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Men and Hypothyroidism

Is it terribly uncommon for a man to be hypo? I am a male who had a TSH of 16.96. I went and had more blood work done monday and still have not received a call from my doctor. I am just nervous and feel bad. I was just talking with guys at work and they never heard of men having thyroid problems, and then I check on line and it is rare. I was just wondering if anyone here knows of any men who have thyroid problems?
And if my 16.96 TSH is something to be concerned about.
THANKS!
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Avatar universal
Can anyone explain the link between Hypothroid-Obesity-BP-SUGAR
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Avatar universal
Has anyone heard of a connection of hypothyroidism to trigeminal neuralgia?
I seemed to get diagnosed with both ailments around the same time. I have just started to take thyroxin and it may not be the correct dose. If I find that the neuralgia eases off as treatment progresses, I will re-post in case others are affected also. Thanks in advance
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Avatar universal
How important is Free T3?

Well Free T3 is the ONLY thing your body's cells ACTUALLY uses.  TSH is produced by the Pituitary gland.  So from a very rudimentary perspective ask yourself why you would test and rely 100% upon a Pituitary hormone to determine your THYROID health rather than the ACTUAL and ONLY Hormone your body's cells actually use????

TSH is nothing more than a hormone to turn your thyroid gland on to produce Thyroid.  Similar to a thermostat on your home furnace.  hence it's name Thyroid Stimulating Hormone or TSH.

When everything is running perfectly, the TSH "signal" hormone is sent out by your PITUITARY gland in your brain.  And then it turns on the Thyroid gland to produce Thyroid hormone.  The gland itself produces BOTH T4 and T3 but mostly T4.  The T4 hormone is a storage hormone that remains in your blood and when the body sense need for Thyroid it converts the T4 into T3.  And the T3 that does not get attached to a protein thus known as "free T3" because it is unattached is actually used by your body.  When the body is happy the TSH signal hormone is reduced and turns down your Thyroid gland to produce Thyroid.

If the world was perfect than reliance upon TSH would be reasonable.  But since we all know the world is FAR from perfect several problems can occur.

One is that your Pituitary that produces TSH doesn't work right.  Thus TSH would not be produced correctly or in the correct amount to regulate Thyroid.

Another is that the Thyroid doesn't work right and either over or under produces regardless of TSH.

Another is that they thyroid produces some but just enough to trick the TSH from being elevated enough to get a Dr to believe you have a problem.

So in order to TRULY get at the performance of your Thyroid. It is best to test the Thyroid hormone levels in your blood.  These being Free T4 and Free T3.  Only then can a determination be made if there is enough for your body.

If you only Get Free T4 measured. That is better than just TSH alone, but it does NOT tell the whole story.  Remember that your body ONLY uses the Free T3 hormone.  There are a couple of things that can happen if you only test for FT4.

You see it is possible for enough FT4 to be in your blood.  But if your body is not efficient in the conversion process of converting the T4 into usable FT3, then it does little good.  This is like a car with a full tank of gas, but if the engine is not getting enough gas it will run like crap and not give you full power etc.  This is exactly what happens when a person has good (meaning mid range or above) FT4 levels but still feels like crap.  Or is at least one cause.

Another cause that can go undiscovered with FT4 testing only is again the levels are good but still feel like crap may be a different kind of conversion problem.  This conversion problem occurs when during the conversion process the FT4 converts too many of hormone into what is known as REVERSE T3 or RT3.  This is an exact replica of the T3 hormone but the molecule is exactly a mirror image of the true T3 molecule.  The trick here is that the body's cells will accept the RT3 but it is biologically inactive and doesn't do anything.  Other than plug up your body's cells for other Free T3 to properly get to. This is analogous to a plugged fuel filter.  You can have as much gas going through the fuel lines as you want but if the filter is plugged, your engine won't run correctly.  Everyone has some RT3 made when converting but some people although a bit more rare have a condition maybe even temporarily that they produce way too much RT3 and the "plugging" situation results.

