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Can TPO ever fluctuate??
Hello- Please help. I'm so confused. I'm 48 years old, have exercised all my life, ate healthy. Can the thyroid's TPO test show high because the thryroid was compromised due to dental problems? What I'm trying to ask is can the thryoid bounce back from a high TPO result? For 6 months I went to a dentist, dental surgeon, endodontist, and finally a periodontist to find out what exactly was wrong with my constant pain in my tooth. After numerous root canals and antibiotic, about 10 in those 6 months the periodontist told me what was wrong. Keep in mind I floss and brush regularly....
After this ordeal which was stressful and with all the antibiotics I was on now I'm showing signs of hypothyroidism. Can my thyroid bounce back after a month or two and become better by itself???
I really don't want to take synthroid for the rest of my life if I don't have too.
I'm 128lbs (same as high school), 5'5" walk/run 20 miles a week and very active. I have no signs of hypo other then tired with 4 children. My hair and skin is healthy also.
I'm really scared and don't know who to turn too. My doctor said I have to take the medicine or I'll be sick. She won't listen to me and won't think of Armour. I was to get my adrenal glands checked and my progesterone checked but she isn't calling. If feel so lost. I know two people on synthroid and they can't even walk 1 mile, can't lose weight and have hair loss....
After this ordeal which was stressful and with all the antibiotics I was on now I'm showing signs of hypothyroidism. Can my thyroid bounce back after a month or two and become better by itself???
I really don't want to take synthroid for the rest of my life if I don't have too.
I'm 128lbs (same as high school), 5'5" walk/run 20 miles a week and very active. I have no signs of hypo other then tired with 4 children. My hair and skin is healthy also.
I'm really scared and don't know who to turn too. My doctor said I have to take the medicine or I'll be sick. She won't listen to me and won't think of Armour. I was to get my adrenal glands checked and my progesterone checked but she isn't calling. If feel so lost. I know two people on synthroid and they can't even walk 1 mile, can't lose weight and have hair loss....
COMMUNITY LEADER
Hi Amy... thanks for the update. I'm glad to hear that you're still doing well.
Although it's true that all the hormones have to work together, it's actually thyroid malfunction that messes up the reproductive hormones, not the other way around. It's very common for those with thyroid conditions to have problems with menstrual cycles or menopause issues.
I'm glad you're getting by so long without medication. I've figured that I had Hashimoto's for approximately 15-20 yrs before it did enough damage for me to need medication. Unfortunately, Hashimoto's did cause menstrual/peri-menopause issues that caused me to have a hysterectomy that I might not have needed had we known I had it at the time...
Although it's true that all the hormones have to work together, it's actually thyroid malfunction that messes up the reproductive hormones, not the other way around. It's very common for those with thyroid conditions to have problems with menstrual cycles or menopause issues.
I'm glad you're getting by so long without medication. I've figured that I had Hashimoto's for approximately 15-20 yrs before it did enough damage for me to need medication. Unfortunately, Hashimoto's did cause menstrual/peri-menopause issues that caused me to have a hysterectomy that I might not have needed had we known I had it at the time...
COMMUNITY LEADER
Not everyone does well on Synthroid - it wasn't all that good for me, either. I, actually, did better on generic levo than I did on Synthroid - some of us do. I'm on Levoxyl now and doing well with it.
Sorry if I sounded like I was nit-picking with the Free T4 and Free T3, but if not specified, it's assumed one is referring to Total T4 and Total T3 and we sort of cringe when we see those... lol
At 45% of the range, your Free T4 is just slightly lower than the mid range we, typically, recommend and your Free T3 is in the upper half of its range, which is good. We, typically, recommend that Free T3 be in the upper half to upper third of its range.
Symptoms (or the lack of) is the most important thing and if you're feeling well that's what counts.
I'm very happy that you're doing so well, for having Hashimoto's and hope you continue to do well. While I'm up a 5:00 am most mornings, I'm retired so I no longer work all day, but if I did, I'd certainly not have the energy to run a few miles afterwards.
We'll look forward to future updates...
Sorry if I sounded like I was nit-picking with the Free T4 and Free T3, but if not specified, it's assumed one is referring to Total T4 and Total T3 and we sort of cringe when we see those... lol
At 45% of the range, your Free T4 is just slightly lower than the mid range we, typically, recommend and your Free T3 is in the upper half of its range, which is good. We, typically, recommend that Free T3 be in the upper half to upper third of its range.
Symptoms (or the lack of) is the most important thing and if you're feeling well that's what counts.
I'm very happy that you're doing so well, for having Hashimoto's and hope you continue to do well. While I'm up a 5:00 am most mornings, I'm retired so I no longer work all day, but if I did, I'd certainly not have the energy to run a few miles afterwards.
We'll look forward to future updates...
5 Comments
Thanks Barb for the posts. Good to know about the Levoxyl but hope I never need it. :)
Have a great summer and I will post again toward the end of year.
Have a great summer and I will post again toward the end of year.
Thanks Barb for the posts. Good to know about the Levoxyl but hope I never need it. :)
Have a great summer and I will post again toward the end of year.
Have a great summer and I will post again toward the end of year.
Have a good summer... :-)
Hi Barb135,
Its November 2017 and my lab result just came in. My TSH, Free T3, and Free T4 are the same and my Cholesterol, Ferritin, Vitamin D are excellent. Feeling great and I hope you are doing well.
Have a wonderful Thanksgiving and Christmas.
