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Thyroid levels rollercoaster?
Okay...I'm going through the "fallout" of simple thyroiditis...At first, I was hyper, then hypo...Now, with synthroid, I'm not sure? I'm 6 weeks into taking the medication, and actually feel like the hyper may be coming back although the body temp is ranging subnormal to normal...the heart rate feels like it's pounding quite a bit, and is 90-112 beats/min at rest...here's the labs since the thyroiditis started...
5-20-08 TSH <.01 Free T-4 3.8
7-02-08 TSH 59.87 Free T-4 <.4
8-07-08 TSH 1.08 Free T-4 1.6
TSH ref (.04-5.0) Free T-4 ref (.07-1.5)
So, if the TSH is "low normal range", and the Free T-4 is just barely high...is the Synthroid working too good, or maybe this means the thyroid is trying to regulate itself and is going back to normal? Has anyone experienced this? Will too much Synthroid damage the thyroid or cause it to become "lazy"? Thanks... ~MM
5-20-08 TSH <.01 Free T-4 3.8
7-02-08 TSH 59.87 Free T-4 <.4
8-07-08 TSH 1.08 Free T-4 1.6
TSH ref (.04-5.0) Free T-4 ref (.07-1.5)
So, if the TSH is "low normal range", and the Free T-4 is just barely high...is the Synthroid working too good, or maybe this means the thyroid is trying to regulate itself and is going back to normal? Has anyone experienced this? Will too much Synthroid damage the thyroid or cause it to become "lazy"? Thanks... ~MM
Thank you very much for your feedback! My T-3 levels are in range currently (they were very high when the hyperthyroid was in full swing)...You've answered my most pressing question about if too much Synthroid over a period of time would be damaging to my thyroid...Currently, I'm waiting for my endo to go over the labs and decide if he's going to reduce the med now, or wait just a bit longer...I just finished chemo 1 week ago, (it caused the thyroiditis) and expect that my thyroid levels will normalize with time...Hopefully, the synthroid won't be needed too much longer!... :) Besides the heart pounding sensations, I'm feeling really good! Thanks again for your reply! It was very helpful and reassuring... ~MM
Thanks you so much for all the info. I think I have googled hypothroid osteoporosis before, but as you, I can't remember what it said - LOL.
Your thyroperoxidase (do you know how many names this test has?) antibodies indicates autoimmune something, but it takes more puzzle pieces to say with authority that it indicates this or that.
If you have a history of sub-clinical hypothyroidism (high TSH is an indication), it PROBABLY means you have autoimmune hypothyroidism, or Hashimoto's disease.
Howver, TPOab can be present in Hashimoto's, or Grave's disease, which is hyperthyroidism, or several other autoimmune conditions.
The nodules and the enlarged lobe point more toward hypothyroidism, so it is a safe bet you have Hashimoto's. Hashimoto's is the most common form of hypothyroidism, so it's not a death sentence. Hashimoto's can take many different paths. Some of them are easy to control, some of them are not.
The fact that the nodules did not show up on the uptake scan is good, as that means they are not "hot" nodules that are producing hormones independant of the thyroid.
The loss of bone density is also a result of hypothyroidism.
The last Free T4 test you had is low, but it should still be enough to provide adequite Free T3. Whether or not your Free T3 is low is a guess. The Total T3 test is completely useless for evaluation purposes. It's just useless period.
Thyroid Peroxidase antibodies, when found in the titer that your results show, attack the thyroid tissue directly, killing cells as if it were a foreign invader. That causes swelling and inflamation. It causes irregularities in the natural regeneration of the gland. It slowly destroys the gland, one little infection after another.
If your TPOab was lower, say 100, then there might be some debate over what it means. As high as your's is, it means either Hashimoto's or Grave's, and you don't show any signs of Grave's.
On the plus side, you tested negative for Thyroglobulin antibodies. At least you don't have those antibodies.
Your calcium is perfect, except your body is not using it correctly. Google "hypothyroid osteperosis" or "thyroid calcium deficiency" and see what you find. There is a connection, and a way to address the problem, but I forget right now what that would be.
A combination of malabsorbtion and a deficiency of magnesium or something...
I hope the Endo is more helpful to you than your PCP.
Oh, MVP? I have it too. Thyroid related.
If you have a history of sub-clinical hypothyroidism (high TSH is an indication), it PROBABLY means you have autoimmune hypothyroidism, or Hashimoto's disease.
Howver, TPOab can be present in Hashimoto's, or Grave's disease, which is hyperthyroidism, or several other autoimmune conditions.
The nodules and the enlarged lobe point more toward hypothyroidism, so it is a safe bet you have Hashimoto's. Hashimoto's is the most common form of hypothyroidism, so it's not a death sentence. Hashimoto's can take many different paths. Some of them are easy to control, some of them are not.
The fact that the nodules did not show up on the uptake scan is good, as that means they are not "hot" nodules that are producing hormones independant of the thyroid.
The loss of bone density is also a result of hypothyroidism.
