based on your symptoms and your TSH, I would be taking meds. Please note you should be testing FT3 and FT4 (frees, not the T3 and T4 which are total and include protein bound unavailable hormone).
However, I would recommend starting on 1/2 of the 50 mcg for the first 4-6 weeks, then testing TSH again and adding in the second half if necessary based on both blood work and how you feel.
I don't think 'most literature' states 5 - 10 TSH should not be treated. Most recent reputable literature states the opposite. And the 'normal' reference range was reduced down to 3.5. Knowledgeable doctors would already treat if the patient has TSH above 3 (even with FT3 and FT4 at middle or lower half of the reference range) if the patient has clear symptoms. Of course monitor blood work to ensure that the patient doesn't go hyper (on basis of FT3/FT4 results).
There is definitely no harm to treat with monitoring and see how you feel. I am certain you will be feeling much better with the meds.
just so confused since all this started with an injury and somehow the nerve is involved.
Somehow skeptical that am going down a blind ally again. But am starting to feel even more crud, real bad headaches/ nausea type feelings.. Bad stomach, feeling fluish.. so its making me wonder even more. I think my main concern was if the symptoms were really hypo since they seem so generic and I was already aware of them..
Yea I was tested for free t4. not the ft3 though.
my bet is that the injury is separate from (even if occurring at the same time) as the thyroid issues. However, being hypo will definitely affect your ability to heal.
Start the meds. It will take a few weeks but I think you will start feeling better.
Sometimes stress (such as injury) will bring on flares, especially if it's autoimmune thyroid disease. There are soo many women out there that would love to be given meds b/c they feel like crap, but b/c the endos are going by an outdated ref range, they suffer needlessly. Don't be afraid of the meds, they are pretty harmless, and since you feel bad now, what you could loose? I've researched several articles/sites regarding thyroid disorders, and have never heard what you mention!!
Here is one such article, and there are quite a few, but are buried in medical journals like pubmed and medscape.
some assumptions -
It seems there really is no reason to treat sublicinal Hypo IF there are not symptoms.
An example of why I am hesitant.
They described my injury as a neuropraxic injury, I think to the long thoracic nerve. And that can take up to two years to heal. So then is my inability to heal form this, is it because of the nerve, or the hypo... and how can I tell. Are the fatigue, anxiety, irritability etc from the injury or they hypo.
Thanks for the input.. Just super paranoid :(
"It seems there really is no reason to treat sublicinal Hypo IF there are not symptoms."
- All these symptoms and those also in your other post just so happen to be very common hypo symptoms. You have symptoms.
As noted previously, a simple free T3 test along with TPO and TgAb will tell you what is going on. And then you dont have to be paranoid anymore. It really is that simple. No need to make this harder than it is. Being hypo also WILL prolong injury recovery rates.
what are these two? TPO and TgAb the antibodies
TPO and TgAb are the antibody tests that would point to Hashimoto when combined with your symptoms. TSI , which you might have seen is only for Graves (hypEr).
ah - ok
So talked to the doctor - again - and he said he thought it was most likely Hashimotos...
I also got Skelaxin... to help after physical therapy.. might try the magnesium citrate too I got it but never started it.
Went and got the antibodies test done as well as t3.
In my meeting with the endocrinologist - Here is some feed back please tell me what you think.
1.) Typically she waits till it gets above 10 to treat.
2.) Regardless of if its Hashimotos or not - there is really no reason to start the meds now.
3.) Even though the antibodies are present, it doesn't mean that it will get worse. Better to take a wait and see approach at the moment.
4.) She checked my out and doesn't find any hypo- symptoms.
5.) My t4 was normal to her - indication that it's subclinical and again not reason/benefit to treat.
6.) My muscular aches etc are not related to hypo in her mind.
So thats it folks, will wait on the blood work. and see what happens then.
So there it is, I have talked to about 4 docs and it seems the decision is split and at any rate seems to be not big deal to start or not to start the meds..
I can appreciate your dilemma and the conflicting opinions of the doctors. I would consider that the doctor has said it is most likely Hashis (would be really wise to have this finally confirmed with a simple blood test) Since it may be hashis & you have already done your homework, you probably know it is an autoimmune condition that attacks your thyroid. With a TSH of 7.72, that is an indication that your body is not producing enough thryoid hormone to serve its diverse metabolic needs otherwise your pituitary would not be sending out TSH to stimulate the thyroid for more. Since thyroid hormone affects the metabolism of every cell in the body that includes the healing processes related to your injury.
