Thyroid trouble

[Wandall]

I have been treated for the past 17 years for hypo and the last 3 months for Hashimoto's.  I received my latest test results today and I'm more confused than ever.  My TSH is 16.46, range 0.450 - 4.500, T4 10.7, range 4.5 - 12.0 and T3 uptake 31, range 24 - 39.
I've read several posts today and am wondering if my doc is testing for free T3 and 4.  
I've been jumping through hoops for the last 3 months after learning about the hashi.  I'm on 150 mcg of levo from my reg MD and my holistic doc has me on all kinds of nutrition to fight the hashi.  My reg MD says my holistic doc is a witch doctor.
I have no energy, very dry skin, no sex drive (my poor husband) and have put on 50 lbs.  I've tried to get my reg MD to take my symptoms seriously and I try to educate myself on my condition but she just rolls her eyes at me when I try to talk to her intelligently.  She says there is no treatment for hashi except for thyroid supplements.  I'm so desperate to get my life back.  It's been years since I've felt well!

[gimel]

Please post those thyroid test results and their reference ranges.   Also if you look at this listing of typical thyroid symptoms, which ones would you say that you have had when hypo?  Did you notice any improvement when your labs were looking "pretty good"?

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

[Wandall]

Well...  A lot has happened over the last 2 weeks.  I got my test results back from my new MD.  But after discussing things we have thrown out the results.  The reason is that my "holistic" doctor put me on 2 tablets of GTA-Forte (which each contains 20 milligrams of porcine thyroid glandular) to get my 16.46 TSH down quickly so my regular MD wouldn't see the high TSH reading.  My doctor says the other doctor is practicing medicine without a license.  He was very upset.  

So, now I've quit taking the GTA-Forte (and ALL the fistfuls of supplements my holistic doc had me on) and have to wait 6 weeks for him to retest me.  Otherwise, the numbers for TSH, FT3 and FT4 came back looking pretty good!  BTW, I have never in my life seen my TSH go so high and I can only assume it was due to the "program" my holistic doc put me on.

One thing I want to tell people that have been "diagnosed" with hashimoto's.  I thought it was caused by my hypothyroidism.  This is what my holistic doc led me to believe.  The truth is, my typo was caused by hashi.  My real MD said all medical doctors know about hashi.  The ONLY treatment for it is to treat the resulting symptoms, whether you are hyper or hypo.  Unfortunately for me, this was a very expensive lesson.

[Wandall]

Thanks so much for the info, gimel.  I decided to try a new doctor that my holistic doc had recommended.  I was able to see him yesterday and took all my lab paperwork for the last 6 months with me.  He had no problem ordering the FT3 AND FT4 tests but said it will take about a week to get the results.  It sounds like he will be willing to work with me based on these results.  I will come back here and post my results when I get them.
I was taking armour thyroid for a long time but at that time had no clue what tsh, FT3 and FT4 was so I'm sure I've never been properly dosed.  I switched back to levo when the armour became hard to get.  Is cytomel  better than armour?
As for Vit D3 I take 5000 IU daily.  I also take 500 mg of magnesium twice a day and well as a B-50 supplement twice a day.  My last labs said my iron is in the normal range but it doesn't appear they tested me for the other items.  I will ask my doc to test me for those.

[gimel]

Not necessarily.  Many Endos specialize in diabetes, not thyroid.  Many also have the "Immaculate TSH Belief"  and rely predominantly on TSH as the diagnostic by which to medicate a thyroid patient.  That absolutely does not work.  Many Endos also use Reference Range Endocrinology, by which they interpret any test result within the reference range as  "normal" and adequate for the patient.  That does not work very well for many patients as well.  

As I described above a good thyroid doctor treats a patient clinically by testing and adjusting Free T3 and Free T4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels.  A good thyroid doctor is also willing to prescribe thyroid meds with T3, if necessary to increase Free T3 levels.

It is always possible that you could give some of all this info to your regular doctor and see if he might be agreeable to testing you for Free T3 and Free T4, and then treating you clinically.  Maybe a copy of the link I previously gave you might have some influence on him as well.

If you have no success with that, this is a link to a Top Thyroid Doctors site for Idaho.  Have a look through the list and see if any are near you.  You should also read the patient reviews and see if any look like good prospects for you.

http://www.thyroid-info.com/topdrs/idaho.htm

[Wandall]

Is a "thyroid" doctor an Endo?

[gimel]

I think that if the doctor is willing to treat her clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, then the decision about the medication should be between the doctor and Wandalls.  Based on my own experience I admit I am biased toward a desiccated type T4/T3 combo med.  But that is just my opinion.  Synthroid/Cytomel is certainly a viable alternative.

[Brucergoldberg]

Gimel,

If wandalls ft3 is low are you suggesting he adds cytomel in, or that he switches to some form of nt?  I'm curious.

[gimel]

I don't know of anything specially for hyper related headaches.  I'd just try the usual, something with Ibuprofen.  For allergies, the best I have found for me is Claritin, (not Claritin D).  If you have Target store, you can buy their brand of the same med for about 30% of Claritin cost.

[jmamie1]

hello ..i was just diagnosed with hyper ..i took blood work on monday and now its thursday so it seems im gonna have to call to find out my results..to see if i have graves..or hyper..or whatever..im just curious to know ..what is a good for headaches when you have thyroid disorders..please help..and what are good otc drugs to take when you have allergies..because ihavent started my treatment yet ..but i have the worse case of allergies and i suffer alot..thanks so much for the help ..

[Super_sally888]

advice above is excellent.  Please also have Vit D levels and iron/B12 tested.  These can contribute to feeling bad and tired in addition to thyroid.

[gimel]

From your test results, I'd first say that not you are not being tested for the biologically active thyroid hormones, Free T3 and Free T4.  The tests for Total T4 and T3 uptake are somewhat outdated and not very useful, by comparison.  You should go back and request testing for FT3 and FT4 and don't accept any  excuses, just insist on it and don't take no for an answer.  Remember that you are the customer suffering with the hypo symptoms.  

From those tests I also expect that you will find that your FT3 is low in the range, which is frequently associated with being hypo.  I won't get into a long discussion of why, but the ranges are far too broad.  Members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.  The reference ranges should not be considered as pass/fail, but guidelines within which to adjust levels as necessary to relieve symptoms.  

Many hypo patients taking T4 meds find that their FT3 level is low in the range, even when their FT4 level is okay.  This occurs due to inadequate conversion of T4 to T3, when taking T4 meds.  Inadequate conversion can also be associated with low levels of iron, zinc, and selenium.  So longer term you should get those tested as well.  If you haven't also been tested for Vitamin A, D, B12, and RBC magnesium, that would be a good idea also.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH.   Symptom relief should be all important, not test results.  Test results are valuable mainly as indicators during diagnosis and afterward to track FT3 and FT4 while meds are adjusted to relieve symptoms.

Short term, I suggest that you need to get those FT3 and FT4 tests done and then post results and reference ranges shown on the lab report so that members can help interpret and advise further.  You should also find out if the doctor is going to be willing to treat you clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms.  Also, find out if the doctor is going to be willing to prescribe meds other than T4 types, because with a FT3 that is low in the range as I expect, you will need to add a source of T3 to your meds.  If the doctor is not willing to do both of these, then you may as well look for a good thyroid doctor that will do so.

If you want to read more about clinical treatment, this is a good link.  It is a letter written by a good thyroid doctor for patients that he is consulting with from a distance.  It is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf