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NEED HELP UNDERSTANDING LAB RESULTS PLEASE
Hi-
I am an american living in Germany and was recently diagnosed with having a low thyroid. I had my first test done in 11/11 and then again 2/11. My TSH levels first go around were .76 and then after putting me on l-thyroxine drops for 3 months my TSH levels are now -.23! How is this even possible? My iron levels are in the negative range and actually got worse after being on a zinc supplement for 3 months. I am now anemic. The doctor is a gp so I am not sure they even know what to do about this but I have gained 30 pounds over the past year and I am normally a thin person. All of the symptoms I started having right after my last child was born and have been getting worse. Any advice? Thanks
I am an american living in Germany and was recently diagnosed with having a low thyroid. I had my first test done in 11/11 and then again 2/11. My TSH levels first go around were .76 and then after putting me on l-thyroxine drops for 3 months my TSH levels are now -.23! How is this even possible? My iron levels are in the negative range and actually got worse after being on a zinc supplement for 3 months. I am now anemic. The doctor is a gp so I am not sure they even know what to do about this but I have gained 30 pounds over the past year and I am normally a thin person. All of the symptoms I started having right after my last child was born and have been getting worse. Any advice? Thanks
Thanks for the info! I am cutting back to 10mcg today and will likely stay on that until my next blood test in 4 weeks.
Some people do have a difficult time going from no T3 to anything more than 10 mcg. So it could be just a thing you need to work up to. It seems I've read numerous reports here where anyhting over 15 people had trouble. For you to start at 20 mcg that is one big jump.
Did they say how long to cut back to 10. T3 is fast acting so cutting back for something like 2 weeks or so would probably Be OK and then jump up to 15 and then wait another 2 weeks or so and see how it goes. By that time you'll probably have to take another test.
Also when on T3 meds. Do NOT take your T3 meds before you have blood drawn. As such you may want to take that into consideration and have your lab test be fairly early in the morning. Reason for this is that the T3 gets into your blood quickly and depending upon the time after you take your T3 medication can affect the blood lab results falsely indicating a higher FT3 amount in your blood than really is the case because you just surged your body with T3 med.
Did they say how long to cut back to 10. T3 is fast acting so cutting back for something like 2 weeks or so would probably Be OK and then jump up to 15 and then wait another 2 weeks or so and see how it goes. By that time you'll probably have to take another test.
Also when on T3 meds. Do NOT take your T3 meds before you have blood drawn. As such you may want to take that into consideration and have your lab test be fairly early in the morning. Reason for this is that the T3 gets into your blood quickly and depending upon the time after you take your T3 medication can affect the blood lab results falsely indicating a higher FT3 amount in your blood than really is the case because you just surged your body with T3 med.
Ughhh. I asked a nurse and she told me to go back to 10 mcg until my side effects get better since I haven't been on the cytomel for very long. It is either that or split it up. I can't take another night of the not sleeping though.
COMMUNITY LEADER
ACTH stimulation is the most specific test, but there are others. Some doctors merely do an ACTH blood test, without the stimulation. I don't think that's accurate though. I'm not an expert at adrenal; here's a web site that will tell you more than I can.
http://endocrine-system.emedtv.com/adrenal-insufficiency/adrenal-insufficiency-testing.html
In addition, you might want to ask about a 24 hr saliva test done for cortisol.
Be careful cutting back on the cytomel, because your FT3 level wasn't very high to begin with; at 3.64, you still had quite a bit of room to go up, with the range of 1.90-5.10. You may risk bringing back or worsening other symptoms.
http://endocrine-system.emedtv.com/adrenal-insufficiency/adrenal-insufficiency-testing.html
In addition, you might want to ask about a 24 hr saliva test done for cortisol.
Be careful cutting back on the cytomel, because your FT3 level wasn't very high to begin with; at 3.64, you still had quite a bit of room to go up, with the range of 1.90-5.10. You may risk bringing back or worsening other symptoms.
I am only 35 and this has just recently started with the addition to the cytomel. I am usually stressed so it could be a combination. I had my "sexual hormones" tested along with everything else and they were good. I took half of the cytomel this morning and am thinking of maybe cutting back to 10 mcg rather than 20. I call them sweats but its more like clammy not actually sweating. Do you know what the adrenal would be called on the test results? Thanks again!
COMMUNITY LEADER
I don't know your age, but have you had other hormones checked, such as reproductive hormones, adrenal function, etc?
