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Startling New Symptom??


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Old 12-23-2009, 08:55 AM   #1
Paseo
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Startling New Symptom??

So, last night I got myself on my treadmill even though I was dead and ran 4 miles. Towards the end I started to feel this slight tightness in my throat when I would breathe and then I felt some sort of pressure pain in the upper left portion of my chest (high up on the pec, just below the collar bone). Not very pronounced, just noticeable.

Anyway, after finishing I get off and about 15 minutes later I sit down for dinner. I started to noticed a strange sensation of something in my throat and it felt way down there, just under the adams apple, just above the collar line. It wasn't very bad just felt more "funny" than anything.

When it was time for bed I noticed it had gotten a little worse and I actually woke up one time with a cough because it felt like something was there.

When I wouldn't swallow it felt (feels) like I have a slight tight band around that area. Just enough to notice but not enough to "freak out" about.

Also, had called my GP yesterday to see if he had ordered LH and FSH and when his assistant called back I told her about my new symptoms and she had mentioned that the labs were back on thyroid. I asked for the TSH since I knew that was the one he ran and it was "normal" at 4.5.

Ok, I already know that is "old" normal, but is it normal for someones TSH levels to go from 1.91 to 4.5 in a year regardless whether it is so-called "normal" or not?

I don't believe it is normal and I think something is going on especially now that my throat feels weird.

I am actually happy (I know that's weird) because I finally have a reason why I feel like crap all the time. I know my GP will probably just wave me on, but I know what is up now and will pursue the right doctor to get this taken care of. Tired of being the hypochondriac. I stopped going to all doctors just to prove to everyone that I wasn't a hypochondriac even though I KNEW something was wrong over 10 years ago. And where did it get me? 30 and feeling like poo...

 
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Old 12-23-2009, 09:30 AM   #2
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Re: Startling New Symptom??

Well Paseo, 4.5 is not normal. According to the American Association of Clinical Endocrinologists (AACE), the reference range was changed to 0.3-3.0mIU/L. You can find that info easily and show your doc.

 
Old 12-23-2009, 09:33 AM   #3
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Re: Startling New Symptom??

That TSH is high, not normal. Even the stodgy American Association of Clinical Endocrinologists says that 3 is the upper limit of TSH, while most of us really know that 1-1.5 should be the highest level for healthy people.
So yes, you do have a thyroid problem and the throat discomfort is very common with this. You definitely need those free T3 and free T4 tests done and this is something that needs treatment as soon as possible. If your doc doesn't agree then find one who will.
I would hold off on any hard exercise until you get treated and more normalized. Your metabolism is in a very low mode right now and you are only punishing yourself by doing 4 mile runs!

 
Old 12-23-2009, 09:49 AM   #4
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Re: Startling New Symptom??

If that proves I am sick then so be it

Just kidding, I will take it easy, but I don't necessarily want to stop. I run 4 days a week with mileage ranging from 3-15 miles at a time. If felt my first weird chest feeling and throat "tightness" when I was running my first 12 or 13 mile run about 4-6 weeks ago.

She did tell me that the Free T3 and Free T4 were within normal range, but we didn't discuss the numbers. I sensed her hesitance since not all the labs were back and I'm not sure the doctor had time to see the results yet.

Can someone touch upon the increase of TSH from 1.91 to 4.5 in a year and a half? Does TSH vary by this much?

Thanks,
Paseo

 
Old 12-23-2009, 10:36 AM   #5
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Re: Startling New Symptom??

Have you had your antibodies tested too? Usually with autoimmune disease TSH can vary widely but if could also be that your hypothyroidism is progressing quickly for other reasons. See about getting your results of the FT3 and FT4 tests. I suspect these are low too.

 
Old 12-23-2009, 12:48 PM   #6
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Re: Startling New Symptom??

My doctor said the only thing antibodies without a high TSH prove is that you may eventually develop hypothyroidism. He mentioned >5. But he did say that Free T3 & Free T4 were useless if TSH was lower than 5 too.

But then he tested Free T3 & Free T4 anyways. Wonder if he believes my symptoms might be related, eh? Nurse said they were on the lower end of normal. So, let's look at this another way...

