I was reading one of your posts that caught my eye. It was with regard to still having Hashimotos without antibodies. What test would need to be done for this...was that an FNB, and what is that? You have seen Dr. Arem, correct? Since I have not had much luck with two physicians, if I went to see Dr. Arem would he just run ALL tests and do some kind of US or scan? I feel I may be one of those Hashimoto people who present with hyper symptoms in the acute phase. The two docs I have seen haven't done any free T3, 4, nor have they done an antibody for Graves. I was just going to wait this out since the hyper symptoms are sputtering out.......I can go for days feeling great, then, BAM, increased heart rate and palpitations, although I will say that the palpitations are not has strong as they were when I was really having that hyper buzz. I had been feeling pretty much back to normal for a couple of weeks, some weight came back on, and now this week I have had some hyper symptoms, although, again, less severe, and interestingly I have dropped a few pounds. I just really don't want to go to another doctor who will give me the tsk, tsk look. Since the endo I saw on manual exam felt my thyroid wasn't enlarged, will Dr. Arem still pursue an US? My TSH was 2.7 two weeks in a row. Any input you have with Dr. Arem regarding his diagnostic skills would be great.
Sparkie...............I do think he runs the right tests. The first time I went to him he ordered an ultrasound that day and did blood test for TSH, Free t4, Free t3, and did a random cortisol test. He thought I might be producing too much cortisol. He said that could give you all the same symptoms as low thyroid, but the test was normal.
My ultrasound came back showing 2 nodules and he ordered FNB. Results of that were benign but confirmed hashimoto's. On my 1st visit he said he could tell I had hashimoto's just by feeling of my thyroid. The first and last time I had my antibodies checked 1 1/2 yrs ago, I had no TPO antibodies and my thyroglobulin antibodies was 35 with normal lab range being 0 -2 . Most peoples antibodies are very much higher than that (in the 100's or even 1000's).
The first time I went to him my TSH was suppressed.........Ft3 was in upper part of range, but ft4 was on the very bottom of range. He cut my meds in half. The 2nd visit he cut a little more, and today he added just a tiny bit of t4.
When I told him about my spiking bp, heartrate, and anxiety, he is running adrenal test (24 hr. urine test). See my post today about the test he ordered and what they are for.
When I went to him yesterday, I had to refresh his memory because he asked me, "have you had an ultrasound? have you had a FNB? I told he yes, and told him the results and he finally found the paperwork in my folder. Then he told me the anxiety attacks were a completely different issue......that my thyroid wouldn't cause my bp to spike, and heartrate to go up. but then he ordered the urine test to check to see if my adrenals are putting out too much adrenalin and maybe that is causing my problem.
So, yes, I guess he is good to order the right tests, but I think he goes too much by TSH and doesn't give enough medication if you are hypo. I live 150 miles from Houston and when they sent the jug with me to collect 24 hrs. of urine they said they would let me know where I could take it for the lab to pick it up (He only uses Clinical Pathology Laboratories, Inc. in Austin, Tx). Well today they called and said I would have to bring it all the way back to Houston. That is pretty expensive to have to take a day off from work and drive that far when I don't see what it would hurt for me to get the test done here. My visit yesterday with labs was 907.00.
I asked him if he thought I might need a TSI test to see if I was going hyper? He said "No, not unless you just want to waste your money".
I am trying my best to give him the benefit of the doubt because he is susposed to be such a good doctor. A few of my symptoms have left but they have been replaced by worse ones (anxiety, bp, and hrate).
I feel, judging from all I have read, that my anxiety attacks and all my other symptoms are caused by either my t3 and t4 levels being too low OR the hashimoto and nodules causing me to swing between hypo and hyper.
You can read all over this board and the internet that hypothyroidism DOES cause some to have paps, high blood pressure, and anxiety.
Were you hypo and then went hyper or are you hypo and just having the hyper swings. What are your labs TSH and free t's.? He may be better at treating Graves.
I am confused right now as to whether he is helping me or not.
SHMILY.....free T's you ask?? Ha, can't get a doc to run them. TSH has been 2.7. I had to BEG to get a couple of antibodies run, which were within normal range, but not all were tested. I had severe hyper symptoms. I have never had a palpitation in my life, and out of the blue, while driving, my heart was pounding, not particularly fast but hard. I almost went to the emergency room but decided against it since I was not tachycardiac, and had no pain, pressure, or tingling. That same night, after I went to bed, I had the same thing again but harder. Almost went to the ER, but realized my heart rate was 80, which is still high for me, normal in the low 50's, but not out of range. I haven't had palpitations that bad since, although I have had much lighter ones. I had ALL the hyper symptoms, but as I mentioned, these symptoms have sputtered out. I will now occasionally have an increased heart rate or a mild palpitation. The elevated temp and the "buzz" is gone, I haven't had tongue tingling in over a week, feeding frenzy is over, along with weight loss (darn!). I still have the memory problems and sometimes have some weird muscle pain, like carrying a load of laundry would cause my forearms to ache, even though I lift weights on a regular basis. Since symptoms are fizzling out, I have decided to put off seeing yet another MD. I read about silent thyroiditis which is like a mini case of Hashimotos and am wondering if this is what I had. It "usually" occurs post-partum which I am not, but I wonder about the "usually" part. If symptoms persist, I may see Dr. Arem as I am tired of the hunt and peck method these other physicians do, and would rather just have the full workup. You get to the point where you don't care what the cost is, you just want some answers.
The pounding heart and paputations can be a symptom of hypothyroidism also, especially if you have hashi's. I am hypo but still swing back and forth because I have autoimmune hashimoto. My TPO antibodies were neg. and my thyrogobulin antibodies were just slightly elevated at "35" with a range 0 -2.
First of all you really do need to have all the right thyroid tests run.........TSH...Freet3........Free t4......TPO antibodies and thyrogobulin antibodies.