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Help with Hypo an Hyper Symptoms
Hi, I was wondering if anyone might be able to help me with, what is suspect, is an autoimmune mediated thyroid disorder. I have been having symptoms of both Hypo and Hyper for years (Extreme heat intolerance, extreme fatigue, weight gain, intestinal upset, edema, quickly elevating cholesterol with no dietary change, resting sudden and persistent resting tachycardia, sweating, extreme sleep disturbances, elevated BP, chronically low vitamin D for which I take 50,000iu x 3 weekly, brain fog (I can’t remember simple things or, often, what happened moments ago and become agitated when trying, the list truly goes on). I should add that I have SLE (Systemic Lupus). I have been trying to get symptoms under control by treating what is believed to be the underlying cause; however, I have had a growing suspicion that I didn't have just one problem, but rather multiple issues that all require treatment for symptom relief.
Recently, the doctor order a thyroid profile (FT4 1.04 [.89-1.76], Total T3 1.44 [.6-1.81], and TSH .34 [.5-2.5]
Obviously my TSH gave me pause (especially in faced with such normal FT4 and Total T3). Given my existing autoimmune disease, I was thinking the beginning of Hashi or Central (I also have empty sella with suppressed gonadotropins for which I take Testosterone Replacement Therapy, and transient mild prolactin elevation.
This past Monday, by BP starting to rise, it felt as if my heart was going to jump out of my chest, my hands began to shake, breathing became difficult (I would describe it as if my blood suddenly became too thin to carry oxygenated blood). This lasted for 36 hours. Since my doctors don’t really believe this is a thyroid issue, I paid out of pocket to have a profile done with Labcorp. The results are below:
FT4 1.08 [.82-1.72] ng/dl
FT3 4.3 [ 2.0-4.4] pg/ml
TSH .374 [.450-4.50] uIU/ml
TPO 6 [0-34]
TAA 1:5###)
Recently, the doctor order a thyroid profile (FT4 1.04 [.89-1.76], Total T3 1.44 [.6-1.81], and TSH .34 [.5-2.5]
Obviously my TSH gave me pause (especially in faced with such normal FT4 and Total T3). Given my existing autoimmune disease, I was thinking the beginning of Hashi or Central (I also have empty sella with suppressed gonadotropins for which I take Testosterone Replacement Therapy, and transient mild prolactin elevation.
This past Monday, by BP starting to rise, it felt as if my heart was going to jump out of my chest, my hands began to shake, breathing became difficult (I would describe it as if my blood suddenly became too thin to carry oxygenated blood). This lasted for 36 hours. Since my doctors don’t really believe this is a thyroid issue, I paid out of pocket to have a profile done with Labcorp. The results are below:
FT4 1.08 [.82-1.72] ng/dl
FT3 4.3 [ 2.0-4.4] pg/ml
TSH .374 [.450-4.50] uIU/ml
TPO 6 [0-34]
TAA 1:5###)
COMMUNITY LEADER
Just to put your mind at ease, we don't have a delete or edit feature and we all make mistakes, so don't let them bother you... LOL
Thank you for clarifying. Just so you know... TPO is an enzyme from which thyroid hormones are produced. TPOab are the antibodies that attack TPO. I figured the test you had that was labeled TPO was really TPOab because that's what LabCorp calls it and I've never seen a test for actual TPO.
I wasn't sure about the TAA, however, because we aren't used to seeing that in place of the TgAb. There is a test for Thyroglobulin (Tg) and a separate test for TgAb, so I'm not sure if the result means Thyroglobulin (Tg) is < 1 or the TgAb is < 1. It's probably the TgAb, but you might want to clarify that with the lab, just to be sure.
At this point, it doesn't look like you have an autoimmune thyroid disorder, unless you have Graves Disease, which you won't know unless you have the TSI test. That test is based on a percentage rather than a flat result.
Your Ferritin is good, so no worry there. Your B-12 is in range, but on the low side and could use supplementation. Anything below 500 can cause symptoms of deficiency... fatigue and brain fog are most common... I have to keep my level at the very top of the range (my lab uses a range of 200-1100) in order to keep symptoms at bay.
Once you get your ultrasound report, you can post it and we can see what it says, though I'm not an expert at reading those.
Have you had vitamin D tested? Adequate vitamin D is also necessary for proper thyroid hormone synthesis.
Thank you for clarifying. Just so you know... TPO is an enzyme from which thyroid hormones are produced. TPOab are the antibodies that attack TPO. I figured the test you had that was labeled TPO was really TPOab because that's what LabCorp calls it and I've never seen a test for actual TPO.
I wasn't sure about the TAA, however, because we aren't used to seeing that in place of the TgAb. There is a test for Thyroglobulin (Tg) and a separate test for TgAb, so I'm not sure if the result means Thyroglobulin (Tg) is < 1 or the TgAb is < 1. It's probably the TgAb, but you might want to clarify that with the lab, just to be sure.
At this point, it doesn't look like you have an autoimmune thyroid disorder, unless you have Graves Disease, which you won't know unless you have the TSI test. That test is based on a percentage rather than a flat result.
