Avatar universal

Why Exactly Am I Hypothyroid?

Hi.  I'm trying to solve this mystery, so I know what treatment to pursue.
I was healthy & normal with a TSH of 1.5 when this all started.
In my quest to be healthy forever I started eating better & taking supplements.  
One supplements was 6.25 mg of Iodoral which I took for 2 years.  I read that it
was risky to do so, so I dropped the dose to 225 mcg.  That's when this all started (not 100% certain iodine caused this, but it's suspicious).

October 2014, Diagnosed very hyperthyroid, TSI was 81.  TRAB was negative.
I took the methimazole & after 6 months, even though I reduced the dosage rapidly once Free T4 got in range, I became hypothyroid which is where I'm currently stuck.  I just don't understand "why" I'm hypothyroid.

Here are my newest labs (been off methimazole about 7 weeks):
May 28th, 2015:
TSH: 4.25 (0.27-4.20)
Free T4: 1.05 (0.93-1.70)
Free T3: 2.7 (2.0-4.4)
Reverse T3: 11 (8-24)
Total T4: 5.5 (4.5-11.7)
Total T3: 96 (80-200)
Antithyroglobulin Antibody: 10 (<115)
TPO: <10 (<34)
TSI: 90 (<=122%)
TRAB: <0.90 (<=1.75)

So does anyone know "why" I am hypothyroid.  Is there some other testing I can do that will help?  

The doctor says "mild" hypothyroidism, but I'm sure not a fan.  Mostly I have a woozy head & fatigue especially when I try to exercise or get stressed.  It just ***** because I have no energy to do anything.  I used to hike & bike & work out.  Now I'm lucky if I survive a good walk.

Thank you !
6 Responses
Avatar universal
You are hypothyroid because your Free T4 and Free T3 are too low in their ranges.  For many people, the ranges are far too broad to be functional across the entire breadth of the range.  Due to the erroneous assumptions in calculating the ranges, the lower half is usually suspect for hypothyroidism.  

In the words of a good thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

So you need a doctor that will treat clinically, by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  Is the doctor willing to prescribe thyroid meds and treat clinically?  If not, then you will need to find a good thyroid doctor that will do so.

Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, I highly recommend getting those tested as well.  D needs to be about 55-60, B12 in the very upper end of its range, and ferritin about 70 minimum for men.

If you need something to help convince your doctor, this link might suffice.

1756321 tn?1547095325
Injured thyroid cells due to excess iodine might be a reason for why you have mild hypothyroidism.  Thyroid cells can heal as my mother has found out since she is in remission for Hashimoto's thyroiditis. She did a number of things to improve her antioxidant levels and the main one was increasing stomach acid so she could absorb antioxidants.

Avatar universal
Thank you both for the info !  If I had injured thyroid cells how would I find out?  I've had all the tests I listed & I also had an ultrasound when this all started.  All they found was a mildly inflamed thyroid on the ultrasound.
1756321 tn?1547095325
The inflammation and hypothyroid labs/symptoms is showing some damage occurring.  Excess iodine intake is a listed cause of painless thyroiditis (inflammation of the thyroid gland).

"Subacute and painless thyroiditis often occur in four stages: initial thyrotoxicosis, a transitory euthyroid phase, a hypothyroid phase (lasting weeks to up to 6 months), and a final return to a euthyroid state. This may take as long as 9 months overall" - Clinical Key - Thyroiditis.
Avatar universal
Thanks Red..........that seems to fit pretty well.

One thing that confuses me is TSI.  I've read that if I have TSI (even below range) that I have Grave's Disease.  I'm not sure if that's true or not.  I tested positive for TSI at the beginning & now, but both times below range.  My TRAB has always tested negative.
1756321 tn?1547095325
I found a few articles that are interesting.

"The TSI test is often interpreted by physicians as negative if results are lower than 130% activity although some labs interpret results higher than 90% as presumptive, and results in patients without autoimmune thyroid disorders are in the range of <2% activity." - Elaine Moore - TSI in Children with Graves Disease May be Negative.

"For reasons that are somewhat unclear, the safeguard mechanisms that protect the thyroid gland may break down in some patients who are exposed to excess amounts of iodine. This may lead to production and secretion of excess amounts of thyroid hormone.

Iodine-induced hyperthyroidism is more likely to develop in patients who live in areas of the world where there may not be enough iodine in the diet. It is also more likely to develop in patients who have preexisting autonomously functioning thyroid nodules or mild Graves' disease. In rare cases, iodine-induced hyperthyroidism may develop in patients who have completely normal thyroid glands." - John Hopkins - Hyperthyroid and Graves disease

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