Will post next year and hopefully with the same results! :)
Its November 2017 and my lab result just came in. My TSH, Free T3, and Free T4 are the same and my Cholesterol, Ferritin, Vitamin D are excellent. Feeling great and I hope you are doing well.
Have a wonderful Thanksgiving and Christmas.
Will post next year and hopefully with the same results! :)
Hi Barb135,
It is August 1st 2018 and I just had my labs done. My TSH, Free T3, and Free T4 are all excellent as well as Cholesterol, Vitamin D and Ferritin. Thankfully I am medication free, and just take vitamins. I still firmly believe that peri menopause for some women, can cause havoc on the thyroid and some of these women are misdiagnosed and put on synthroid or Levoxyl for hypothyroidism too quickly, instead of allowing the body to run its course with the fluctuating hormones until the hormones stabilize during menopause. I just am lucky I had the courage to find a doctor to listen to me and so far everything is going well.
I will post with my next lab results, as I update this forum for others to read incase they are going through the same ordeal as I did.
(I am 2 1/2 years now in menopause.)
I hope your summer is going well!
It is August 1st 2018 and I just had my labs done. My TSH, Free T3, and Free T4 are all excellent as well as Cholesterol, Vitamin D and Ferritin. Thankfully I am medication free, and just take vitamins. I still firmly believe that peri menopause for some women, can cause havoc on the thyroid and some of these women are misdiagnosed and put on synthroid or Levoxyl for hypothyroidism too quickly, instead of allowing the body to run its course with the fluctuating hormones until the hormones stabilize during menopause. I just am lucky I had the courage to find a doctor to listen to me and so far everything is going well.
I will post with my next lab results, as I update this forum for others to read incase they are going through the same ordeal as I did.
(I am 2 1/2 years now in menopause.)
I hope your summer is going well!
COMMUNITY LEADER
Hi Amy... I'm very sorry to hear about your mom; that's always a hard thing to have to go through.
I disagree with your doctor that normal people have elevated TPOab for no reason. Antibodies are produced when the body discovers something foreign and decides it needs to be destroyed. Elevated TPOab antibodies indicates Hashimoto's, which attacks and destroys the thyroid. We can have it for years before enough damage is done to actually put our thyroid hormones out of balance enough to cause a lot of symptoms or make us really ill, but that doesn't mean our body is working in perfect sync. It's also normal for our adrenal glands to try to take up the slack when there isn't enough thyroid hormone to satisfy the needs of our body.
One thing to keep in mind with Hashimoto's, is that it can swing from hypo to hyper and everything in between for years before settling into a permanently hypo state and that could be what happened to you. You were hypo to begin with, but you could have swung back to a normal state or even slightly hyper, in which you didn't need medication. I went through a few of those episodes over the course of about 15 yrs before I finally settled into permanent hypo... I'd suddenly have a lot of hypo symptoms, gain weight like there was no tomorrow, etc, then suddenly, the weight would fall off and I'd switch back to normal or slightly hyper. At the time, I didn't know what was happening, but since I've learned about how the thyroid works, I realize that's what was going on - it's just that nobody bothered to check... The hypo episodes usually only lasted a few months, then I'd switch back to normal and the normal episodes would last for a couple years or more, usually, but when my thyroid finally died, it did it with a bang... It can be different for everyone.
The swings are the thyroid's efforts to maintain a normalcy it can no longer keep up with. It will sputter and dump hormones sporadically, even work fine at times, before it gives up.
I agree that your ferritin and vitamin D were too low. Iron is necessary for the proper conversion of the Free T4 storage hormone to the usable Free T3. Vitamin D deficiency can cause some hypo-like symptoms.
There are still doctors that won't treat hypothyroidism until TSH gets over 10. They are, often, doing their patients a disservice, because they unnecessarily, leave them with untreated symptoms, all because of a pituitary hormone that neither causes nor alleviates symptoms.
As to how many people (not just women) are put on medicine that don't need it - I'd say those are few and far between. There are those that feel better with a higher TSH and lower Free T4 and Free T3, but they're relatively rare. On the other hand, thousands more are left with symptoms, by doctors who refuse to treat because TSH is less than 10. They end up spending years in needless misery, when a simple daily hormone pill would allow them to live a full, healthy life.
The bottom line, however, is how you feel and what your actual Free T4 and Free T3 are (not just T4 and T3, as those indicate Total T4 and Total T3, which are obsolete). If one still has symptoms, the chosen protocol may not be the right one.
It would be interesting to see your Free T3 and Free T4 levels, with reference ranges.
I absolutely agree that a diet full of fruits, veggies and healthy fats is the way to go. The way we treat our microbiome goes a long way in helping to determine the way we feel.
I disagree with your doctor that normal people have elevated TPOab for no reason. Antibodies are produced when the body discovers something foreign and decides it needs to be destroyed. Elevated TPOab antibodies indicates Hashimoto's, which attacks and destroys the thyroid. We can have it for years before enough damage is done to actually put our thyroid hormones out of balance enough to cause a lot of symptoms or make us really ill, but that doesn't mean our body is working in perfect sync. It's also normal for our adrenal glands to try to take up the slack when there isn't enough thyroid hormone to satisfy the needs of our body.