Testing BOTH FT4 AND FT3 is the only way that allows some ability to diagnose these conversion problems.

The goal for most is that most people get symptom relief when you have TWO conditions met.

1) your FT4 is in the MIDDLE of the range if not slightly above

AND

2) Your FT3 levels are in the UPPER 1/3 of the range.

Understand that simply being "somewhere within the range" as being normal or good enough is SIMPLY FALSE.  Dr's who only medicate you until you get them into some portion of the range is doing a HUGE disservice and you will never feel completely well.  We here on this forum call those Dr's "reference range endocrinology".  

If your FT4 is middle or more and your FT3 is below mid range if not in the upper part of the range, it suggests a conversion problem of converting from T4 to T3.

If on the other hand both the FT4 & FT3 are middle and upper 1/3 respectively and you are still symptomatic.  This suggests a possible RT3 problem.  And RT3 CAN be tested for but I understand it is a bit expensive so really only done when it is suspected.  Also a condition like both levels proper may be reason to suspect adrenal fatigue as well and tests can be done for that as well.

Furthermore, if you do start on a Thyroid medication.  It is ENTIRELY possible that the medication itself will suppress the pituitary TSH response.  That is essentially the blast of the medication into your bloodstream will be sensed by the Pituitary and it will "see" that no additional Thyroid is needed.  Kind of like it "goes to sleep" once it has check the level. So it won't produce to stimulate TSH production and thus you may still have inadequate Thyroid in your body for the day, and is ths "suppressed.  But since little or no TSH was produced.  And if your Dr ONLY uses TSH.  The Dr. will be getting a false indication that you have enough Thyroid otherwise your TSH would be higher.

Frequently what will happen is that the patient will have a elevated TSH.  The Dr prescribes Thyroid medication.  the medication suppresses TSH.  And the patient truly still is lacking T4 and T3.  But in 6 weeks when you get your TSH tested again. The TSH will so LOW.  That the Dr will reduce or remove the prescription for thyroid believing that the patient is now HYPER by his medication giving too much Thyroid.  But in reality the TSH is only suppressed and the patient is still actually Hypo (low thyroid). The patient may even be telling the Dr. that they are starting to feel better and have NO symptoms what so ever of Hyper.  By reducing or canceling the prescription.  The Dr is actually making the EXACT WRONG decision.

However had this Dr also tested FT4 and FT3.  He would then be able to determine that the levels of the ACTUAL hormones are still low in the range and thus understand that the TSH has been suppressed and thus is of little value.

Also understand that I am NOT a Dr.  But this is what I have learned through my own research primarily here on this forum.

Reliance upon "immaculate TSH belief" is one of the most negligent things in the medical industry in my opinion.  Followed closely behind are those Dr's who believe in reference range endocrinology.  The first will almost assuredly keep you sick or on a roller coaster.  The latter is better in that they will generally medicate you so that you feel a little better, but you'll likely never feel completely well either.

I hope this long winded response helps you understand why using TSH ALONE is almost completely useless other than a screening tool at best.  Relying on it solely will almost certainly guarantee that you will NOT be treated properly.  Or it will result in a roller coaster ride by using an improper test to try to adjust your medication.  And why testing of the two Free hormones FT4 and FT3 is essential in being able to properly treat Thyroid problems.
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Avatar universal
Well, being a military man you will understand when I say that your doctor needs to go through "basic training" on thyroid.  I hope you took the time to read the link I gave you on the letter written by a good thyroid doctor.   That pretty well spells out what a good thyroid doctor would do for you, and it certainly would not be to ignore everything but TSH.  

Regarding the importance of Free T3, here is a link to a scientific study that shows conclusively that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.

http://www.ingentaconnect.com/content/routledg/cjne/2000/00000010/00000002/art00002

You appear to have secondary hypothyroidism, which means that your pituitary is not producing enough TSH to cause your thyroid glands to provide adequate thyroid hormone.  This is evident in your very low-in-the-range Free T3 and Free T4 levels.

