Hypo and Hyperthroidism

[sharon_lee]

My Dr. said, I am both hypo and hyper...will I eventually go one direction, and stay there...??
I also have a goiter and nodule...


He said, to come back in 6 mos. He said, my counts are all normal...

My TSH is 0.150  my labs normals being 0.360-4.800.uIU/mL
    T3 Total 1.25    lab recommends         0.70-1.90ng/mL
    T4       10.7                                       4.8-13.9 ug/dL

I struggle so with tiredness, and weakness...
Thank you...

[goolarra]

I was trying to give him the benefit of the doubt!  Can anyone really be that dense?

Yes, I think your thyroid hormones are totally messed up, and you will probably find that many of those other things go away when you get thyroid stabilized.  But, you have to find a new doctor to help you with that and to see you more often (before October) until you're stable.

[sharon_lee]

Re. your comment...SWEET, does not cut it, with me, unless my Dr. does more than read results to me....especially when I am complaining of an ongoing miserable mouth thrush...and even stuck my tongue out...I just kind of thought he might listen to my heart, and feel my neck, and check the inside of my mouth....To me it feels like they are just looking at the numbers...and my symptoms be -------  He did say, He is just going to have to pin all of my symptoms back on my PTSD...of course what I heard...I did not say what he said...rather what I heard...is, it's all in your head...I've heard that most of my life...or it is your Fibromyalgia, was my previous Docs response to everything...until the goiter became visible...and I had already lost over 20# I'm now 112,  I think.or was a few weeks ago...people say, you are so skinny. My current huger, did go on to say, We know she has the thyroid, and the atria fibrillation. Otherwise, I have to give all of her symptoms to the PTSD. From all that I have read on this site, and others, I could almost pin my new diagnosis, PTSD, on thyroid! Please keep in mind that I am just processing.

[sharon_lee]

You are right gimel, a hug was not in the least what I had in mind...like maybe, when I stuck my tongue out...come and look at my mouth full of thrush...but he sat in his chair across the room...I've mentioned the length of time between appointments for me, and my pharmacist said, he did the same to him, and another lady, the same...because as one of you stated too big a case load...My pharmacist wrote down the name of a troche to be disloved in the mouth 5 times a day, and said, it works really good...he also was surprised to hear that I have already taken 4 diflucan, and have not improved one whit! As he said, usually one will do it. I'm calling tomorrow to ask for an appointment...the nurse did tell me to do that anytime I feel the need...boy did I feel the need.
I'm also going to check the list of Dr. in Eugene...thank you...and how kind of you to do that research for me...bless you!

[gimel]

Take a look at this list of thyroid doctors in the Eugene area.  If you read through the patient reviews you can get a good idea of which ones might appeal to you most.  Then you can call their offices and say that you need to make an appointment with a good thyroid doctor but would like to ask one of the nurses a few questions first.   Then you can quiz them about insurance coverage, cost and time to get an appointment.  Also, ask if the doctor is willing to treat a patient for symptoms, by testing and adjusting  free T3 and free T4 levels as necessary to relieve symptoms.  Also ask if the doctor is willing to prescribe natural, dessicated type thyroid meds.   If the answer to either question is no, then keep looking.

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

If you find a good thyroid doctor I'm sure he will also check your pituitary function, as well as your goiter and nodule issues.

[goolarra]

I'm sorry, but I couldn't help laughing at the last line of your first post...not exactly what you had in mind (a hug)?  Sweet (I guess), but doesn't exactly replace a thorough exam, does it?  Actually, most of my endo appointments are pretty hands-off.  He always palpates my thyroid while I swallow sips of water, but other than that it's just yack, yack...I sit in a chair, and he draws illustrations on the paper that covers the exam table...it has to have SOME use!

My dad had thrush once, and they used a monistat ointment on him (the same stuff that monistat for vaginal yeast infections has in it), except in an oral format.  It did the trick for him, and he was very sick and in a nursing home at the time.

I don't think it sounds like you're making excuses for not traveling at all.  I think it sounds like the doctor is making excuses for not seeing you frequently enough because he may have too big a caseload.  Even once I was stable, my endo kept seeing me every three months for a while, then four, now we're up to six.

You're not TOO far from Eugene...there should be a wide choice of doctors there???

[sharon_lee]

I just re read my post, and sounds like I am making excuses for not traveling, for a Dr. I have a very tight budget...is my reason! Just my social security. Since the Thyroid became an issue, I'm looking at things I can cut...I pay them all every month...just can't pay some in full...but this new one I did pay in full this mo.

