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Thyroid help
These are my latest labs. Tsh 1.3 range 0.27-4.2 free t4 10.1 range 12.0-22.0 free t3 3.37 rang 3.9-6.70. Anti thyroid peroxidase 174 range 0-34 anti thyroglobulin antibodies 343 range 0-115. What does this all mean I feel like crap and have lots of chest and back pain. Help!
Forgot to mention I had a thyroid ultrasound done which states echo texture is quite heterogenous with no discrete nodules. Thyroid is noted to be hyper vascular. This raises the possibility of thyroidis. My throat often feels tight and feels like there is lots of excess mucus sitting in the back of it. Do I need further testing of some kind?
Thanks for your help. I am new to all this and very confused as well as horribly anxious. I am currently taking 25mcg of levothyroxine and 12.5 mcg of cytomel. I have been on these for about 2 weeks. How long before I can expect to feel a bit better. I am off to an endocrinologist next week due to a sympathetic ER doctor who got me an appointment. Waiting list is 12 months. What other test should I ask for? Is upper back and chest pain associated with this or is there something else going on? Doctor is a bit dismissive of this and chalking it up to anxiety!
It means that you have Hashimoto's Thyroiditis. With Hashi's the autoimmune system erroneously determines that the thyroid gland is foreign to the body and produces antibodies to attack and eventually destroy the gland. Along the path to destruction, the output of the gland is diminished and Free T4 and Free t3 levels drop and the TSH levels increases. Both your Free T3 and Free T4 are extremely low. No wonder you would have hypothyroid symptoms.
Your TSH is atypically low for a Hashi's patient, so it will either start climbing or there is a dysfunction in the hypothalamus/pituitary system that is keeping it lower than it would be with Hashi's. Regardless the important thing is to get your doctor to start you on thyroid meds and gradually increase the dosage as needed to get your Free T4 to the middle of its range, at minimum, and your Free T3 into the upper third of its range, or as needed to relieve hypo symptoms.
When you go back to the doctor you need to find out if the doctor is going to be willing to treat clinically, by testing and adjusting Free T4 and free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH results.
Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, so you should get those tested and supplement as needed to optimize. D should be 55-60, B12 in the upper end of its range and ferritin should be 70 minimum. Low levels can cause symptoms that mimic hypothyroidism. Low D or ferritin can interfere with metabolism of thyroid hormone.
Your TSH is atypically low for a Hashi's patient, so it will either start climbing or there is a dysfunction in the hypothalamus/pituitary system that is keeping it lower than it would be with Hashi's. Regardless the important thing is to get your doctor to start you on thyroid meds and gradually increase the dosage as needed to get your Free T4 to the middle of its range, at minimum, and your Free T3 into the upper third of its range, or as needed to relieve hypo symptoms.
When you go back to the doctor you need to find out if the doctor is going to be willing to treat clinically, by testing and adjusting Free T4 and free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH results.
Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, so you should get those tested and supplement as needed to optimize. D should be 55-60, B12 in the upper end of its range and ferritin should be 70 minimum. Low levels can cause symptoms that mimic hypothyroidism. Low D or ferritin can interfere with metabolism of thyroid hormone.
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As for your symptoms being related to hypothyroidism, from a very long list of symptoms that can be hypo related, have a look at this section.
Pain:
Migraines
Chronic headaches
Chronic back and loin pain
Wrist pain
Muscles and joint pain
Carpal Tunnel Syndrome (hands or forearms)
Tarsal Tunnel syndrome (legs)
Joint stiffness
Tendonitis
Heel spur
Plantar fasciitis
Arthritis
Gout
Painful soles of feet
Muscle cramps
Aching bones
Aching muscles
Joint pain
TMJ
Fibromyalgia
Always keep in mind that a good thyroid doctor will treat clinically, as I described above. I don't hold out much hope that the Endo will be a good thyroid doctor because many of them specialize in diabetes, not thyroid. Many of them have the "Immaculate TSH Belief" and only pay attention to TSH. That does not work. If they go beyond TSH typically they test for Free T4 and then will tell you that a thyroid test that falls anywhere within the range is adequate. That is very wrong also. The ranges are far too broad due to the erroneous method used to establish them Basically any Free T4 and Free T3 results in the lower half of the ranges should be suspect. You can get some good insight from tis link written by a good thyroid doctor.
http://www.hormonerestoration.com/Thyroid.html