Thyroid Disorders Community
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Avatar universal

Underactive Thyroid Gland

My readings go up and down and so too does my medication. I don't understand this.  Should I used the dame lab each time?

The doctor only seems to give me TSH and 4 bloodwork.

Here are my TSH results since 2011:

Aug 14.4
Sep 0.81
Feb .03
Mar .02

Doc has me on 112 now but in the past I've been on 100, 112, 125, 137. My T4 reading in Aug 2012 was 11.7 (okay).

It just seems backwards to me to have an Underactive Thyroid and then the doctor lowers the medication?

This is for starters. I've had a long history of thyroid disease but in my 20's and 30's it was very overactive.  Since my 40's I've had an Underactive Thyroid.

Can some of you please shed some light on this condition and tell me what foods will help/hurt, what medications hurt (lithium?).  I've done some research but some info seems contradictory.  My doctor doesn't seem to think there are any food issues.

Thanks, Christina
P.S. I've gained over 30+ lbs since going underative.  I can't seem to take it off no matter how hard I try and I'm frustrated.
15 Responses
649848 tn?1534637300
Your doctor is relying way too much on TSH as a diagnostic/treatment tool.  Thyroid can be confusing, but TSH works opposite of what you think it should.  In a perfect world, when TSH goes up, thyroid levels are down and when TSH goes down, thyroid levels are up.  Your doctor is assuming that because your TSH is very low, that your thyroid hormone levels are either high, or normal.  

Unfortunately, doctors who do this tend to keep their patients ill for a very long time.  

Do you know if that T4 in Aug 2011 (?) was Free or Total?  They aren't the same.  If the lab report only says T4 and doesn't indicate Free or FT4, etc, then it's for total, which is considered obsolete and of little value.

You need to be tested for Free T3 and Free T4, which are the actual thyroid hormones that are available for use (FT3) or conversion (FT4).  

Do you know if you have an autoimmune thyroid disease?  That would be either Hashimoto's Thyroiditis, which is generally associated with hypothyroidism or Graves Disease, which is most often associated with hyperthyroidism.   Hashimoto's is often characterized by periods of overactive thyroid in the beginning stages, then as the thyroid is destroyed the thyroid becomes underactive.  If you haven't been tested for antibodies, you should request to have those done.  Tests needed would be Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) for Hashimoto's and Thyroid Stimulating Immunoglobulins (TSI) for Graves Disease.

Weight gain is common when hypo, because FT3 is instrumental in controlling metabolism.  Once thyroid hormone levels are adequate, many people find that they are able to lose excess weight, though some of us have to really work at it.  

There are other conditions, such as insulin resistance and/or PCOS that cause excessive weight gain/inability to lose, as well, so should also be ruled out, if still unable to lose after thyroid levels are optimal.

Avatar universal
I agree with what Barb has said.  I can't tell you how important it is to have FREE T3 and FREE T4 tested every time you have blood work.  TSH can be very unreliable, since once on meds, TSH often goes down close to zero.

Goitrogens (you can google a list), when eaten raw can cause thyroid inflammation.

Lithium can decrease thyroid hormone production and cause hypothyroidism.  It is also associated with weight gain.  

As Barb said, TSH is the opposite of what you'd think...when it's high, your thyroid function is low and vice versa.  "It just seems backwards to me to have an Underactive Thyroid and then the doctor lowers the medication?"  If you take too much medication, you can become hyperthyroid, so your doctor has to be sure that your thyroid hormones are kept in balance and you are neither hypo nor hyper.

Can you tell us a little bit more about the contradictory information you've found?  Perhaps we can help shed some light on it.  
Avatar universal
The list I found on goitrogens said nothing about cooking.  It simply said avoid them.  I did find some patients say you could eat them if you cooked them.  Also one web site said you could cook the cabbage family foods, etc (goitrogens).

I will call the doctor's nurse and tell her my next test must include FreeT-3 and Free T-4. Do I also need TSH and anything else?  Does insurance (CIGNA) cover all the thyroid tests?  Maybe that's why he just gives me TSH and T-4.  As I said, this and the chronic pain (FM) is wearing me down.

What breads can I eat:  Ezekial?

Thanks for your input.  
Thanks for your kindness
P.S. Barb it was 2011 for 14.4...fat fingers

Is there anything natural I can do to boost the thyroid?
Avatar universal
Your doctor is most likely going to want to order TSH; he'll want to see it, I'm sure.  

As Barb mentioned, if you don't know the cuase of your thyroid dysfunction, antibody tests would be a really good idea.  TPOab and TGab are the tests for Hashi's.  TSI is the test for Graves'.  I'd consider TSI optional unless your doctor is feeling very generous about testing.

If the doctor orders them, most insurance covers all thyroid tests, but you'd have to question Cigna specifically to be sure.  I doubt whether or not insurance covers it is behind his decision to order only TSH and FT4.  It's much more likely that he learned in med school that TSH was the gold standard of thyroid tests and that if FT4 was good, FT3 was good , too.  We know that neither of those is true, but the medical profession does not change its ways fast.

Many of us have not changed what we eat one iota.  If anything bothers you, avoid it, otherwise, you can eat anything you want.

There's likely little you can do to boost your thyroid.  Hashi's is the most prevalent cause of hypo in the developed world.  Antibodies attack and destroy thyroid function.  Once the thyroid is in effect "dead", there's no bringing it back.
Avatar universal
I just got back from the endcrinologist and even through I have hypothyroidism she thinks that my problems (pain, tired, run down, sleeplessness, fatique, irritability, weight gain. depression, and headache, etc., are caused by Fibromyalsgia.  

She gave me a prescription for CTOMEL (only generic LIOTYHRONNIE SOD 5 MCG TAB).  I'm to take 1 twice daily along with my once daily Synthroid 112 on an empty stomach.  Then in 6 weeks I will have these tests
FT4 - Free T4 -AIM
FT3 - Free T3 - AIM

In the meantime the doctor wants me to ask my pain management spcialist to give me something to help me sleep (I cannot take ambien because it makes me walk in my sleep and do strange things).Honestly I don't know what all this means but she doesn't think it's my thyroild, even though I have thyroid disases.

As far as the TSH numbers I indicated she said that's not unual and the numbers were'nt that far apart.

The sad thing is I took all my pain medication early and the doctor is not going to like that.  He may be the doctor but I don't think he gave me enough codeine to take care of my needs so I took extral of that and Soma to get by.  This is an endless cycle for me and it's making me sick in addition to hurting and not sleeping properly.

The endo doctor said eat anything you like.  Healthy food of course.  She doesn't believe in giving up cabbage, kale, brocolli, turnips, and othe "goitrogens."  As for weight gain, lots of wxercise and less food. The exercise part , althought I do it, is difficult due to the FM.

You all answered my questions to my liking and I give you all the "best."  thanks.

649848 tn?1534637300
Fibromyalgia is often found to be a set of unexplained symptoms, which often go away, once thyroid levels are optimal for you.  

I'm glad the endo is ordering the FT3 and FT4; those will tell us a lot more about what's going on than TSH will.  Did you ask about the antibody tests?  

As goolarra said, many of us don't change the way we eat.  Most people take thyroid medication in the morning, and you aren't going to be eating a lot of cabbage, and other goitrogens, until at least lunch, by which time your thyroid medication will have been dissolved and absorbed.  

Plenty of veggies and protein will help you lose weight, but watch the sauces and toppings; those are what get you.  

You mentioned Ezekial's bread....... are you gluten free?  If so, do you have celiac.  If you don't have celiac why are gluten free, if you are?
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