Aa
barking up the wrong tree
I think my dr's and I have been focusing on the wrong thing trying to find a genetic problem with my heart when the answer's been staring us in the face all along.
Someone showed me a study that floored me because I've read little about the thyroid/cardiac link and The Effects of L-thyroxine Treatment on QT Dispersion in Primary Hypothyroidism. Hypothyroidism has various cardiovascular manifestations and exhibits electrocardiographic change and explains so much about my problems. When I go through the list of QT dispersion and Hypo; I have almost everything on the list and explains almost every cardiac symptoms I've had.
If you want to read the study you can go to the The National Center for Biotechnology Information and search for the study under The Effects of L-thyroxine Treatment on QT Dispersion in Primary Hypothyroidism or just google the study title.
I've had my TSH tested many times over the years and the dr's I've been to haven't tested anything else and go on that basis alone. I didn't realize how important Thyroid is though until reading so much this week. What my dr's have failed to do is take into consideration that I was dx back in 1998 and treated until 2000 when I was pregnant and my new gyn took me off Synthroid. (I thought I was taking 'female' hormones lol I didn't understand back then what he was talking about)
I even had a spreadsheet and list of all of my blood tests & symptoms hoping some dr would find what's wrong with me, but none have put anything together until my new doctor last month. I keep going back to Nov 1997 where I developed Group B Streptococcus that turned septic and wrecked havoc on my body. I started many symptoms and was dx shortly after.
Could it be this simple? Has anyone else gone untreated for many years and it cause cardiac or other problems like this? Any thoughts on the study?
I read that I should start with a low dose of levothyroxine (25mg) rather than Armour....reason being, Armour contains T3 which is like a "direct drive" med and can cause cardiac symptoms and this is what my dr suggested.
I'm hoping this small dose would help with my grocery list of symptoms. Should I see an Endo also or will my primary do since she's willing to do the right tests and treat me?
Someone showed me a study that floored me because I've read little about the thyroid/cardiac link and The Effects of L-thyroxine Treatment on QT Dispersion in Primary Hypothyroidism. Hypothyroidism has various cardiovascular manifestations and exhibits electrocardiographic change and explains so much about my problems. When I go through the list of QT dispersion and Hypo; I have almost everything on the list and explains almost every cardiac symptoms I've had.
If you want to read the study you can go to the The National Center for Biotechnology Information and search for the study under The Effects of L-thyroxine Treatment on QT Dispersion in Primary Hypothyroidism or just google the study title.
I've had my TSH tested many times over the years and the dr's I've been to haven't tested anything else and go on that basis alone. I didn't realize how important Thyroid is though until reading so much this week. What my dr's have failed to do is take into consideration that I was dx back in 1998 and treated until 2000 when I was pregnant and my new gyn took me off Synthroid. (I thought I was taking 'female' hormones lol I didn't understand back then what he was talking about)
I even had a spreadsheet and list of all of my blood tests & symptoms hoping some dr would find what's wrong with me, but none have put anything together until my new doctor last month. I keep going back to Nov 1997 where I developed Group B Streptococcus that turned septic and wrecked havoc on my body. I started many symptoms and was dx shortly after.
Could it be this simple? Has anyone else gone untreated for many years and it cause cardiac or other problems like this? Any thoughts on the study?
I read that I should start with a low dose of levothyroxine (25mg) rather than Armour....reason being, Armour contains T3 which is like a "direct drive" med and can cause cardiac symptoms and this is what my dr suggested.
I'm hoping this small dose would help with my grocery list of symptoms. Should I see an Endo also or will my primary do since she's willing to do the right tests and treat me?
Since you mentioned calling an Endo today, this occurred to me. When looking for a good thyroid doctor for friends and members, I call the prospective doctor's office and mention that I am looking for a good thyroid doctor, but before making an appointment I would like to ask one of the nurses two questions. This has almost always succeeded in getting a nurse on the phone. The two questions I ask are , "Is the doctor willing to treat a thyroid patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels". And next, "Is the doctor willing to prescribe meds other than T4 only types"? If the answer to either is no, then you might as well keep on looking.
If you can find an Endo that meets the definition of being a good thyroid doctor, that's great; however, they seem to be few in number.
If you can find an Endo that meets the definition of being a good thyroid doctor, that's great; however, they seem to be few in number.
