OH! GOOD LUCK ON MED SCHOOL! Become a thyroid savvy Endo and we will flock to you!
You sound a lot like me. You might wnat to start checking out my thyroid care and concerns threads. I will post the urls for you...
Weeks 6 and 7 and my latest one on endocrine balance issues are not included here...
My relevant Threads Summary:
Humm.. this was a rambler. We went over a few things old and new. Peruse at your leisure, if you so desire. More on physical and pulmonology effects.. as well as medicine and adrenal questions and my opinions.
Week 3 and 4 of my Thyroid care and concerns thread series:
This thread has a lot of discussion on the mental(cognitive), genetic probabilities, and physical effects (cardiological and pulmonary to name a few) of thyroid disorders. Look into it if you are interested.
Week 2 of my Thyroid care and concerns thread series:
This thread is jam packed with information on my ideas and opinion of what optimal and basic thyroid care should be.. accuracy of testing.. necessity of testing.. TSH suppression.. TPOAb and TSI effects and mechanisms.. Latest TSH range.. change in 2006 to 0.3-2.5! It is a lot of good stuff. It is a must read for all you getting started and questioning, “Am I getting the care I deserve?” For most the answer is “NO, I am not!”
Week 1 of my thyroid care and concerns series..
you can read a bit about me and my story.. it continues on in the following weeks.. as well as others. It also goes into why I feel and will keep up with these weekly threads as long as I am permitted.
Now lets see what your blood is telling us and if your symptoms match! Blood results as of 10/23/08:
TSH: 6.27 range: 0.45-4.5
This tells that you are hypothyroid. Clear cut and with out doubt. The latest TSH normal levels as off 2006 are 0.3-2.5.. these are over 6 years out of date... pre 2002.
Both your Ft4 and Ft3 are subnormal. You need T4 and T3 supplementation. T3 alone will not cut it. fT3 (I was on pure T3 at the time): 2.1 range: 2.3-4.2
You are -10.5% of normal range. let us see if this parallels your FT4. fT4: 0.56 range: 0.61-1.76
You are -4.3% of normal range. You are inbalance with your T3 levels. Balance can be assumed when Ft3 and Ft4 test results are with in 10% of each other. You have to give a 10% window due to inherent experimental error in the Ft testing processes.
Your blood indicates that you need T4 adn T3 supplementation. Reverse T3 was off the charts on blood test in June so I started pure T3 therapy, despite my underperforming adrenals.
Just started with a new doc who put me on armor because my reverse T3 went back down and I was getting heart palps on the T3 alone.
Your balance in T4 and T3 is not bad. As a result your body does not seem to be suffering too much from low cortisol production at this time. It may have been a side effect of your LOW thyroid hormone state and your adrenals may kick back up after supplementation. You need to test your Ft3 and Ft4 levels every 4-6 weeks until you reach optimal. Salivary Cortisol test done 12/07 (old I know)
morning: 6.3 range: 3.7-9.3
noon: 0.9 range: 1.2-3.0
evening: 0.7 range: 0.6-1.9
night: 0.2 range: 0.4-1.0
You also need to check your fasting 8 am bloods serum ACTH and cortisol levels. This will indicate whether or not your adrenals have recovered since the T3 and T4/T3 treatment.
Also, prev. blood test showed negative for anti-thyroid Ab...but Hashimoto's runs in my family. Had a wicked case of hives all over my legs and but that lasted for a month and randomly disappeared. Itched until I bled.
This sounds like classic Hashimoto's. Did treatment using steriods make the issue go away? If so it is another clear sign of autoimmune in origin.
