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Old 05-19-2008, 08:41 AM   #1
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Need Help- interpret my symptoms and test results

I am a 32 y.o. female who has been experiencing sx of thyroid problems (most hypo sx but some hyper as well) but have been told my tests are normal. I have scheduled an appt. with an endo nonetheless, after continuing to feel awful..that appt is next week. My sx are as follows:

-Weight gain and unable to lose
-Extreme fatigue
-Dizziness
-Brain Fog
-Cystic Acne
-Hot Flashes
-muschle soreness and weakness
-sensitivity to heat and cold
-depression
-frequent urination
-sensitivity to light and sound
-night sweats
-heartburn
-difficulty swallowing at times
-periods are less regular

My NP did some thyroid tests on me and these are the results:

TSH: 1.27
Free T4: 1.3
Free T3: 265

I was told these were "normal" and I just have a lot on "my plate" right now, with an increase in my ssri. The thing is, I know my body and I feel terrible..I insisted on an evaluation by an endo as my last blood work was in Septeber of '07. Can somebody give me some feedback on my last test results...thanks so much.

 
Old 05-19-2008, 08:53 AM   #2
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Re: Need Help- interpret my symptoms and test results

You need to call back and get the ranges on those FTs.

The look suboptimal too me if the ranges correspond to my ranges.

Optimal FT3 and Ft4 levels for a childbearing age female is 60-80% according to my MFM.
TSH: 1.27
Free T4: 1.3 (if 0.8-1.8) This would be at 50%
Free T3: 265 (if 230 - 420) This would be at 18%.. way too low.

Give the imbalance if those ranges are vaild You need further investigation into T4 to T3 conversion by testing your T3 Uptake and reverse T3 (rT3) levels. In addition to this you need you Cortisol levels and ACTH checked. Hyperadrenalism can cause surppression of T3 levels as well. I am leaning toward hyperadrenalism given your symptoms. Look up Cushings and hyperadrenalism and see what you think.

This is just my take on it. Also did they test you for Hashimoto's thyroiditis? TPOAb and TGAb? It can cause many symptoms before the blood work matches traditional hypothyroid levels. I am Hasmoto's with Graves with hypoadrenalism. So I just went through and am going through even more of this testing myself.

MG
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Last edited by mkgbrook; 05-19-2008 at 08:57 AM.

 
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Old 05-19-2008, 09:20 AM   #3
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Re: Need Help- interpret my symptoms and test results

I just called the doctors office and was told the lab ranges for the free T4 is .8-1.8 and the free T3 is 230-420. They didn't have the tsh range available.

Thanks so much for your feedback, I really appreciate you taking the time to respond!

 
Old 05-19-2008, 09:25 AM   #4
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Re: Need Help- interpret my symptoms and test results

TSH range should be 0.3-2.5 if they are up on the latest recommended levels and proceedures in accordence to A A C E (American Association of Clinical Endocrinology) and N A C B (National Association of Clinical Biologists) guidelines. They determine the normal ranges for tests.

So you suffering from a 31% suppression. This is more than diet can induce. High doses of steriods will do it or your body in steriodal production overdrive (hyperadrenalism) or the poor conversion. You need the added testing. Sorry but my recommendation is to get your MD to bleed you some more.

T3 Uptake and rT3, TPOAb and TGAb to wrap up the thyroid function testing.
ACTH, Cortisol (blood serum and fasting 8 am)
Cortisol (saliva 24 hour rhythm test)
DHEA Sulfate

Depending on the results of the above tests.. more tests might be necessary.

MG
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Last edited by mkgbrook; 05-19-2008 at 09:27 AM.

 
Old 05-19-2008, 10:48 AM   #5
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Re: Need Help- interpret my symptoms and test results

Thanks for the expertise on all of this. Hopefully I will know more after next week. It always helps to be armed with some information before a doctor's appointment. Just curious, how long did it take for you to get the proper diagnoses..and what kinds of symptoms did you have? It must be frustrating to deal with all three issues. Hope you have gotten them all under control!

 
Old 05-19-2008, 01:42 PM   #6
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Re: Need Help- interpret my symptoms and test results

I took five years and every specialist that might be associated with groups of symptoms.. before I realized thyroid All the ladies in my family have these same issues.. true theirs cam about in their lat 40's while my issues started when I was 28. I am just an early bloomer. *snort*

My symptom list is in week 2 of my thyroid care and concerns post.. it is extensive and it cycles.

So I got my Hashimoto's diagnosed in July 2007.. then in August I made my OB test for Graves and I had that too. Went to an Endo in town.. supposedly the best. She was fairly knowledgable.. but conservative in treatment... clinging to the TSH standard. SHe said you either have Graves of Hashimoto's not both. Hashitoxicosis is just a version of Graves. Humm... she made me wait.. well the untreated hypoT kept getting worse and my adrenal glands died in another three months. So in November I got the ball going for diagnosis of Hashimoto's Encephalopathy... I get to hopefully run to the last on that this Wednesday. I ditched my Endo at this time and began looking for someone else on my Cardio's recommnedation, because the thyroid was affecting my heart adversly... so in January I had an appointment with my last hope in town. Got in on the 2nd. She diagnosed me with Hashimoto's and treated me that day. She was disgusted with my issues and lack of care. Well she put me on 50 mcgs of T4 and listened about the lump in my neck. So the following week I had an US.. which proved I did have a nodule.. just one.. 9 mm^3. So Off to my ENT. He had already done two sinus surgeries on me, but since I had been on Synthroid for only 4 weeks he wanted to wait five months and then do another US with an FNA if the nodule was the same size or greater.. Well it is greater and I have a nice goiter going now. I did a lumbar pucnture to determine psuedotumor cerebri, rule out Lupus/MS, or narrow down the HE diagnosis.