One thing to keep in mind with Hashimoto's, is that it can swing from hypo to hyper and everything in between for years before settling into a permanently hypo state and that could be what happened to you. You were hypo to begin with, but you could have swung back to a normal state or even slightly hyper, in which you didn't need medication. I went through a few of those episodes over the course of about 15 yrs before I finally settled into permanent hypo... I'd suddenly have a lot of hypo symptoms, gain weight like there was no tomorrow, etc, then suddenly, the weight would fall off and I'd switch back to normal or slightly hyper. At the time, I didn't know what was happening, but since I've learned about how the thyroid works, I realize that's what was going on - it's just that nobody bothered to check... The hypo episodes usually only lasted a few months, then I'd switch back to normal and the normal episodes would last for a couple years or more, usually, but when my thyroid finally died, it did it with a bang... It can be different for everyone.
The swings are the thyroid's efforts to maintain a normalcy it can no longer keep up with. It will sputter and dump hormones sporadically, even work fine at times, before it gives up.
I agree that your ferritin and vitamin D were too low. Iron is necessary for the proper conversion of the Free T4 storage hormone to the usable Free T3. Vitamin D deficiency can cause some hypo-like symptoms.
There are still doctors that won't treat hypothyroidism until TSH gets over 10. They are, often, doing their patients a disservice, because they unnecessarily, leave them with untreated symptoms, all because of a pituitary hormone that neither causes nor alleviates symptoms.
As to how many people (not just women) are put on medicine that don't need it - I'd say those are few and far between. There are those that feel better with a higher TSH and lower Free T4 and Free T3, but they're relatively rare. On the other hand, thousands more are left with symptoms, by doctors who refuse to treat because TSH is less than 10. They end up spending years in needless misery, when a simple daily hormone pill would allow them to live a full, healthy life.
The bottom line, however, is how you feel and what your actual Free T4 and Free T3 are (not just T4 and T3, as those indicate Total T4 and Total T3, which are obsolete). If one still has symptoms, the chosen protocol may not be the right one.
It would be interesting to see your Free T3 and Free T4 levels, with reference ranges.
I absolutely agree that a diet full of fruits, veggies and healthy fats is the way to go. The way we treat our microbiome goes a long way in helping to determine the way we feel.
2 Comments
Hi Barb-
I understand what your saying and hope I don't go hypo. Synthroid was my worse enemy and my family can attest I was living proof of it.
I feel great and have no issues with weight gain or feeling horrible. When I said T3 and T4 I meant the the Free T3 and T4 and they are fine. Free T4 1.25 and Free T3 3.4
The doctor didn't dismiss the fact that I have markers for hashimotos but did state--- that in his findings in very rare cases the TPO antibodies are found in normal people. I stress 'rare'.
Barb I will keep updating the board as my blood tests are taking yearly. I pray that I stay healthy because after getting up at 5 and working a full time job, I still have the energy for a few mile run or walk and feel great.
I understand what your saying and hope I don't go hypo. Synthroid was my worse enemy and my family can attest I was living proof of it.
I feel great and have no issues with weight gain or feeling horrible. When I said T3 and T4 I meant the the Free T3 and T4 and they are fine. Free T4 1.25 and Free T3 3.4
The doctor didn't dismiss the fact that I have markers for hashimotos but did state--- that in his findings in very rare cases the TPO antibodies are found in normal people. I stress 'rare'.
Barb I will keep updating the board as my blood tests are taking yearly. I pray that I stay healthy because after getting up at 5 and working a full time job, I still have the energy for a few mile run or walk and feel great.
Sorry reference ranges for T4 Free is .82-1.77
and T3 Free is 2.0-4.4
and T3 Free is 2.0-4.4
COMMUNITY LEADER
Hi, Amydreamer... goolarra is no longer active on the forum, but feel free to update the rest of us, anyway; she may see your post and chime in...
2 Comments
Hi Barb-
I would love to update the board.
Firstly My Mom passed and I miss her terribly and there is not a day that goes by that I don't think of her. She was my inspiration.... Here is my journey during the last six years...
Someone who heard my story told me about a hormone doctor and thought he may be able to tell me why my body reacted the way it did to the synthroid. Its a fact that normal healthy people have high TPO's for no apparent reason. I was peri menopausal which caused fluctuating hormones, under a tremendous amount of stress with taking care of Mom and Dad...then Mom dying. My oldest going to college....
My cortisol starts in the lower third level on a good nights sleep. Normal cortisol starts at the midpoint level. Apparently I was born this way. I was a preemie twin and an incubator baby. He claims he would not treat me unless my TSH goes over 10. I've had my levels checked twice a year since my last post. This year for the first time my TSH is at 4.3. My T4 and T3 are great. He said body is working in perfect harmony with itself regardless of the high TPO. I have lower cortisol on a good day but with the added stress it affected the other hormones. The synthroid sent me over the edge because I didn't need it. I've exercised all my life and try to eat a balanced diet. He said if he treats the lower cortisol it will definitely send me hypo. He claims that my body is working in perfect harmony with itself. I still am med free. :)
As an aside my ferritin, which is the store iron in your body was at 46. The hormone doctor says most doctors do not check for this. It should be up around 90. My Vitamin D needs to be up over 50, mine was 21. These two items plus eating a lot of veggies and fruits and making sure I take in enough protein and good fats (olive or coconut oil) helped me get back on track.
I would love to update the board.
Firstly My Mom passed and I miss her terribly and there is not a day that goes by that I don't think of her. She was my inspiration.... Here is my journey during the last six years...