I was on a full daily replacement dosage of T4 med for over 30 years, and still had lingering hypo symptoms.  Then I found this Forum and learned about the importance of Free T3.  Got mine tested and confirmed as low in the range.  Doctor switched me to a T4/T3 combo type med and after some tweaking I now feel best ever.  My Free T3 is near the high end of the range and free T4 is a bit below the middle of its range.

Do you think there is any chance that you might be able to show scientific data to the doctor and get him to change his mind about treating you?  If so we can give you plenty of links to good information.
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Avatar universal
Thank you for your concern. My doc says TSH is all I need to worry about, and that FT3 doesn't matter, my thyroid is fine. I asked if he could test for Hashi's, but says he will add more labs if I chose to request so in about 6 weeks. Im now on wellbutrin 150mg twice daily after my referrel to mental health. Ive read several articles on how to interpret my lab results and basically I fall into that Euthryoid Sick Syndrome, but what about FT3? Is free t3 really that important? If you have a similar experience I would love to share with you. Thanks again.
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Avatar universal
No need to be over concerned.  Successful treatment of hypothyroidism is primarily a matter of finding a good thyroid doctor, which I'll explain later.  First I'd like to explain a bit about your situation.  From your descriptions of being hypothyroid and autoimmune, I assume you have been diagnosed as having Hashimoto's Thyroiditis.  The purpose of your autoimmune system is to protect you from anything foreign to your body, by producing antibodies to attack and kill the foreign substance.  Unfortunately, with Hashi's the autoimmune system sees your thyroid gland as foreign and produces antibodies that start attacking the gland and continue over an extended period until the gland is eventually destroyed.

Along the way, you will need to gradually replace the loss of natural thyroid hormone with thyroid medication.  The whole purpose of the thyroid medication is to keep you from having symptoms caused by inadequate thyroid hormone.  The reason you don't feel better now is because you are either not being given the right medication, or the right amount, and your thyroid hormone levels are still too low.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good info from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the Primary Doctor to help guide treatment.

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

If you are being medicated based on the TSH test only, that doesn't work.  TSH is a pituitary hormone that is supposed to reflect levels of the thyroid hormones, but in actuality it does not correlate well at all.  The most important consideration in treating a hypo patient is symptoms, followed by the levels of the biologically active thyroid hormones, which are Free T3 and Free T4.  In the link I gave you above, you can note this statement, "TSH-based thyroidology is an unjustified faith in the infallibility of the hypothalamic-pituitary axis. One must instead base the diagnosis and dosing on symptoms first, and on the free T4 and free T3 levels second."

So the first thing I recommend is that you make a copy of the letter above and discuss it and all this info with your parents.  Then it would be a good idea to go back and get tested for Free T3 and Free T4 (not the same as Total T3 and Total T4).  If the doctor resists, then you should insist on it and don't take no for an answer.  Maybe even give the doctor a copy of the letter as well.  It would also be a good idea to get tested for Vitamin D, and B12.

When test results are available, please get a copy of the lab report and post test results and their reference ranges shown on the report and members will be glad to help interpret and advise further.  

Please don't be dismayed by all this info at once.  To be successful in getting properly treated it is always a good idea for you to learn as much as possible about hypothyroidism and become your own best advocate.  

If you will hang with us, you will find many experienced and knowledgeable members who will be very happy to answer your questions and make suggestions that will help you.  

One last thing is that sometime soon you are going to need to find out if your doctor is willing to treat you clinically, for symptoms, as described in the letter.  Also you need to know if your doctor will prescribe T3 type meds if necessary to raise your Free T3 level.  If the answer to either is no, then you will need to find a good thyroid doctor that will do so.  And by the way, that does not automatically mean an Endocrinologist.  
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