I was diagnosed with Hashis this past spring. I'd been to several doctors over the last 2 years trying to find out WHAT was wrong with me (long list of aches & pains & elevated anxiety & periodic insomnia, weight gain) My back hurt constantly and I felt like my body had the flu without the fever. My TSH was in range (at that time) so they did no further thyroid testing. Instead they prescribed antidepressants or antibiotics - for two years! (I said no to the antidepressants) Meanwhile my thryoid was going HAYWIRE and nodules developing all the while. Finally in March 2010 my TSH of 7.56 led to an anti-TPO test and confirmation of autoimmune antibodies. I do believe that intervention with modest doses of thyroid hormone (if given after appropriate tests & confirmation of hashis) may have reduced the growth of the nodules. Now I must deal with another needle biopsy in 2 weeks. We all know thyroid hormones do not cure Hashis and that there IS no cure - but if you can give your pituitary & adrenal glands a break with low dose thyroid meds, it may be worth considering. My first endo also said my hypothryoid condition & hashis did not cause body aches & pains. Many patients in this forum including me would absolutely disagree.
I often wonder what set-off my hashis from asymptomatic to symptomatic. I broke two bones in my foot in August 2008. I also was dealing with a great deal of stress at work and financial worries (furloughs at work because of the economy) Then a root canal gone wrong (fractured root) causing dental inflammation & bone loss. It took 2 years of complaints at the dentist before I demanded they extract the tooth - and they finally SAW the root had been fractured for 2 years! Inflammation in your body can strain your endocrine system.
Our bodies are not disconnected parts - there is a delicate synergy especially when it comes to hormones & metabolism. May I ask what kind of injury the doctors are treating? You called it a "neuropraxic injury" and 8 months later you are still having muscle issues? I just googled neuropraxic injury" and read that metabolic conditions including thyroid disorders can contribute to the development of neuropathy in the body. Your muscle issues just might be thyroid related despite your doctors believing that a TSH of 10 is their queue for treatment. That is a surprise to me since the endocrine society even accepts a much lower number as worthy of low therapeutic doses of thryoid hormone. I too was hesitant to take thyroid hormone. I wanted my body to do what it had always done. But I also knew I could not stand feeling sickly. I felt like I was dying.
In the meantime, I recommend taking the magnesium & calicum (important for muscles!) & also selenium & to espescially get your vitamin D levels checked because they are all essential to thyroid function and are often found to be deficient in thyroid patients.
Oh, and also ask for an ultrasound of your thyroid - you might have nodules and not know it. I had several when the doctors finally got around to checking my thryoid - what made them order and ultrasound? My TSH of 7.56.
Thanks for writting all that, it really helps.
I had low Vitamin D (23). So am getting that taken care of. I got magnesium citrate, just have not started to take it yet. As it falls under that "I dont really like taking anything" category.
The injury started with pulling a muscle doing triceps exercises. Then a week later I pulled my whole right side doing a pulled up. I went to a chiropractor a day later and he popped my neck and back 4 times in a week and told me I had bones out of place etc etc. I think this is where the damage happened but o well. HAd all the MRI and xrays etc, they said it looks normal (thought some Cervical DDD) Lower back looked perfect.
Since the, its been and seems to be all muscular. Things like mowing my lawn cause me lots of fatiuge and takes three days to recover. As many doctors I saw, they just told me it was all in my head, and that I needed to take anti depressants. Then 7 months later I finally found a doctor that new what it was, injury to the long thoracic never etc and sent me to the PT to confirm. SO while I had been told to stretch by another pt for 2 months, it was actually the wrong thing to do.
And also 7 months later I found an internist that did full blood work and found those two things and gave me 5mcg of Levo. He said he was most likely hashi.
ANd like you said, it feels like fluish type without the flu.
I also get buzzing in my feet.
A ton more anxiety then normal and am extremely paranoid. I've had nightmares for the past month and am have migranes that I have never had before.
Its funny because the endocronologist I saw today said I had not symptoms. She did say that I needed to check the anxiety out though.. but I thought that was a symptom of thyrooid? Yet I have always had anxiety, but recently its really been bad. The endo has now ordered the free t3 as well as antibody so I should find out in a couple days. She basically was against treatment. The internist was for treatment :(
I know I sound like I am in denial. But as far as the symptoms of being hypo its hard to tell for me. I do have dry skin but it's really dry here in colorado, I think the humidity was 36 the last time I checked. As far as anxiety - I have always had this. I live alone etc, most of my family is at another place. I used to have nothing and have worked really really really hard to be where I am at.
I do get cold feet, even in the summer months.
Are anxiety, insomnia part of being hypo?
Also, to be honest, I have not had a good night sleep for about 4 months now :(