2 months back when I was driven hyperT on 75 mcg with a Graves flare my Primary Adrenal Insufficiency was suspected.. once again by me and then I had my IM who is treating the endocrine mess of ME run the appropriate tests. Well a week after my tests I was called back in and my adrenal insufficiency confirmed...

Humm so I have the Hashimoto's, Graves, and Adrenal insufficiency diagnosed.. i am treating them to the best of my ability.. I am still working on the final diagnosis of Hashimoto's Encephalopathy.. working on all the necessary information for a TT.. and that is it.. other than right now I tend to be hyperT in T3 hypoT in T4.. and just can not get comfortable. BUT I have comfort in the fact I am not stagnant in my care and I KNOW what is wrong with me.. getting it treated an under control is a whole different battle.

Good luck and let me know how it goes.
MG
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Old 05-19-2008, 05:26 PM   #7
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Re: Need Help- interpret my symptoms and test results

mkg-

It is good you are so well-versed in all of this, otherwise who knows where you'd be today. I am starting to learn that if you are not an "educated" patient, you can really suffer in the long term..docs do not = gods. I hope you eventually are able to get all of your dx under control once and for all!

I saw on another thread somewhere that hives are sometimes a sx of thyroid problems...is this true? I don't get them all over, but I get them at random times on my face. This had subsided for a number of years until the last couple of months..I can always feel when one is about to surface. I've also noticed my cuticles are less noticeable too and I have to clear my throat alot- swallowing seems hard at times.
Ugh, I feel like I read into every thing..
I just want to feel better.
Thanks for your guidance. I can tell how much you help everyone on this message board, it is really wondeful.

 
Old 05-19-2008, 05:27 PM   #8
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Re: Need Help- interpret my symptoms and test results

P.S. did any of the doctors get annoyed/angry with you for suggesting tests???

 
Old 05-19-2008, 06:35 PM   #9
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Re: Need Help- interpret my symptoms and test results

Well I am a certified martial arts instructor with 2 masters and almost a Ph.D. It is futile to argue with me. If they refuse I say thank-you. Give me a referral to this MD. Or given MDs in the family I can get them to write the script for blood work. Thus the MDs know up front that I have a Neurologist, Cardiologist, Dermatologist, Allergist/Immunologist, Sleep Specialist/Pulmonologist/IM, Neuro-opthamologist, ENT, IM, 2 OB (FACOGs), MFM.. you get the picture.. only missing an Endo.. they don't play well with others.

I make sure to talk with the MD extensively on our first meeting and lay it on the line. I grill them and let them know what I know I come armed with hundreds of academic and medical journal articles and have pre-discussed my theories with at least one family MD (OB/Neuro). So they know this is what I expect and I will settle for nothing less. I haven't had many issues with running tests if they start gripping insurance I whip out the cell and call and ask if I can have XYZ.. and then with their approval I do it. I go in knowing and the MD just fills in the blanks on a form and signs a signature. Most of my MDs know that they are dealing with an anal retentive researcher that may be cute and blonde.. but has the bite of a bulldog.

I admit when I am wrong and oftimes I wish I was wrong more often. But I know my body and mind and thus have an advantage over them. If an MD gets upset with you asking for thorough testing when you are the one paying for the tests in blood and money.. they are not much of an MD. I started with the please will you run this and humor me. Now I come in with a typed list and say. This is on the lab agenda for today.

I have had an MD tell me no you do not need this.. then I wouldn't let him leave until he filled in the form and referred me to another MD of my choosing. My current MDs tell me that I can be intimidating.. I am 5' 2" and blonde.. well red-blonde! *snort* Just because I have 2 second degree black belts and do not tolerate back talk in my students doesn't mena I am mean. If my MDs get mad at me.. they do not do it to my face or take it out on me in my care. I do not let them.

MG
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Old 07-24-2008, 08:49 PM   #10
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Re: Need Help- interpret my symptoms and test results

Can anyone provide any clarification on my newest results? New doc and different lab values. FT3 and FT4 look similar (almost identical) to my original post- but my TSH has been cut in almost 1/2. Can't figure this out...

FreeT3 2.71 (1.71-3.71)
FreeT4 1.3 (.70-1.48)
Tsh .63 (.35-4.94)

Also:
Ferritin 57.3 (11.0-306.8)

What could be causing this drop in TSH? Thanks all of you experts out there?

 
Old 07-24-2008, 08:54 PM   #11
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Re: Need Help- interpret my symptoms and test results

P.S. Probably totally unrelated- but my bilirubin came back high:

1.4 (0.0-1.2)

Thanks

 
Old 07-25-2008, 11:52 AM   #12
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Re: Need Help- interpret my symptoms and test results

What timeof day did you run the tests. The earlier your have the blood work drawn.. the higher the TSH.

Your ferritin is a bit low. You need to take and iron supplement and get that up. that will cause hypoT like symptoms and hair shedding/loss are one of the biggest attributed to low ferritin.

Your FT3 is at 50%.
Your FT4 is at 64%.

Your a bit out of balance with your T3 lower than your T4.. but you are just at the low end of optimal. This could be due to low iodine or minearl imbalances.. it could also be early Hashimoto's. A TSH of 0.63 is not that bad. It is a bit low.. but the FT3 and FT4 are not excessively high.. so worrying over it being too low would be a waste of your time.

You also need to get your Hashimoto's antibodies tested. Right now something is causing you to flux.

MG
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Last edited by mkgbrook; 07-25-2008 at 11:54 AM.

 
Old 07-25-2008, 02:13 PM   #13
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Re: Need Help- interpret my symptoms and test results

Thank you very much! I appreciate it.

 
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