Aa
Help with test results
I have been told I have Hashimotos -- tons of symptoms including lots of weight gain despite diet and exercise; fatigue, joint and muscle pain, etc..
recent labs:
TPO AB 424 IU/mL (lab range: 0.00 - 35.00)
TSH 4.24 uIU/ml (lab range: 0.50 - 6.00)
FT3 2.23 pg/mL (lab range: 2.00 - 4.90)
FT4 .79 ng/dL (lab range: .75 - 1.54)
My primary care doctor tells me I am perfectly healthy.
What do these labs mean?
recent labs:
TPO AB 424 IU/mL (lab range: 0.00 - 35.00)
TSH 4.24 uIU/ml (lab range: 0.50 - 6.00)
FT3 2.23 pg/mL (lab range: 2.00 - 4.90)
FT4 .79 ng/dL (lab range: .75 - 1.54)
My primary care doctor tells me I am perfectly healthy.
What do these labs mean?
Soy can lower the production of thyroid hormones. So, as long as you still have thyroid function left, it's probably best avoided.
Gluten is a more controversial subject. There are those who claim that gluten triggers the autoimmune reaction, and eliminating it will lower antibodies. However, even these people do not claim that it will send them into remission. Antibodies vary wildly, even intraday, so it takes a succession of tests to determine if there is actually a trend in them or just "normal" variation (up one time, down the next).
I was g/f a few years back for other reasons. I didn't do it to help my thyroid condition, and it didn't. My recommendation is that if you feel better g/f, then by all means do it. If you're going g/f in hopes of stemming the attack on your thyroid, you're probably going to be disappointed.
I've done a lot of reading on the subject, and I find the whole theory backed by very little science. However, there's a lot out there to read (and in the archives here), and you should make your own value judgments.
Gluten is a more controversial subject. There are those who claim that gluten triggers the autoimmune reaction, and eliminating it will lower antibodies. However, even these people do not claim that it will send them into remission. Antibodies vary wildly, even intraday, so it takes a succession of tests to determine if there is actually a trend in them or just "normal" variation (up one time, down the next).
I was g/f a few years back for other reasons. I didn't do it to help my thyroid condition, and it didn't. My recommendation is that if you feel better g/f, then by all means do it. If you're going g/f in hopes of stemming the attack on your thyroid, you're probably going to be disappointed.
I've done a lot of reading on the subject, and I find the whole theory backed by very little science. However, there's a lot out there to read (and in the archives here), and you should make your own value judgments.
Those are good questions to ask.
Also another possibility is to go to your pharmacy and ask if they will tell you what Dr's prescribe T3 medications such as Cytomel and/or Dessicated thyroid such as Armour or Nature Thyroid.
This would narrow the search for a Dr to at least a few (or one) in your area that you KNOW will treat with T3 type medication. And then narrow your phone calls to those Dr's.
Also have you been tested for the following which all can cause fatigue and Hypo similar symptoms and/or contribute to poor thyroid metabolism if they are low.
Vitamin D3
Vitamin B-12
Iron
Ferritin
Also another possibility is to go to your pharmacy and ask if they will tell you what Dr's prescribe T3 medications such as Cytomel and/or Dessicated thyroid such as Armour or Nature Thyroid.
This would narrow the search for a Dr to at least a few (or one) in your area that you KNOW will treat with T3 type medication. And then narrow your phone calls to those Dr's.
Also have you been tested for the following which all can cause fatigue and Hypo similar symptoms and/or contribute to poor thyroid metabolism if they are low.
Vitamin D3
Vitamin B-12
Iron
Ferritin
1 Comments
Thank you for this great advice. Another question -- do you know if it is true with Hashimoto that cutting out soy and gluten are recommended?
Unfortunately, just because a doctor is an endo doesn't assure he's a good thyroid doctor. Many of them are really only interested in treating diabetes.
I think it's really worthwhile to interview them before making an appointment. I'd ask to speak to a nurse. If you get a particularly protective receptionist on the phone, he might try to keep you away from the nurses. In that case, I'd say something like, "Then perhaps you can answer a couple of questions for me. Can you tell me which meds for hypothyroidism the doctor is open to prescribing?" Okay, now he knows he's out of his league, and he's going to let you talk to a nurse.
Some questions that will weed out the worst of the worst:
Approximately what percentage of the practice is thyroid patients?
Which tests does the doctor customarily order for hypo patients? (You want to hear FT3, FT4 and TSH. But if they say FT4 and TSH, I'd press on with, "Will he order FT3 on patient request?")
Which meds is the doctor open to prescribing? (Ideally, they should be willing to use synthetic T4, synthetic T3/T4 combos and desiccated. Practically speaking, most fall into the synthetic camp or the desiccated camp. Just stay away from any who won't prescribe some form of T3.
