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Old 09-27-2004, 12:50 PM   #1
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What are the best thyroid tests???

Hi,

I'm in a very desperate situation health-wise but I will not bore you with it.

However, could someone please educate me on what thyroid tests are available to me when I go to my GP/Doctor and ask him to test my thyroid? I know there is a standard blood test but are there any others that are more conclusive?

Could someone also tell me how you thyroid hormone levels are measured (i.e how is it decided that your thyroid is "normal" or not?) and what are the boundaries for a irregular functioning thyroid (Hyperthyroid, Hypothyroid etc etc)?

Many thanks and god bless all of you struggling with problems.

from a 22yr old male.

 
Old 09-27-2004, 07:38 PM   #2
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Re: What are the best thyroid tests???

Ask him to test your TSH, Free T4 and Free T3... If he's cooperative with those, ask for anti-thyroid antibodies (TPO for hypo; TSI Tg for hyper; Tg for either) as well. This will give you the best idea of what your thyroid is doing.

There are other thyroid tests - Total T4/T3, T3 uptake, and free thyroxine index (a.k.a T7) among them, but none of these is as good as the above combination.

Quote:
Could someone also tell me how you thyroid hormone levels are measured (i.e how is it decided that your thyroid is "normal" or not?) and what are the boundaries for a irregular functioning thyroid (Hyperthyroid, Hypothyroid etc etc)?
There is much controversy among professionals about what is "normal", and many times they're just plain mistaken. You can get as many different interpretations for your tests as doctors you show them to. So be warned that you will have to educate yourself before you accept any doctor's word that your tests are "normal".
Many MDs insist that a TSH test is all you need to know if a problem exists. This is not true. The free Ts are the actual thyroid hormones, and their levels are the all-important ones. In general, 95% of the healthy, non-symptomatic population has a TSH around 1.0. The Amer. Acad. of Clinical Endo's says that a TSH above 2.5 strongly suggests hypoT and, with symptoms, warrants a trial of thyroid hormone.
Most people need their free T levels to be in the upper part of the "normal" lab range to feel their best and have no symptoms.

I'm not as clear about what constitutes hyperT, but TSH at or below the normal lab range, especially in the presence of TSI antibodies fits the definition. Look for posts by K9Mom to learn more about hyperT.

Read thru our "Information Archive" to learn more about both conditions.

 
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Old 09-28-2004, 03:07 AM   #3
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Re: What are the best thyroid tests???

I agree with Midwest about the most important tests to have done.

With hyperthyroidism it is possible to have a high Free T3 only - called T3 Toxicosis (with a suppressed TSH) so it is important to get the Free T3 as well as the Free T4.

Many times labs will do what is called a "cascade". Meaning that they initially do a TSH test....if it is normal they stop there. If it is abnormal then they run a Free T4. If the Free T4 is normal they stop there, if abnormal they then run a T3.

In my opinion the cascade is not the way to go. You will want at least these 3 tests:

Free T4
Free T3
TSH

If these are abnormal, then you will want the thyroid antibody tests that Midwest mentioned so that the CAUSE of your thyroid disease can be identified.

Good luck!
__________________
Dx Graves 4/99, tx w/Tapazole & Atenolol - Remission 7/03; Relapse 1/06, back on Tapazole, remission & off meds again 11/06.

 
Old 09-28-2004, 08:16 AM   #4
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Re: What are the best thyroid tests???

I have been diagnosed with a problem called Gastropaeresis which can be, and often is, caused by thyroid problems. Gastroparesis is when the nerves in the stomach fail to contract the stomach leading to a series of debilatating problems (nauseua, vomiting, severe pains in the stomach lasting upto 3hrs, weight loss, complete loss of appetite,fatigue etc). I've been battling with this problem for two years as their is no effective treatment for it. I've had to drop out of university, lost contact with a lot of my friends and basically had a hellish time with this illness.

I have had EVERY test/examination under the sun relating to digestion and, after consulting FIVE specialists, have been presented with the soul destroying diognosis that the Gastroparesis is "idiopathic" and untreatable. You can imagine what that has done to a 22yr old who has just had his life pulled out form underneath him.

I had my thyroid tested a couple of times, i believe, and was told it was "fine" (very informative, eh?).