I had night sweats horribly when I was going through menopause (surgically induced), and for years after. I still get them regularly, but I'm neither starting a new thyroid med nor taking too much. For me, I think they have more to do with stress/anxiety than anything else. I find that keeping my bedroom cooler and using lightweight blankets goes a long toward alleviating the sweats, but if I'm really stressed out, nothing works.
If I were you, I'd see about cutting back on the levo and start splitting the thybon dose, along with getting reproductive hormones and adrenal function tested, as soon as possible.
I had night sweats horribly when I was going through menopause (surgically induced), and for years after. I still get them regularly, but I'm neither starting a new thyroid med nor taking too much. For me, I think they have more to do with stress/anxiety than anything else. I find that keeping my bedroom cooler and using lightweight blankets goes a long toward alleviating the sweats, but if I'm really stressed out, nothing works.
If I were you, I'd see about cutting back on the levo and start splitting the thybon dose, along with getting reproductive hormones and adrenal function tested, as soon as possible.
I have been having night sweats the past few nights? Is this normal when starting a new thyroid med or does that mean I am taking too much? I will wake up and it feels like fire and ice under my skin and I go back and forth between hot and cold and can't sleep. Any ideas? Thanks
COMMUNITY LEADER
Once you have an autoimmune, it's yours and you have it for life, though antibody counts may go down, once there is no longer healthy tissue for the antibodies to attack. In the case of the thyroid, at that point, you would be completely dependent on the replacement medication. There are a few of on this forum that have reached that point. Regulating thyroid hormones seems to be easier, once we no longer have the thyroid randomly putting out hormones, too.
If you have the lab report, check on the TPO to see what it is. TPO is necessary to produce thyroid hormone. TPO antibodies attack the TPO, so it can't do its job.
I'm sure she's right that this can all be figured out; it just takes time, patience and research.
I'm only guessing, of course, because I'm not a doctor and don't know all your issues, but I don't agree that "having a permanent issue won't be the case". I think you should do as much research as you can, so you can become your own advocate. Some doctors are not good thyroid doctors, but can be "trained"......lol If your doctor is willing to listen and learn, you have more than a lot of us do.
If you have the lab report, check on the TPO to see what it is. TPO is necessary to produce thyroid hormone. TPO antibodies attack the TPO, so it can't do its job.
I'm sure she's right that this can all be figured out; it just takes time, patience and research.
I'm only guessing, of course, because I'm not a doctor and don't know all your issues, but I don't agree that "having a permanent issue won't be the case". I think you should do as much research as you can, so you can become your own advocate. Some doctors are not good thyroid doctors, but can be "trained"......lol If your doctor is willing to listen and learn, you have more than a lot of us do.
Wow! You sure do know a lot about all of this! Does autoimmune thyroid disease stick around forever or does it come and go? I have no idea about the TPO. She ordered quite a few tests and I have a copy of the results. She also seems to think that all of this can be figured out and that having a permanent issue won't be the case but everything I have read about thyroid problems are long term. What do you think?
COMMUNITY LEADER
This from Mayo Clinic regarding positive ANA:
"An ANA test detects antinuclear antibodies in your blood. Your immune system normally makes antibodies to help you fight infection. In contrast, antinuclear antibodies often attack your body's own tissues — specifically targeting each cell's nucleus.
In most cases, a positive ANA test indicates that your immune system has launched a misdirected attack on your own tissue — in other words, an autoimmune reaction. But some people have positive ANA tests even when they're healthy.
Your doctor may order an ANA test if he or she suspects you have an autoimmune disease such as lupus, rheumatoid arthritis or scleroderma."
While lupus may not be genetic, it is autoimmune and autoimmune diseases tend to run in families, so the fact that your mother has lupus increases the chance that you will have an autoimmune, also... aside from the ones, listed here, there's also Pernicious Anemia, celiac, Hashimoto's, etc. Additionally, once a person has one autoimmune, chances are greater that they will get a second one. For instance, I have both Hashi's and Pernicious Anemia.
Was that an actual TPO test or was it TPO antibodies? They aren't the same thing. If it was the antibody test, you also need to get Thyroglobulin Antibodies TGab), because some people with Hashi's are positive for only TPOab, some are postive only for TGab and some have both. Without having both tests, the cause of your hypothyroidism could be missed.
In my opinion, it's most likely that you have autoimmune thyroid disease. Some people may not have antibodies, and others may not have them at one point, but have them later.