Someone who heard my story told me about a hormone doctor and thought he may be able to tell me why my body reacted the way it did to the synthroid. Its a fact that normal healthy people have high TPO's for no apparent reason. I was peri menopausal which caused fluctuating hormones, under a tremendous amount of stress with taking care of Mom and Dad...then Mom dying. My oldest going to college....
My cortisol starts in the lower third level on a good nights sleep. Normal cortisol starts at the midpoint level. Apparently I was born this way. I was a preemie twin and an incubator baby. He claims he would not treat me unless my TSH goes over 10. I've had my levels checked twice a year since my last post. This year for the first time my TSH is at 4.3. My T4 and T3 are great. He said body is working in perfect harmony with itself regardless of the high TPO. I have lower cortisol on a good day but with the added stress it affected the other hormones. The synthroid sent me over the edge because I didn't need it. I've exercised all my life and try to eat a balanced diet. He said if he treats the lower cortisol it will definitely send me hypo. He claims that my body is working in perfect harmony with itself. I still am med free. :)
As an aside my ferritin, which is the store iron in your body was at 46. The hormone doctor says most doctors do not check for this. It should be up around 90. My Vitamin D needs to be up over 50, mine was 21. These two items plus eating a lot of veggies and fruits and making sure I take in enough protein and good fats (olive or coconut oil) helped me get back on track.
I wonder how many women are needlessly put on hormone meds when they don't need it. And I question the ones that are on the meds that still feel horrible. Its a grey area in the doctor field and most endos don't know what they are doing..
Thank you so much for the update. It sounds like you've had quite a year.
After 11 weeks, the meds have had more than enough time to be out of your system, so you are meds-free and feeling well. That's wonderful! Just keep up with your semi-annual blood work, and don't hesitate to have interim blood work if you should develop any symptoms.
I'm doing well, although sick to death of winter. How's your mom been doing?
After 11 weeks, the meds have had more than enough time to be out of your system, so you are meds-free and feeling well. That's wonderful! Just keep up with your semi-annual blood work, and don't hesitate to have interim blood work if you should develop any symptoms.
I'm doing well, although sick to death of winter. How's your mom been doing?
1 Comments
Hi gallarra Happy Spring! Its been over six years and I would love to update all on where I stand with my thyroid.
HI ! How are you? Its been almost a year since I was diagnosed with hypothyroidism and you started helping me understand the condition.
I wanted to let you know what took place the last year.
I started developing extreme anxiety after being on synthroid after 2 months. Couldn't sleep, I couldn't shut my mind off for nothing. I had a heartbeat in my ear that every time I tried to doze off at night it woke me up in its intensity. I broke out in a sweat, needed a bowel movement and had horrible tinnitus, and panic attacks. Left key in the front door, left the stove on and was jumping at 5 tasks at a time. Doctor 1 told me to deal with it and to stop thinking of myself. My TSH is fine its not the synthroid. I endured this for 5 months with an average of 10 hours sleep a WEEK. I did go back to doctor 2. Much to his hesitation he took me off the synthroid because I was only borderline hypo and he would retest my TSH. He wanted to see me 4 weeks later. At the 4 week checkup he was ready to put me on depression anxiety meds. I was a mess. I would not take them because I knew something was causing me to be anxious and I didn't want to cover it up with meds. By six weeks I started sleeping 7 to 8 hours a NIGHT again. Thank God. It's been 11 weeks and I have no heartbeat, tinnitus or anxiety/depression. The endocrinologist (that we discussed) tested my thryoid levels at 7 weeks and they were fine. He said although I have markers for hypothyroid ie. elevetated TPO and slightly bumpy thryoid it doesn't mean I will go hypo. They are just markers and 20% of the population have these markers but don't go hypo. He said my TSH elevated may have been normal for me at that time last year. He said clearly I was put on sythroid too soon and was misdiagnosed. Although it was only .25 it I was extremely sensitive to it. He will retest me every 6 months to see what the thyroid levels.are.
If I indeed listened to doctor 1 and not my gut feelings I would be on sythroid and taking depression meds. I wonder how many people in this world are misdiagnosed.
Thanks goolarra for your help.
I wanted to let you know what took place the last year.
I started developing extreme anxiety after being on synthroid after 2 months. Couldn't sleep, I couldn't shut my mind off for nothing. I had a heartbeat in my ear that every time I tried to doze off at night it woke me up in its intensity. I broke out in a sweat, needed a bowel movement and had horrible tinnitus, and panic attacks. Left key in the front door, left the stove on and was jumping at 5 tasks at a time. Doctor 1 told me to deal with it and to stop thinking of myself. My TSH is fine its not the synthroid. I endured this for 5 months with an average of 10 hours sleep a WEEK. I did go back to doctor 2. Much to his hesitation he took me off the synthroid because I was only borderline hypo and he would retest my TSH. He wanted to see me 4 weeks later. At the 4 week checkup he was ready to put me on depression anxiety meds. I was a mess. I would not take them because I knew something was causing me to be anxious and I didn't want to cover it up with meds. By six weeks I started sleeping 7 to 8 hours a NIGHT again. Thank God. It's been 11 weeks and I have no heartbeat, tinnitus or anxiety/depression. The endocrinologist (that we discussed) tested my thryoid levels at 7 weeks and they were fine. He said although I have markers for hypothyroid ie. elevetated TPO and slightly bumpy thryoid it doesn't mean I will go hypo. They are just markers and 20% of the population have these markers but don't go hypo. He said my TSH elevated may have been normal for me at that time last year. He said clearly I was put on sythroid too soon and was misdiagnosed. Although it was only .25 it I was extremely sensitive to it. He will retest me every 6 months to see what the thyroid levels.are.