The more I read the more I'm inclined to think this has been my thyroid all along....that would be SUCH a relief. Here doctors have been searching for genetic things and trying to point towards a bad heart etc.
Going to call a Endocrinologist/Internist I found on my insurance plan last night. [crosses fingers] heck toe crossing too...
I really hope this is the answer =)
Going to call a Endocrinologist/Internist I found on my insurance plan last night. [crosses fingers] heck toe crossing too...
I really hope this is the answer =)
Oh wow you;re right; I completely overlooked it was total T3 because T4 was listed as free right above it.
That's frustrating because I asked specifically to make sure the FT3&4's were done and the nurse called me and said that's what they ordered.
Good thing it's almost time for new blood tests; I'll make sure they know which ones I want done.
That's frustrating because I asked specifically to make sure the FT3&4's were done and the nurse called me and said that's what they ordered.
Good thing it's almost time for new blood tests; I'll make sure they know which ones I want done.
There are numerous links about the AACE changing the range for TSH. This is just one of them.
http://www.thyroid-info.com/articles/aacereversal.htm
Would you please double check that T3 test? From the range it looks more like a total T3 than a Free T3.
For info, the reason given for the AACE's change of the TSH range was that there were lots more hypo patients than the 2.5% predicted by their old range. When they carefully purged suspect hypo patient data from their data base, and recalculated, the range went from .5 - 5.0 down to .3 - 3.0. this was a huge change. When I realized the number of patients with hypo symptoms that have FT3 in the lower end of the range, it made me wonder why the ranges for FT3 and FT4 had never been revised for the same reason as TSH.
I have done a lot of searching about this and came to the conclusion that the ranges for FT3 and FT4 should be revised also, and for the same reason as TSH. Having a background in statistical analysis I estimated some time ago that the range for FT3 should change from 2.3 - 4.2 up to 3.2 - 4.2. Likewise the range for FT4 should be revised from .6 - 1.5 up to 1.0 - 1.55. Of course this would not be necessary if the doctors used these reference ranges as guidelines within which to adjust FT3 and FT4 as necessary to relieve symptoms. Instead they are used as pass/fail decisions, resulting in many patients being misdiagnosed and under medicated.
For info I have had many email discussions about this with the AACE, but they steadfastly refuse to engage in any meaningful way. They claim their ranges are "evidence based". I replied that my position was also evidence based on many scientific studies I have found and also based on the number of patients who suffer from hypothyroidism as a result of the way the ranges are applied currently by most doctors.
At any rate, your FT4 is too low in the range and I suspect your FT3 is the same.
http://www.thyroid-info.com/articles/aacereversal.htm
Would you please double check that T3 test? From the range it looks more like a total T3 than a Free T3.
For info, the reason given for the AACE's change of the TSH range was that there were lots more hypo patients than the 2.5% predicted by their old range. When they carefully purged suspect hypo patient data from their data base, and recalculated, the range went from .5 - 5.0 down to .3 - 3.0. this was a huge change. When I realized the number of patients with hypo symptoms that have FT3 in the lower end of the range, it made me wonder why the ranges for FT3 and FT4 had never been revised for the same reason as TSH.
I have done a lot of searching about this and came to the conclusion that the ranges for FT3 and FT4 should be revised also, and for the same reason as TSH. Having a background in statistical analysis I estimated some time ago that the range for FT3 should change from 2.3 - 4.2 up to 3.2 - 4.2. Likewise the range for FT4 should be revised from .6 - 1.5 up to 1.0 - 1.55. Of course this would not be necessary if the doctors used these reference ranges as guidelines within which to adjust FT3 and FT4 as necessary to relieve symptoms. Instead they are used as pass/fail decisions, resulting in many patients being misdiagnosed and under medicated.
For info I have had many email discussions about this with the AACE, but they steadfastly refuse to engage in any meaningful way. They claim their ranges are "evidence based". I replied that my position was also evidence based on many scientific studies I have found and also based on the number of patients who suffer from hypothyroidism as a result of the way the ranges are applied currently by most doctors.
At any rate, your FT4 is too low in the range and I suspect your FT3 is the same.
Thanks for the info; luckily someone shared the link and I took it to my primary but she surprised me willing to do the tests my other doctors haven't done.
Back in 2009 when I tried to get my GYN to send me my original labs, it was too late to get them since they destroy records after 7 years :( sure wish I had known to request copies of them then.