If TSH about 4 years ago was 2.41 and maintaining low-normal levels of Free T3 and Free T4 then what does it mean when TSH is 4.5 and still only pumping out low-normal levels of Free T3 and Free T4?

Sounds to me like the thyroid is trying harder and harder over time just to maintain a low-normal level of hormones...

 
Old 12-23-2009, 03:22 PM   #7
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Re: Startling New Symptom??

Sorry to bump just needed to add info!

Free T3 and Free T4 were "within range", but I didn't get to see them. My doc wants to see me today to rule out any heart related issues with an EKG.

Anyway, I was running on my treadmill today and I noticed the increase in the tightness in my throat. I touched the are with my hand and it was ice cold from the adam's apple down to my collarbone and about 2-3 inches on either side.

What the heck does that mean? Could this be my thyroid screaming at me? Anyone else ever had this sensation?

Also, sometimes when I swallow I feel it, but other times I don't really feel it. But right now I have this sense of tightness or fullness that will increase and decrease periodically. Is this typical or hypo?

Thanks,
Paseo

Last edited by Paseo; 12-23-2009 at 03:23 PM. Reason: Additional info

 
Old 12-23-2009, 04:44 PM   #8
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Re: Startling New Symptom??

Quote:
My doctor said the only thing antibodies without a high TSH prove is that you may eventually develop hypothyroidism. He mentioned >5. But he did say that Free T3 & Free T4 were useless if TSH was lower than 5 too
Sorry but your doc is misinformed. Positive thyroid antibodies mean that you've got autoimmune thyroiditis or Hashimoto's disease. This is a real disease where your antibodies attack the thyroid and eventually destroy it. It's best treated by replacing all your thyroid hormones to a level where the thyroid is shut down and this will stop the antibody attacks and what are known as "Hashi's swings". TSH can swing from very high to quite low with Hashi's depending on how the antibodies are acting but the disease will progress and it's better treated early rather than later. Any TSH over 1.4 is a greater risk for heart disease and death so it's very much in your interest to treat this whether or not you've got Hashi's.

Free T3 and free T4 can be low with a low TSH and this still means you're hypo, it's the amount of free T3 that really counts since it's the active thyroid hormone and the true definition of hypothyroidism is low tissue levels of T3-- not high TSH. TSH is just a pituitary signal that sometimes, but not always, will indicate hypothyroidism. There are studies that show that the pituitary itself can have high levels of T3 when the rest of the body is very low in T3 and hypo, hence it will not send out TSH signalling despite the TRH signals from the hypothalamus. It's a very complex system that the current TSH-only testing does not adequately address.

Again, I think you need to hold off on the heavy exercise, including running, until you get yourself treated. You are not doing yourself any favors here. You will only stress your adrenals further because they will try to produce more cortisol to make up for the low T3 in your system, and if you don't already have adrenal fatigue you will get it, or make it worse. Yes, your thyroid is screaming because it's trying to make hormones that it can't make, hence the throat pain. I would also suggest you get your thyroid ultrasounded to see if you've developed nodules or goiter.

Last edited by javelina; 12-23-2009 at 04:46 PM.

 
Old 12-23-2009, 05:57 PM   #9
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Back from Doc Appt...

Ok, so here I am back from his office.

EKG was normal as I knew it would be.

Here are some lab results:
Cortisol 17 (3-22)
Prolactin 5.9 (2.1-17.7)
Ferritin 117.3 (23.9-336.2)

TSH 4.541 (0.35-5.5)
T3 Total 107 (100-215)
T4 8.7 (4.5-10.9) looks like T4 having hard time converting to T3? He refused to do Free tests

Did a COMP MET PANEL GFR:
BUN 23 (8-20) only one that stood out

Lipids:
Calculated LDL 116 (0-100) this is the only one that stood out

B12 1244 (180-914) was on supps
Vit D 25OH 42.5 (4.8-52.8)

He did another Testosterone test but is awaiting results. I told him that I told him that I had one done at the urologists office and he said, "Oh, sorry I had you do it again."

Ok, down to brass tax. He will not do Antibody tests or Free tests. Says they are useless unless TSH is >5.5. I cited the AACE and he said you can find 6 organizations that disprove the new range of .3-3.0.

