I am a 35 year old female living in Toronto, Canada. I got married in October and my husband and I are hoping to start a family soon.
I went to my family doctor and she ran some blood tests to make sure everything was ok before I got pregnant. When the tests came back she told me that my thyroid levels are very high. She sent me in for a second round of tests to check for Graves. They came back with my thyroid levels still very high, but that I don't have Graves.
Now, what I find very unsettling is that I don't have ANY symptoms at all. I am very active and fit, running 10k a week and working out. No rapid heart rate, sweats, tremors, bulging eyes, my skin is normal, hair growing like crazy and I'm not thin. I'm actually about 10-15 heavier than my ideal weight. My life is great, I feel great, yet I have this condition.
My doctor wanted to send me in for the scan/uptake test, but I did some research into it and I would rather not do that while trying to get pregnant. I feel that putting my efforts to start a family on hold, to do this tests and any treatments for something that doesn't bother me at all, might be a mistake.
My doctor was okay with cancelling the scan/uptake test, and is going to get me in to an endochrinologist. The problem is that could be months from now, I could very well be pregnant by then.
What I'm thinking is my hyperthyroid isn't that bad because I have no symptoms, so why should I treat it?
Is anyone out there hyperthyroid with no symptoms? What is your experiene with treeatments or pregnancy?
Jettablue- Do you know what your lab results were? If so - would you post them. If you did have Graves disease - it could be in remission right now - and you would not be presenting any abnormal feelings. But pregnancy - especially late in the pregnancy - it can cause a problem. I know - my baby was born 7 weeks early. She was fine - but that can turn out not to be the case for everyone - we were truly blessed that she was so well developed.
I guess I would like to see your labs - because you say your levels were high - if the tsh is high - that could point to Hashi's disease - hypothyroidism - but anyone here would need to see the results to know for sure. So please post those if you have them along with the lab ranges. Thanks.
Please do post the lab results. There are certain conditions that can present with high thyroid hormone levels and no symptoms of hyperthyroid. It's a rare finding but not unheard of. Also, it would be helpful to know if you are taking any type of medications, especially bcp's or other female hormones.
Weird. But if they sent you for another round of tests, where are those results? A diagnosis cannot be based on tsh alone. It sure looks like a hyper tsh reading but it's impossible to tell without knowing at least the free t4 level as well.
Had any good infections or other illnesses lately?
hmm , I have some symptoms pertaining to Graves disease but they are extremely mild besides of my eyes that are greatly affected by Graves disease and they are getting pretty red...and even tough i dont have most of the Hyperthyroid symptoms besides of the eyes , i know for sure that i am Hyperthyroid , but for some reason only 1 blood test result showed that i have hyperthyroid , afterwards i took like 5 more blood tests and they all came up to be normal... and i dont know what to do about it , beacuse the doctors keep putting me through blood tests rather than putting me on meds...and meanwhile i am suffering because of my eyes...its really unfocortable this redness in the eyes.
Had any good infections or other illnesses lately?
Well, besides tearing my ACL (knee ligiment) in Sept playing soccer, I haven't had anything more significant than the sniffles in ten years. I am a really healthy, active, happy person.
I eat about 2000-2300 calories a day, my weight is steady (5'7 - 163 lb) and like I said before, I could stand to lose 15 lbs, but that would be the very slimmest I'd want to be.
I don't take anything other than a multivitamin daily. Have been off the BCP since Sept.
My resting pulse is about 66, and it gets up to 155 (never higher than 160) after running for 10-15 minutes.
I do have chronic Hep C, have had it for many years (15) but my liver enzymes are normal and it has never ever been an issue for me, meaning I've never "felt" sick from it besides one time when I was 20.
I have another call into my doctor asking about the free T4 level, and will post once I hear back.
I'm just worried that I'm never going to be able to have a baby unless I get this treated, but if I treat it I could lose my quality of life.
