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fluctuating thyroid, testosterone and pituitary results.
Hi, I have been very tired achy and cold for the last 2 months. I am a runner and I am unable to run without losing my breath now. I went to the doctor 2 weeks ago and my tests showed a tsh 7.32 my t4 was 1.1 free t3 7.2. The test also showed that my testosterone was very low and my pituitary was very high. My doctor referred me to an endo but they can't get me in for a couple of months, so the Dr. did more tests. I just got those results and am very confused. The testosterone is good, pituitary good and my Tsh is .64, T4=.8 and freet3=3.4. I still feel cruddy. These test were less than 2 weeks apart. Has anyone had this happen? I still have my appt. with the endo. Any info would be great. I read about hashimotos and I do have the symptoms for that. Thanks!
COMMUNITY LEADER
We need to have reference ranges for all the lab results. Ranges vary lab to lab and have to come from your own report(s).
I'm not sure what you mean by "my pituitary was very high". Are you referring to the TSH, which is a pituitary hormone? TSH fluctuates greatly, even intraday. At 7.32, yours was higher than normal, but at 0.64, it's within the normal range.
Your T4 (is that Free?) seem to be quite low, but again, we need the reference ranges. Without the ranges, I'm not sure about the Free T3's because they're so far apart.
If your primary doctor is willing to do more tests, you should ask her/him to go ahead and order the antibody tests that will determine whether or not you have Hashimoto's. The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). You need them both, because some people have only one or the other, while others have them both. While Hashimoto's is most often associated with hypothyroidism, it's not unusual to have alternating hyper and hypo periods in the beginning. Getting the antibody tests now, could save time when you get to the endo.
Have you had a thyroid ultra sound to determine if you have swelling/inflammation of the thyroid, or nodules?
"I still feel cruddy." What are some of the symptoms that make you feel cruddy?
You should make sure you keep close watch on the testosterone levels. While all hormone levels can fluctuate, there shouldn't be extremely wide swings in testosterone levels. You said your level was "very low", then it was "good"....... this is where actual results with reference ranges come in, so we can see your result in relation to the range used by your lab. Your testosterone could have been below range, to start, but low normal on the second test, so the "swing" may not be as great as it might appear and most doctors tend to think that anything within the reference range is "good"....even if it's not right for the individual....... We're pretty complex beings and almost none of us fit into the same set of numbers.
I'm not sure what you mean by "my pituitary was very high". Are you referring to the TSH, which is a pituitary hormone? TSH fluctuates greatly, even intraday. At 7.32, yours was higher than normal, but at 0.64, it's within the normal range.
Your T4 (is that Free?) seem to be quite low, but again, we need the reference ranges. Without the ranges, I'm not sure about the Free T3's because they're so far apart.
If your primary doctor is willing to do more tests, you should ask her/him to go ahead and order the antibody tests that will determine whether or not you have Hashimoto's. The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). You need them both, because some people have only one or the other, while others have them both. While Hashimoto's is most often associated with hypothyroidism, it's not unusual to have alternating hyper and hypo periods in the beginning. Getting the antibody tests now, could save time when you get to the endo.
Have you had a thyroid ultra sound to determine if you have swelling/inflammation of the thyroid, or nodules?
"I still feel cruddy." What are some of the symptoms that make you feel cruddy?
You should make sure you keep close watch on the testosterone levels. While all hormone levels can fluctuate, there shouldn't be extremely wide swings in testosterone levels. You said your level was "very low", then it was "good"....... this is where actual results with reference ranges come in, so we can see your result in relation to the range used by your lab. Your testosterone could have been below range, to start, but low normal on the second test, so the "swing" may not be as great as it might appear and most doctors tend to think that anything within the reference range is "good"....even if it's not right for the individual....... We're pretty complex beings and almost none of us fit into the same set of numbers.
My understanding about testosterone levels is, testosterone is a short acting hormone that follows a strong daily cycle. Typically high in the morning, low in the evening. I think much of it is generated during REM sleep very early in the morning. That make testosterone tests very tricky to interpret and very subject to other health issues.
"my testosterone was very low and my pituitary was very high"
There are two pituitary hormones, actually more, but,
TSH is thyroid stimulating hormone which controls how much thyroid hormone your thyroid produces. One assumes that not what is meant.
Then there is FSH Follicle-stimulating hormone and LH Luteinizing hormone. If these are high and testostrone is low, then you get primary hypogonadism.
