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Old 08-16-2008, 02:22 PM   #1
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labs are weird....TSH and T4...PLEASE help

So having had cancer for 5 years and only recently moved the responsibility of my care from my parents to myself (I just turned 21). I've been noticing some weird things:

I have been on 150 mcg fairly consistently (and I've weighed in between 130-150), and only recently have I started to feel crummy, achy, etc.

I was looking at my labs from 18 months ago, and my TSH was .25, which was my target suppresion, but my T4 was 2.2. However, recently having started to feel crummy, my TSH was .02 and my T4 was 1.7 when it was tested a month ago.

Does that just mean my metabolism is slowing down? If my TSH was .25 and thats the "regulatory thermostat", as they say, does that mean I was meant to have a hgh T4 level and now I'm meant to have a low T4 level?


what do those results mean? PLEASE help, this is very confusing and all my endo will tell me is that its too complex for me to understand.

 
Old 08-19-2008, 05:21 AM   #2
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Re: labs are weird....TSH and T4...PLEASE help

Quote:
Originally Posted by DoogiePCT View Post
So having had cancer for 5 years ...............


what do those results mean? PLEASE help, this is very confusing and all my endo will tell me is that its too complex for me to understand.
Hope you don't mind that I shortened the quote because it's so easy to go back if anyone wants to read all of it again, just bumping this up since you didn't get any answers.

You've had cancer for 5 yrs? I would think that makes your questions more interesting, though I don't personally know anything. You're in remission?
Good luck finding someone who can help with your question.

Could you explain to your endo that you've read doctors online, and forums, and tell him "Try me" with the facts? That anything you don't understand you can easily look up?

 
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Old 08-19-2008, 08:22 AM   #3
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Re: labs are weird....TSH and T4...PLEASE help

That's a really arsinine attitude for an endo. Who does he think he is automatically assuming that his patients are too stupid to understand something? The least he could do is explain it to you in terms that you can understand. Being able to understand your illness is one of the most important steps in dealing with a chronic disease.

First off, you say you're starting to feel crummy. Did you tell him this? Or is he just ignoring the fact that you don't feel right?

There could be several explanations for the decrease in TSH. You're correct that the TSH is considered the regulatory thermostat. It's influenced by many things but the main regulator of TSH is the circulating T3 level. The way it usually works is the higher the T3 level, the lower the TSH. An increase in FT3 will reduce the TSH and in turn, lower the FT4 level. The circulating T3 is made mostly in the liver by a chemical reaction that slices off one molecule of the T4. Is that really hard to understand? Has your FT3 level been tested? Perhaps it's a little too high? Since FT3 is considered the active hormone, an increase in FT3 can make a person feel crummy.

Also, at 21, even though considered an adult, you're still a growing boy. A couple more years and that will stop. Your body and hormone levels are still settling into adult levels. Not just the thyroid hormones but all the other hormones as well. It's well known that female hormones can have quite an impact on thyroid hormones. Were you aware that males also have some female hormones and females have some male hormones? A fluctuation in those could cause a shift in thyroid hormone levels. So can a fluctuation is growth hormone and many of the others.

I really don't think that you were meant to have low T4 levels. If you felt better at the higher level, then it's more likely that something has changed that has caused the lower T4 level. The two things I would check first would be your FT3 level and run a cbc and metabolic panel just to check and see if there's a possibility of an intercurrent illness that might be mucking with your levels and causing you to feel crummy. Like I said, the thyroid hormone cycle can be influenced by many other factors.

I'm also assuming that the cancer you speak of was thyroid cancer? Have you had your thyroglobulin level checked to make sure there isn't any residual thyroid tissue somewhere?

Just some thoughts. I really hope you get to the bottom of this. There's no reason you should have to feel crummy.

 
Old 08-19-2008, 09:32 PM   #4
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Re: labs are weird....TSH and T4...PLEASE help

Quote:
Originally Posted by accessn12 View Post
That's a really arsinine attitude for an endo. Who does he think he is automatically assuming that his patients are too stupid to understand something? The least he could do is explain it to you in terms that you can understand. Being able to understand your illness is one of the most important steps in dealing with a chronic disease.

