hashimoto thyridist

[faisal2t8]

my free t4 is 1.53 ng/dl
myfree t3 6.1 pomol/l
my tsh  5.280 ulu/ml


my my tsh high if other homorne my only sysptom easy to gain weight and hard to lose them
and hair thin


i take 25 mcro gram.      thyroxine


can any body help me

[faisal2t8]

i guess i will find me a private endocrine doc
and re do the test to check wether my weight gain is regarding the free t 3
i have set up an appointment on first of june

[faisal2t8]

i have made new test and it come out today unfortunately no free t4 or free t3
result are
tsh 3.88 uiu/ml       0.2-4.50
anti tg 42.11 iu/ml    less yhan 115.00
tg 0.13 ng/ml     low    1.4-78.00
hba1c      5.4%
mono   12.1% dont know what is that

[gimel]

Many hypo patients find that when starting on thyroid med, at first their levels don't increase as expected.  That occurs because the med reduces TSH levels and that reduces the output of hormone from the thyroid gland.  Only after the med dosage is increased enough to minimize the effect of diminished TSH will the serum levels of Free T4 and Free T3 start to rise enough to affect symptoms.  In addition, as goolarra pointed out, your body is not adequately converting the T4 med to T3, so that is why she recommended adding some T3 to your med.  

Have you discussed with your doctor adding T3 to your med?  If not, you need to do so.  Also, at next opportunity you should request to be tested for Vitamin D, B12 and ferritin.  Hypo patients are frequently too low in the ranges for those as well, which can cause symptoms and also adversely affect metabolization of thyroid hormone.

[faisal2t8]

am start gaining a lot of weight since I start taking levothyroxine I wonder if replace this medicine will be better

[goolarra]

Your FT4 is a little high here.  It's 69.3% of range, which is high of the 50% target.  On the other hand, FT3 is a low.  It's 30% of range and should be 50+%.

We can assume your FT4 is even higher now with the increase to 75 mcg.

It looks to me like you need to add some T3 to your meds and lower your dose of T4.  Your body isn't converting enough T4 to T3, so you have to take some T3.  Have you talked to either of your doctors about prescribing that?

[faisal2t8]

12 to 22 poml/l  i get 18,93  t4free
4to 6.8 poml/l     i get 4.83    t3 free
0.27 to 4.3 miu/l  i get 4.38    tsh
  this before i increase dosage to 75micro gram
this tes was on 22 of march last month

[goolarra]

Did you stop your meds for a while?  Please post you labs with ranges.

[faisal2t8]

i went normal from last time till now my docs actually increase my dosage to 50  and recently to 75

cos i have sysptom like increase pressure and headache  and ny tsh they say is abit high so am wondering wether is the right thing to do and i feel am gaining weight so easily

[goolarra]

If I were you, I'd sit down with my doctor and talk about your symptoms.  I'd also want him to explain to me why he thinks your TSH is still high when FT3 and FT4 are both 77% of range.  He seems to be ignoring that.

Once you have antibodies (Hashi's), you have them for life.  It can take years or decades before they do enough damage to cause symptoms.  Some people never develop symptoms. For some, the disease progresses very quickly, for others very slowly.  Also, in the early stages of the disease, you can swing back and forth from hypo to hyper.  

I'd also talk to my doctor about stopping meds and seeing how you feel.  You'd have to follow that up with blood work in 4-6 weeks to see what your levels were without meds.  

[faisal2t8]

thabk you goolarra for ur reply can please guide me
in what should i do precisely to be sure am in right bath
wether i need treatment or not
what else i need to worry about

is my condition can move further to tromor

what should

[goolarra]

Your doctor is making the same mistake many of them make...he thinks TSH is the be all and end all in thyroid testing, and he's ignoring the fact that your FT3 and FT4 do not support a high TSH.  TSH is a pituitary hormone, and it can be influenced by any number of factors aside from FT3 and FT4 levels.  Remember that TSH causes NO symptoms.  It's nothing but a messenger from your pituitary to your thyroid to tell the thyroid to produce more thyroid hormones.  FT3 and FT4 levels are what cause symptoms.  

When you discuss this with your doctor, be sure to make him explain to you why FT3, FT4 and TSH all went up.  TSH is supposed to reflect FT3 and FT4 levels.  When FT3 and/or FT4 go up, TSH should go down and vice versa.  Yours didn't work that way, so obviously your TSH is unreliable.

[faisal2t8]

but now even am 77% high why i get tsh high
i still did not say anything to my doc about my syptom i only show him my current blood test and i ask me to increase my dosage

i will go bk to uae for one week i will go and do one more test and i will discuss the syptom with my doc

i wish that i dont have to take medication at all

[faisal2t8]

yes my previous one was with out medication

[goolarra]

Stress can make any autoimmune condition worse.