Your Ferritin is good, so no worry there. Your B-12 is in range, but on the low side and could use supplementation. Anything below 500 can cause symptoms of deficiency... fatigue and brain fog are most common... I have to keep my level at the very top of the range (my lab uses a range of 200-1100) in order to keep symptoms at bay.
Once you get your ultrasound report, you can post it and we can see what it says, though I'm not an expert at reading those.
Have you had vitamin D tested? Adequate vitamin D is also necessary for proper thyroid hormone synthesis.
Barb,
Thanks for the replies. I'm sorry about the repost. I saw several errors in the original that were driving me crazy, and I can't find a way to delete or edit.
Are the TgAB and TPOab somehow different than the TPO (Thyroid Peroxidase) and TAA (Thyroglobulin With Antithyroglobulin Antibody) that I've already had performed? The labcorp website makes them all seem the same.
As for my labs:
Ferritin 202 [22-340]ng/ml
B12 418 [211-911] pg/nl
I have already had a thyroid ultrasound.I am waiting on the results. The doctor tried to email them yesterday, but he not not the most tech savvy. I was holding on the TSI because of the cost (and because I didn't think it could come back as a Graves' possibility). I will add that to my list.
Thanks for the response, and I will keep the information posted.
Thanks for the replies. I'm sorry about the repost. I saw several errors in the original that were driving me crazy, and I can't find a way to delete or edit.
Are the TgAB and TPOab somehow different than the TPO (Thyroid Peroxidase) and TAA (Thyroglobulin With Antithyroglobulin Antibody) that I've already had performed? The labcorp website makes them all seem the same.
As for my labs:
Ferritin 202 [22-340]ng/ml
B12 418 [211-911] pg/nl
I have already had a thyroid ultrasound.I am waiting on the results. The doctor tried to email them yesterday, but he not not the most tech savvy. I was holding on the TSI because of the cost (and because I didn't think it could come back as a Graves' possibility). I will add that to my list.
Thanks for the response, and I will keep the information posted.
COMMUNITY LEADER
It isn't necessary to repost if someone doesn't respond right away... we aren't online all the time to comment as soon a question is posted, but we do answer as soon as possible...
When you had your own thyroid labs done, you should have had a Thyrogolobulin Antibodies test TgAb, along with the TPOab that you had done. Both are markers for Hashimoto's and some of us have one or the other, some have both, so without them both, you can miss the diagnosis.
In addition, you should also have had a Thyroid Stimulating Immunoglobulin (TSI) test, which is the definitive test for Graves Disease.
Your low TSH and high FT3 (88% of its range) would indicate hyperthyroidism, but your FT4 is only at 28% of its range, which is a contradiction and could indicate central hypothyroidism, which is not autoimmune. Central hypothyroidism is an issue in the pituitary/hypothalamus axis.
Another possibility is a thyroid nodule that's dumping T3 into your system independently of the thyroid. You might ask for a thyroid ultrasound to see if this is a possibility.
Another possible autoimmune that can cause brain fog and extreme fatigue is pernicious anemia. PA is an inability to absorb vitamin B-12 via the gut. There are also causes for B-12 deficiency, other than PA, such as inadequate intake. Many vegetarians/vegans are deficient, since B-12 only comes from animal sources. But it would be to your benefit to get B-12 levels tested as many people with thyroid like symptoms are deficient in B-12.
You should also get ferritin tested. Ferritin is the iron storage hormone and iron is necessary for thyroid hormone synthesis and conversion of FT4 to FT3 (which doesn't seem to be an issue for you).
Your high FT3 level could very well explain the trembling and difficulty breathing.
When one has Hashimoto's, it's very possible for symptoms to show up long before standard labs (FT3, FT4 and TSH) indicate an issue. Hashimoto's is also, often characterized by periods of hyper in the early stages so it can mistaken for Graves Disease. It's also possible for one to have, both, Hashimoto's "and" Graves Disease at the same time with one or the other being dominant at any given time, so they both need to be confirmed/ruled out, completely.
Last, but not, least, when a person has one autoimmune condition (in your case, SLE), the changes of getting another, or more are greater than for someone who doesn't have any autoimmune condition.
To recap... you need TgAb and TSI tests, along with vitamin B-12 and Ferritin, plus a thyroid ultrasound, if you haven't already had one. If you've had any of that, let me know and we can discuss it.
When you had your own thyroid labs done, you should have had a Thyrogolobulin Antibodies test TgAb, along with the TPOab that you had done. Both are markers for Hashimoto's and some of us have one or the other, some have both, so without them both, you can miss the diagnosis.
In addition, you should also have had a Thyroid Stimulating Immunoglobulin (TSI) test, which is the definitive test for Graves Disease.
Your low TSH and high FT3 (88% of its range) would indicate hyperthyroidism, but your FT4 is only at 28% of its range, which is a contradiction and could indicate central hypothyroidism, which is not autoimmune. Central hypothyroidism is an issue in the pituitary/hypothalamus axis.
Another possibility is a thyroid nodule that's dumping T3 into your system independently of the thyroid. You might ask for a thyroid ultrasound to see if this is a possibility.
