elevevated tsh levels?

[magrette]

HI
I WAS DX WITH HYPERTHYROIDISM 7 YEARS AGO AND RECEIVED THE RADIOACTIVE IODINE TX.  I DID BECOME HYPOTHYROID AND HAVE BEEN TAKING SYNTHROID FOR 7 YEARS.
I WAS TAKING 150MCG FOR 2 YEARS AND HAVE REQUIRED INCREASED OVER THE YEARS. I AM 5'7
AND MY WT IS APPROX 135LBS.  MY CURRENT BOARD CERTIFIED ENDOCRINOLOGIST THOUGHT THAT IT WOULD BE FINE TO MONITOR ME ANNUALLY?  MY ANNUAL CHECK UP SHOWED A TSH OF 77  CHOLESTEROL LEVEL OF 407 AND LDLS OF 240 NEVER HAD THIS HIGH.   MY HDL IS 113 AND MY RATIO IS 3.6.   MY ALBUMIN IS 3.3 CALCIUM IS 8.6  AND MY VIT D LEVEL IS LOW.  I DID NOT FEEL THIS DROPPING.  THE DOC THOUGHT I HAD A SUBPOTENT BOTTLE OF MEDS.  I FEEL THAT I SHOULD HAVE BEEN MONITORED AT LEAST SEMI ANNUALLY PERHAPS IT WOULD HAVE BEEN CAUGHT.  I AM NOT HAPPY TO SAY THE LEAST.  AS THIS SHOWS THAT I AM TRULY NOT BEING FOLLOWED UP PROPERLY.  I HAVE AN APPT WITH ANOTHER ENDOCRINOLOGIST.  MY SYNTHROID WAS INCREASED TO 200 AND THE TSH WENT DOWN TO 34 CHOL WENT TO 299 LDL 165 AND MY HDL WAS AGAIN 113.
THE DOC THEN TOLD ME TO TAKE AN EXTRA 1/2 SYNTHROID ON WEEKENDS.   I HAD A TSH DONE AT WORK THE OTHER DAY AND IT IS NOW 11.  SEEMS EVERYTHING IS GOING DOWN VERY QUICKLY.  I NOW FEEL COLD I FEEL THAT MY HANDS AND FEET SWELL AT TIMES AS WELL AS MY LEGS.  THEY DO GO DOWN.  MY BP AND PULSE ARE PERFECT.  I FEEL EMOTIONAL AT TIMES.  JUST WONDERING WHY I AM HAVING SOME SYMPTOMS NOW?    NEVER FELT THIS HAPPENING.  I FEEL IT HAPPENED OVER A PERIOD OF TIME.  ANY INPUT WOULD BE APPRECIATED  I HAVE NOT GAINED ANY WEIGHT  2 LBS OVER A YEAR?    I DO FEEL THAT I AM NOT ABSORPTING PROPERLY AND I HAD TERRIBLE MUSCLE SPASMS ON MY SHINS?  THEY HURT.   THANKS

[gimel]

No, all our board members are patients, just like you, with differing thyroid problems.  The thing we all have most in common is the need for good thyroid doctors.  Needless to say we are all ecstatic when we find one that will treat our symptoms with whatever type med is required, and without being a slave to TSH.  

If you can get your FT3 and FT4 levels tested and then post here, our many experienced members can give you the best response and suggest what further is needed.  Keep in mind that frequently FT3 has to be in the upper part of its range and FT4 at least at the midpoint in order to alleviate symptoms.  Low vitamin D is common with hypothyroidism, and you need to also work on that.  Also, suggest you get checked for Vitamin B levels.

[magrette]

hi
i forgot to ask. Are you an M.D. ?

[magrette]

hello
one of the doctors that i work with ordered these tests as he disagreed with my endocrinologist.  they are within the upper range.  all of my free t4 was 1.0 when first tested which was within range for this lab.

i am actually going to a different endocrinologist as i do not have faith in this one anymore

i do not feel that there are many endocrinologists that are truly "good"
i would trust the doc that i work with to treat me before this board certified endocrinologist and he is a nephrologist?  
thanks for your input i am feeling better actually.

i have had both hyper and hypothyroidism.  neither has pleasant sx's when not treated properly.

[gimel]

Unfortunately, you are yet another victim of the "Immaculate TSH Belief" that so many doctors continue to cling to.  In reality, TSH is totally inadequate as a diagnostic, by which to be medicated.  TSH is a pituitary hormone that is affected by many variables, including the time of day when blood is drawn.  At best it should be used as an indicator, to be considered along with the more important indicators, which are symptoms, and the levels of the actual, biologically active thyroid hormones, free T3 and free T4 (FT3 and FT4).
Free T3 is the most important, because it is four times as active as FT4, plus FT3 largely regulates metabolism and many other functions.  FT3 also correlates best with hypo symptoms.  TSH does not correlate very well at all with hypo symptoms.  

In my opinion the very best way to treat a thyroid pateint is to test and adjust the levels of the actual thyroid hormones, FT3 and FT4, with whatever type med is required to alleviate symptoms, without being constrained by the resultant TSH levels.  From many members we hear that this requires that the FT3 be increased into the upper part of its range, and FT4 adjusted to at least the midpoint of its range.  

So, l think that you should go back and insist that they test for both FT3 and FT4 and request that you want to be treated for your symptoms, by adjusting FT3 and FT4 as necessary to alleviate symptoms.  If your doctor has a problem with this approach, then it is time to start looking for a good thyroid doctor.