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Hypothyroidism and Memory
Hi, I was diagnosed with hypothyroidism almost three years ago. For the past five years though I have been having trouble with my memory, I am only 23 years old so it's not related to my age. According to all my blood work I am healthy with the exception of my thyroid. The levels aren't terrible but they aren't perfect either. I have tried exercise, diet, omega fatty acid supplements, vitamins (for long periods of time) but none of it has helped my memory. It only helped improve my lab results. Generally it is just very foggy and I can't remember detail, or I completely can't remember an event or someone saying something. It's really annoying and I'm tired of living with this problem. It is interfering with almost every aspect of my life on a daily basis. I really need some advice from someone about this. I decided not to take the medication from my endocrinologist last time I went because I wasn't going to have insurance to follow up. But I have saved the money and plan to get my results read and am hoping that the medication he gives me will improve my memory. To be perfectly honest I'm not exactly sure what all these results mean, but here are my most up to date labs I have older test results available if it'll help):
12/09:
Free T4 0.9
Tsh Third Generation 3.7
T3 Uptake 36
6/10:
Free T4 1
Tsh Third Generation 2.01
7/10:
Tsh Third Generation 2.35
I also have eight nodules which were checked with an ultrasound and seem to be fine.
Thanks for any help.
12/09:
Free T4 0.9
Tsh Third Generation 3.7
T3 Uptake 36
6/10:
Free T4 1
Tsh Third Generation 2.01
7/10:
Tsh Third Generation 2.35
I also have eight nodules which were checked with an ultrasound and seem to be fine.
Thanks for any help.
I suspect you never had any relief of your symptoms because your FT3 and FT4 levels were never adjusted high enough. Just being in the lower ends of those two ranges is seldom good enough to relieve symptoms. FT4 should be somewhere around midrange or higher and FT3 in the upper half to third of the range.
Definitely post your current labs when you get them back. Request FT3 as well, and if they balk, insist. You're the customer here, you deserve to get what you need. FT3 testing can be tough to get. A lot of doctors don't "believe" in FT3 testing. They were taught that if FT4 was okay, FT3 was, too. However, we hear from way too many people with conversion problems to buy that line. If you don't convert well, your FT4 can be perfect, and your symptoms will remain as T3 is the only form of the thyroid hormones your cells can use.
Please, post the rest of those labs you list, especially interested in TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodes), but post them all if it's not too much trouble.
Relief of symptoms is what this is all about. Labs have value, IF they're interpreted properly. They can be used as a guide for meds adjustments, but with the knowledge that ranges are flawed and that we all have our personal comfort levels somewhere (but not everywhere) within those ranges.
Definitely post your current labs when you get them back. Request FT3 as well, and if they balk, insist. You're the customer here, you deserve to get what you need. FT3 testing can be tough to get. A lot of doctors don't "believe" in FT3 testing. They were taught that if FT4 was okay, FT3 was, too. However, we hear from way too many people with conversion problems to buy that line. If you don't convert well, your FT4 can be perfect, and your symptoms will remain as T3 is the only form of the thyroid hormones your cells can use.
Please, post the rest of those labs you list, especially interested in TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodes), but post them all if it's not too much trouble.
Relief of symptoms is what this is all about. Labs have value, IF they're interpreted properly. They can be used as a guide for meds adjustments, but with the knowledge that ranges are flawed and that we all have our personal comfort levels somewhere (but not everywhere) within those ranges.
goolarra
My endo wanted me to stay on the meds, but because the levels were in the "lower" range he said it was okay but I needed to come back at the first sign of symptoms and always get them rechecked every six months. He really didn't want me to stop taking them though and tried to convince me otherwise. While I was on it I didn't notice any relief of my symptoms, everything just kind of stayed the same which is why he changed it to levoxyl. If you're interested I can always post up my current labs when I get them back. They only checked for T4 and TSH, once again I don't understand the lack of T3 testing. I was tested for these other labs: ANA Screen, ANA Titer, Thyroid AB (ATA, TPO), Thyroglobulin AB, Thyroid Peroxidase AB, Heterophile Screen and Titer
Thyroglobulin, Rheumatoid Factor, DNA AB (DBL Strangd/ Native), SM AND SM/RNP SM AB, EIA, SM/RNP AB...I do not know what all those are...but they were on the thyroid lab results. I just know the general facts and am trying to understand the whole thyroid itself so I know what is actually going on with my body. I remember asking my endo if it was caused by nutrition, etc, he said no that it would have eventually surfaced. It just happened to be really early for me.
sandsoftime
Glad you found something to help you feel better and not like you live in a fog. It's hope that I can have the same someday. I am sure your meds will stabilize within you and you'll be better on the foggy days. I'm sure the bloods mean something, but it probably depends on the patient and how they feel.
