Thyroid Disorders Community
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Avatar universal

So confused. Thoughts please

My regular dr moved so I was given a NP to see. Did and she did bloodwork. Then she left suddenly I just ignored it all hoping I'd wake up and all would be normal. Not. In Dec, they assigned me a new NP, meet her and it was "Give me your history in 15 mins" .  More bloodwork done at my request.
My symptoms for the past 4 months have been mostly hyper but some hypo are there.
Aniexty level off the charts,panic attack increased, can't deal with any type of stress, moody, tired but just can't sleep, hair is breaking straw, dry skin, balance & dizziness problems, trembling (mostly internal while I lie down) my head says do things but my body just wouldn't move, if I do too much, I basically can barely move for a few days (not pain, just weak legs especially my right one, body hair doesn't grow, no outer eyebrowns, I don't sweat, even when I'm hot. It's 9 degrees here and I sleep with the window open. My cholesterol levels bounce around. Higher pulse but perfect blood pressure. Hungry and I eat but don't really want to. My bowel habits go back and forth. The list goes on.
I have been officially diagonsied as Hashimoto's Thyroiditis.
I am positive for TPO as well as TSI postive but my actual thyroid numbers have never been outside of  range.
BTW, before my dr left, she said she wouldn't put me on meds because it would make me too hyper.
I requested the repeated anti-TPO antibodies because I was gluten-free for about 7 months. Apparently those numbers did come down, don't really know if that's the reason but it did absolutely nothing to help my symptoms.

6/29/13  (This was an afternoon draw)
TSH      2.20  (.35-4.00)
T4, free  1.00  (0.71-1.63)
T3, free   2.94 (2.30-4.20)
Vitamin  D  24  (30-100)

12/23/13 (Morning fasting draw-again different lab)
TSH        2.86  (0.55-4.78)
Total T4   9.8   (4.5-12.0) Don't know why they didn't do Free T4)
Free T3    3.3    (2.3-4.2)
Reverse T3  18   (8-25)
TPOautoAb  237 (<35)
Tgab           <20  (<40)
Requested TSI but they didn't do it.
Vitamin D  20.5 (30-100)
Magnesesium 1.6  (1.8-2.4)
Vit B12           417 (211-911)

I am on Metoprolol 25 mg which I take at night because it makes it sleepy but doesn't carry over into the day.
Also I do take Xanax as needed during the day with does seem to help somewhat.

How do I figure out percentages?
Any advise welcome. Thank you.

7 Responses
649848 tn?1534637300
The first things that jump out at me are that your vitamin D level is below range.  Vitamin D deficiency can cause some thyroid like symptoms.  Are you supplementing that?  You should try to get your level up, at least around 50-70.  

Your Vitamin B12 level is, also, too low in the range.  Many of us find that we have to keep levels very near the top of the range in order to feel well.  B12 deficiency can cause a lot of the fatigue issues, bran fog, etc.

Your magnesium is also too low.  Low magnesium levels can cause the weakness, moodiness, etc.  Make sure you get a magnesium citrate, chelate, etc as the mag oxide is pretty much just a laxative.

Your TPOab would indicate Hashimoto's.  Do you have the previous results for TSI?  TSI works a bit different - just being positive isn't necessarily adequate to diagnose Graves Disease.  

Hashimoto's is often characterized by periods of hyper switching to hypo.  Additionally, a lot of the symptoms can apply to both, so it's often hard to tell.

Your Total T4 is at 70% of its range, but most of that will be bound by protein, which makes it unusable and we don't know the "free" amount.  

Your FT3 is at 53% of its range, which is lower than we'd recommend if you were on medication.  At 2.58, your TSH is actually toward the high side, since your lab is using an outdated reference range.  Recommended range is 0.3-3.0.

