Aa
Hypo even tho doc says no?
I am 43 years old. I was diagnosed with thyroiditis in 2007, several nodules on ultrasound that endo said not to worry about. No meds or treatment. My mom has been hypo since her 20's. I get tested every year (tsh only) and it has been 1.2 in 2009, 1.01 in 2010, now a month ago it tested at 4.27. I am always cold, feel run down and sometimes depressed (me? not usually like that) Other symptoms of hypo too (constipated, heavy periods). In the last few weeks it feels like my thryoid is swollen (Not visible). Should I get a second opinion? The first doc was internal med, not endo. Worrier too, so of course I am thinking cancer...
COMMUNITY LEADER
This is a very old thread and we haven't heard from Huskerjean since she originally posted. I'll check and see if we have doctor listed for your area.
If you still have hypo symptoms, it sounds like your medication needs to be adjusted. I have to ask if your doctor goes more by TSH than your actual thyroid hormone levels.
If you have actual test results, with reference ranges, you can post for us, we might be able to help you out.
If you still have hypo symptoms, it sounds like your medication needs to be adjusted. I have to ask if your doctor goes more by TSH than your actual thyroid hormone levels.
If you have actual test results, with reference ranges, you can post for us, we might be able to help you out.
I am in Omaha as well. I have been hypo since my 20's (now 40) but despite numbers in the normal range I still feel I have symptoms. How are you doing now and do you like your doc? I am considering switching so curious on what your experience has been.
Since T4 meds have a half life of about one week, it takes 4 weeks to build up to over 90% of the final effect on blood levels. the effect on symptoms can lag behind changes in blood levels, so you may have to be a bit patient.
The purpose of waiting the full hour before eating is to maximize absorption of the meds; however, many patients find that to be very difficult with their schedules, so they do the most convenient thing. If you chose not to wait, it may reduce the full effect on blood levels, but that can be offset with a slightly higher dose. The key is consistency.
I looked through the listing of Top thyroid Doctors in Nebraska, shown in this link. Based on the patient reviews of Omaha doctors, there looks to be a very good prospect for you.
I sent the doctor's name by PM.
http://www.thyroid-info.com/topdrs/nebraska.htm
The purpose of waiting the full hour before eating is to maximize absorption of the meds; however, many patients find that to be very difficult with their schedules, so they do the most convenient thing. If you chose not to wait, it may reduce the full effect on blood levels, but that can be offset with a slightly higher dose. The key is consistency.
I looked through the listing of Top thyroid Doctors in Nebraska, shown in this link. Based on the patient reviews of Omaha doctors, there looks to be a very good prospect for you.
I sent the doctor's name by PM.
http://www.thyroid-info.com/topdrs/nebraska.htm
Thanks for the good tips. I am in Omaha Nebraska. I started 100mcg of Synthroid this morning. We'll see if this changes anything. I should wait a few weeks before I notice anything, right? Do I need to wait the full hour before eating? I work at 6am so I don't want to push the alarm clock back too much more! :)
All those lousy symptoms you mentioned have affected Forum members at one time or another, I'd guess. I know that I've had my share, anyway. LOL But, if you locate that good thyroid doctor as I described, who will treat you clinically, there is no reason to be less than optimistic for your future to be symptom free. It is all a matter of good doctor, correct meds and the right dosage.
In looking for a good thyroid doctor, I've found that you can save a lot of time and aggravation by calling the office of any prospects and telling them you are looking for a good thyroid doctor, but before making an appointment, you'd like to ask one of the nurses a couple of questions. When the nurse answers ask what tests the doctor usually runs to diagnose and medicate a thyroid patient. If Free T3 and Free T4 are not mentioned, not a good sign. Then I would ask if the doctor is willing to treat a patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. And finally I would ask if the doctor is willing to prescribe meds other than just T4 types. If the answer to either of the last two questions is no, then just keep on looking.
If you will please tell us where you are located, perhaps members can recommend a good thyroid doctor, based on their personal experience, and save you lots of time and frustration.
In looking for a good thyroid doctor, I've found that you can save a lot of time and aggravation by calling the office of any prospects and telling them you are looking for a good thyroid doctor, but before making an appointment, you'd like to ask one of the nurses a couple of questions. When the nurse answers ask what tests the doctor usually runs to diagnose and medicate a thyroid patient. If Free T3 and Free T4 are not mentioned, not a good sign. Then I would ask if the doctor is willing to treat a patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. And finally I would ask if the doctor is willing to prescribe meds other than just T4 types. If the answer to either of the last two questions is no, then just keep on looking.