Here's my results from 2004 - 2011
TSH 4.48 4.91 3.709 4.07 4.28 [normal - 0.40-4.50]
FT4 1.0 - 1.0 - 1.0 [normal - 0.8-1.8]
FT3 - - - - 108 [normal - 76-181]
I've been hesitant to do any meds because of my heart issues, but I'll try anything to get rid of all these symptoms. I thought maybe Hyperparathyroidism because of the bone aches & pains but my calcium is ok and stays between 9.1 - 10.0
Since I was dx & treated in 1998 my "normal" TSH should be 0.3-3.0 correct? I've tried to find those links but haven't yet.
I'm crossing my fingers this may finally be some answers and relief.
Back in 2009 when I tried to get my GYN to send me my original labs, it was too late to get them since they destroy records after 7 years :( sure wish I had known to request copies of them then.
Here's my results from 2004 - 2011
TSH 4.48 4.91 3.709 4.07 4.28 [normal - 0.40-4.50]
FT4 1.0 - 1.0 - 1.0 [normal - 0.8-1.8]
FT3 - - - - 108 [normal - 76-181]
I've been hesitant to do any meds because of my heart issues, but I'll try anything to get rid of all these symptoms. I thought maybe Hyperparathyroidism because of the bone aches & pains but my calcium is ok and stays between 9.1 - 10.0
Since I was dx & treated in 1998 my "normal" TSH should be 0.3-3.0 correct? I've tried to find those links but haven't yet.
I'm crossing my fingers this may finally be some answers and relief.
So glad to hear that you may have found the cause for your many symptoms and are starting on the path to feeling better. Thanks for the link to that study. Haven't absorbed it all yet, but very interesting.
To me the decision on medication type would be dependent on blood tests for FT3 and FT4. If, for some reason your FT3 was much lower in the range than FT4, indicating a lack of T4 to T3 conversion, then a T4/T3 med might be best for you. If not, then a T4 might work well and of course T4 medication can be taken only once per day and it has a longer half-life than T3, so it builds up in your body more slowly.
I also was a victim of the "Immaculate TSH Belief" for many years. Even after I finally got my doctor to give me a therapeutic trial of T4, and got good results, I was stuck with that and lingering hypo symptoms for over 25 years until finding out on this Forum about the importance of FT3. When I got my FT3 checked it was in the very low end of the range. After getting my meds changed to Armour and tweaking the dosage until FT3 is now in the upper third of the range, I feel best ever.
You don't necessarily need an endo. They are frequently the most rigid about TSH being all important, and also tend to believe that any thyroid hormone test that falls within even the very low end of the range means that all is okay and that you need nothing further. What you really need is a good thyroid doctor, by which I mean a doctor that will treat a patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not test results. Test results are valuable mainly as indicators during diagnosis and then afterward to track FT3 andFT4 levels as meds are increased to relieve symptoms.
I have found this link to provide good insight into clinical treatment. The letter was written by a good thyroid doctor for patients that he is consulting with from a distance. the letter is sent to the PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
To me the decision on medication type would be dependent on blood tests for FT3 and FT4. If, for some reason your FT3 was much lower in the range than FT4, indicating a lack of T4 to T3 conversion, then a T4/T3 med might be best for you. If not, then a T4 might work well and of course T4 medication can be taken only once per day and it has a longer half-life than T3, so it builds up in your body more slowly.
I also was a victim of the "Immaculate TSH Belief" for many years. Even after I finally got my doctor to give me a therapeutic trial of T4, and got good results, I was stuck with that and lingering hypo symptoms for over 25 years until finding out on this Forum about the importance of FT3. When I got my FT3 checked it was in the very low end of the range. After getting my meds changed to Armour and tweaking the dosage until FT3 is now in the upper third of the range, I feel best ever.
You don't necessarily need an endo. They are frequently the most rigid about TSH being all important, and also tend to believe that any thyroid hormone test that falls within even the very low end of the range means that all is okay and that you need nothing further. What you really need is a good thyroid doctor, by which I mean a doctor that will treat a patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not test results. Test results are valuable mainly as indicators during diagnosis and then afterward to track FT3 andFT4 levels as meds are increased to relieve symptoms.
I have found this link to provide good insight into clinical treatment. The letter was written by a good thyroid doctor for patients that he is consulting with from a distance. the letter is sent to the PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
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