"An ANA test detects antinuclear antibodies in your blood. Your immune system normally makes antibodies to help you fight infection. In contrast, antinuclear antibodies often attack your body's own tissues — specifically targeting each cell's nucleus.
In most cases, a positive ANA test indicates that your immune system has launched a misdirected attack on your own tissue — in other words, an autoimmune reaction. But some people have positive ANA tests even when they're healthy.
Your doctor may order an ANA test if he or she suspects you have an autoimmune disease such as lupus, rheumatoid arthritis or scleroderma."
While lupus may not be genetic, it is autoimmune and autoimmune diseases tend to run in families, so the fact that your mother has lupus increases the chance that you will have an autoimmune, also... aside from the ones, listed here, there's also Pernicious Anemia, celiac, Hashimoto's, etc. Additionally, once a person has one autoimmune, chances are greater that they will get a second one. For instance, I have both Hashi's and Pernicious Anemia.
Was that an actual TPO test or was it TPO antibodies? They aren't the same thing. If it was the antibody test, you also need to get Thyroglobulin Antibodies TGab), because some people with Hashi's are positive for only TPOab, some are postive only for TGab and some have both. Without having both tests, the cause of your hypothyroidism could be missed.
In my opinion, it's most likely that you have autoimmune thyroid disease. Some people may not have antibodies, and others may not have them at one point, but have them later.
I didn't think OTC pills would have anything to do with that either. My TPO was 9.4 <16 so it was normal. Now one thing I should mention is that my Mom has lupus and I have always been told it is not genetic but the dr did do an ANA and my results were high 1:320 back in 11/11 and in 2/12 it was 1:160 so it was lower. The dr said she does not think I have an autoimmune disease but that I am predisposed to getting one and that if I do not get everything in check soon then it is likely going to happen in the future??? Does this make sense? It didn't to me but none of it really does.
COMMUNITY LEADER
Diet pills can affect a lot of things; however, I doubt taking an OTC diet pill over 10 yrs ago, would have anything to do with your current issues.
Have you been tested for thyroid antibodies to determine whether or not you have Hashimoto's Thyroiditis? You would need to get Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). While there is such a thing as postpartum thyroiditis, that's temporary and it often leads to long term hypothyroidism, especially, when there's an immune system disorder. Try to get antibody tests done; once you know the cause of your hypothyroidism, it may be easier to deal with, even though treatment won't change.
Have you been tested for thyroid antibodies to determine whether or not you have Hashimoto's Thyroiditis? You would need to get Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). While there is such a thing as postpartum thyroiditis, that's temporary and it often leads to long term hypothyroidism, especially, when there's an immune system disorder. Try to get antibody tests done; once you know the cause of your hypothyroidism, it may be easier to deal with, even though treatment won't change.
Oh Wow! What city do you live in? All of this thyroid mess is a lot to take in....
Hi Betty,
I am also an American living in Germany :)
and was also just diagnosed with thyroid issues.... that is why I was snooping around here looking for answers...
how long have you been in Germany?
I am also an American living in Germany :)
and was also just diagnosed with thyroid issues.... that is why I was snooping around here looking for answers...
how long have you been in Germany?
Yes-the idea of taking something for something I don't have a problem with seems weird to me but what do I know. The doctor never said I was hypothyroid just kept saying everything was low and not what it should be but that we would figure it out.
Another strange thing I thought was one of the first things she asked me if I had taken diet pills after she did an ultrasound of my thyroid (the left side was enlarged). I said I had taken fat burners about 10 years ago but nothing prescription and it almost seemed like she didn't believe me. Do diet pills affect your thyroid? I personally think my thyroid problem is coming from my last pregnancy. That is when this all started....
Another strange thing I thought was one of the first things she asked me if I had taken diet pills after she did an ultrasound of my thyroid (the left side was enlarged). I said I had taken fat burners about 10 years ago but nothing prescription and it almost seemed like she didn't believe me. Do diet pills affect your thyroid? I personally think my thyroid problem is coming from my last pregnancy. That is when this all started....
COMMUNITY LEADER
No, there isn't "one thing that seems to work for most people", because we are all so different and our bodies react differently to each medication. What's right for me, may make you much worse; however, we do have the T3 med in common. I've been taking generic T3 since early 2009 and have done well on it. Just last month, I talked my endo into a slight increase to bring my FT3 level up a bit.
I have heard of people being put on metformin, which is a diabetes med, for weight loss, but that can be pretty tricky if one doesn't have high blood sugar, since the metformin can cause blood sugar to drop too low. I agree with you, that it's best to try the thybon first.