Another possible autoimmune that can cause brain fog and extreme fatigue is pernicious anemia. PA is an inability to absorb vitamin B-12 via the gut. There are also causes for B-12 deficiency, other than PA, such as inadequate intake. Many vegetarians/vegans are deficient, since B-12 only comes from animal sources. But it would be to your benefit to get B-12 levels tested as many people with thyroid like symptoms are deficient in B-12.
You should also get ferritin tested. Ferritin is the iron storage hormone and iron is necessary for thyroid hormone synthesis and conversion of FT4 to FT3 (which doesn't seem to be an issue for you).
Your high FT3 level could very well explain the trembling and difficulty breathing.
When one has Hashimoto's, it's very possible for symptoms to show up long before standard labs (FT3, FT4 and TSH) indicate an issue. Hashimoto's is also, often characterized by periods of hyper in the early stages so it can mistaken for Graves Disease. It's also possible for one to have, both, Hashimoto's "and" Graves Disease at the same time with one or the other being dominant at any given time, so they both need to be confirmed/ruled out, completely.
Last, but not, least, when a person has one autoimmune condition (in your case, SLE), the changes of getting another, or more are greater than for someone who doesn't have any autoimmune condition.
To recap... you need TgAb and TSI tests, along with vitamin B-12 and Ferritin, plus a thyroid ultrasound, if you haven't already had one. If you've had any of that, let me know and we can discuss it.
***Corrected
Hi, I was wondering if anyone might be able to help me with, what is suspect, is an autoimmune mediated thyroid disorder. I have been having symptoms of both Hypo and Hyper for years (Extreme heat intolerance, extreme fatigue, weight gain, intestinal upset, edema, quickly elevating cholesterol with no dietary change, persistent, resting tachycardia, sweating, extreme sleep disturbances, elevated BP, chronically low vitamin D for which I take 50,000iu x 3 weekly, brain fog (I can’t remember simple things or, often, what happened moments ago and become agitated when trying, the list truly goes on). I should add that I have SLE (Systemic Lupus). I have been trying to get symptoms under control by treating what is believed to be the underlying cause; however, I have had a growing suspicion that I didn't have just one problem, but rather multiple issues that all require treatment for symptom relief.
Recently, the doctor ordered a thyroid profile (FT4 1.04 [.89-1.76], Total T3 1.44 [.6-1.81], and TSH .34 [.5-2.5]
Obviously my TSH gave me pause (especially faced with such normal FT4 and Total T3). Given my existing autoimmune disease, I was thinking the beginning of Hashi or Central (I also have empty sella with suppressed gonadotropins for which I take Testosterone Replacement Therapy, and transient mild prolactin elevation).
This past Monday, my BP starting to rise; it felt as if my heart was going to jump out of my chest. My hands began to shake, breathing became difficult (I would describe it as if my blood was too thin). This lasted for 36 hours. Since my doctors don’t really believe this is a thyroid issue, I paid out of pocket to have a profile done with Labcorp. The results are below:
FT4 1.08 [.82-1.72] ng/dl
FT3 4.3 [ 2.0-4.4] pg/ml
TSH .374 [.450-4.50] uIU/ml
TPO 6 [0-34]
TAA <1 [0.0-0.9]
Hi, I was wondering if anyone might be able to help me with, what is suspect, is an autoimmune mediated thyroid disorder. I have been having symptoms of both Hypo and Hyper for years (Extreme heat intolerance, extreme fatigue, weight gain, intestinal upset, edema, quickly elevating cholesterol with no dietary change, persistent, resting tachycardia, sweating, extreme sleep disturbances, elevated BP, chronically low vitamin D for which I take 50,000iu x 3 weekly, brain fog (I can’t remember simple things or, often, what happened moments ago and become agitated when trying, the list truly goes on). I should add that I have SLE (Systemic Lupus). I have been trying to get symptoms under control by treating what is believed to be the underlying cause; however, I have had a growing suspicion that I didn't have just one problem, but rather multiple issues that all require treatment for symptom relief.
Recently, the doctor ordered a thyroid profile (FT4 1.04 [.89-1.76], Total T3 1.44 [.6-1.81], and TSH .34 [.5-2.5]
Obviously my TSH gave me pause (especially faced with such normal FT4 and Total T3). Given my existing autoimmune disease, I was thinking the beginning of Hashi or Central (I also have empty sella with suppressed gonadotropins for which I take Testosterone Replacement Therapy, and transient mild prolactin elevation).
This past Monday, my BP starting to rise; it felt as if my heart was going to jump out of my chest. My hands began to shake, breathing became difficult (I would describe it as if my blood was too thin). This lasted for 36 hours. Since my doctors don’t really believe this is a thyroid issue, I paid out of pocket to have a profile done with Labcorp. The results are below:
FT4 1.08 [.82-1.72] ng/dl
FT3 4.3 [ 2.0-4.4] pg/ml
TSH .374 [.450-4.50] uIU/ml
TPO 6 [0-34]
TAA <1 [0.0-0.9]
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