If you will please tell us where you are located, perhaps members can recommend a good thyroid doctor, based on their personal experience, and save you lots of time and frustration.
I have an appt with another doc who is very good (reputation anyway) but I couldn't get in until May 18. I will start the treatment and meet with the new doctor in m
Hypo and getting treated for it, if that means I'll feel normal. Or is this just me...?
Hypo and getting treated for it, if that means I'll feel normal. Or is this just me...?
Yes, a huge difference. The .9 is still on the low side, but .09 would have been almost non-existent.
When you go back for the re-test and the additional tersting suggested, then it would be a good time to find out your doctor's opinion on treating you clinically, by testing and adjusting the biologically active thyroid hormones, Free T3 and Free T4, as necessary to relieve symptoms, without being constrained by resultant TSH levels. If the doctor is reluctant to treat you in this manner, then you will need to find a good thyroid doctor that will do so.
When you go back for the re-test and the additional tersting suggested, then it would be a good time to find out your doctor's opinion on treating you clinically, by testing and adjusting the biologically active thyroid hormones, Free T3 and Free T4, as necessary to relieve symptoms, without being constrained by resultant TSH levels. If the doctor is reluctant to treat you in this manner, then you will need to find a good thyroid doctor that will do so.
This is your post that you just put up. I've moved it to this older thread, so that all is consolidated.
Huskerjean, 1 minute ago
So I feel really stupid now. I saw a new Endo and I just got my test results. I have been diagnosed with Hashi's since 2007, with a multinodular goiter, no meds, no symptoms at the time. My mom has been hypo since before I was born.
Now I am freezing most of the time, run down, depressed, slow pulse (52 at times), weird period. Sometimes these symptoms are gone and I have a lot of energy, racing heart, feel warm/flushed/clammy. The last few years my TSH (only test) has been 1.01, 2.3, and this past January 4.27.
In February I noticed what felt like my thyroid was swelling, although it isn't apparent to the eye, so wanted it tested again. TSH 2.080, Free T4 was .09. He said I am not hypo, but offered to put me on meds to shrink the thyroid if I wanted. What does this mean? Any help would be appreciated. Now I feel like I am going nuts, dreaming up symptoms. Seriously embarassed by how cold I am all the time. Thank you!!!
____________________________________
Please double check the FT4 result. Could it have been .9 instead of ,09? Also, why didn't Free T3 get tested?
Regardless of that, with those symptoms you should accept the Doctor's offer to start on meds. Then after 4 or 5 weeks to allow the meds to be fully reflected in your blood levels, go back for a re-test. At that time you need to insist on testing for Free T3, Free T4 again and the thyroid antibodies, TPO ab and TG ab. The latter two tests are to determine the possibility of Hashimoto's Thyroiditis, which is the most common cause of hypothyroidism.
I also expect that based on your experience to date that you are going to have to find a good thyroid doctor. By that I mean a doctor that will treat you clinically, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.
Huskerjean, 1 minute ago
So I feel really stupid now. I saw a new Endo and I just got my test results. I have been diagnosed with Hashi's since 2007, with a multinodular goiter, no meds, no symptoms at the time. My mom has been hypo since before I was born.
Now I am freezing most of the time, run down, depressed, slow pulse (52 at times), weird period. Sometimes these symptoms are gone and I have a lot of energy, racing heart, feel warm/flushed/clammy. The last few years my TSH (only test) has been 1.01, 2.3, and this past January 4.27.
In February I noticed what felt like my thyroid was swelling, although it isn't apparent to the eye, so wanted it tested again. TSH 2.080, Free T4 was .09. He said I am not hypo, but offered to put me on meds to shrink the thyroid if I wanted. What does this mean? Any help would be appreciated. Now I feel like I am going nuts, dreaming up symptoms. Seriously embarassed by how cold I am all the time. Thank you!!!
____________________________________
Please double check the FT4 result. Could it have been .9 instead of ,09? Also, why didn't Free T3 get tested?
Regardless of that, with those symptoms you should accept the Doctor's offer to start on meds. Then after 4 or 5 weeks to allow the meds to be fully reflected in your blood levels, go back for a re-test. At that time you need to insist on testing for Free T3, Free T4 again and the thyroid antibodies, TPO ab and TG ab. The latter two tests are to determine the possibility of Hashimoto's Thyroiditis, which is the most common cause of hypothyroidism.