[sharon_lee]

Yes ma'am this is the same Dr. unfortunately I learned he is in the same co op with the one I just left, many of them are doing that now.....and he is treating some thyroid patients differently..my town it the pits when it comes to medical treatment, of any kind.I so agree with you, 6 months...is a long time...I've been on meds for the thrush, and it is still not responding well..some better...only some! 2 more pills to go, so will see how it is. I thought that since I have just become what they refer to as normal with my counts..for the first time....that I should be tested every 6 weeks, at least for awhile...but my labs are for Oct. To get a new Dr. I would have to travel, and my other dilemma, so many are now, no longer accepting Medicare patients...I am going to ask my psychiatrist if he will order the FT3 and FT4 for me...I see him in June that will be 8 weeks since my appointment...will also ask about some recommendations, as he comes here from Eugene... I started writing this earlier, and, nature called,  WELL, I just came back from the pharmacy as my Hyomax for IBS...of all things, I found 3 whole ones in my stool...so they gave me a different brand..My pharmacist goes to the same Dr. I do...and he said, they are just getting so busy that they are not having us come back, like they used to...Dr. told him to come back in 4 mo. and it used to be 2..he also said, that is an awfully long time to go without blood draws for the thyroid, as was his opinion that I am not stable, yet. He studied Thyroid...Our health care system is the pits...He also suggested that I call and ask for a troche for the oral thrush, as the dyflucian is not doing much for me. "very" slight, improvement. Thanks for letting me vent...I was thinking maybe my new Dr. didn't like me...this is the first Dr. I have ever gone to, who never had me on the table, or touched me...I told him that on the way out the door...so he hugs me.

[goolarra]

This is the same doctor who was weaning you off meds completely?  Now, he/s decided to keep you on 44 mcg levo and see you in six months?  Way too long, in my opinion.  You are not stable.  You should be having labs and seeing him every 5-6 weeks.  I think you have to look at the lists of both hypo and hyper symptoms and watch for all, but mostly hypo (this opinion from previous posts).  Your doctor is also ordering obsolete tests, so it's very hard to determine where you are...he should be ordering FT3 and FT4.  I think you need a new doctor.  You may have to travel a bit as Oregon can be difficult.

[sharon_lee]

Is it common to go back in 6 mo. after the very first time that your counts are in the normal range...since diagnosis, in early January. I've changed Dr.s and only seen this one 3 times....
I have a miserable oral fungus, and he did phone in Diflucan.

My TSH is 0.150  L  my labs normals being 0.360-4.800.uIU/mL
    T3 Total 1.25    lab recommends         0.70-1.90ng/mL
    T4       10.7                                       4.8-13.9 ug/dL
Sure seems like a long time to me...
What should I be paying attention to, symptom wise, to know when or if I need to go in sooner?

[sharon_lee]

Thank you, so much for your responses to my inquiry I certainly questioned it when he and his nurse both said, I am both hypo and hyper. Just made no sense, he said, with both a goiter and nodule, if I understood him right, I would eventually go on way or the other.....my therapist and I talked last night about my not being well, and having a rare OK day...She suggested depression, as I recall that is a symptom of thyroid disorder...I am taking 44MCG of Levo, and he gave me a 1 mo. trial of Synthroid, but said, to wait 2 weeks to start...I have a horrible fungus in my mouth, so he put me on 5 days of dyflucan...I hate drugs, and their side affects..For now, this was the only Dr. who accepted my application, in our town, and was willing to see me as a patient. We are very short here in Oregon, on health care professionals.We have a lady now who does only hormone imbalance, ie thyroid...a friend goes to her and she uses arm and Leve. However she will not take Medicare patients..which is my other quandry...no really good ins. and don't have extra money but my S.S.My psychiatrist who comes from out of town once a week...said he believes when all the tests are in, I have the colonsocopy to go, that my health issues will all be related to my thryoid...
Thank you, so much for your suggestions, and I will try to see if he will run the FT3 and FT4. I called 2 days ago about the inneractions of the dyflucan with the other meds I am on, his nurse called back, and said, he is very well aware of the inner actions of my meds...and that is the drug he give everyone for thrush...You have no idea, then again, maybe you do, how much I would like to just go off of everything, and see what happens, I won't, but oh is it ever tempting.
This must sound garbled...thank you, so very much for your time and caring.

[rumpled]

Hmmm... The TSH is low - which really just points to central hypothyroidism. Pituitary source.
Your T3 and T4 seem to be in the middle - but my doc prefers free T3, free T4, but I like to be on the high end of the ranges.
I suspect he gave you no meds, and he has no idea what he is doing.

[gimel]

I disagree with your doctor.  You cannot be both at the same time.  He is obviously one who relies on TSH a lot for diagnosis, thus he has decided that your TSH is hyper.  You are hyper only if you have excessive levels of the active thyroid hormones, mainly FT3,  and FT4 along with hyper symptoms.  Symptoms are what should  define your thyroid state.  Your symptoms sound like hypothyroidism.  We could know a lot more if the doctor had run tests for the actual, biologically active thyroid hormones, free T3 and free T4, instead of the somewhat obsolete tests for total T3 and total T4, which don't really tell very much.

I suggest that you go back and insist that they test for FT3 and FT4, along with TSH.  Since the TSH level is low along with those T3/T4 tests, I think they should also be testing your pituitary function.

In my opinion the very best way to treat a thyroid patient is to test and adjust the levels of the active thyroid hormones, FT3 and FT4, with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH levels.  Many of our members report that symptom relief required that FT3 was adjusted into the upper part of its range and FT4 was adjusted to at least the midpoint of its range.  Symptom relief is all important.  If your doctor is not willing to reconsider and test and treat you in this manner, then you might as well start looking for a good thyroid doctor, which are not easy to locate.