Did the Md test TPOAb and TGAb? If that is a NO, he tested the old OLD 60% positive identifiers of Hashimoto;s. TPOAb is the 80% blood identifier for Hashimoto's. The only 100% identifier is biopsy of the thyroid tissue. Do you have issues swallowing? Does your lower throat throb and hurt occasionally? You may want to request a thyroid ultrasound. It would be good to have a baseline anyway. IGF-1: 374 range: 116-358
This is a sign of insulin resistance/PCOS/Reactive hypoglycemia. You need further testing and will most likely see a benefit from starting metformin. Testosterone (total): 77 range: 14-76
Testosterone (free): the top value of the range
Esradiol: 68 (very low end of norm range)
Progesterone: 4.6 (very low end of norm. range)
Supportive of PCOS. If your DHEA is high that is another check in the PCOS box. You probablys should get an ovarian ultrasound. They are ummm.. uncomfortable. You have to drink 48 ounces of water an hour before your test and then.. YOU CAN NOT PEE until after the test. Man that was a hard test. LH: 7.2 (mid cycle) midcycle range: 8.7-76.3
FSH? No? You need this in conjunction with the LH. If your ratio is 2.5 or greater then you have another PCOS indicator. Total Cholest: 127
HDL: 60 range: 40-59
LDL: 56 range: 0-99
Not bad.. can be off because of low adrenal issues. Sodium, Potassium, Chloride: all close to the bttm of the range
Signs of hypothyroid malabsorption issues. You need to test your ferritin, B12, vit D and magnesium levels as well.
It sounds like you have a few issues working to compound your problems. Treating them slowly and testing frequently will help. You can do it. How do I know?
I ahve Hashimoto's and Graves.. My Hashimoto's kicked my Graves is TAIL! My thyroid is near destroyed now, but because I am hypoadrenal in cortisol production I have to go slow on the thyroid supplementation adjustments. Graves is mucking with my eyes though. I also just got diagnosed as hypoglycemic, insulin resistant, and PCOS! So I personally have went through all the testing and am now medicating all my conditions. The adrenal and thyroid supplementation were key for either condition to be treated well. Treating these alone did not cure me. I had to also treat my low B12, B6, vit D, Mg, and ferritin. I didn't start to feel like I was getting anywhere til I added metformin. MANY symptoms of muscle fatigue/ache/pain and overall energy, hunger issues and more disappeared upon treatment of my HG/PCOS/IR combination with metformin. If they start you on metformin.. it will muck with your female cycles. It through my period off by over 10 days. Now I am back to wondering when the monthly visitor will come.
When titrating to the proper dose of metformin following your symptoms is key. You also can increase by 500 every 2-4 weeks by re-occurrence of symptoms alone initially. After 1000 a day you should test your fasting glucose and insulin levels before additional increases. Maximum level of metformin recommended for use are 2000. I take 1000 but I have only been on my glucophage for a little over a month. At 2 weeks my symptoms came back out of nowhere. It sucked, but with in 24 hours of boosting to 1000 the symptoms disappeared. it was quite amazing.
You can learn a lot from the vets here and your own family. We need more MDs willing to bat for us. Most deal with MDums. My SIL and friend are not MDums they are grade A MDos and they patient load testifies to that. They were top in their class in their chosen fields and are just great people that are MDs because they want to HEAL.. not make the big bucks. They also got biological engineering and science undergrad degrees. I really think this helped in how they approach each patients problems and solve them... but they are an Ob and a Neurologist. Neither feel up to dealing with my endocrine issues. They have been depressed by the results of helping me find a good Endo to manage my care. To date MS is a dry zone. The one in AL is full on patients and TN is proving to be a dry Endo zone. I found the best care through my most recent all around MD, an internal medicine specialist that practices integrative medicine. Together we are detecting and managing all my issues. The Endos refused to look much beyond my TSH even with TPOAbs near 2000 and TGAbs near 500. I also had TSIs 125 which they completely ignored. My neuro-opthamologist doesn't ignore my TSI since my optic nerves are being attacked and I have other issues indicative of TED as well. I hope that I have been helpful and welcome to our dysfunctional thyroid family. Keep us informed of on your test results and care. We can all learn from each other.