If I indeed listened to doctor 1 and not my gut feelings I would be on sythroid and taking depression meds. I wonder how many people in this world are misdiagnosed.
Thanks goolarra for your help.
Your mom's uptake is high, indicating hyper, but T3 uptake is considered an obsolete test. However, from what you say about her symptoms, she sounds hypO??? The T4 test looks like a total T4, not free T4 to me...also of limited usefulness. TSH certainly does not look hyper.
Methimazole is an anti-thyroid med used to control hyper. In addition to the tests you mentioned, I'd include a TSI (thyroid stimulating immunoglobulin). TSI is the definitive test for Graves' (autoimmune hyperthyroidism). Is she feeling any better on the methimazole?
Methimazole is an anti-thyroid med used to control hyper. In addition to the tests you mentioned, I'd include a TSI (thyroid stimulating immunoglobulin). TSI is the definitive test for Graves' (autoimmune hyperthyroidism). Is she feeling any better on the methimazole?
Hi thanks for responding. As far as Mom goes its a bit of a nightmare right now. I urged my Dad to see an Endo but he doesnt want too. My Dad has been through a lot (double bypass with complications) and didn't want to hear about going to another doctor and put all his trust in the primary doctor. He (primary doctor) seemed to get uptight with my questions and wanting further tests.
I'll be visiting them soon and check what blood tests he had done and reply.
She is back on the methimazole which I believe will interfere with the other readings correct?
What is frustrating is my Mom has all the signs of an autoimmune disease but the primary doctor feels if he did the Uptake it ruled out any problems from the beginning.
I'll get back to you when I return. Thanks again and I hope you are feeling well.
I'll be visiting them soon and check what blood tests he had done and reply.
She is back on the methimazole which I believe will interfere with the other readings correct?
What is frustrating is my Mom has all the signs of an autoimmune disease but the primary doctor feels if he did the Uptake it ruled out any problems from the beginning.
I'll get back to you when I return. Thanks again and I hope you are feeling well.
Thank you so much for the update. I just realized that I never saw the post about your mom. Did the doctor run the tests you requested? How's she doing? Yes, you aked for the right tests...FT3 and free triiodothyronine are the same test (thus the abbreviation!). The only thing I'd have added is TGab, which is the other antibody that indicates autoimmune disease.
Your numbers are a little on the low side still...but if you feel well, they are not seriously off. A definite improvement...keep up with regular bloodwork. As your thyroid function further deteriorates, you'll need meds increases.
Your numbers are a little on the low side still...but if you feel well, they are not seriously off. A definite improvement...keep up with regular bloodwork. As your thyroid function further deteriorates, you'll need meds increases.
Hi! You had asked me to check back and let you know how I was doing. After a month on synthroid .25 the doctor had my blood checked again. Here are the results:
TSH 2.480 ref .450-4.500
T4, Free (Direct) 1.23 ref .82-1.77
Reverse T3 221 ref 90-350
Triiodothyronine, free, serum 3.0 ref 2.0-4.4
It seems like the sythroid is doing it job. I feel fine too. I hope this followup finds you well.
Regards,
Amydreamer
TSH 2.480 ref .450-4.500
T4, Free (Direct) 1.23 ref .82-1.77
Reverse T3 221 ref 90-350
Triiodothyronine, free, serum 3.0 ref 2.0-4.4
It seems like the sythroid is doing it job. I feel fine too. I hope this followup finds you well.
Regards,
Amydreamer
Hi goolarra how are you?
My Dad asked me for advice and I want to make sure I gave him the right info since you were such a big help to me. I urged him to get her thyroid tested since I found I was hypothyroid.
My Mom is on Dilantin for a seizure she had many years ago. She has been very sleepy and out of it and going downhill for the last year. The doctor just took her off arisept for dimentia and detrol for urination because of her condition. Now her blood work came back as follows.
T3 Uptake range 42.70 Range 22.5-37.01
T4 9.5 Range 4.5-10.9
Tsh 2.079 Range 0.35-5.60
Albumin 3.0 Range 3.2-4.6
The Primary doc put her on methimazole.
With all the help from you and the rest of the great people here today I gave my Dad this advice today but told him I was also waiting to hear back from Med Help.
She starting methimazole yesterday. I told my Dad to stop giving her the methimazole.
Have the primary doc prescribe TSH +Free T4, Free T3, TPO Perioxidase and the Triodothyrnonine, Free, Serum..
I called the primary Doc and left a message on this answering machine to please have these tests done and that my Mom is off the methimazole until we know these numbers.
I believe the T3 Uptake is outdated and we need to know the rest of these numbers.
Did I advice him correctly?
Thank you,
Amydreamer
My Dad asked me for advice and I want to make sure I gave him the right info since you were such a big help to me. I urged him to get her thyroid tested since I found I was hypothyroid.
My Mom is on Dilantin for a seizure she had many years ago. She has been very sleepy and out of it and going downhill for the last year. The doctor just took her off arisept for dimentia and detrol for urination because of her condition. Now her blood work came back as follows.
T3 Uptake range 42.70 Range 22.5-37.01
T4 9.5 Range 4.5-10.9
Tsh 2.079 Range 0.35-5.60
Albumin 3.0 Range 3.2-4.6
The Primary doc put her on methimazole.