The last Free T4 test you had is low, but it should still be enough to provide adequite Free T3. Whether or not your Free T3 is low is a guess. The Total T3 test is completely useless for evaluation purposes. It's just useless period.
Thyroid Peroxidase antibodies, when found in the titer that your results show, attack the thyroid tissue directly, killing cells as if it were a foreign invader. That causes swelling and inflamation. It causes irregularities in the natural regeneration of the gland. It slowly destroys the gland, one little infection after another.
If your TPOab was lower, say 100, then there might be some debate over what it means. As high as your's is, it means either Hashimoto's or Grave's, and you don't show any signs of Grave's.
On the plus side, you tested negative for Thyroglobulin antibodies. At least you don't have those antibodies.
Your calcium is perfect, except your body is not using it correctly. Google "hypothyroid osteperosis" or "thyroid calcium deficiency" and see what you find. There is a connection, and a way to address the problem, but I forget right now what that would be.
A combination of malabsorbtion and a deficiency of magnesium or something...
I hope the Endo is more helpful to you than your PCP.
Oh, MVP? I have it too. Thyroid related.
Dear AR . . .can you please intrepret my test and lab results. You are so knowledgeable, and I'm a novice. I am an RN, but my specialty is NICU, not adult stuff and I feel very stupid right now.
TSH 4.6 in Feb. 2006 Asymptomatic except for HTN and palpatations (I have MVP)
April 2006 HTN persists so started on 25 mg Toprol XL every day
No labs in 2007
June 2008 -- TSH 5.137 - sypmtomatic at this time. Feel like I have a lump in my throat
June 27, 2008 sent for neck ultrasound -- shows two nodules and an enlarged left lobe of thyroid.
July 18,2008 - Thyroid Scan w/RAI uptake. Elevated three and 24 hour I-123 uptake. No evidence of thyroid nodules (but evidence on ultrasound, so I know they are there) Larger left lobe and hyperfunctioning of thyroid gland.
July 15,2008
Thyroperoxidase AB 704.7 (<9.0)
Thyroglobulin AB screen 1.8 (<4)
Free T4 0.74 (0.5-1.2)
T3, Total 1.25 (0.4-1.8)
PCP said I have something autoimmune going on, but won't commit. I see Endo on 8/21. I also had a bone density done end of June and I have severe osteoporosis in my spine with a high risk of fracture. That came out of nowhere since I have no family hx of osteo.
PTHI 54.6 (12-88)
Calcium 9.4 (8.4-10.2)
Oh, and when I asked my PCP about a Free T3, she said there was no such test, only a 'reverse' T3; which I know is BS, because the healthcare system I work at runs Free T3's. Didn't think it was worth getting into it at that time, since I'm getting the feeling she's not very informed on thyroid problems.
Any thoughts? I wold appreciate your input.
Thanks, Tracy
TSH 4.6 in Feb. 2006 Asymptomatic except for HTN and palpatations (I have MVP)
April 2006 HTN persists so started on 25 mg Toprol XL every day
No labs in 2007
June 2008 -- TSH 5.137 - sypmtomatic at this time. Feel like I have a lump in my throat
June 27, 2008 sent for neck ultrasound -- shows two nodules and an enlarged left lobe of thyroid.
July 18,2008 - Thyroid Scan w/RAI uptake. Elevated three and 24 hour I-123 uptake. No evidence of thyroid nodules (but evidence on ultrasound, so I know they are there) Larger left lobe and hyperfunctioning of thyroid gland.
July 15,2008
Thyroperoxidase AB 704.7 (<9.0)
Thyroglobulin AB screen 1.8 (<4)
Free T4 0.74 (0.5-1.2)
T3, Total 1.25 (0.4-1.8)
PCP said I have something autoimmune going on, but won't commit. I see Endo on 8/21. I also had a bone density done end of June and I have severe osteoporosis in my spine with a high risk of fracture. That came out of nowhere since I have no family hx of osteo.
PTHI 54.6 (12-88)
Calcium 9.4 (8.4-10.2)
Oh, and when I asked my PCP about a Free T3, she said there was no such test, only a 'reverse' T3; which I know is BS, because the healthcare system I work at runs Free T3's. Didn't think it was worth getting into it at that time, since I'm getting the feeling she's not very informed on thyroid problems.
Any thoughts? I wold appreciate your input.
Thanks, Tracy
It sounds like your dose may need to be adjusted down just a bit. Your Free T4 should not be out of range.
Too much Synthroid will drive you hyper. It won't damage your thyroid specifically. Your thyroid will perform as best it can, over-riding the artificial support.
Your TSH and your thyroid hormones have been through some major adjustments and things are still settling. I'd try to get bloodwork done again in a couple of weeks to make sure your levels are not still shifting.
A Free T3 test would be nice...
Too much Synthroid will drive you hyper. It won't damage your thyroid specifically. Your thyroid will perform as best it can, over-riding the artificial support.
Your TSH and your thyroid hormones have been through some major adjustments and things are still settling. I'd try to get bloodwork done again in a couple of weeks to make sure your levels are not still shifting.
A Free T3 test would be nice...
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