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Excessive bleeding, large clots and abdominal pain for weeks, any guidance?
I have been passing large clots, bleeding excessively and having abdominal (labor like) pain for a couple of weeks(off and on[but mostly on]). I had a similar experience about 6 weeks prior. When I went to the doctors at the end of the first experience my thyroid stimulating hormone was above 20.0- The doctor assumed it was because of that and they increased my synthroid. This time around my tsh was normal. I am afraid there is something far more nefarious going on. That is the short of it - can anyone offer guidance
Yes, hypothyroidism can definitely cause heavy or erratic menstrual issues - both are endocrine and we need the right balance of all hormones in order for our body to work the way it was intended.
Is TSH the only thyroid related test your doctor ordered or did they also order Free T4 and Free T3? Those are the actual thyroid hormones and correlate with symptoms much closer than TSH, which is a pituitary hormone. Just because TSH is "normal" doesn't mean your thyroid hormone levels are optimal, or even adequate.
If you have results for Free T4 and Free T3, could you please post the results, along with their corresponding reference ranges, so we can get a better idea what's going on.
What's your dose of Synthroid and how long have you been on it.
Do you know the cause of your hypothyroidism? Hashimoto's, RAI, thyroidectomy, etc?
Because of the heavy bleeding, I'd say you need to get Ferritin tested, as well. Ferritin is the iron storage hormone. Iron is necessary for proper metabolism of thyroid hormones. Vitamin C helps the body absorb iron better. Vitamin D and B-12 are also, both needed for proper metabolism of thyroid hormones and there's also a link between Vitamin D and B-12 deficiencies and heavy periods. Many of us find that we're deficient in a variety of vitamins/minerals.
Is TSH the only thyroid related test your doctor ordered or did they also order Free T4 and Free T3? Those are the actual thyroid hormones and correlate with symptoms much closer than TSH, which is a pituitary hormone. Just because TSH is "normal" doesn't mean your thyroid hormone levels are optimal, or even adequate.
If you have results for Free T4 and Free T3, could you please post the results, along with their corresponding reference ranges, so we can get a better idea what's going on.
What's your dose of Synthroid and how long have you been on it.
Do you know the cause of your hypothyroidism? Hashimoto's, RAI, thyroidectomy, etc?
Because of the heavy bleeding, I'd say you need to get Ferritin tested, as well. Ferritin is the iron storage hormone. Iron is necessary for proper metabolism of thyroid hormones. Vitamin C helps the body absorb iron better. Vitamin D and B-12 are also, both needed for proper metabolism of thyroid hormones and there's also a link between Vitamin D and B-12 deficiencies and heavy periods. Many of us find that we're deficient in a variety of vitamins/minerals.
10 Comments
I do have Hashimoto’s thyroiditis. My T3 and T4 were normal when my TSH was over 20 (in the ER, in September). My results this time around were all normal. I had intercourse at the end of June (immediately after my last regular period) and again at the beginning of August- no periods in July Or August. I was thinking maybe an incomplete miscarriage -but when they did a pregnancy test, in the ER,in September wouldnt they have been able to tell me if I was having a miscarriage?
I went from 75 mcg to 100 mcg.
I am going to look up all thyroid related levels from September and last week.
I am going to look up all thyroid related levels from September and last week.
To follow up:
September 24(ER)
TSH: 20.88. Ref: 0.27-4.2
Free T4: 0.9. Ref: 0.8-1.8
December 10 (OBGYN)
TSH: 3.6 Ref:0.4-4.5
Iron 49. Ref 40-90
Iron Binding:310. Ref:250-450
Ferritin 27. Ref 16-154
September 24(ER)
TSH: 20.88. Ref: 0.27-4.2
Free T4: 0.9. Ref: 0.8-1.8
December 10 (OBGYN)
TSH: 3.6 Ref:0.4-4.5
Iron 49. Ref 40-90
Iron Binding:310. Ref:250-450
Ferritin 27. Ref 16-154
If you were in the process of having a miscarriage when you went to the ER, I'd think they'd have been able to tell that if they did the right tests.
I don't see a T3 result - I guess that means they didn't do it?