With all the help from you and the rest of the great people here today I gave my Dad this advice today but told him I was also waiting to hear back from Med Help.
She starting methimazole yesterday. I told my Dad to stop giving her the methimazole.
Have the primary doc prescribe TSH +Free T4, Free T3, TPO Perioxidase and the Triodothyrnonine, Free, Serum..
I called the primary Doc and left a message on this answering machine to please have these tests done and that my Mom is off the methimazole until we know these numbers.
I believe the T3 Uptake is outdated and we need to know the rest of these numbers.
Did I advice him correctly?
Thank you,
Amydreamer
It's hard to say which of the two doctors is the lesser of the two evils...the first won't use dessicated, the second will, but thinks your antibodies might miraculously disappear and doesn't want to start treatment until you've had ample opportunity to get sick! What a choice!
You usually have to interview through a nurse...they guard their doctors better than a junkyard dog does. This endo you interviewed should be testing FT3. Confused about Armour and T3 meds...maybe the nurse just didn't know what you were talking about. The brand name for T3 is Cytomel (she might recognize that).
My advice (my personal opinion only) is that I'd keep trying to find another thyroid doctor. If you are absolutely sold on dessicated, then Dr. #1 is not going to do you any good. However, Dr. #2 won't treat you. Have you ever contacted your cardio to get his opinion on thyroid meds and LBBB? I don't know how much of an issue these two create together, but it might be nice to have the cardio's opinion. I would probably go with Dr. #1. First, because she's willing to treat you now, not wait until you're sick and have gained 50 lbs. Second, many of us do absolutely fine on T4-only meds. Crossing each bridge as it comes along, if that is not the case with you, you can address that later. And has she even said that she would not consider using T3 meds or dessicated if T4 alone doesn't do it for you?
I'm sorry to hear about your family's health problems....at least you are feeling good and have the energy to deal with it (relatively speaking, of course).
You usually have to interview through a nurse...they guard their doctors better than a junkyard dog does. This endo you interviewed should be testing FT3. Confused about Armour and T3 meds...maybe the nurse just didn't know what you were talking about. The brand name for T3 is Cytomel (she might recognize that).
My advice (my personal opinion only) is that I'd keep trying to find another thyroid doctor. If you are absolutely sold on dessicated, then Dr. #1 is not going to do you any good. However, Dr. #2 won't treat you. Have you ever contacted your cardio to get his opinion on thyroid meds and LBBB? I don't know how much of an issue these two create together, but it might be nice to have the cardio's opinion. I would probably go with Dr. #1. First, because she's willing to treat you now, not wait until you're sick and have gained 50 lbs. Second, many of us do absolutely fine on T4-only meds. Crossing each bridge as it comes along, if that is not the case with you, you can address that later. And has she even said that she would not consider using T3 meds or dessicated if T4 alone doesn't do it for you?
I'm sorry to hear about your family's health problems....at least you are feeling good and have the energy to deal with it (relatively speaking, of course).
My dad had a double by pass and we are taking care of Mom so I had to put my issues on the back burner...I had a few minutes so: I called the endo my Primary wants me to see.
I spoke to the nurse and she said the doctor will not look at a questionaire to answer to ask her the questions. (I should have known then to hang up) I took your advice and asked her:
Which tests does the she routinely order and use to treat thyroid patients?
Her answer was TSH Ft4
I asked if they use Armour or any T3 combo drugs and they sounded confused.
When I asked if the Dr. ever treated a patient with the Left Branch Bundle Block they called back and told me to find a specialist maybe out of the area because they are unfamiliar with all of my questions!!
Actually Dr.2 is open to anything and I wonder if he would work with me on the T3/T4 meds. He wants to recheck all my levels in 3 months. Not just the TSH/FT4.
Your thoughts? Should I continue to search for an endo in my area that would work with me? I think I know what your answer is. :/
I spoke to the nurse and she said the doctor will not look at a questionaire to answer to ask her the questions. (I should have known then to hang up) I took your advice and asked her:
Which tests does the she routinely order and use to treat thyroid patients?
Her answer was TSH Ft4
I asked if they use Armour or any T3 combo drugs and they sounded confused.
When I asked if the Dr. ever treated a patient with the Left Branch Bundle Block they called back and told me to find a specialist maybe out of the area because they are unfamiliar with all of my questions!!
Actually Dr.2 is open to anything and I wonder if he would work with me on the T3/T4 meds. He wants to recheck all my levels in 3 months. Not just the TSH/FT4.
Your thoughts? Should I continue to search for an endo in my area that would work with me? I think I know what your answer is. :/
I understand your concerns about taking meds...I don't take anything I don't absolutely have to take. However, you do have Hashi's, so it's only a matter of when, not if, you start meds. I was very symptomatic when I started meds, and, I'll tell you, those symptoms sure convinced me that I couldn't do without these meds! If I sat for more than about 10 minutes, I was asleep. My muscles in my back would hardly hold me up. The problem is that it can be very insidious...symptoms creep on you until one day you're in really bad shape and don't know how you got there and so many of the symptoms can be "blamed" on something else.. I really think there's some merit in avoiding all that...
However, I think avoiding Dr. 2 is a very good idea. He missed the mark on several points. Get another opinion...hopefully, you'll find someone you feel you can trust and work with. Keep us posted.