Anyways, hard to tell, especially without lab results and ranges.
PS: Sometimes doctors will misinterpret testosterone results. As in
Test 1: 160 range 300-850. Oh so very very low!
Test 2: 305 range 300-850. Oh absolutely normal!
That said, I;d work down the thyroid issues, especially get your doctor to run a thyroid antibody panel. Early thyroid autoimmune disease can result in levels to swing all over the place. (often seems to me that doctors should abandon TSH as a screening test and go right for the antibodies and save vast numbers of patients grief)
"my testosterone was very low and my pituitary was very high"
There are two pituitary hormones, actually more, but,
TSH is thyroid stimulating hormone which controls how much thyroid hormone your thyroid produces. One assumes that not what is meant.
Then there is FSH Follicle-stimulating hormone and LH Luteinizing hormone. If these are high and testostrone is low, then you get primary hypogonadism.
Anyways, hard to tell, especially without lab results and ranges.
PS: Sometimes doctors will misinterpret testosterone results. As in
Test 1: 160 range 300-850. Oh so very very low!
Test 2: 305 range 300-850. Oh absolutely normal!
That said, I;d work down the thyroid issues, especially get your doctor to run a thyroid antibody panel. Early thyroid autoimmune disease can result in levels to swing all over the place. (often seems to me that doctors should abandon TSH as a screening test and go right for the antibodies and save vast numbers of patients grief)
Hi, I have had two more test.
The results
3/22/13
Tsh .64 (range .4-4.7)
free t3 3.4(range 2.8-5.3)
Free t4 .8(.07-1.9)
testosterone total 482 (normal,no range given)
Next test results 05/2013
Tsh .68
free t4 .9
NO antibodies on thyroperoxidase ab or thyroglobulin ab
I am still having symptoms of fatigue, painful joints, insomnia but am tired, and an increase in migraines.
The endo said since all tests were in range I was A okay, dr. feels the same. Do I let it be or get a second endo opinion. I am not sure what to do at this point. Any opinions will be appreciated :)
The results
3/22/13
Tsh .64 (range .4-4.7)
free t3 3.4(range 2.8-5.3)
Free t4 .8(.07-1.9)
testosterone total 482 (normal,no range given)
Next test results 05/2013
Tsh .68
free t4 .9
NO antibodies on thyroperoxidase ab or thyroglobulin ab
I am still having symptoms of fatigue, painful joints, insomnia but am tired, and an increase in migraines.
The endo said since all tests were in range I was A okay, dr. feels the same. Do I let it be or get a second endo opinion. I am not sure what to do at this point. Any opinions will be appreciated :)
COMMUNITY LEADER
I'd get another opinion because your FT4 is only at 8% of its range and your FT3 is only 24% of its range. Rule of thumb is, typically, to have FT4 at about mid range and FT3 in the upper 1/3 of range.
You also need to have the thyroid antibodies. Hypothyroid symptoms can be present long before blood tests will prove to a doctor that you are really ill. Antibodies can be present, too, before actual thyroid hormone levels fall out of range, because Hashimoto's is progressive and as it destroys thyroid tissue, less hormones will be produced. Both the endo and your pcp "assume" that since your blood tests are "normal", you're just fine. They don't stop to consider what might be causing those symptoms.
You should also get vitamin B12 and vitamin D tested. Low levels of Vitamin B12 can cause horrible fatigue and low levels of vitamin D can cause hypo-like symptoms.
You also need to have the thyroid antibodies. Hypothyroid symptoms can be present long before blood tests will prove to a doctor that you are really ill. Antibodies can be present, too, before actual thyroid hormone levels fall out of range, because Hashimoto's is progressive and as it destroys thyroid tissue, less hormones will be produced. Both the endo and your pcp "assume" that since your blood tests are "normal", you're just fine. They don't stop to consider what might be causing those symptoms.
You should also get vitamin B12 and vitamin D tested. Low levels of Vitamin B12 can cause horrible fatigue and low levels of vitamin D can cause hypo-like symptoms.
"Men in the highest quartile of total testosterone (above 550 ng/dL) had a 30% lower risk of cardiovascular events. Any level of total testosterone below 550 ng/dL resulted in significant increased risk, thus helping to establish a minimal baseline as to where total testosterone should be to guard against heart attack or stroke." - Life Extension - The Testosterone Controversy
The "normal" range - welcome to the illness industry. :)
The "normal" range - welcome to the illness industry. :)
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