However, let's get back to your FT3 and FT4 levels.  In the previous ones you just posted, your FT4 was 40% of range, and your FT3 was 69%.  I'm assuming that was before meds?  Those are perfectly adequate levels for most people.  You do have antibodies, but people can have them for years or even decades before they do enough damage to cause problems.

Your FT3 and FT4 are now up to 77%, which is too high for most of us.  Your symptoms (difficulty sleeping, racing heart) are symptoms of too much medication.  Have you reported this to your doctor and asked him if you need to continue taking meds at this point?  

[faisal2t8]

the racing thing happend two time only so far in one month

[faisal2t8]

onething am sure about it all started since i marry and had terrible experience with my wife  she have major depression disorder and anxity and she fight me everyday and should threaten me

now am in devorce phase with here still she cause alot of trouble even in court  


now if am in diet really hard to lose weight and if i eat little i get fat so easy
and my other strange syptom is that in bed i feel  bad and weak and sometime heart racing i wake up and get scare that why i dont know what i should do
last year i did all heart test moniter and gamma camera echo stress all sort of thing and csrdiolgist conclude i have not heart problem

[faisal2t8]

i have first blood test they are in different unit cos the one who discover my disease is german doctor i give my old t4 and t 3 and tsh

free t3 range. 1.71- 3.71 am 3.1 ng/l
free t4 range  7.0-14.8.  am 10.1 ng/l
tsh range 0.35-4.98.  am 2.81 mu/l

i feel some of my symptom gone when i start takeing thyroxine
however recently in evening i cant sleep very well i have sleep disturb and i have racing heart in evening when i wake up and i wen to hospital they say i dont have heart problem so i dont know either stress or maybe thryroid  hormone imbalance

i also did ultra sound before i start thyroxine they found abit goitre but no enlargement


i have texted my german doc yesterday he told me to increase dosage to 50 micro gram and ask me to come to his clinc in uae but i still wondering what is going on
    

[faisal2t8]

i have first blood test they are in different unit cos the one who discover my disease is german doctor i give my old t4 and t 3 and tsh

free t3 range. 1.71- 3.71 am 3.1 ng/l
free t4 range  7.0-14.8.  am 10.1 ng/l
tsh range 0.35-4.98.  am 2.81 mu/l

i feel some of my symptom gone when i start takeing thyroxine
however recently in evening i cant sleep very well i have sleep disturb and i have racing heart in evening when i wake up and i wen to hospital they say i dont have heart problem so i dont know either stress or maybe thryroid  hormone imbalance

i also did ultra sound before i start thyroxine they found abit goitre but no enlargement


i have texted my german doc yesterday he told me to increase dosage to 50 micro gram and ask me to come to his clinc in uae but i still wondering what is going on
    

[goolarra]

Your TGab (thyrogloubin-ak) is a bit elevated, and your TPOab (tpo-ak) is very elevated,.  So, it looks like you have Hashimoto's thyroiditis (Hashi's).  

TRab (tsh-rez ak) is within range, but TRab is a tricky test to interpret.  1.75 represents the level at which most people start having symptoms of Graves' Disease, but the fact of the matter is that people who don't have Graves' have TRab much lower...less than 0.02.  So, it's possible you have both and may be in transition between one and the other.

Have your meds made you feel any better?

Do you have prior FT3, FT4 and TSH tests so we can see how the meds affected your levels?  

[faisal2t8]

my other test were these concern auto imuune which is sec

thyrogloubin-ak tak  which normal range should be below 40 iu/ml.  well am 67+
and tpo-ak mak  which it should be below 40 iu/ml am 1000+
tsh-rez ak trak which it should  be below 1.75u/l  am 0.84

[faisal2t8]

my other test were these c

[goolarra]

Both your FT3 and FT4 are high at 77% of range.  When FT3 and FT4 are high, TSH ought to be low, but your TSH is also on the high side.  

You are on a very small dose of meds.  

I'd question whether you need to be on meds at all.  Did you have symptoms before starting meds?  Have any of those symptoms gone away or gotten worse?

Do you have other labs with reference ranges to compare to see if there is a trend?

[faisal2t8]

for t3.   from 2.8- 7.1
for t4.    from 0.93- 1.71
tsh.         from 0.270 - 4.300

i tried three clinic two clink blood test show my tsh still high
and one clinic mention my tsh is normal
this blood test is fourth now in singapore the other test were in uae

[goolarra]

Please provide reference ranges for your FT3 and FT4.  Ranges vary lab to lab, so you have to post both together.

Has your TSH come down at all since starting medication?