So why do I believe In could still have a thyroid problem then? Well, I have so many symptoms these days and many of them have never been related with gastroparesis:

I have problems with heat. I can't bare the heat and sweat profusely (something I didn't do 2 yrs ago) when I am hot. I also get unbearable itchiness over my back and shoulders when I'm too hot and come out in mild redness over those areas.

My stress levels are immense. Sure, a lot of that is down to the dark cloud that has been cast over me, but i'm permenantly jumpy, anxious and nervous and get "hot flushes" when it all gets too much.

I cannot seem to put any weight on at all and my once athletic build has lost all it's muscle and I cannot seem to get it back no matter how hard I try.

I sometimes have problems with my balance and feel unsteady on my feet when walking.

I'm constantly hyper and my heart seems to be going 100miles an hour even when I'm lying down.

Regular headaches lasting all day sometimes.

And the big one, and most alarming for me, my usually strong hair has got thinner and started falling out over the past 3 months. I'm pretty sure it's not male pattern baldness due to how quickly it has happened and the fact that the WHOLE of my hair has got thinner not just my hairline or the top. I find when I wash my hair or run my hands through it my air is falling out!!

Any ideas or information anyone can give out would be greatly appreciated and thank you for your help so far! People like you give me something to hope for when I open my eyes in the morning.

God Bless.

 
Old 09-28-2004, 09:20 AM   #5
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Re: What are the best thyroid tests???

Hi Peejee,
I am not trying to be bossy but you said you had thyroid test and they said it was fine right? Don't go by them saying fine. My doctor told me that too.

When I found these boards, they told me to get a copy of my bloodtests(required by law) and post them here.

Well I am glad I did because my bloodtests showed me hypo.

You may not have a thyroid problem. I just thought I would tell you that in case you didn't know.

 
Old 09-28-2004, 09:39 AM   #6
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Re: What are the best thyroid tests???

Quote:
Originally Posted by peejee
I have been diagnosed with a problem called Gastropaeresis which can be, and often is, caused by thyroid problems. Gastroparesis is when the nerves in the stomach fail to contract the stomach leading to a series of debilatating problems (nauseua, vomiting, severe pains in the stomach lasting upto 3hrs, weight loss, complete loss of appetite,fatigue etc).
You probably don't even realize it, peejee, but you've taught me about one way the thyroid affects the digestive system. You came here with questions and unwittingly provided an answer. Thank you for that.

Quote:
the Gastroparesis is "idiopathic" and untreatable.
"Idiopathic" is supposed to mean "unknown cause", but to me, it simply means the MDs are either too stupid or too lazy to figure out a reason for illness. I'm glad you aren't just lying down and accepting it.
Quote:
I had my thyroid tested a couple of times, i believe, and was told it was "fine" (very informative, eh?).
You have the classic symptoms of hyperT. Press on as hard and as far as you can on the thyroid angle. I doubt very much that you've had the right tests; or even if you did, they probably weren't interpreted correctly.
K9Mom is extremely knowlegeable about hyperT. (I know far more about hypo, because that's my issue.) Follow her excellent advice. Use the search feature on this board to find more posts of hers.

Do not give up on this! I think your hunch is correct that all of your problems are thyroid-related. You're far too young to be so "mysteriously" (so 'they' say) sick to give up now.
Please let us know how it goes... we care.

 
Old 09-30-2004, 04:51 PM   #7
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Re: What are the best thyroid tests???

Midwest,

May I first just say thank-you. After 2yrs of misery I know not to get my hopes up but you have put a smile on my face and given me some hope and and I will be indebted to you and everyone else who has responded in this thread if something comes of this.


Quote:
Originally Posted by midwest1
"Idiopathic" is supposed to mean "unknown cause", but to me, it simply means the MDs are either too stupid or too lazy to figure out a reason for illness. I'm glad you aren't just lying down and accepting it.
You have the classic symptoms of hyperT.
This also made me smile but for reasons that you may recognise in the following. Here is a shortened version of my struggle over the last two years (it's long but please read):

Left home for university in Sept 2002 aged 20. Began experiencing several uncomfortable yet constant symptoms in Nov 2002 such as sudden nausea, 3hr long stomach cramps, loss of appetite, early satiety, weight loss etc. Went to see GI Specialist. He ran a few tests and his diagnosis was I was fine and whatever it was would get better by itself. Continued to feel very ill and had to leave university January 2003. Over the next 8 months I had every GI procedure imaginable (10 in total, 7 of them invasive), under the same GI specialist and was told they were all "fine".