Blackey - If you are having eye symptoms, perhaps a trip to an Opthamologist would be in order. They can evaluate the eyes and perhaps discuss or recommend a course of treatment to your regular doctor. Have they tested you for graves antibodies? That's usually a TSI test.
Jetta - That's a tough one. I really don't feel confident saying anything about your possible thyroid status without at least a FT4 to look at. Do you have a goiter/enlarged thyroid?
I do know that pregnancy can alter thyroid hormone status and thyroid problems can make a pregnancy more difficult sometimes but by no means impossible. I've never been pregnant. Never tried before having my uterus removed at 34. But there are a lot of women on this board who have had children and dealt with their thyroid issues at the same time.
There's also an awful lot of people out there who have successfully treated their thyroid problems and still have a great quality of life. Even some of us who are not really treated are able to have a lot of fun too.
I don't have a goiter. I don't feel hot. I haven't lost weight. I don't have a rapid heart rate. I don't have insomnia. I don't have any fatigue. My hands don't tremble. My eyesight is fine. I don't have muscle weakness. I have absolutely no symptoms except that my periods are quite irregular and I've not gotten pregnant after 8 months of trying.
At this point, the only reason I have to consider treating this is in order to be able to have a family.... but from what I read, the "cure" is likely to bring about a whole host of changes that might be considered quite negative if a person is coming from a place where they feel perfectly fine.
I am really terrified about this whole thing. I can't find anything about people with no symptoms and I don't want to suddenly become ill because some doctor talked me into "killing" my thyroid.
One more thing that's missing. The lab reference ranges for the ft3 and ft4. At a lot of labs in the states, those would be hyper readings. If they were in britain or a lot of europe, they'd be normal readings. I do not know if canada uses standard ranges across all their labs but they will be printed on the lab report.
Your TSH is supressed but if your hormone levels are normal, it would be no wonder you have no symptoms. If you'll get me the lab's normal reference ranges for your results, I'll see what I can find out for you.
Helen, do you know if it's normal to have the tsh go down first before the other labs go up? I know with Graves the other labs can be normal, but the tsh is supppressed because tsi falsely decrease tsh.. but that's AFTER meds.
Usually tsh falls when the pituitary detects that there is an excess in circulating thyroid hormone levels. So no, it doesn't usually fall without some type of feedback from the circulating hormones or something that's telling it to slow down.
The most common cause of a reduced TSH is thyroid hormone excess. A low tsh coupled with normal thyroid hormone levels is also sometimes associated with subclinical hyperthyroidism. But usually the tsh is a little higher than it is here. We also don't yet know what the lab ranges for the FT4 and FT3 are so it's kinda hard to pinpoint anything yet.
The other causes of a reduced tsh can be attributed to crossreactivity problems, endogenous analyte antibodies, heterophilic antibodies and drug interactions.
Often times several months are required for the re-establishment of TSH secretion after a body is no longer thyrotoxic. It is mostly seen in patients with graves disease after surgery or radioactive iodine where TSH remains suppressed despite a rapid return to a euthyroid or even hypothyroid states. But it can also be seen in any long standing type of thyrotoxicosis. This is because prolonged excessive thyroid hormones causes physiological "atrophy" of the thyroid stimulatory limb of the hypothalamic-pituitary thyroid axis. It causes TRH synthesis to be reduced, TRH mRNA in the PVN is absent, TRH receptors in the thyrotroph may be reduced and the concentration of TSH beta and alpha subunits and both mRNAs in the thyrotroph are virtually undetectable.
In other words, hyper mucks up the system for a while and it sometimes takes a while to recover.
In October 2006 I was tested and everything was normal.
TSH 0.74 (range 0.35 - 5.00)
T4 free 11 (range 10-20)
May 2007 these are my results;
TSH <0.01 (range 0.35 - 5.00)
T4 free 18 (range 10-20)
T3 free 5.5 (I don't have the range for this, but it is in normal range)
anti_THYROID peroxidase negative
Also I am "possibly" iron deficient.