However, I think avoiding Dr. 2 is a very good idea. He missed the mark on several points. Get another opinion...hopefully, you'll find someone you feel you can trust and work with. Keep us posted.
Again a million thanks on all your info. I appreciate your time and effort in explaining this to me in detail.
I've decided not to go back to Dr. 2.
I will do a follow up and let you know the results of my Endo search and my progress on which medication I will be taking.
I'm scared to take meds and keep thinking of what I read about synthroid making the thyroid stop working...because the medication does the work for the thyroid.
I've decided not to go back to Dr. 2.
I will do a follow up and let you know the results of my Endo search and my progress on which medication I will be taking.
I'm scared to take meds and keep thinking of what I read about synthroid making the thyroid stop working...because the medication does the work for the thyroid.
Question #1 - Which tests does the doctor routinely order and use to treat his thyroid patients and adjust meds?
If they say "TSH only", run. don't walk away! If they say TSH and FT4, you can walk this time. If they say FT3, FT4 and TSH, they've passed question #1.
Question #2 - Which meds is the doctor open to using...T4-only, synthetic T3/T4 combos, dessicated?
I believe they should be open to all three. This will weed out doctors who only treat using one or two of the three. Some of us only function well on one of the three, so we don't want our options limited.
Question #3 - Does the doctor have first-hand experience treating thyroid in somone with LBBB (and any other health issues that you think might conflict with thyroid treatment)?
Question #4 - Does the doctor recommend therapy and expect the patient to follow it or does he work with the patient, sharing all test results and informing her of all options so that doctor and patient can come to a mutually agreed upon treatment plan?
This may sound like a no-brainer, and you'd think that NO one would say that they expect the patient to blindly follow. However, when I was looking for a dentist a while back, most of the people I interviewed had no problem whatsoever, saying "oh, in this office, patients have NO RIGHT (eek!) to refuse "proper" care. Amazing...
You might also ask if you see the doctor himself or a PA, if that's important to you. I think there are many things a PA can do quite nicely, but once you're referred to a specialist, you've already seen and MD or DO, so isn't seeing a PA in a specialist's office a bit of a step backward?
Just some ideas, although I'd never make an appointment with an endo without asking at least #1 and #2. I actually made up a multiple guess questionnaire when I was looking and faxed it to the possible endos in the area. Because it was multiple choice, it didn't take much of their time to fill out. Good luck in your search.
If they say "TSH only", run. don't walk away! If they say TSH and FT4, you can walk this time. If they say FT3, FT4 and TSH, they've passed question #1.
Question #2 - Which meds is the doctor open to using...T4-only, synthetic T3/T4 combos, dessicated?
I believe they should be open to all three. This will weed out doctors who only treat using one or two of the three. Some of us only function well on one of the three, so we don't want our options limited.
Question #3 - Does the doctor have first-hand experience treating thyroid in somone with LBBB (and any other health issues that you think might conflict with thyroid treatment)?
Question #4 - Does the doctor recommend therapy and expect the patient to follow it or does he work with the patient, sharing all test results and informing her of all options so that doctor and patient can come to a mutually agreed upon treatment plan?
This may sound like a no-brainer, and you'd think that NO one would say that they expect the patient to blindly follow. However, when I was looking for a dentist a while back, most of the people I interviewed had no problem whatsoever, saying "oh, in this office, patients have NO RIGHT (eek!) to refuse "proper" care. Amazing...
You might also ask if you see the doctor himself or a PA, if that's important to you. I think there are many things a PA can do quite nicely, but once you're referred to a specialist, you've already seen and MD or DO, so isn't seeing a PA in a specialist's office a bit of a step backward?
Just some ideas, although I'd never make an appointment with an endo without asking at least #1 and #2. I actually made up a multiple guess questionnaire when I was looking and faxed it to the possible endos in the area. Because it was multiple choice, it didn't take much of their time to fill out. Good luck in your search.
I really appreciate all of your help.
Yes I would like an idea of some questions to ask.
Thank you very much.
Yes I would like an idea of some questions to ask.
Thank you very much.
Sorry, I calculated that and then forgot to mention it. FT3 / RT3 * 100 is 1.34. My readings have indicated that this ratio should be between roughly 1 and 2, preferably in the upper end of the 1-2 range. Your range and mine are off by a factor of 10. Yours would be 1.8-2.0 if we adjusted for that. Maybe that's what they mean by "preferably the upper end of the range"??? It may be tilted a little toward RT3 dominance, but I think I'd work on FT3 and FT4 levels at the moment and just monitor RT3 for future reference.
IF RT3 dominance is truly a factor, the treatment is usually straight T3 therapy with no T4 meds at all. This is temprorary until FT3/RT3 balance is restored. Then T4 meds are re-introduced (or introduced in your case). Whether or not you need to take both T3 and T4 depends on your FT3 and FT4 levels, not RT3. If FT4 is midrange or above (general rules of thumb here), but FT3 lags in the bottom of the range and symptoms persist, this indicates that you are not converting properly and need some added T3. However, you will not know this until you've gotten your FT4 level up a bit.
I think it would be a good idea to see an endo. But, I'd preinterview them over the phone first (probably through a nurse) to get an idea how good they are at thyroid - unless, of course, you can get a personal reference from another thyroid patient. Many endos just want to do diabetes and really don't keep up on thyroid at all. Some of them are really useless as thyroid doctors. If you'd like, I'll give you an idea of some questions to ask.
