preparing for my endo referral in 2 days...

[clareyh]

Hey everyone,

Wondered if anyone can help me in what the important things to stress to the endocrinologist i am seeing this thursday are:

The history of my TSH levels are:

Dec 2008: 7.5
Feb 2009: 5.8
May 2009: 5.7
September 2009: 7.2
October 2009: 5.7

obviously they are not consistant, I have just had my Thyroid antibodies tested and the levels are normal- ruling out anything autoimmune. I have had a full blood work done for which everything else was ok.

I have over the last year suffered from: muscle weakness, tiredness, bad joint pain, extreme coldness in feet hands and nose, have gone from u.k size 4 to u.k size 8 (which doesnt bother me as i have always been too thin!), a very slight numbess in my left leg (and sometimes in my left arm), irregular periods (that are heavier than they used to be), TMJ pain (dont know if this is related or independent from thyroid problems), noticed a lot of hair falls out in the shower and when brushing, brittle nails, dry itchy eyes, vertigo (although i feel this is more related to my TMJ and grinding my teeth in my sleep).

my main worry is that my G.P keeps saying, oh, your not much over the lab range (which upper limit is 5.5) and i get so annoyed as it is still over the threshold, even if 'not by much'. She keeps trying to prescribe me mild forms of an antidepressant for my anxiety, but i keep trying to tell her that I seem so anxious because I have been feeling like this for a YEAR now and no one is doing anything.

I am worried the endo will say the same thing? Does anyone know whether they use more sensitive lab ranges or will maybe trial me on some kind of meds? I am just wondering what to expect really, and if anyone has any advice as to what I can say to insist my case.

thanks in advance for any help anyone can give,

Clare :-)

[Barb135]

I don't know that you need to wait to start your med until you get an FT3; your doctor should have scheduled you for a recheck in 5-6 weeks, so insist on it then.  FT3/FT4 and TSH should all be done at the time, so you get a picture of what was in THAT blood draw.  Doesn't correlate well, when you're trying to compare multiple blood draws for the individual parameters.

Your test results from March looked good, actually.  Your FT4 might have been a bit low, but TSH and FT3 were both really good.  Were you having symptoms, then?

What symptoms are you having now?

[Otto44$]

I just realized that I probably would also have a repeated blood test for the TSH & FT 4 also to collaborate together with the results of my FT 3? not sure if he'll do a repeat test or if insurance would pay for it, but I will try.

[Otto44$]

Hi there! Thanks for the quick response. I remember being told that my FT 3 level should also be tested along with the tsh & FT4. Unfortunately, as we know a lot of dr.'s won't test the FT 3 all the time. I guess it's a costly test & I'm learning that some Dr.'s care more about saving Ins. Companies money, than their patient. Anyhow, I had to beg my PCP to test my FT 3 back in March and these were my results:  FT 3 was 3.04 range 1.71-3.71, Free T4 was 1.03 range 0.70-1.48 and my tsh level was1.286 range 0.350-4.940. Do you think maybe I should've my FT 3 level checked again before starting the hormone replacement and wait for the results? I can try by begging him to recheck it again. I did just find a Endocrinologist where we relocated to. Unfortunately, I can't get in until Oct.

[Barb135]

Yes, your TSH is higher than normal.  It's really too bad you didn't have the FT3, because that's the active thyroid hormone and correlates best with symptoms.  It should be tested every time you have a TSH and FT4.  

Yes, your doctor has started you on the correct medication.  Typically, one is started on a T4 only med and if it's determined that you don't adequately convert FT4 to FT3, a T3 med, such as cytomel would be added.  The only way to tell if you are converting adequately is to have the FT3 done, along with the FT4.

[Otto44$]

I'm back & hoping that you or anyone can help me in deciding if what the Dr. just put me on is of help for my high TSH levels, that are apparently probably the cause of some issue's I'm having at this time. I'm sorry that I haven't been participating in the forum. However, between relocating to another city, recovering from a medical procedure that lead into complications, ect. has set me into a depression, not to mention other things that's been going on in my life. Well, enough of that for now. First and for most, I'm in need of a Endocrinologist in the Buffalo NY area, if anyone knows of a good one. I'd be greatly appreciated if they'd share some names with me. goolaara, I chose to address my question to you, because you've helped me so much in the past with learning about the thyroid. However, anyone feel free to jump in. So, besides having now that I know a lot of issue's like depression, muscle spasms in my legs, insomnia, ect. being caused from my thyroid disease. I was had labs repeated. Results, TSH 7.41 range 0.40-4.50 and T4 Free 1.0 range 0.8-1.8. PCP didn't check my T3 level this time. Well, the Dr. has started me on Levothyroxine 0.25 mgs. due to the high TSH level. I know I've read that when taking thyroid replacement to not just take one for the T4 alone. Please advise if this is the proper procedure to just take this one replacement by itself. I'm at total loss and to be honest, real scared not only about this disease, but taking this medicine. Thank you once again for all your help & advice.

[Otto44$]

Sorry, I tend to get real confused at times. Scratch that information above pertaining to my results stating they were from 12/24/02. Those were actually my recent results in 4/2012. Sorry for any confusion. Unfortunately, I don't have a copy of my sonogram from 2002, and wouldn't dare ask for them at this time, lol! I say laugh out loud, because I think with me being concerned about my health issue's and keep asking the PCP for results, & test regarding my thyroid, liver and a lump I discovered under my right rib cage in the back area because of having stinging, burning & throbbing ect. & me not agreeing with him, thinking he's a Endo., Hepatologist and internist. For instance, he tried to tell me that alot of Endo's don't understand the thyroid & that the Free T3 count (when I requested the test) doesn't have a play in the thyroid, but I was able to talk him into testing. Not realizing until, you mentioned above that I've only had the one test of the Free T3 that indeed he didn't run it again. He also said, that Dr.'s wait for the TSH level to go off the charts before providing medicine. Well, I'm learning so much more than he knows about the thyroid. Also, same as with the liver, thinks he knows it all & didn't want me to see a hepatologist, even though I've a fatty liver & high liver enzymes. Which unfortunately, when your liver enzymes are elevated, it's telling you that your liver is injured or damaged. I'm hoping they were high due to the lipitor he had me on. So I can go on & on, but I think you understand what I'm saying. I've become a big believer that we've to watch our for our own health.