hypothyroid symptoms

[dfleming]

Two months ago today, I began having symptoms such as a racing heart, palpitations, a "heavy beating" heart and extreme fatigue.  Since then, other symptoms have come up, such as weight loss, shortness of breath and chest pain (more soreness than pain).  A stress test showed that my heart was in the clear, a chest x-ray showed my lungs looked fine, and a liver ultrasound (long story) was also clean.  The only thing that stood out was my blood tests that revealed high cholesterol (which I knew about) and a high TSH number (which I didn't know about).  The first test level was 7.13 and the next test a month later was 7.85.  So, clearly I have hypothyroidism.  I am 43 years old.

But, my questions are these:  Aren't my symptoms, specifically the heart issues and the weight loss, more indicative of hyperthyroidism?  I'm confused about that.  Second, I have a question about medication.  I'm not taking anything right at the moment, as I'm trying to decide between Synthroid and Armour Thyroid.  Some people I've talked to said that Synthroid made their heart race and that makes me nervous because the last thing I want is for my heart to race even more.  Can anyone shed some light on that?  Thanks in advance for any help...

[magpieannie]

When my daughter's t3 was low and her t4 was higher she got heart palpatations (PVC's) felt as a rapid beat any time she'd try to suddenly exert herself. She'd get suddenly out of breath, and hold her heart like she just ran a 50 yard dash, instead of just  running up the stairs, or jumping up and down, or shuffling her feet side to side in play as kids do. When I got her on desiccated hormone (over 1 year ago) that had t3 in it and got it higher then the t4 on labs, her heart issue went away, as well as many other hypo. health issues that she suffered on t4 only Synthetic Synthroid, which she could not convert into enough t3 which is the active hormone that all the organs, cells and body needs to work properly. Careful on the new Armour though, it didn't work well for my daughter (nine and born without a thyroid gland). Pay close attention to labs and symptoms and journaling everything is important! Get copies of all labs and post them here. I'd get labs in 4 to 6 weeks while adjusting. If the Armour is not doing what it needs to do over time, then I'd suggest Erfa Thyroid from Canada (like old good Armour) or compounded desiccated. My daughter is on the old good Nature-throid, however, the new stuff they are putting out now has also been changed similar to the Armour we here, and there are issues with labs/symptoms showing up/reappearing in people who are trying it. There is also Synthroid with added t3 Cytomel several times per day that works for many who can't convert well. Good luck and read up on it all. Stay in the loop as this is the only way to figure all this out!

[dfleming]

If I may, let me just ask one other symptom-related question.  Is there a correlation between physical exertion and an aggravation of symptoms?  I'm talking about the kind of physical exertion that I used to do routinely--anything from double-timing it up stairs to lifting heavy objects around the house.  Basically, anything short-term that would require a good shot of adrenaline to accomplish.  When I push myself in this manner, I feel OK at the time, but then within a few hours all symptoms become much worse and usually culminate in a horrible night's sleep of just rolling around.  I'm not talking about taking a brisk walk, which I try to do every night.  That doesn't seem to trigger it.

I guess I'd love to just tell people, "Sorry, I just can't push myself that hard."  But, I don't think that will work as a long-term strategy.

[Smilerdeb]

Hypo and HYper symptoms can be very much the same.
I have had the racing heart when hyper and hypo.
As Stella said .....you will learn the symptoms as you go along.
Journal EVERYTHING everyday and then you can look back on it to see a 'pattern'.
Write yr dose of T4 med, your symptoms, yr pulse, yr labs.
Do this for a few months (I still do it 2 years later) and find it so helpful.
I usually now know if I am heading borderline hyper or hypo before labs even tell me.

All the best and yes .........there is light at the end of the tunnel.

[dfleming]

I would sincerely like to thank you guys for your help and information on this.  I did start a 30mg Armour dosage this morning, as I'm sick of yo-yo-ing on symptoms while trying to get through a work day.  Hopefully, within a couple of weeks, I'll know something one way or the other.

