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Old 09-19-2004, 11:18 PM   #1
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Todd D. HB User
Low Thyroid?

Hello,
I've been very tired and fatigued since November of 2003. I also cannot focus and concentrate well. The blood tests for my thyroid always came back normal. Recently I started going to a new doctor. He told me that the normal range for TSH had changed. My TSH is above 4, but below 5( I forget the exact amount). In the old normal range, my TSH level would be considered normal, but it's considered high in the new normal range. My T3, T4, and Free T3 were normal. I was wondering if it's possible that I could have a low thyroid because of my high TSH level, even though my T3, T4, and Free T3 came back normal? Thanks.

 
Old 09-20-2004, 12:27 AM   #2
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Felix73 HB User
Re: Low Thyroid?

Hi Todd,

Welcome to the board. Sorry you are feeling so bad.

Can you get hold of the exact numbers and ranges for your FT3 and FT4 numbers?

If you are in the lower side of the lab ranges for these, there may be a good chance you are suffering from some form of thyroid problem with a high TSH. It is definitely worth looking into as you have been feeling so awful.

if you can get them, post them on here and we can have a look.

Do you have any other symptoms, a long with fatigue?

Felix x

 
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Old 09-20-2004, 08:53 AM   #3
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Gopherhead HB User
Re: Low Thyroid?

As Felix said just being "normal" means nothing. I have FTs in the 'normal' range, but they are in the low normal range, and my TSH was also between 4 and 5, but I had just about every symptom you could list. I finally found a specialist who believes in preventative treatment and agreed to take me on. I would lobby to get those exact numbers and post them here; you'll get some good advice.

Women feel best when their FTs are in the upper 3rd of the range and when TSH is around 1. Men tend to need their FTs in the middle 3rd of the range; but those are just the 'average' - what is best for you could be different. There's a thread here called "What about for a Man" with some advice that you might find useful (Or not, this is me assuming that Todd.D = male )

You should also get tested for thyroid antibodies.

It sounds like your new doctor is up to speed on the new range for TSH, perhaps he would listen to you if you provided further information that your FTs need to be higher?

Nat
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Last edited by Gopherhead; 09-20-2004 at 08:55 AM.

 
Old 09-20-2004, 03:23 PM   #4
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Todd D. HB User
Re: Low Thyroid?

Thanks for the replies. I am a male. I do not have the exact numbers for my T3 and T4. They were done by a previous doctor and those results were faxed to my current doctor. I have another doctor's appt. on September 29 so I can ask for a copy of those results then, or call before that. My current doctor had my Free T3 tested at my last appt. I received the results this past weekend and my Free T3 is 2.9 with the normal range being between 2.0-4.9 Besides severe tiredness, it's hard for me to concentrate and focus. My short-term memory isn't good. My stomach feels upset a lot with bloating, and it growls and rumbles an awful lot. I always feel tired and I don't have problems falling asleep or staying asleep.

I think I forgot to mention that my current doctor put me on thyroid medication on September 8. I started taking 30 mg a day on the 9th. I took 30 mg a day for ten days, and then I started taking 2 pills a day on Sept. 19, which would be 60 mg a day. After ten days of taking 2 pills a day, then I'm to start taking 3 pills a day which would be 90 mg a day. The brand I take is called Thyroid. I know it's a brand name cause the doctor put brand name necessary on the prescription, but I thought the medication had different names besides just being called Thyroid? I thought that my doctor might take me off the thyroid medication now that my Free T3 came back normal? Or is the TSH level usually the main indictor of a thyroid problem?

 
Old 09-20-2004, 03:39 PM   #5
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Gopherhead HB User
Re: Low Thyroid?

Todd, first off, your FT3 is low, which would explain why you feel tired and unable to concentrate / focus. To be in the mid range (where most men feel best) you'd want a FT3 of 3.5ish. The good news is it sounds like your doctor has put you on natural desiccated thyroid instead of synthetic meds, which as you'll come to realize many of us have to lobby for. A lot of us seem to do much better on the natural thyroid med than the synthetic. I'd assume your doctor put you on this because it contains natural T3, which you are quite low in. In Canada the natural med is called Thyroid (by Pfizer) and it is on par with Armour Thyroid in the US. It also comes in 30, 60 and 90 mg size (or 1/2 grain, 1 grain, 1 1/2 grains).

Unfortunately you don't usually come off thyroid meds - they are given when your own thyroid stops making hormones and they are usually given for life.

