syndrome is often found in patients with stressful, chronic illnesses such as cancer, diabetes and heart disease….if you look for it. Dr. Massey has also diagnosed SES in patients with severe, chronic stress without other diseases. Treating SES can restore energy and vitality. By definition, patients with SES also have adrenal fatigue.
There is no traditional medical therapy for sick euthyroid syndrome. However, integrative medicine combines the best of traditional medicine and complementary and alternative medicine…and has a solution. SES is not a disease and therapy is not a life-long process. Most patients with sick euthyroid syndrome, if properly treated, do very well in the short and long term.
ALT-MED integrative medicine approach it tailored to the specific patient and may include the following:
Tests to confirm SES and adrenal fatigue
Specific thyroid medication – short term
Specific supplements to help with adrenal function and stress
Intravenous vitamins
Lifestyle changes
Energy medicine to reduce stress and balance energy flow
Acupuncture to reduce stress, increase energy
Massage therapy to reduce stress, increase “relaxation” hormones"
Alt Med - Sick Euthyroid Syndrome
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