Does the doctor treat clinically, with the relief of symptoms the goal, or does he treat by the numbers? (Seems like an obvious answer, but staff can be amazingly candid at times.)
Since you know you have a positive TPOab, another good question: In the case of someone with a positive TPOab, does the doctor wait until FT3 and/or FT4 are out of range before treating, or will he treat sooner?
I think it's really worthwhile to interview them before making an appointment. I'd ask to speak to a nurse. If you get a particularly protective receptionist on the phone, he might try to keep you away from the nurses. In that case, I'd say something like, "Then perhaps you can answer a couple of questions for me. Can you tell me which meds for hypothyroidism the doctor is open to prescribing?" Okay, now he knows he's out of his league, and he's going to let you talk to a nurse.
Some questions that will weed out the worst of the worst:
Approximately what percentage of the practice is thyroid patients?
Which tests does the doctor customarily order for hypo patients? (You want to hear FT3, FT4 and TSH. But if they say FT4 and TSH, I'd press on with, "Will he order FT3 on patient request?")
Which meds is the doctor open to prescribing? (Ideally, they should be willing to use synthetic T4, synthetic T3/T4 combos and desiccated. Practically speaking, most fall into the synthetic camp or the desiccated camp. Just stay away from any who won't prescribe some form of T3.
Does the doctor treat clinically, with the relief of symptoms the goal, or does he treat by the numbers? (Seems like an obvious answer, but staff can be amazingly candid at times.)
Since you know you have a positive TPOab, another good question: In the case of someone with a positive TPOab, does the doctor wait until FT3 and/or FT4 are out of range before treating, or will he treat sooner?
I guess I should really focus on getting an endo. I havent seen one yet. I was planning to make an appointment with an endo that is in my PCPs same medical group -- but I worry that person will follow the same "normal" guidelines as my PCP.
When I was looking for my endo, I sent out a questionnaire. It was multiple choice so it didn't take up too much of their time. You can do that, or you can interview them over the phone. That usually happens through a nurse. Are you looking for an endo or a new PCP?
any advice from anyone on how to find a doctor who is more knowledgable than just looking at lab ranges and declaring "normal"?
I'm afraid there are only two options: If you have a really good relationship with your doctor, you can try to educate him, or you can find a new doctor. Your symptoms confirm that you are hypo. I think you'd feel so much better on meds.
hi thanks for your repsonse -- LOTS of symptoms for years and years...
including
IBS/ Diverticulitis, Extreme Fatigue, Anxiety, chronic back pain, chronic foot pain, migraines, thinning hair, major weight gain (non responsive to diet/exercise) -- all of this was preceeded by a sudden bout with clinical depression (about 3 years ago) and weight loss of 25 pounds...
what do you do when your doctor keeps telling you you are in great health.
including
IBS/ Diverticulitis, Extreme Fatigue, Anxiety, chronic back pain, chronic foot pain, migraines, thinning hair, major weight gain (non responsive to diet/exercise) -- all of this was preceeded by a sudden bout with clinical depression (about 3 years ago) and weight loss of 25 pounds...
what do you do when your doctor keeps telling you you are in great health.
i have much more tsh than yours some 6 but my free t4 is in middle of reference range and raising my thyroxine dosage tsh might reduce but make my thyroxine level to be increased and gives hyperthyroid and may be even more hypo due to raised reverse t3. thus tsh can't never be taken as a method to determine the thyroid condition even if current range is reduced to .3 to 3
so how to determine the correct levothyroxine dosage just look at free t4 value. yours is less than 50% in range so need to slowly raise the current doage like in 12.5 mcg steps until it become in around 50% range. your current doctor is ignorant regarding this so get another opinion.
also if in your country t3 only medicine available then trying that in low dose along with levothyroxine will be very useful as your t3 also very low which may or may not improve with levothyroxine.
so how to determine the correct levothyroxine dosage just look at free t4 value. yours is less than 50% in range so need to slowly raise the current doage like in 12.5 mcg steps until it become in around 50% range. your current doctor is ignorant regarding this so get another opinion.
also if in your country t3 only medicine available then trying that in low dose along with levothyroxine will be very useful as your t3 also very low which may or may not improve with levothyroxine.
Your labs mean that you are NOT perfectly healthy. FT4 is on the floor of the range. It should be about 50% of range. FT3 should be over 50% of range, and yours is 8%. AACE recommended years ago that TSH range be changed to 0.3-3.0. As you can see, labs have been very slow to adopt the new range. Your TSH is above 3.0. All three tests indicate you are hypo.
TPOab is positive, so I agree with your doctor that you have Hashi's.
Other symptoms?
TPOab is positive, so I agree with your doctor that you have Hashi's.
Other symptoms?
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