My endo wanted me to stay on the meds, but because the levels were in the "lower" range he said it was okay but I needed to come back at the first sign of symptoms and always get them rechecked every six months. He really didn't want me to stop taking them though and tried to convince me otherwise. While I was on it I didn't notice any relief of my symptoms, everything just kind of stayed the same which is why he changed it to levoxyl. If you're interested I can always post up my current labs when I get them back. They only checked for T4 and TSH, once again I don't understand the lack of T3 testing. I was tested for these other labs: ANA Screen, ANA Titer, Thyroid AB (ATA, TPO), Thyroglobulin AB, Thyroid Peroxidase AB, Heterophile Screen and Titer
Thyroglobulin, Rheumatoid Factor, DNA AB (DBL Strangd/ Native), SM AND SM/RNP SM AB, EIA, SM/RNP AB...I do not know what all those are...but they were on the thyroid lab results. I just know the general facts and am trying to understand the whole thyroid itself so I know what is actually going on with my body. I remember asking my endo if it was caused by nutrition, etc, he said no that it would have eventually surfaced. It just happened to be really early for me.
sandsoftime
Glad you found something to help you feel better and not like you live in a fog. It's hope that I can have the same someday. I am sure your meds will stabilize within you and you'll be better on the foggy days. I'm sure the bloods mean something, but it probably depends on the patient and how they feel.
I've had no memory for many years - my thyroid tests - tsh were in the normal range.
Now I am on replacement Eutrosig 100mcg and I am having good times with my memory (sometimes I think to myself I wont have recall and I do - I am still nervous about this) and then sometimes it is still slow. However my medication is not stabilized - it's early days for me. My tsh level was just over 4 - I have to wonder whether blood tests mean anything at all (I've had 40 years of only being only partly present) - surely if you are well then that has to be important. My feelings.
Now I am on replacement Eutrosig 100mcg and I am having good times with my memory (sometimes I think to myself I wont have recall and I do - I am still nervous about this) and then sometimes it is still slow. However my medication is not stabilized - it's early days for me. My tsh level was just over 4 - I have to wonder whether blood tests mean anything at all (I've had 40 years of only being only partly present) - surely if you are well then that has to be important. My feelings.
So, your endo wanted you to go back on meds the last time you saw him (when?), but you decided not to?
TSH is a pituitary hormone, and it's often not a really good indicator of thyroid status. FT3 and FT4 are much better. That being said, the range for TSH currently recommended by AACE is 0.3-3.0. As you said, we're all individually different, but many people have to be below the middle of the TSH range before symptoms go away. FT4 needs to be midrange or above, and yours were very close to the bottom.
It would be interesting to see current labs (FT3, FT4 and TSH). Once on meds again, you should have levels re-tested in 4-5 weeks and adjust as necessary until your FT3 and FT4 are higher in the ranges and your symptoms have been relieved. (I'm completely convinced your brain fog and poor memory are thyroid related. From the labs you did post, your FT4 has never been as high as it should be.)
Has a cause of your hypo ever been identified? If not, you might consider having TPOab and TGab tested to see if you have autoimmune thyroid disease.
TSH is a pituitary hormone, and it's often not a really good indicator of thyroid status. FT3 and FT4 are much better. That being said, the range for TSH currently recommended by AACE is 0.3-3.0. As you said, we're all individually different, but many people have to be below the middle of the TSH range before symptoms go away. FT4 needs to be midrange or above, and yours were very close to the bottom.
It would be interesting to see current labs (FT3, FT4 and TSH). Once on meds again, you should have levels re-tested in 4-5 weeks and adjust as necessary until your FT3 and FT4 are higher in the ranges and your symptoms have been relieved. (I'm completely convinced your brain fog and poor memory are thyroid related. From the labs you did post, your FT4 has never been as high as it should be.)
Has a cause of your hypo ever been identified? If not, you might consider having TPOab and TGab tested to see if you have autoimmune thyroid disease.
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Your FT4 is very low; it's almost on the floor of the range. It should be much closer to midrange. I'm sure that you'd feel much better on meds once they're adjusted properly and your FT3 and FT4 levels are higher in their ranges.
It takes a while to get levels adjusted properly. We're usually put on a starting dose. Then we have to wait 4-5 weeks before we can re-test and re-evaluate symptoms. It takes that long for the meds to build up in your body. After that, this process has to keep being repeated until we are symptom-free. Some of us find our optimal dose realatively quickly, some struggle with it.
Seriously, you might consider changing doctors. It was not at all nice of him to laugh at you, and he should be answering your questions. Also, it sounds like your levels were never adjusted propery (to the point where your symptoms went away). However, since your appointment with your current endo is relatively soon, you can probably at least get a starting dose from him since he's already said he wantted you to stay on meds.
Once you get that, you might try to find a doctor you can work with better. Hashi's is for life, so it's worthwhile to find a good doctor to help you manage it.
Although it's best to have FT3 tested every time, your FT4 is so low currently that it's going to be a bit of a non-issue anyway. If he'll order it, fine, otherwise I think it can wait until your next blood test, which should be 4-5 weeks after re-starting meds.