That said, your Free T4 is only at 10% of range, so even though it's "in range" that doesn't mean it's optimal (or even adequate). Most of us need Free T4 to be, at least, 50% of range. You've got a long way to go to get there. We also need Free T3 to be 1/2 - 3/4 of range, but your doctors didn't order a Free T3 so we don't know where that stands. The problem is that your Free T4 is so low, there's not a lot to convert to Free T3, which is the hormone that individual cells in your boy need.
When you had the December labs, again, I see no Free T4 or Free T3 so I guess they didn't order those? Even though your TSH was within the lab's range, it's higher than it should, typically be. In addition, both, your iron and Ferritin levels are too low, even though they're within the reference ranges. Iron is needed for the conversion of Free T4 (storage hormone) to Free T3 (used by individual cells), along with all its other uses, so even if you had adequate iron levels, you wouldn't have enough Free T4 to be converted.
The bottom line is that even though the limited labs they've done indicate "normal" levels, they aren't optimal and you won't feel well.
Next time you have blood work, insist that they order, both, Free T4 and Free T3 so you know where you are, thyroid-wise.
Are you trying to get pregnant? Adequate thyroid hormones are necessary pregnancy to occur (and prevent miscarriage). In addition, adequate thyroid hormones are necessary for fetal development. The mother's thyroid hormones have to be high enough to sustain, both, herself and the fetus for, at least, the first trimester, or until the fetus's thyroid kicks in to produce adequate thyroid hormones on its own.
IMO - you're quite hypo and if you're trying to conceive, you should wait until your thyroid hormone levels are high enough to sustain, both, yourself and a fetus. It's customary when one is pregnant (or trying to conceive), thyroid hormone dosages are increased to accommodate fetal development. If your doctor isn't willing to do this, I'd highly recommend you find a different doctor.
I don't see a T3 result - I guess that means they didn't do it?
That said, your Free T4 is only at 10% of range, so even though it's "in range" that doesn't mean it's optimal (or even adequate). Most of us need Free T4 to be, at least, 50% of range. You've got a long way to go to get there. We also need Free T3 to be 1/2 - 3/4 of range, but your doctors didn't order a Free T3 so we don't know where that stands. The problem is that your Free T4 is so low, there's not a lot to convert to Free T3, which is the hormone that individual cells in your boy need.
When you had the December labs, again, I see no Free T4 or Free T3 so I guess they didn't order those? Even though your TSH was within the lab's range, it's higher than it should, typically be. In addition, both, your iron and Ferritin levels are too low, even though they're within the reference ranges. Iron is needed for the conversion of Free T4 (storage hormone) to Free T3 (used by individual cells), along with all its other uses, so even if you had adequate iron levels, you wouldn't have enough Free T4 to be converted.
The bottom line is that even though the limited labs they've done indicate "normal" levels, they aren't optimal and you won't feel well.
Next time you have blood work, insist that they order, both, Free T4 and Free T3 so you know where you are, thyroid-wise.
Are you trying to get pregnant? Adequate thyroid hormones are necessary pregnancy to occur (and prevent miscarriage). In addition, adequate thyroid hormones are necessary for fetal development. The mother's thyroid hormones have to be high enough to sustain, both, herself and the fetus for, at least, the first trimester, or until the fetus's thyroid kicks in to produce adequate thyroid hormones on its own.
IMO - you're quite hypo and if you're trying to conceive, you should wait until your thyroid hormone levels are high enough to sustain, both, yourself and a fetus. It's customary when one is pregnant (or trying to conceive), thyroid hormone dosages are increased to accommodate fetal development. If your doctor isn't willing to do this, I'd highly recommend you find a different doctor.
Thank you so much for your help. I’m going to follow up with my PCP and request my T3 and T4 levels this week. I am more at ease to know that it can still be caused by my thyroid. I had all kinds of crazy notions going on from cancer to extrauterine pregnancy. I have an ultrasound with the obgyn in January 7.
Make sure you always specify FREE T4 and FREE T3... if you just say T4 and T3, you'll get different tests that aren't very helpful.
What type of ultrasound are you having on Jan 7?
What type of ultrasound are you having on Jan 7?