Hope this isn't all too confusing...
IF RT3 dominance is truly a factor, the treatment is usually straight T3 therapy with no T4 meds at all. This is temprorary until FT3/RT3 balance is restored. Then T4 meds are re-introduced (or introduced in your case). Whether or not you need to take both T3 and T4 depends on your FT3 and FT4 levels, not RT3. If FT4 is midrange or above (general rules of thumb here), but FT3 lags in the bottom of the range and symptoms persist, this indicates that you are not converting properly and need some added T3. However, you will not know this until you've gotten your FT4 level up a bit.
I think it would be a good idea to see an endo. But, I'd preinterview them over the phone first (probably through a nurse) to get an idea how good they are at thyroid - unless, of course, you can get a personal reference from another thyroid patient. Many endos just want to do diabetes and really don't keep up on thyroid at all. Some of them are really useless as thyroid doctors. If you'd like, I'll give you an idea of some questions to ask.
Hope this isn't all too confusing...
As an aside to my last reply, I thought taking synthroid makes your thyroid inactive and not function on its own. I'm kind of confused.
Thank you for your replies. What do you think about seeing an endocrinologist. They both said the same Dr. and she is credited.
Is the FT3 and RT3 ratio a 13.4??? I was doing some research and think I may have figured out what the ratio should be. It said around 18-20 and if I figured mine out it's low.
Does this mean I need the T3 supplement and the T4 supplement?
Is the FT3 and RT3 ratio a 13.4??? I was doing some research and think I may have figured out what the ratio should be. It said around 18-20 and if I figured mine out it's low.
Does this mean I need the T3 supplement and the T4 supplement?
Hi again.
Since your previous labs, TSH has gone from 4.68 up to 5.05...not a big jump, but higher nevertheless.
FT4 has stayed absoluely the same, but it's a bit on the low side, in the bottom quarter of the range (midrange is the rule of thumb). FT3 is in the bottom third of the range (upper half to third is recommended). Antibodies have not changed, which is to be expected, especially when they report as "greater-than 600" rather than giving an actual count.
Your two doctors are basically on the two sides of this argument of "when to start treating Hashi's". The first recognized the Hashi's and wants to treat before you develop symptoms. The second sees your labs as "normal" (they are, except for TSH, but low), so doesn't think it's worth starting to treat now. However, he's also saying that the antibodies might spontaneously resolve, which makes me think he doesn't know a lot about thyroid.
Most of us didn't have the luxury of being diagnosed early enough for this to have been a consideration for us. However, if I were in your position, I think I'd be tempted to start treatment (very unlikely with your low range labs that you'll go hyper). You might avoid a lot of very unpleasant symptoms and support your thyroid so that some of the physical thyroid manifestations of Hashi's are minimized (like nodules and swelling).
Looking back over your second opinion's statements, I don't think this guy is someone I'd trust. If you're still on the fence about what to do...maybe a third opinion?
Since your previous labs, TSH has gone from 4.68 up to 5.05...not a big jump, but higher nevertheless.
FT4 has stayed absoluely the same, but it's a bit on the low side, in the bottom quarter of the range (midrange is the rule of thumb). FT3 is in the bottom third of the range (upper half to third is recommended). Antibodies have not changed, which is to be expected, especially when they report as "greater-than 600" rather than giving an actual count.
Your two doctors are basically on the two sides of this argument of "when to start treating Hashi's". The first recognized the Hashi's and wants to treat before you develop symptoms. The second sees your labs as "normal" (they are, except for TSH, but low), so doesn't think it's worth starting to treat now. However, he's also saying that the antibodies might spontaneously resolve, which makes me think he doesn't know a lot about thyroid.
Most of us didn't have the luxury of being diagnosed early enough for this to have been a consideration for us. However, if I were in your position, I think I'd be tempted to start treatment (very unlikely with your low range labs that you'll go hyper). You might avoid a lot of very unpleasant symptoms and support your thyroid so that some of the physical thyroid manifestations of Hashi's are minimized (like nodules and swelling).
Looking back over your second opinion's statements, I don't think this guy is someone I'd trust. If you're still on the fence about what to do...maybe a third opinion?
Hi I hope I have the right tests now.
TSH 5.05
Triiodothyronine, Free Serum 2.7 pg/ml ref 2.0-4.4
Reverse T3 201 pg/ml ref 90-350
TPO 600 IU/ml <35
Vit D 37.4 32.0-100.0
Cortisol 8.6 ug/dl 2.3-19.4
T4 1.05 ng/dl .82-1.77
Thanks for your input. I'm not sure what the ratio of the Rt3 and T3 should be.
TSH 5.05
Triiodothyronine, Free Serum 2.7 pg/ml ref 2.0-4.4
Reverse T3 201 pg/ml ref 90-350
TPO 600 IU/ml <35
Vit D 37.4 32.0-100.0
Cortisol 8.6 ug/dl 2.3-19.4
T4 1.05 ng/dl .82-1.77
Thanks for your input. I'm not sure what the ratio of the Rt3 and T3 should be.
Yes I will ask the Dr.tomorrow. I have an order for TSH/FT4 but not FT3. I will ask for the FT3 because of the importance of knowing the ratio of the RT3 vs the FT3.
My progesterone was 0.8. Not sure if that matters.
Thanks again! I'll reply when the results of the tests are here.
My progesterone was 0.8. Not sure if that matters.
Thanks again! I'll reply when the results of the tests are here.
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