So, I have no symptoms, feel fine, and really am not too interested in having RAI. I'm thinking I can just wait it out and this will either go into remission or start causing symtoms that will make me want to move forward with treatment.
I guess my only real concern is trying to start a family..... supposedly this can cause fertility problems, and we've been trying for 8 months with no luck so far. So maybe if I don't get treatment I'll never have a child? I'm almost 36 so I don't have a lot of time to figure this out. Should I go along like everything is normal or should I consider treatment?
Hey Jetta, you seem to be a strange case, with labs showing hyper and no symptoms. My labs ft3 and ft4 were lower than yours and I felt BAD!!! My tsh was undetectable though.When my tsh went up to .41 at one point I felt better, but then I went and screwed everything up by stopping meds for a week and cutting my dose in half, my labs went almost to where they were 8 months ago and it took only 2-3 weeks. I definitely wouldn't get RAI, but if you are truly hyper, the meds might help you get pregnant, what does your doc say, would he try meds first? You say you don't have Graves, did you have a tsi test or other antibodies tests?
My question would be, did they do tsi, tgab and an ultrasound or scan or anything that might indicate you have a true thyroid problem? If they all come back negative, I'd say have the tsh redone at a different lab and see if they come up with the same results. One abnormal tsh result does not necessarily indicate a thyroid problem and sure isn't enough to justify rai. Your thyroid hormones are in the upper portion of the range but some people do quite well there.
You're right Helen...it just goes to show what's a good level for some people might be kind of funky for others! She's(Jetta) an example of that if she has these labs and no symptoms...but would it interfere with getting pregnant?
ps good luck on tests you're having H
A funky tsh level, in and of itself shouldn't have an affect on being able to get pregnant. It would be the thyroid hormones themselves. But you do have me wondering. Jetta, have they tested your female hormone levels?
Thanks brans. I'm not real happy with what the tests imply but at least things are finally starting to move forward.
Jetta - I was diagnosed with Graves last year. My gyno and endo told me my levels needed to be in check if I wanted to get pregnant otherwise I might be more likely to have a miscarrige. Like yourself I did not have any symptoms of the disease (my tsh was < 0.01 and T3, T4 levels were elevated). I opted to be put on PTU and my levels normalized after about 6 weeks on the drug and have been normal ever since. My endo told me once I got pregnant she would most likely take me off the PTU as pregnancy has a way of normalizing your levels. I am also on a low does of PTU 50 mg/day.
I actually had my TSH tested twice in the past few weeks, and both were <0.01. She tested me for Graves antibodies too and that was negative, but I don't have the exact results.
My doctor was going to send me in for the thyroid uptake scan, but I said I didn't want to do that either because I'm trying to get pregnant, that I'd rather see an endochrinologist first. She seemed very okay with that.
She did send me in for the female hormone levels for testing which should be back very soon.
I'm getting more and more comfortable with this whole thing, and it's due to all of your comments and all of the info I'm reading. Thank you so much for your help.
I think I'll just patiently wait to see the endochrinologist assuming I'm still feeling good, and if anything may go on the PTU if he/she thinks that's necessary. No RAI for me, unless things take another turn.
I wonder if I should be careful about letting my heart rate get past a certain level when running, just to protect my heart. I run about 10 k a week and wouldn't mind slowing my pace. lol Anybody know anything about that?
It's the resting pulse rate you need to worry about. I have trouble with mine and it's important to keep it under 100. I use beta blockers to keep it down. I'm doing pretty good if I can keep it under 80.
PTU would raise your tsh, but in the process lower your t4 and t3. If you aren't having symptoms of hyper, having those hormones lower than you're used to can also cause problems. I've played that game and it ain't no fun. What you probably need to read up on is something called subclinical hyperthyroidism. There's a lot of controversy over treatment of that. The one thing they almost agree on is the possible importance of treating it in the elderly.
Sorry I can't give you an excuse to slow down your running. Besides, it's good for you.