Count yourself lucky, this doctor seems to know his/her stuff. TSH is almost meaningless once you have begun treatment, it is the FREE T's that matter (FT4 and FT3) as they are the thyroid hormones (TSH is pituitary).

How are you feeling now? Most people find they notice an improvement almost immediately with this type of thyroid medication.

Nat
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Old 09-20-2004, 04:19 PM   #6
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Todd D. HB User
Re: Low Thyroid?

Gopherhead,
I'm still feeling very tired along with the other symptoms. My doctor told me that the thyroid medication I'm on can be slow to take effect. He said I should start noticing a difference when I start taking three pills a day(90 mg a day). I'll start on three pills a day on Sept. 29 which is the same day as my next doctor's appt.

I'm in the United States, so you would think the medication I'm on would be called Armour Thyroid and not Thyroid? What is the difference between T3 and Free T3 and T4 and Free T4?

I read that you should take the medication on an empty stomach. Should I wait a certain time after I take the medication until I eat something? Also, it said about not taking iron or calcium within 4 hours of taking the medication. I take a normal multivitamin. Should I always wait four hours to take the multivitamin after taking the medication? Thanks.

 
Old 09-20-2004, 05:15 PM   #7
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Gopherhead HB User
Re: Low Thyroid?

That is weird, Todd. I wonder if he put you on Nature Thyroid (Naturethroid)? It's a form of desiccated thyroid that is not often prescribed unless asked for - all natural, very unlikely to have reactions to it (which is a good thing).

Are you splitting your dose? Many people find that taking this med twice a day makes for no afternoon slumps. T3 is active w/in hours of taking it but it wears off fast as well, usually w/in 8 hours - dividing the dose helps with this. T4 is the inactive hormone that is converted to T3 - T4 can take weeks to make it into your system. People on just T4 tend to take weeks to feel the effects of their medication, those getting some T3 feel better sooner, but it can take weeks, because T4 is still needed.

Free T4 refers to that amount of T4 that is free to be converted to T3. Most of the T4 and T3 in our bodies are attached to proteins which serve as carriers in the blood, to be usable they must be unbound, or Free. So you have T4, Free T4, T3 and Free T3, this is why test for just T4 or just T3 aren't accurate enough - you can't 'use' all of the T4 or T3 that is present.

Yes, all thyroid medication works best on an empty stomach - it's better absorbed this way. And calcium / iron are two of the supplements that can bind to it and inhibit its absorption, so they should be taken 4 hours after or before. If your multi is iron free you might be OK - most contain very little calcium, but to be on the safe side, I'd wait. Wait 2 hours for other supplements and for food, this is the amount of time given because it's about how long it takes for the stomach to empty.

Cheers,
Nat
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Old 09-21-2004, 01:19 PM   #8
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Todd D. HB User
Re: Low Thyroid?

Gopherhead,
I got a call today from my doctor. He said that my Free T3 level of 2.9 (normal range 2.0-4.9) is a good result and near optimal. He said that Free T3 is the one he usually follows in the dosing of thyroid medication since it's the active thyroid hormone. I asked him about my TSH level being above 4, and he said that tests can be inaccurate sometimes.

He wants to keep me on the thyroid medication for the time being. My doctor wants to do another panel of Thyroid tests, though it can't be done for another three months at least, because my insurance won't pay for it again until that time. He said that some people have another type of hypothyroidism, but I forget what he called it. I assume though that he doesn't think I have a low thyroid anymore. So I guess I'm out of luck. I couldn't go back to college this semester because of my symptoms.

 
Old 09-21-2004, 01:48 PM   #9
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Gopherhead HB User
Re: Low Thyroid?

Quote:
Originally Posted by Todd D.
He said that my Free T3 level of 2.9 (normal range 2.0-4.9) is a good result and near optimal.


I assume though that he doesn't think I have a low thyroid anymore. So I guess I'm out of luck. I couldn't go back to college this semester because of my symptoms.
I hate to tell you, Toots, but at this point I'd be looking for another doctor. You feel awful, still, and your FT3 is below where most men feel good. Granted you have not been on your meds for long, so there is room for you to feel better. It could be that your doctor thinks this is the best you'll get and he won't treat you further, which is too bad, seeing as he's looking at some of the right test, he's just not interpreting them well - and then there are your symptoms. Argg. Frustrating.

