I've been diagnosed with addisons (primary) for about a year now, and i'm doing fine. today at my appointment my TSH was 4.6 - which falls within the "normal" range according to the labs chart. however, i've read conflicting information. Should I push for more tests for hypothyroid? and if so, which ones?

I'm very confused about the whole thyroid thing - Addison's was straighforward in comparison!

You need to come to the thyroid board. There you will be told by many.. YOU ARE HYPOTHYROID. ;)

Okay in 2002 the American Association of Clinical Endocrinology determined that the old range was insufficient and millions were going undiagnosed as a result. The new range was established to be 0.3 - 3.0. The laboratories which test the blood are not expected or held accountable for noting and adjusting said range. They just run the blood and let the instrument spit out the data. Thus MDs that are not thyroid savvy and too busy to keep up with current research just go by the lab ranges and leave people to suffer and wonder why? I am NORMAL. Sorry.. I have stepped up on the soap box here.

You need to get tested thoroughly for thyroid function;
TSH 3rd Gen
FT3
FT4
T3 Uptake
T3
T4

Now is your Addison's autoimmune in nature? If so add Hashimoto's thyroiditis antibodies to your thyroid panel: Lab codes TPOAb and TGAb.

Remember be wary of the NORMAL. Instead get a copy of these results and post the results and ranges in a new thread on the thyroid board. Ask for help interpreting them and we can help you.

I was just diagnosed primary adrenal insufficient. Mine is AI induced. The AI that started it all was Hashimoto's thyroiditis.. a very slow killer of the thyroid.

Please do not wait. you are hypoT and need to be treated appropriately. Yeah! More pills just what you wanted to hear. I wish you the best and hope to see you soon on the thyroid board.

Sincerely,
MG

Thank you for your advice - I reposted on the thyroid board, and will get a second opinion from another endo.

What do you mean is my Addison's autoimmune in nature? Isn't that the only possibility (aside from TB)?

If I don't have any symptoms do you think I can wait? The problem is I am traveling for a few months...

it is best in my opinion to get the diagnosis and have a copy of your blood work. If something happens while you are traveling it will save precious time. You will have the data the MDs need to treat you on hand. Even just starting on a token 25 - 50 mcg synthroid dose might be beneficial. I am glad that you are having no symptoms at your TSH level. At a TSH of 2, I was on death's door. To figure out exactly where you are and rule out lab error in that first TSH, you should have a complete thyroid panel recheck.
TSH 3rd Gen
FT3
FT4
T3 Uptake
T3
T4
TPOAb
TGAb

If all this comes back normal and your TSH is high but your FTs optimal.. something is up with the pituitary gland and the thyroid is doing its job, maybe it was just an error in the initial blood work, but I wouldn't wait... if it was me.

MG

ok these are not my most recent labs, but maybe you can help me understand them while i'm waiting for the new ones?

T3 uptake : 30.10 (23.50-40.60 units)
T4 : 6.3 (5.5 - 11.00)
FT1: 1.90 (1.65- 4.07)
TSH Third generation: 1.89 (.465- 4.68)
Total T3: 1.08 (.97-1.69)

thank you for your help. I have already made an appointment to get a second opinion. i can't tell if my symptoms are psychological.

These are helpful.
Were you on birth control pills or hormone supplements (estrogen/progesterone) during these labs? If so your Total Ts will be artificially inflated.

T3 uptake : 30.10 (23.50-40.60 units) - This just tells you that you are converting T4 in your liver at a normal rate. In a perfect conversion process you will have balanced T4 and T3 levels where your T4 and T3 are with in 5-10% of each other.

T4 : 6.3 (5.5 - 11.00) - To determine percentage of T4 in your system. Optimal is 50-80% of normal. There is a 10 - 20 % source of error in herent in this analytical test. [6.3-5.5]/[11.00-5.5]*100 = 14.5 % An FT4 test is preferred because it only has a 2.5-5% error.

Total T3: 1.08 (.97-1.69) Optimal is the same upper middle range as the T4. There is the same inherent source of error as well. {1.08-.97}/{1.69-.97}*100 = 15.28% Once again FT3 is much more accurate.

TSH Third generation: 1.89 (.465- 4.68) The range should have been 0.3 - 3.0 here as well.

Either way while you may be in normal range your Total T levels are way to low and you are definitely in need of supplementation.

Sincerely,
MG

Thank you! this stuff is quite difficult to understand.

To answer your question about birth control, I am not taking anything and never have.

the only medication i take is 22.5 of hydrocortisone. and vitamins.