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Old 04-24-2008, 01:24 PM   #1
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Labs vs. symptoms, something is not adding up here

Here are my labs for the past 20 months or so:

6/06 TgAB <20 range <40
TPO 11 <10
TSH 2.172 (.35-5.5) FT3 2.9 (2.3-4.2) FT4 1.2 (.8-1.8) 40%
2/07 TgAB <20
TPO <10
TSH 1.706 (.35-5.5) FT3 2.5 (2.3-4.2) 10% FT4 1.01 (.61-1/76) 34%
7/07 TSH 1.664 (same) FT3 2.5 (same) FT4 1.01 (same)
3/08 TSH 2.144 (same) FT3 2.7 (same) 21% FT4 1.34 same) 63%

My symptoms are not jiving with the labs. I had the March studies because I was having more hyper-type symptoms, albeit fairly mild, and was expecting the TSH to be lower. When the TSH was 1.664 was when I was sooo tired. Now, I have lack of energy, can still workout daily, but feel leaden, not where I feel I need to lie down, but just heavy and tired. My weight has been stable to down a couple of pounds, my hair continues to fall out and become drier and drier. Any thoughts on what the heck is going on here? I have no official diagnosis, although my GYN said I most likely had a thyroiditis back in March of 06 (TSH then was 2.7). I am on no meds. Any thoughts? Why is the FT3 stubbornly low?

 
Old 04-24-2008, 01:54 PM   #2
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Re: Labs vs. symptoms, something is not adding up here

Have they checked your adrenal function? Your T3 and T4 levels are way out of balance. Low T3 in comparison to T4 is normal the result of one of two things.

Poor T4 to T3 conversion where instead of converting T4 to active T3 your liver strips the wrong iodine and makes RT3. The blood test you need for this is RT3. Along with this you should get a T3 T4 and T3 Uptake run so that you have an approximate T4 usage. If for some reason your T3 uptake is low and your RT3 normal.. you are looking at cause TWO!

Adrenal glands!!!
If you produce too much cortisol it tells the liver.. do not convert T4 to T3. Our endocrine system is a tightly woven delicate hormonal balance. We need T4 and T3 levels with in 5-10&#37; of each other to be considered in balance. When we are unbalanced we risk hyper-hypo swings or constant symptoms. In hyperadrenalism you produce too much cortisol and it can effect many things and evently result in the collapse of your adrenals.

The blood work you need here is DHEA Sulfate, ACTH (blood serum fasting 8 am), Cortisol(blood serum fasting 8 am), Cortisol saliva rhythm test minimum. To get a thorough picture you would add pregnenolone, aldosterone, and the sex hormones (testosterone, estrogen.. etc).

I think you have an additional issue aggravating hypothyroidism.
MG
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Old 04-24-2008, 03:04 PM   #3
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Re: Labs vs. symptoms, something is not adding up here

Wow, what a comprehensive reply...fascinating stuff. When all this started two years ago, the endo I saw (once) immediately said adrenal. He ordered a 24-hour urine which was WNL. At that time TSH was 2.7 and T3 and T4 were smack in the middle, antibodies negative. I too agree that this is probably not a primary thyroid problem. I found a site online where I can order the RT3, T3 uptake, etc. I am going to order it on my own because I know I would never be able to get a physician to order those. I have been shot down a few times and am not eager to see another physician until I have lab evidence to show. I checked online to look at symptoms of hypercortisolism and I really don't have any. Interestingly, if anything, I have more symptoms of adrenal insufficiency. It's really not clear if I have either though. I am a distance runner, exercise vigorously and religiously, and don't think I would be able to do this if I was truly hypothyroid. I will order the first set of blood tests and go from there. Thanks so much for your input.

 
Old 04-24-2008, 03:24 PM   #4
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Re: Labs vs. symptoms, something is not adding up here

Look into adrenal fatigue. This can have fluxing cortisol levels and make everything run a muck.

Humm.. with in normal limits. It is rarer to just be T3 deficient. If this is the case T3 supplementation will help you. The 24 hour saliva cortisol is more accurate when done right. There is also the aldosterone deficiency/hyper case.

I am Hashimoto's with adrenal insufficiency and some other crud. So I have been through this walk myself. What supplements are you on? Any DHEA or pregnenolone in your diet? As a runner I am assuming you supplement alot. This in itself can cause issues.

MG
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Old 04-24-2008, 05:48 PM   #5
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Re: Labs vs. symptoms, something is not adding up here

MKG, the only supplement I take is a Centrum Performance. I know my diet isn't probably the best. My husband is out of town a lot so even though I have good intentions to eat well, I usually end up, like today, having yogurt and cottage cheese, or cheese and crackers. How would I know if I was taking in DHEA or pregnenolone? There are times I wonder if there is something going on with the pituitary since I did have a bout of mastitis last year when I was 45 and certainly not nursing. My GYN mentioned that mastitis at my age tends to be related to pituitary. I wouldn't know where to begin for testing for that. I do have one pupil that tends to be larger than the other, but I have had that for 8 years, noticed after Lasik, with only a "huh" from the ophthalmologist. I am not sure, but I don't think the pituitary has anything to do with the optic nerve. These days my eyes are so dry I want to scream. I am not sure if this is related to the previous Lasik. I have a few neurologic symptoms, tingling tongue, I sometimes have a very cold feeling deep in my thigh, but nothing major. The adrenal insufficieny did not sound cool! It appears to make a lot of things out of whack. Good luck dealing with that MKG.

 
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