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Old 12-15-2004, 07:04 AM   #1
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Question Secondary HypoT, Spuressed TSH?

Ok, a few quick questions (again! )

based on my levels, some have suggested I have a supressed TSH. What is that and what does it mean?

review of my levels: TSH: .68 normal range is from .34-4.82
Free T4: .66 normal range is from .59-1.17

Also, if it is secondary HypoT, does that always mean a problem with the pituitary gland or can it be another issue?

And finally - one of the symptoms I have is a immune system problem... I don't exactly know how they would check for this or whatever, but I catch EVERYTHING that is around me. I know have had 3 colds already this season, and any bug that is around I catch. Is this a symptom of HypoT or Pitutary problems?

OK, I think that is all for now! All this stuff is so new to me, and I have no idea what the dr will tell me tomorrow.
I really appreciate all the reply's as well as the info sticky... some great things in there!

LM

 
Old 12-15-2004, 07:43 AM   #2
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Re: Secondary HypoT, Spuressed TSH?

Simply put, the hypothalamus, pituitary, and thyroid operate in a roundabout way. One tells the other what to do next. If there's a short circuit, things get messed up. In most cases, the pituitary keeps putting out its hormone until the thyroid gets the message to increase its own production. That's why TSH rises to the top of, or above, the range as the thyroid hormone levels fall.
In your case, there's some reason why your pituitary isn't putting out enough TSH. The thyroid sits there doing nothing while waiting for the TSH to show up. So, both the pituitary TSH and the thyroid FT4 are low.

Whatever you do, don't let the doctor pronounce you well just because the TSH isn't elevated. You are hypo; don't take "well" for an answer.

 
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Old 12-15-2004, 08:10 AM   #3
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Re: Secondary HypoT, Spuressed TSH?

Thanks for you responses!
I remember when I was in High School they tested me for thyroid levels, and all they said was "normal"... makes me wonder how normal they were.

Quote:
Originally Posted by midwest1
Whatever you do, don't let the doctor pronounce you well just because the TSH isn't elevated. You are hypo; don't take "well" for an answer.
This really was good for me to hear Midwest.... I am going to go into this tomorrow as informed as I can be. My dr. already knows I am fed up with feeling this way. He isn't my normal dr., mine was out the day I went in, so I feel pretty blessed to see him since it seems like he is trying to figure it out (my other dr just liked to pass my fatigue off as "depression" from a fairly recent miscarriage... and for awhile I wondered, but there is just too much wrong in my body for that to be the case!) I am just so tired of not feeling like myself...

One (or two) more question - how exactly do you know if your TSH is supressed... what does that mean? Is it normally high if you are Hypo?

Also - how should I approach my dr about all this. I am hoping for the best (ie: he realizes something is up and tests further) but how do let him know what I have learned without looking like a freak who is obsessed with the internet? I want to come off as informed and not crazy! haha

Thanks again y'all!

 
Old 12-15-2004, 08:28 AM   #4
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Re: Secondary HypoT, Spuressed TSH?

Quote:
Originally Posted by gracesufficient
(my other dr just liked to pass my fatigue off as "depression" from a fairly recent miscarriage...
This happens more than you know! Also, if you don't already know, low thyroid hormones are often the cause of miscarriage. That's why, if you're planning other pregnancies soon, you need to get things in order to avoid more heartbreak.

Quote:
One (or two) more question - how exactly do you know if your TSH is supressed... what does that mean? Is it normally high if you are Hypo?
Simple, clear cut cases of hypo show elevated TSH. Most healthy people have TSH around .8 to 1.0, so you can see why a doctor wouldn't worry about a reading like yours. I'd guess that most people diagnosed hypo have TSH still within the "normal" lab range. The fact is that most labs' ranges are far too wide, despite the AACE's desire to narrow them. meaning that many folks will remain undiagnosed.
Also, your TSH is not technically "suppressed". "Suppressed" in TSH terminology means almost zero, and yours has a long way to go before then.

Quote:
Also - how should I approach my dr about all this. I am hoping for the best (ie: he realizes something is up and tests further) but how do let him know what I have learned without looking like a freak who is obsessed with the internet? I want to come off as informed and not crazy!
That's a very good question, but one without a clear answer. It sort of depends on the doctor and his mindset.
I'd say try to avoid emotion, because that denotes 'craziness'... lol... and will only get you another script for anti-anxiety meds. A man who sees a woman near tears doesn't know what to do with that information... lol.
If you want to mention Internet information, make sure it comes from reputable medical sources. As great as this Board is, I doubt any doctor would accept what we say here as scientific evidence.