I found a problem called Gastroparesis on the web and mentioned this to my GI specialist. His reply? "I don't think you have that". He referred me to a Professor who wanted the GI procedures repeated. Had them done and was referred to another, younger GI doctor. I pushed the Gastroparesis angle yet he wanted to illiminate things that hadn't been addressed first because, I've learnt since, he had limited knowledge of Gastroparesis (I ended up knowing more than this "specialist" on the subject). Bloods for things like Diabetes and Thyroid problems were done and I was told they were "fine". HE eventually settled on MY diagnosis that it was Gastroparesis and determined it was "idiopathic" and "untreatable" except for a few motility drugs which didn't work. His advice? "Go and get on with your life and it may get better by itself"!!!

At this point the strength I had shown thus far buckled and I went into deep depression. This problem is so debilatating and noone can do anything about it or even give me a definate diagnosis and cause. My brilliant parents found a Medical University professor who apparently knew all about this problem. His technique was to sit me down and tell me that at 22 you may or may not get better and you have get used to that fact. I have since learnt that his correspondance with my previous GI Doctor raised the topic of drugs and that I just may have taken drugs at University which caused this problem and I didn't want to admit it!!! I've never touched a drug in my life for god's sake! Sure I drink but that's it and to even think that i'd taken drugs not to mention wouldn't admit it to help myself was bizarre!

My "last chance" was the Specialist who treated David Blaine after he fasted in that perspex box in London last year (remember that). I travelled to London to see him two months ago and was told nothing new (again) which has left me in such a hopeless predicament.

So there you have it! I have a seriously life affecting problem which WAS caused by something (a Thyroid problem in my opinion) yet "idiopathic" was the diagnosis. I've been left alone with my parents to tackle this and it's tough, real tough. I've been "cut loose" by the medical profession with not so much as a phone call to see how I am doing for the past 10 months!!

Quote:
Originally Posted by midwest1
Do not give up on this! I think your hunch is correct that all of your problems are thyroid-related. You're far too young to be so "mysteriously" (so 'they' say) sick to give up now.
Please let us know how it goes... we care.
Thank-you again! I've been thinking about it for a while but you put your faith in Medical people and when you are told your thyroid is "fine" you believe it because these people are paid well to say this! Interestingly, I never brought up that this problem could be caused by thyroid ilnesses with the specialists and I don't think they knew it could be. Even more interestingly I read yesterday that HYPO and HYPER are two of the 10 most regularly misdiagnosed or "unrecognised" problems out there. That gives me hope and hope is what stops the "untreatable" closing their eyes and never opening them again, right?

God Bless and thank you Midwest and K9Mom.

Last edited by peejee; 10-02-2004 at 08:14 AM.

 
Old 09-30-2004, 08:26 PM   #8
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Re: What are the best thyroid tests???

Because of the term you used.... "left home for university"... it leads me to think you are either in Canada or the UK. True? The medical systems in those two countries are far different from those in the US, so it would be hard for me to suggest ways to get a doctor who will listen to the thyroid angle of your illness.

In the US, doctors receive about an hour's worth of thyroid training, and few of them even complete an endocrinology rotation during residency. That's the main reason for the missed and mis-diagnoses that are all too common.

I diagnosed myself with hypoT, with the help of the Internet. My own MD at that time refused to run a TSH test at my request... I had to insist on it. I also asked for antibodies testing, but he refused that as well. The TSH turned out high-normal, and with the urging of the kind and helpful regulars on this board at that time, I saw another doctor for more tests, and my diagnosis was confirmed. I've read that it takes an average of six consultations before a thyroid diagnosis is made. One woman here saw 36 MDs before she was finally treated.

Try to do your utmost to get the tests we mentioned.

 
Old 09-30-2004, 09:19 PM   #9
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Re: What are the best thyroid tests???

peejee
Just wondered if you have been checked for diabetes,I didn't notice
that in your posts.I'm sorry you are having such a hard time.Good
luck to you.
I have more questions about tests but it sounds like you are very
knowledgeable and have run the gamut.

Last edited by dogtired; 09-30-2004 at 09:33 PM.

 
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