What is a typical length of time to wait to be re-tested?  I've heard everything from a few weeks to a several months.  Does it depend on how I feel?  Also, is it quite normal that I may have to bounce around on different dosages until I hit the one that works?

Again, my thanks for all of your help and sage advice which makes this more bearable!

[goolarra]

Thyroid peroxidase antibody (TPOab) is the test that indicates autoimmune disease, in your case Hashimoto's thyroiditis.  TPOab is basically positive or negative...results in the thousands are not unusual, but any elevation above range is considered positive.

TSH is high indicating hypo.

Your free thyroxine (FT4) is just above midrange, which is where it should be according to the rule of thumb.

FT3 is quite low as the recommendation for FT3 is upper half to upper third of range.

Given your profile, with FT4 looking good, but FT3 low, I'd opt for dessicated (like Armour) since it contains both T3 and T4, and it's your T3 that needs to come up.  However, please do a LOT of research on dessicated.  Armour was changed last year, and many of our members have found that the new formulation is nothing like the old.  There's lots of material in the archives discussing alternatives to Armour, and you should read all you can before deciding.

Since you have Hashi's, your thyroid will continue to be compromised, so it will become less and less able to produce thyroid hormone.

I think you might consult an endo...I think your doctor's right, but it never hurt to get a second opinion.  

[dfleming]

Here are the results I have; please excuse my ignorance about some of these tests:
THYROXINE, FREE  0.94 (range 0.54 - 1.30)
TSH 3RD GEN         7.85 (range 0.34 - 5.60) HIGH
THYROID PEROXIDASE ANTIBODY    98.1   (range 0.0 - 9.0) HIGH (what is this, and why is it 10x more than the range??)
T3, FREE                 2.7 (range 2.4 - 4.2) - this is low(ish), but still in range??

I also had lead levels checked (negative) and a urinalysis to check for anemia (also negative).  My doctor's words as I left the office with my bloodwork were "You clearly have hypothyroidism.  If you want to confirm it with an endocrinologist, be my guest."  He also indicated that he had no qualms about prescribing the Armour as opposed to the Synthroid.

So, if anyone would like to weigh in on these results and his comments, please do.  Thanks in advance.

[goolarra]

If your FT3 and/or FT4 are high in their ranges or over range, hyper would be indicated.  If low or under, hypo.  T3 and T4 are the actual thyroid hormones (TSH is a pituitary hormone and can be affected by many factors other that thyroid hormone levels).  When asking for your results, be sure to request the reference ranges, too, as these are lab-specific and have to come from your own lab report.  BTW, TSH is not like FT3 and FT4...it's counterintuitive...a higher than range number indicates low (hypo) thyroid, a llow number hyper - theoretically).

In addition, you might check to see if your doctor ran thyroid antibody tests (TPOab, TGab and TSI) to see if you have an autoimmune thyroid disease.  Most thyroid disease in the U.S. is autoimmune.  If no, you might request these tests also.

[dfleming]

Thank you for your response, and yes, you'll get no argument from me--I'm sure I have a lot to learn about this condition.

I'm pretty sure I got tested for T3 and T4 levels in the second round of tests.  I wasn't given those results, but I'm sure they exist.  Part of the problem is that I'm dealing with a GP and not an endocrinologist (which is why I turned to this forum).

Assuming I can get those numbers, can you further explain how those levels should dictate which meds I should take?  Thanks!

[stella5349]

No - you have more to learn on what really decifers hypo and hyper symptoms and conditions/

You can not base everything on that TSH. You do have a much higher number and clearly you have something but medicating without FT3 and FT4 blood labs is like playing pin the tail on the donkey.

Get all the right tests and make an educated decision based off those labs. Either med can not be leaned on as good or bad until those levels are caculated to give you the best outcome of what to take.