Diagnosed 6 weeks ago and I am totally confused...

[jelko]

I was diagnosed with Hashimoto's disease 6 weeks ago and put on 50 mcg of Synthroid one time per day.  I have not missed a dose and I am definitely not feeling any better at all.  I could sleep all day every day and think nothing of it.  I have been doing some research on Hashi's and found that you all like the labs, so here goes:

Thyroid Panel
TSH  5.47  range
T4 free 1.0 range
T3 free 2.5 range
Thyroglobulin AB >3000  range <
Thyroid Oxidase <10  range <

Additional lab info
Vitamin B12 275 range
Vitamin D 21  
A1C 9  -- YIKES!
I had several other tests run that indicate there is some inflammation as well.  

Basically I had to bully my doctor into running the thyroid panel.  She didn't feel it was thyroid because she had run the tSH before and it was pretty much normal, her words.  I cried when she actually diagnosed me because I was happy to finally get something to work on.  Needless to say, I am not planning on going back to her.  For many reasons, but one is that she doesn't seem to listen to me at all.  She actually refused to give me a referral to an endo, and the endo I want to go see requires one.  

I have an appointment with a new doctor tomorrow at noon.  I have heard nothing but good things and I am excited, yet apprehensive at the same time.

I am wondering what you think of my labs.. my doctor didn't suggest ANYTHING.  I have had to pry the information I have received out of her (including for the diabetes) and I am tired mentally and physically of dealing with all of this.  I am hoping that I can get some guidance from the new doc and from my fellow sufferers here.  Any advice or questions you can think I need to ask the new doc?

Thank you in advance for your assistance.

kel

[jelko]

Sorry the ranges didn't make it into the original post, I must have made a formatting error.

Thank you both for your input, I will post ranges and new doc info tomorrow.

[gimel]

I read from one doctor that when clinical treatment of hypothyroidism was dropped many years ago, to start using TSH (unfortunately), that many patients became undertreated and developed some new symptoms, that had not been seen very much in the past.  He said that one of these became known as fibromyalgia.  So, yes, Fibro is frequently related to being hypothyroid.  You can also find lots of info linking Fibro to hypothyroidism.

From your symptoms and your lab results, especially the Free T3 and TG ab results, you are definitely hypo.  Since your doctor is one that has the "Immaculate TSH Belief" and only relies on TSH, I expect that you will have to find a good thyroid doctor.  By that I mean one that will treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.Test results are valuable mainly during diagnosis and afterward to track Free T3 and Free T4 as meds are revised to relieve symptoms.  

I think you will get some good insight from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

I expect that you are not seeing any real relief from the med yet because of the relatively small amount, the short time, and you are not anywhere near the levels of Free T3 and Free T4 that you need for symptom relief.  Also, since you apparently have the most common cause of hypothyroidism, Hashimoto's Thyroiditis, your thyroid glands are gradually being destroyed by thyroid antibodies produced by your autoimmune system, thus gradually reducing your natural hormone production.  Also, to help with symptom relief you need to raise your Vitamin D level up to around the midpoint or slightly above.  

If you have them, please post the reference ranges that go with your thyroid tests. It is best to use the ranges as guidelines within which to adjust FT3 and FT4 as necessary to relieve symptoms.  Many of our members, myself included  report that symptom relief for them required that FT3 was adjusted into the upper third of its range and FT4 adjusted to the middle of its range.  

When you see your doctor tomorrow, I suggest that you request to be tested for Free T3 and Free T4, along with TSH.  If the doctor resists testing for free T3 and Free T4, then you should insist on it and don't take no for an answer.  I would also suggest you a full panel of tests for iron anemia, just to be sure of that.  I also suggest that you ask the doctor is he is going to be willing to treat you clinically, as described above, and also if he is willing to prescribe T3 type meds.  If either answer is no, then I don't have much hope for that doctor treating you adequately.

Please let us know how it goes with the doctor.  There are lots of experienced and knowledgeable members here who are very glad to help.

[rach7612]

Several dose changes are usually needed before you start feeling better. Also, your A1C number is terrible, as you know. I have also had blood sugar issues, which appear to improve with the more thyroid medication I'm taking. Keep having you blood sugars retested throughout treatment, as they may improve. Please get on some sort of treatment for diabetes as your high blood sugar will eventually cause serious organ and heart damage - INCLUDING damage to your thyroid gland possibly. Hopefully with improved thyroid hormones, it will work itself out, but in the case of type I diabetes, which is also autoimmune, it may not go away. Autoimmune conditions commonly occur together. Everything is very interconnected. I have read some doctor's who believe fibromyalgia is merely untreated or undertreated hypothyroidism. Hang in there and get some emotional support (family, friends, church, therapy etc). I have had a hard time coping with the shock and anger of my diagnosis which I strongly suspect could have been caught many years earlier and is now being mismanaged. It is difficult emotionally to deal with the diagnosis of a chronic illness especially when you realize that it could have been treated a long time ago. Best wishes.

[jelko]

I was thinking about this too... I believe that I have been misdiagnosed with Fibromyalgia.  15 years ago I was diagnosed because of chronic pain, but I have never been able to find anything that helped. I believe it may have been Hashi's all along.