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Old 04-19-2006, 11:59 AM   #1
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Widely Disparate TSH Levels

I recently was diagnosed with hypothyroidism, and I'm trying to find information on my particular situation, which seems to be less common. I'm in my early 30s, thin all my life, in overall good health, and my diagnosis was made after some routine blood tests with a new doctor, not because of any symptoms (he always tests TSH in all his female patients, which I understand is unusual).

This was my first result, with normal ranges in brackets. This was done at 8:30am, after a 12-hour fast:
TSH 30.3 [.2 - 5.5]

Dr. immediately diagnosed me as hypo, and gave me a prescription for .50 mcg of Levo. All my other tests came back excellent, including chloresterol levels. My body temperature was a little low, and I am a bit tired (but I also work full time and go to grad school full time, so tired is sort of part of the game).

Not wanting to start any medication without at least a confirmation, I badgered him into doing another test, and also testing my T4 levels (having done some crash research). He refused to test T3 or antibodies, insisting that they were never needed.

These were my second results, taken exactly 1 week later. Test was done at the same lab, at 4:00pm, no fasting, but I'm not a heavy eater. I had not started on the thyroid yet:

TSH 44.2 [.2 - 5.5]
Free T4 (Analog) .7 [.8 - 1.8]

After seeing this result, I started going on the meds. So far I don't feel at all different, in fact, I feel worse, more tired. I think it's mostly psycho-somatic; I know that I should be sick, so I feel sick. I felt my first doctor was old fashioned and dismissive of my concerns, so I am switching to a new doctor, but won't see him for another 6 weeks. Until then, my big question is Why did my TSH level jump almost 15 points in a week? Was it caused by fasting, or something else?

This matters a lot to me because overall I feel really fine. I'm in better health than almost everyone I know. So test results are the only way I'll be able to tell, maybe, if I am managing this condition right, so I need to know why the level jumped, and how I can get more consistent results in my tests.

I'd also love to know why I don't feel bad, but from reading this board, that's not that unheard of for people with the really high TSH levels. My T4 is below range, which seems to mean that I am genuinely low on thyroid, but if this is what I feel like when I'm bad, I'm frightened what good will feel like, since I am bipolar, and have to watch out for manic periods. Basically, I'd just like to understand what these levels mean, and how I can decide on what levels to shoot for when I don't have body symptoms to really guide me. I've always listened to my body, and this diagnosis was a shock and a betrayal, and something I don't really know how to handle.

 
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Old 04-19-2006, 12:09 PM   #2
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Re: Widely Disparate TSH Levels

Do you take lithium? It's a known common cause of hypothyroidism in those who take it.
You may find the following research article interesting...
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=161639
It talks about how frequently this kind of hypoT presents asymptomatically. You still need to come to terms with taking the hormone, though. Not having enough will lead long-term to heart disease, osteoporosis, and other physical ailments.

 
Old 04-19-2006, 12:21 PM   #3
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Re: Widely Disparate TSH Levels

I don't take lithium, and never have. I was on a common antidepressant briefly, but have been off of it for ten years now. I knew about the lithium-hypothyroidism connection, but it doesn't apply here. I read the article, thank you, but it doesn't apply. Never had any weight gain, I weigh the same as I did in high school 15 years ago, and never on that drug.

No consistent family history of hypothyroidism, almost no symptoms, and really, this has me stumped as to where and why it hit me. And the jump in TSH especially boggles me.

 
Old 04-19-2006, 12:36 PM   #4
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Re: Widely Disparate TSH Levels

OK then... If you want to get to the bottom of it, you really need those antibodies tests.
Autoimmunity is the most common cause of thyroid disease in industrialized nations.

The "jump" in TSH isn't as significant as you believe. The first reading was dramatically high. Even though it got that much higher, it doesn't really mean you are that much sicker. The levels that count most are FT4 and FT3. Your FT4 is below range. It probably wasn't any higher when your TSH was lower.

It is unusual that you don't have a lot of symptoms with FT4 that low. But that's the way it is sometimes.
Unless... you haven't done enough reading yet to know exactly how many symptoms this causes, and you just haven't associated some minor ones you have with the condition.

Last edited by midwest1; 04-19-2006 at 12:37 PM.

 
Old 04-19-2006, 12:37 PM   #5
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Re: Widely Disparate TSH Levels

i'm not sure if its unusual for a 15 point jump in one week. keep in mind that tsh isnt the end-all be-all in thyroid management. i see your ft4 is a little low. not sure what your ft3 is. perhaps you are fortunate enough to be diagnosed before you start feeling the symptoms of hypoythyroidism.

you may not have much to fear about your concern of feeling too good/confusion with manic. though your tsh is high, your ft4 isnt very low and that might be why you're not feeling badly. you might be needing just a little thyroid medication to get you over the hump and maintain.

Last edited by scoot; 04-19-2006 at 12:44 PM.

 
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