Last edited by midwest1; 12-15-2004 at 08:33 AM. Reason: clarity

 
Old 12-15-2004, 08:43 AM   #5
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Post Re: Secondary HypoT, Spuressed TSH?

Midwest is right!

I have been diagnosed with..

Post partum depression

PMDD

depression after post partum never went away.

Always given anti depressants that made me feel worse.

It has been a long road for me.
I have secounday hypo.

Pituitary problems are very real!!

But rare & most doctors do not know much about them.

 
Old 12-15-2004, 11:36 AM   #6
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Re: Secondary HypoT, Spuressed TSH?

One thing that may have been overlooked here is that T3 was not tested for, right? What if T3 is high (such as from a hot nodule), and THAT is what is suppressing the TSH. In order to get to the bottom of this you really need complete testing.

Demand that nothing less than Free T3, Free T4, and TSH tests get ordered so that this can be looked at with enough information to make a real determination about what is going on. A thyroid uptake scan would be a good idea, too so you can see if there are any places on your thyroid that are absorbing more Iodine than the rest of the gland. This would show a doctor whether you have a hot nodule or not and where it is if you do.
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Last edited by Meep; 12-15-2004 at 11:40 AM.

 
Old 12-15-2004, 11:39 AM   #7
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Re: Secondary HypoT, Spuressed TSH?

Quote:
Originally Posted by gracesufficient
Also - how should I approach my dr about all this. I am hoping for the best (ie: he realizes something is up and tests further) but how do let him know what I have learned without looking like a freak who is obsessed with the internet? I want to come off as informed and not crazy! haha
Tell your doctor that you got your information from a thyroid support group. You don't have to indicate that it is a message board on th internet, just a group of people that you are in contact with.
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Last edited by Meep; 12-15-2004 at 11:39 AM.

 
Old 12-16-2004, 07:39 AM   #8
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Re: Secondary HypoT, Spuressed TSH?

Quote:
Originally Posted by Meep
One thing that may have been overlooked here is that T3 was not tested for, right? What if T3 is high (such as from a hot nodule), and THAT is what is suppressing the TSH.
Hmmm... So a hot nodule could conceivably produce only T3, without increasing T4?
Are there any other reasons why, in an untreated person, T3 might be substantially higher than T4?

 
Old 12-16-2004, 08:01 AM   #9
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Re: Secondary HypoT, Spuressed TSH?

Quote:
Originally Posted by midwest1
Hmmm... So a hot nodule could conceivably produce only T3, without increasing T4?
Are there any other reasons why, in an untreated person, T3 might be substantially higher than T4?
Thanks Meep and Midwest for the info... dr appt is this afternoon and I feel so much more informed.
I am going to request FT3 for sure. Is there a reason that they tested for FT4 and TSH but not FT3? Do these tests go hand in hand?

Also, what are hot or cold nodules? Very curious.

And one final question... are headaches common with thyroid issues? I have had the worst headaches for the last couple weeks - pretty much daily.

Thanks again!

 
Old 12-16-2004, 02:38 PM   #10
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Re: Secondary HypoT, Spuressed TSH?

Quote:
Originally Posted by gracesufficient
Thanks Meep and Midwest for the info... dr appt is this afternoon and I feel so much more informed.
I am going to request FT3 for sure. Is there a reason that they tested for FT4 and TSH but not FT3? Do these tests go hand in hand?

Also, what are hot or cold nodules? Very curious.

And one final question... are headaches common with thyroid issues? I have had the worst headaches for the last couple weeks - pretty much daily.

Thanks again!
I hope your appointment goes/went well!

Hot nodules are places in the thyrid gland that produce thyroid hormone whether you need it or not. They tend to produce more T3 than T4, thus the reason I thought you would be well-served to have T3 meaured.

Cold Nodules don't produce homones.

Headaches can be caused by too much or too little thyroid hormone and were on of the big complaints I went to my doc about wehn I was diagnosed as hypothyroid. So, yes, they could be related.

Keep us posted!
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