I'd strongly recommend that you get your vitamin/mineral levels up to where they should be, so you can rule out those deficiencies as causes for your symptoms, then work on the thyroid levels.  It doesn't appear that the antibodies have destroyed enough healthy thyroid tissue to prevent your thyroid from producing hormones, in spite of symptoms.  It's not unusual for symptoms to be present long before lab levels actually go out of range and many doctors aren't willing to treat until TSH is elevated, in spite of symptoms.
Avatar universal
Yes, I do supplement when I remember. Guess I'd better start remembering more.
My last TSI was 2/26/13
156  (<=110)

Do you know anything about sodium levels being down in Hashi's?
I read it on a site about blood tests that Hashi's could affect levels but it didn't go into details. Mine has been slightly lower than normal for the past few tests. Nobody seems concerns. I don't crave salt and I don't normally salt my foods. But I don't avoid it either
649848 tn?1534637300
Can't really find anything much on sodium levels and Hashimoto's, but I do know that many of us tend to retain fluid with too much salt.

What are your potassium levels like?  Potassium and sodium  are both electrolytes and need to be in a balance.  If your sodium levels are only slightly below range, it may not be a problem.  Sodium helps balance body fluids, and maintain blood pressure.  Low sodium could be from excess water in the body.  Do you tend to have an issue with fluid retention?  Many of us with Hashimoto's/hypothyroidism have issues with edema.
Avatar universal
My potassium level is perfect. My blood pressure is also good. No I don't have any fluid retention or edema. I do drink quite a bit of water but this is nothing new. The salt loss is fairly new. So far the NP is not concerned. It's goes between 1-2 pts below normal range.
It seems to be around the time I went gluten free (cut out all fast food & junk)
Didn't help my symptoms any so I went back to regular food.
Side note-my weight has stayed stable no matter what I eat.
1756321 tn?1547098925
Hypothyroidism is one cause of low sodium.  Here is some info from a few websites...

The Medical Journal Of European Endocrinology - Hashitoxicosis – Three Cases and a Review of the Literature...

"It should be pointed out that, especially in the US literature, the term ‘hashitoxicosis’ is sometimes used to describe an autoimmune thyroid disease overlap syndrome of Graves’ and Hashimoto’s disease.  In this article the term is strictly limited to the ‘leakage’ symptoms of active Hashimoto’s disease."


Bella Online - Hypothyroid & Hyperthyroid at the Same Time...

"...some Hashimoto's patients also test positive for antibodies called the TSI antibodies (thyroid stimulating immunoglobulins). This antibody is what usually contributes to Grave's Disease or "autoimmune hyperthyroidism" however, some Hashimoto's patients have these antibodies as well as the TPO and/or TG ones, that typically cause Hashimoto's and is why they may experience spells of Hashitoxicosis or "intermittent hyperthyroidism". You almost could say they are suffering from Grave's and Hashimoto's, simultaneously.

Even without having the TSI antibodies present, Hashimoto's patients can potentially experience flares of thyroiditis, which can also cause mild hyperthyroid type symptoms that are not as severe as those caused by Hashitoxicosis but are still concerning."


Hashitoxicosis: Does It Really Exist? YES!...

"Hashitoxicosis:  What Your Labs Will Look Like  "Hey, Endos, Listen Up!"

"Here's what stumps doctors most when you are dealing with Hashitoxicosis - your labs.  Due to this constant cycling of hypo to hyper from minute to minute and hour to hour, the net effect of these changes is a zero sum game - normal labs."
Avatar universal
Saw my NP to discuss the results. She also feels the lower sodium is thyroid related.
She also said because my anti-TPO antibodies were lower than they have been in the past (usually 400-500's) my thyroid isn't being attacked too badly. Is that true?
Could someone please tell that to my symptoms! And, of corse, the TSH, T4 and FT3 were fine.
As a side note, I have for so many years have an elvated white count and platelets. Nu symptoms. Nobody can figure out why. But now my MCV is elevated too. She says that usually because of lack of folate and or B12. Mine are both in the normal range but I guess need more.
So just as Barb suggested, she did too. Supplement the mag, B12 and Vit D. Guess I'll take folic too. There's room in all to improve.
But I refused the cholestestrol drugs (218), I watch my hubby's liver enzymes go so crazy on them. I don't know why he continues to take them. His his perfect. He's a type 2 diabetic and the dr feels they will protect his heart. What at the cost of his liver? Not for me.
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649848 tn?1534637300
Avatar universal
1756321 tn?1547098925
Queensland, Australia
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