Aa
Remission and going hypo
Diagnosed Graves Disease in 2010. Prescribed methimazole, went into remission in May 2012. I am still in remission. I have had TPO, TBII, TSI and TRAB tests done and all are normal. My Ft4 and Ft3 levels have been in the low "normal" range for the past year. I have been feeling hypo, muscle aches, buzzing tingles in legs, hair loss, dry skin and waves of tiredness. I have complained about my symptoms to my endo and asked if I could go on a low dose of thyroid hormone and he won't do it because "your tsh is borderline hyper". My tsh has remained low (.440 - .721) over the past year. Why so much focus on my tsh? Aren’t the Free T’s levels a true indication of our thyroid status? What do you suggest I do? I'm in Orlando, I've seen two endos and neither one will prescribe replacement. Do you know a physician here in Orlando who would be willing to work with me?
When I was hyper my Dr looked at my free levels and went by how I felt but now that I'm in remission, he just looks at my tsh. From what I gather - I have blocking antibodies and graves antibodies fighting over my tsh...so it will be screwed up regardless however my free t4 and free t3 levels are low. My Free T4 range is .90 - 1.82, my free t4 levels stayed between 1.01 and 1.18 over the past year. What is the harm of trying a low dose of thyroid replacement. I need my levels to to be closer to the other end of range. I know what hyper feels like, I could just stop the meds if it makes me hyper. I feel like an 85 year old women. Just not myself, this *****.
TSH is a pituitary hormone that is supposed to accurately reflect levels of the actual thyroid hormones, but in reality it cannot be shown to correlate well with either Free T3 or Free T4, much less with symptoms, which should be the predominant concern. In the following link you will find graphical presentation of the very poor correlation of TSH to Free T4 and even worse correlation of TSH to Free T3. From a TSH test result you cannot reliably predict a patient's Free T3 or Free T4 level. This is vital to understand since scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.
http://www.clinchem.org/content/55/7/1380/F2.expansion.html
Why not show a copy of the graphs to the doctor and ask just how is it that TSH is supposed to be the best diagnostic by which to treat a thyroid patient, when it doesn't even correlate with the thyroid hormones. Then you can also give a copy of this link. Maybe all that will get him to reconsider your need for treatment.
http://hormonerestoration.com/Thyroid.html
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 most important, not test results and especially not TSH results.
http://hormonerestoration.com/Thyroid.html
If you doctor is not willing to treat clinically, then you really do need to find a good thyroid doctor that will do so. For over 4 years, I have been collecting names of doctors recommended by members, but unfortunately I don't have one for Orlando area. I do have a couple of leads that I will follow up on ASAP and see if I can locate a prospect for you.
.
http://www.clinchem.org/content/55/7/1380/F2.expansion.html
Why not show a copy of the graphs to the doctor and ask just how is it that TSH is supposed to be the best diagnostic by which to treat a thyroid patient, when it doesn't even correlate with the thyroid hormones. Then you can also give a copy of this link. Maybe all that will get him to reconsider your need for treatment.
http://hormonerestoration.com/Thyroid.html
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 most important, not test results and especially not TSH results.
http://hormonerestoration.com/Thyroid.html
If you doctor is not willing to treat clinically, then you really do need to find a good thyroid doctor that will do so. For over 4 years, I have been collecting names of doctors recommended by members, but unfortunately I don't have one for Orlando area. I do have a couple of leads that I will follow up on ASAP and see if I can locate a prospect for you.
.
My doctor pays no attention to my TSH. All free t's for her.
She is an Internal Medicine MD and my primary. No referral needed.
She even said that she believes a lot of people suffer from undiagnosed thyroid problems.
When I got to her I felt awful. My old primary started and kept me on a really low dose of a synthetic medication. She said everything was fine when my TSH came down to the 2's. That is all the testing my old primary would do. With my new doctor she found that both Free T's were in the low normal and we worked to get Free T4 in the mid upper and the Free T3 in the upper range with Armour a NDT.
Although. I don't have autoimmune hypothyroidism.
She is an Internal Medicine MD and my primary. No referral needed.
She even said that she believes a lot of people suffer from undiagnosed thyroid problems.
When I got to her I felt awful. My old primary started and kept me on a really low dose of a synthetic medication. She said everything was fine when my TSH came down to the 2's. That is all the testing my old primary would do. With my new doctor she found that both Free T's were in the low normal and we worked to get Free T4 in the mid upper and the Free T3 in the upper range with Armour a NDT.
Although. I don't have autoimmune hypothyroidism.
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.