I also expect that based on your experience to date that you are going to have to find a good thyroid doctor. By that I mean a doctor that will treat you clinically, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.
TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as the sole diagnostic for thyroid problems. At best TSH is an indicator to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, free T3 and free T4 (not the same as total T3 and total T4)
FT3 is the most important thyroid hormone test because FT3 largely regulates metabolism and many other body functions. Studies have shown that it correlated best with hypo symptoms, while FT4 and TSH did not correlate.
A good thyroid doctor will treat you clinically by testing and adjusting FT3 and FT4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels. symptom relief should be all important, not test results. The main value of the testing is first to help diagnose and then to track levels as medication is increased to relieve symptoms.
So the first thing you need to do is find a good thyroid doctor that will treat you as I described above. That does not necessarily mean an Endo. Frequently they are of the "Immaculate TSH Belief" and only want to diagnose and medicate based on TSH. Sometimes they will go beyond TSH but then interpret any test result that falls within the so-called "normal" range as being adequate and do nothing further. that doesn't work either because the reference ranges are far too broad. For example, many members here report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.
If no one can suggest a good thyroid doctor for you, then if you will tell us your location, perhaps some member might have a rec for you.
When you have a good thyroid doctor, you should be tested for free T3 and free T4 (that's FT3 and fT4, not total T3 and total T$), along with TSH that is always checked. Also, you should check for the possibility of having an autoimmune system problem called Hashimoto's Thyroiditis, by testing for the autoimmune antibodies TPO ab and TG ab. Also, since you previously had nodules, it would be a good idea to have an ultrasound test of the thyroid glands area.
FT3 is the most important thyroid hormone test because FT3 largely regulates metabolism and many other body functions. Studies have shown that it correlated best with hypo symptoms, while FT4 and TSH did not correlate.
A good thyroid doctor will treat you clinically by testing and adjusting FT3 and FT4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels. symptom relief should be all important, not test results. The main value of the testing is first to help diagnose and then to track levels as medication is increased to relieve symptoms.
So the first thing you need to do is find a good thyroid doctor that will treat you as I described above. That does not necessarily mean an Endo. Frequently they are of the "Immaculate TSH Belief" and only want to diagnose and medicate based on TSH. Sometimes they will go beyond TSH but then interpret any test result that falls within the so-called "normal" range as being adequate and do nothing further. that doesn't work either because the reference ranges are far too broad. For example, many members here report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.
If no one can suggest a good thyroid doctor for you, then if you will tell us your location, perhaps some member might have a rec for you.
When you have a good thyroid doctor, you should be tested for free T3 and free T4 (that's FT3 and fT4, not total T3 and total T$), along with TSH that is always checked. Also, you should check for the possibility of having an autoimmune system problem called Hashimoto's Thyroiditis, by testing for the autoimmune antibodies TPO ab and TG ab. Also, since you previously had nodules, it would be a good idea to have an ultrasound test of the thyroid glands area.
Your symptoms sound very hypo, so, by all means, get another opinion. In addition to TSH, you need to have free T3 and free T4 (not total T3 and total T4) tested. These are the actual thyroid hormones and give a much clearer profile of thyroid function.
Several years ago, AACE recommended TSH range be lowered to 0.3-3.0. Most doctors and labs are yet to adopt the "new" standards. Your current TSH is over range, indicating hypo. That should have been enough to prompt your doctor to test FT3 and FT4. If it didn't, you'd probably best find someone more in tune with thyroid.
You might also ask for antibody testing to see if you have Hashi's since you have a family history of hypo. Thyroid peroxidase andtibodies (TPOab) and thyroglobulin antibodies (TGab) should both be tested to confirm or rule out Hashi's.
Don't think cancer...nodules very frequently accompany thyroid disease, especially Hashi's (I've got several myself). Unless large, they're just monitored periodically for changes.
Several years ago, AACE recommended TSH range be lowered to 0.3-3.0. Most doctors and labs are yet to adopt the "new" standards. Your current TSH is over range, indicating hypo. That should have been enough to prompt your doctor to test FT3 and FT4. If it didn't, you'd probably best find someone more in tune with thyroid.
You might also ask for antibody testing to see if you have Hashi's since you have a family history of hypo. Thyroid peroxidase andtibodies (TPOab) and thyroglobulin antibodies (TGab) should both be tested to confirm or rule out Hashi's.
Don't think cancer...nodules very frequently accompany thyroid disease, especially Hashi's (I've got several myself). Unless large, they're just monitored periodically for changes.
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