It is going to be a pelvic ultrasound. Transabdominal and Transvag. Last imaging I had done on my thyroid was probably 8 years ago. I think there was a speckled pattern and an Ana titer of, I want to say, 1:40
Do you think I should see an endocrinologist?
I’m going to make sure that I request a free T3 and free T4 tommorow.
Do you think I should see an endocrinologist?
I’m going to make sure that I request a free T3 and free T4 tommorow.
I don't necessarily think you need to see and endocrinologist - many of them specialize in diabetes and actually are worse at treating thyroid conditions than many primary care physicians or other doctors. I have and endo right now who refuses to test Free T4 and Free T3... he insists that TSH is all that's needed and as long as it's "in range" all is well, with no thought to symptoms or anything else. Doctors like this tend to keep patients ill for a long time.
While you're asking for the Free T4/Free T3, you should also request a thyroid ultrasound if it's been that long since you had one. I'm not sure about a speckled pattern on an ultrasound. ANA is an Antinuclear Antibody blood test - and yes, results can come up with a speckled pattern. ANA is done to see if you have autoimmune condition which is when antibodies attack some part of your own body. ANA test is used to diagnose Lupus, Sjögren's, RA and others. If you had a result of 1:40, that should have been considered positive. Was there any follow up on that?
While you're asking for the Free T4/Free T3, you should also request a thyroid ultrasound if it's been that long since you had one. I'm not sure about a speckled pattern on an ultrasound. ANA is an Antinuclear Antibody blood test - and yes, results can come up with a speckled pattern. ANA is done to see if you have autoimmune condition which is when antibodies attack some part of your own body. ANA test is used to diagnose Lupus, Sjögren's, RA and others. If you had a result of 1:40, that should have been considered positive. Was there any follow up on that?
It didn’t seem right as I was typing it but they were done around the same time and I associated the two. I just spoke with the nurse at my doctors office who said my pcp doesn’t think she needs to check my Free T3 and T4 if I’m taking my medication correctly. Mind you there was never any follow up on that end to determine if that dose was even the right dose. My TSH was done by the obgyn. I don’t know what the harm is in taking the labs. Is that an insurance thing? I’m extremely frustrated but her response. I now have a tele appointment for Next week with her. This should be fun.
I'm not surprised your pcp refused to order Free T4 and Free T3 - many doctors believe that TSH is sufficient. Just taking medication correctly doesn't mean FT4 and FT3 will be adequate.
No, it's not an insurance thing to refuse doing the tests - it's a poor doctor thing. Have you considered finding a different primary doctor.
No, it's not an insurance thing to refuse doing the tests - it's a poor doctor thing. Have you considered finding a different primary doctor.
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The two things might not be related. Did the doctor at least have you do an ultrasound when you went in 6 weeks ago? It sounds like a fibroid or an incomplete miscarriage. If not, I'd call my ob/gyn and insist on one, and also possibly see if an MRI of the abdomen would be possible to do.
I don't know anything about thyroid hormones, so check with your doctor, but if you are having constant bleeding, it seems like at the very least you should be taking an iron supplement. (With a fiber gummy every day, so it doesn't give you constipation.) You don't need anemia on top of everything else.
I'm going to send a pm to Barb who knows about thyroid issues, and she can take a look at this.
I don't know anything about thyroid hormones, so check with your doctor, but if you are having constant bleeding, it seems like at the very least you should be taking an iron supplement. (With a fiber gummy every day, so it doesn't give you constipation.) You don't need anemia on top of everything else.
I'm going to send a pm to Barb who knows about thyroid issues, and she can take a look at this.
1 Comments
When I went to the ER the first time around they treated they payed closer attention to the symptoms that were urgent- dizziness, feet getting cold and numb. The thyroid can have have effects on the heart and the Er physician upped my synthroid. My follow up with pcp about ten Days afterwards:symptoms were gone, she attributed it all to my thyroid and wanted me to continue with the new dosage.
This time around there’s less dizziness and circulatory complications but the pain is worse and the clots(more like tissue) and bleeding are more consistent. My iron is fine now and also when it was checked in the ER.
This time around there’s less dizziness and circulatory complications but the pain is worse and the clots(more like tissue) and bleeding are more consistent. My iron is fine now and also when it was checked in the ER.
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