Vitamin D can cause a lot of "hypo like" symptoms; good that you are taking it.
I have heard of people being put on metformin, which is a diabetes med, for weight loss, but that can be pretty tricky if one doesn't have high blood sugar, since the metformin can cause blood sugar to drop too low. I agree with you, that it's best to try the thybon first.
Vitamin D can cause a lot of "hypo like" symptoms; good that you are taking it.
I will check with my doctor about the l thyroxine. I will also look into taking selenium. I have only had one iron transfusion and she wants me to come every 2 weeks until it is up. I have also started taking vitamin d and had a vitamin d shot as well a few weeks ago. Hopefully once my iron gets back up then things will improve. My doctor also suggested that maybe I go on a diabetes blood sugar med to help lose weight even though none of my blood work indicates me being diabetic. Told her I wanted to wait and see how the thybon works first since I have never heard of anyone doing that. Do people typically do well on the thybon/cytomel? Is there one thing that seems to work for most people? Thanks
COMMUNITY LEADER
You would need to talk to the doctor about cutting back on the levo. Don't think I'd cut back too far, though as you could easily swing the other way.
It's not unusual to have suppressed TSH when on thyroid medication, especially a T3 med. My TSH stays at < 0.01 all the time, since I've been on medication. TSH is a pituitary hormone and often does not correspond with FT3 and FT4 levels or symptoms.
I'd suggest that you get vitamin B12, D, selenium, magnesium, calcium checked, plus your doctor will need to figure out why your iron levels are so low.
I understand how you feel about the weight gain. I've had a hard time losing weight I gained when hypo, too. Hopefully, resolving your other issues would go toward helping you lose (bringing up FT3 levels might help with that). You need adequate B12, D and iron for energy; selenium helps with the conversion of T4 to T3.
If your current doctor can't get to the bottom of all this, you may have to find one who can.
It's not unusual to have suppressed TSH when on thyroid medication, especially a T3 med. My TSH stays at < 0.01 all the time, since I've been on medication. TSH is a pituitary hormone and often does not correspond with FT3 and FT4 levels or symptoms.
I'd suggest that you get vitamin B12, D, selenium, magnesium, calcium checked, plus your doctor will need to figure out why your iron levels are so low.
I understand how you feel about the weight gain. I've had a hard time losing weight I gained when hypo, too. Hopefully, resolving your other issues would go toward helping you lose (bringing up FT3 levels might help with that). You need adequate B12, D and iron for energy; selenium helps with the conversion of T4 to T3.
If your current doctor can't get to the bottom of all this, you may have to find one who can.
Thanks Barb. All of this has been very confusing. I haven't felt well for 3 years and now having extra weight on my 5'2" frame isn't helping. I can't wear any of my clothes and it is depressing. I have been eating clean and try to exercise when I have the energy but when I get on the scale and it hasnt moved or has gone up it is very discouraging.
So as far as the l thyroxin drops-how many should I cut back to? I will try splitting up the thybon. That might be best anyway as far as absorption. Is there anything else you recommend taking as supplements? What about iodine? Why do you think my TSH levels are so low not even being on the scale? Again sorry for all the questions but I am really new to figuring all of this out. Thsnks!
So as far as the l thyroxin drops-how many should I cut back to? I will try splitting up the thybon. That might be best anyway as far as absorption. Is there anything else you recommend taking as supplements? What about iodine? Why do you think my TSH levels are so low not even being on the scale? Again sorry for all the questions but I am really new to figuring all of this out. Thsnks!
COMMUNITY LEADER
No, your results weren't better before medication. As I said before, many feel best with FT4 at mid range (yours is higher than that) and FT3 in the upper 1/3 of its range. You might need to cut back on the levo, since your FT4 is quite high in the range.
If you've only been on the thybon for a week, you need to give it time to actually stabilize in your system. Even though T3 med is "fast acting", it still took several months for my actual blood levels to come up.
If the Thybon is in pill form, you might try splitting it in 1/2 and take 1/2 in the morning and the other 1/2 around noon. This will help your FT3 levels remain more stable throughout the day and may help you feel better.
If you've only been on the thybon for a week, you need to give it time to actually stabilize in your system. Even though T3 med is "fast acting", it still took several months for my actual blood levels to come up.
If the Thybon is in pill form, you might try splitting it in 1/2 and take 1/2 in the morning and the other 1/2 around noon. This will help your FT3 levels remain more stable throughout the day and may help you feel better.
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