First off, you say you're starting to feel crummy. Did you tell him this? Or is he just ignoring the fact that you don't feel right?

There could be several explanations for the decrease in TSH. You're correct that the TSH is considered the regulatory thermostat. It's influenced by many things but the main regulator of TSH is the circulating T3 level. The way it usually works is the higher the T3 level, the lower the TSH. An increase in FT3 will reduce the TSH and in turn, lower the FT4 level. The circulating T3 is made mostly in the liver by a chemical reaction that slices off one molecule of the T4. Is that really hard to understand? Has your FT3 level been tested? Perhaps it's a little too high? Since FT3 is considered the active hormone, an increase in FT3 can make a person feel crummy.

Also, at 21, even though considered an adult, you're still a growing boy. A couple more years and that will stop. Your body and hormone levels are still settling into adult levels. Not just the thyroid hormones but all the other hormones as well. It's well known that female hormones can have quite an impact on thyroid hormones. Were you aware that males also have some female hormones and females have some male hormones? A fluctuation in those could cause a shift in thyroid hormone levels. So can a fluctuation is growth hormone and many of the others.

I really don't think that you were meant to have low T4 levels. If you felt better at the higher level, then it's more likely that something has changed that has caused the lower T4 level. The two things I would check first would be your FT3 level and run a cbc and metabolic panel just to check and see if there's a possibility of an intercurrent illness that might be mucking with your levels and causing you to feel crummy. Like I said, the thyroid hormone cycle can be influenced by many other factors.

I'm also assuming that the cancer you speak of was thyroid cancer? Have you had your thyroglobulin level checked to make sure there isn't any residual thyroid tissue somewhere?

Just some thoughts. I really hope you get to the bottom of this. There's no reason you should have to feel crummy.
You seem like you know a lot about this...which's awesome. Anyway...my TG has held steady, even off suppresion in the beginning, in the 6-8 range, so they think thats where its meant to live, and there is microscopic tissue of cancer hiding somewhere that, if I stay reasonably suppressed, probably will never grow. Anyway, I only weigh 135 lbs., and I was on 150 mcg. Now that its been 4 or 5 years, they'd like to put me back to 137, which I think they feel will be more lifelong. I'm not worried about a recurrence, because I've learned not to drive myself crazy with that. What does scare me, however, is gaining weight. AFter all I went through, I worked very hard through diet and excercise to get a body I am proud of. When I dose to 137, which is what they wanna do, will I automatically gain 10 lbs., or could the circulating T3 stay the same and I can live peacefully in this body that I'm so proud of? Lol.

Thanks so much, access!

Doug

 
Old 08-21-2008, 03:42 AM   #5
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Re: labs are weird....TSH and T4...PLEASE help

Their logic seems quite good on the surface. However, logic isn't always the answer when dealing with thyroid hormones. I've probably got the most illogical thyroid you'll ever run into. It's taken 49 years for the doctors to finally realize how illogical it really is. I'm clincally and chemically hyperthyroid with a normal TSH. My treatment (starting this last february ) is taking Cytomtel to suppress my pituitary. It works great. It's only thru having gone thru my share of arsinine endos and shear desperation that I learned so much.

I'd say they may be worried about the long term effects on your heart and the rate of bone turnover which might lead to osteoporosis. Have you asked why they wish to lower the dose if you were feeling so well at the higher dose? Males normally have slightly higher levels of thyroid hormones than females do.

You won't automatically just put on 10lbs if they lower the dose. It will depend completely on how your body likes that dose. It might. It might not. For some people, 12mcg's doesn't make a difference at all. Perhaps it will just be a little harder to maintain that fantastic bod of yours. But please do keep it. This world needs a lot more of those running around to gaze upon.

With that said, I better run before I get myself in trouble.

Helen

 
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