Keep in mind, Todd, that 'optimal' for you may not be 'optimal' for someone else and while people's numbers do range everyone has that sweet spot where they feel good. If 2.9 was yours chances are you'd feel good. He isn't even concerned with your FT4!

At this point you'd be well to arm yourself with as much information as you can and take it with you to see him next time. Or take it to a new doctor. There is advice in the Information Archive on how to find good doctors - what questions to ask, etc. It would be a good place to start.

Nat
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Old 09-21-2004, 02:08 PM   #10
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Todd D. HB User
Re: Low Thyroid?

Gopherhead,
Well my doctor said he would keep me on my Thyroid medication for now, but I don't know for how much longer. I have another appt. with him on September 29, so I'll have to see what he says then and go from there.

I don't like how I have to wait three months before my insurance will pay for more thyroid tests. If the TSH level isn't very valid in determining low thyroid, why is it even tested?

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Last edited by moderator2; 09-21-2004 at 07:24 PM. Reason: please carefully review the posting rules

 
Old 09-21-2004, 02:21 PM   #11
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quicke HB User
Re: Low Thyroid?

Am I wrong but I have heard once you go on thyroid medicine you are on it forever. Another thing I heard is if a person with a normal functioning thyroid takes thyroid medication they run the risk of then becoming hypothyroid. I'm just wondering if this is true and if it is than how can the doctor prescribe the medication without being absolutely sure?

 
Old 09-21-2004, 03:59 PM   #12
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Gopherhead HB User
Re: Low Thyroid?

Todd, we'd all like to know just why doctors do what they do when it comes to TSH and thyroid function. There are very few enlightened doctors out there, if you search around (information archive) I am sure you can find a directory for one or two in your area. You could always post a thread asking if anyone where you're from knows of any good doctors.

TSH, once you've begun treatment is often meaningless. If you have the time do a search for posts by MEEP in the last 2 weeks, he's written a few great posts about this (one was just yeserday or this morning).

Private messaging is not enabled on this forum - neither is posting e-mail addresses (have aread through the posting rules up top the page) If it's any consolation you're in good company here - we've just about all gone through similar situations with our doctors.

Nat
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Old 09-21-2004, 04:03 PM   #13
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Gopherhead HB User
Re: Low Thyroid?

Quote:
Originally Posted by quicke
Am I wrong but I have heard once you go on thyroid medicine you are on it forever.
Pretty much, quicke. THere are some instances where you do recover and get off the meds, but they are not many.


Quote:
Another thing I heard is if a person with a normal functioning thyroid takes thyroid medication they run the risk of then becoming hypothyroid. I'm just wondering if this is true and if it is than how can the doctor prescribe the medication without being absolutely sure?
I don't believe this is true. It would be more the opposite. If you give thyroid hormones to people who have normally functioning thyroids you would end up with a patient who was hyperthyroid, not hypothyroid. You would exhibit all the lovely symptoms associated with hyperT; diarrhea, racing pulse, high BP, twitching and cramping, etc.

Nat
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A foolish consistency is the hobgoblin of little minds.

 
Old 09-21-2004, 07:59 PM   #14
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Todd D. HB User
Re: Low Thyroid?

Gopherhead,
Do you think I should ask to get an antibodies test? I've been hearing people talk about that. What are all the tests involved in a thyroid panel?

I've read some of Meep's posts. So a person's TSH level can change pretty frequently? That disheartened me, cause I started thinking that maybe my TSH level was high when I got the test taken, and it could have changed anytime after that. And you said that most people with a Free T3 level of 2.9(my level) wouldn't feel that good?

What's the purpose of the buddy list? Did people use to be able to send private messages through that?

 
Old 09-21-2004, 08:06 PM   #15
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Todd D. HB User
Re: Low Thyroid?

Quote:
Originally Posted by quicke
Am I wrong but I have heard once you go on thyroid medicine you are on it forever. Another thing I heard is if a person with a normal functioning thyroid takes thyroid medication they run the risk of then becoming hypothyroid. I'm just wondering if this is true and if it is than how can the doctor prescribe the medication without being absolutely sure?
Yeah, there are dangers involved in taking Thyroid medication when you have a normal thyroid. Such as what Gopherhead pointed out.

My doctor prescribed me Thyroid medication based on my TSH levels which were high. Even though my Free T3 results came back in the normal range, I still believe that I may have a low thyroid.

 
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