I asked him why my TSH went from 1.91 to 4.5 in less than two years and he told me that I could take the test again in 3 weeks and it could very well be 2.0.

He did mention that I could go on a low dose of synthroid but he wants to wait for everything to come back. He is focusing on testosterone and depression/anxiety.

About the feeling in my throat. When he was feeling the area it felt tender and uncomfortable, but he says that it is not swollen and there are no nodules, etc.

He thinks it is a combination between my GERD and anxiety.

He asked about anxiety and I said I wasn't anxious in general, I just wanted to feel better. I also told him that I already take omeprazole (that he prescribed) and I have never had this feeling in my life even when I scarring from undiagnosed GERD and had to have my esophagus stretched open with a balloon.

Anyway, pending the results of the new testosterone he wants to treat me for low testosterone. I want to wait and find out if my thyroid is really the culprit.

Can TSH really vary that much every 3 weeks? I could see maybe .3-.5 but a whole 2.63 points??

Opinions? Suggestions? Loaded gun?

 
Old 12-24-2009, 07:32 AM   #10
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Re: Startling New Symptom??

I would walk away and find another doc. Yours has his own opinions and he's entitled to them but if it were me I would not trust my care to him. He's completely ignoring the most glaringly obvious core probable cause of your health issues, the thyroid. The total T3/T4 tests are next to useless but even so, yours were very low in range and his "refusal" to run free T3/T4 is a real indication of what kind of doctor he is. It's not like he's trying to save you or your insurance co money because he's repeating the testosterone testing and not doing important things like antibodies. And most importantly, he's not listening to YOU, just playing the old shopworn role of Dr God.
Do some searching for a good doctor who understands these endocrine issues, thinks outside the box, and listens to his or her patient. You can look here for any postings for docs in your area or post for one yourself. There are Top Doc sites online where docs are rated too and the Armour website has a list of prescribers. Another way to find a more open-minded practitioner is to ask at your local pharmacies which docs prescribe natural desiccated thyroid, even if you don't choose to go that route for treatment, these doctors tend to have a much more open mind about thyroid treatment.
And this doc will ultimately end up pushing testosterone, antidepressants, and statins on you because that's all he will be able to figure out what to... of course the choice is yours

 
Old 12-24-2009, 07:55 AM   #11
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Re: Startling New Symptom??

Thanks javelina,

By the way, my throat doesn't fell bad today. Is is "normal" for that to be on again off again?

About the TSH. Hypothetically, is it possible that if I went in today that it could be back down around 2 even though it was 4.541 two days ago? I have been doing a lot of research and it seems that peoples TSH levels do fluctuate but not to that extent. Especially since I have had 2 previous tests of 2.41 and 1.91 respectively.

Any thoughts?

I have cross referenced some docs I found on some top doc websites with my insurance company and found 2 potential matches.

Thanks for all the help!

 
Old 12-24-2009, 10:53 AM   #12
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Re: Startling New Symptom??

My TSH was never that variable but if you do have autoimmune thyroid issues then TSH can be affected greatly. It can go high and low depending on the antibody activity. Definitely find a doc who will explore this with you and good luck to you!

 
Old 12-24-2009, 11:17 AM   #13
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Re: Startling New Symptom??

Yeah, it seems strange for me based on prior readings. Another thing I have noticed is my gradual increasing intolerance to cold. I really noticed it about a year ago, but I chalked it up to losing weight and not having enough body fat. But I probably still have 15-18% body fat. I weigh about 168 at 5' 10" tall. My BMI is just under the overweight distinction. I feel like my circulation has decreased as I have become more physically active. Exactly opposite of what I would expect. I normally walk around in my boxers when my house sits at 71. My wife likes it at 74. Now, I have to clothe myself and sometimes I even have to put a jacket on!

This have all culminated within the last year. I have been dealing with issues since I was 19. I would have loved to have had a "baseline" TSH done was I was about 18 or so to see how it has changed since then. Theoretically, I could have been "healthy" at a TSH of about 1 and my TSH could very well have increase gradually over the last 11 years and then now for some reason it is starting to jump up due to unknown factors.

I ran today, and while I was not able to maintain the speed I used to (around 9.2 mph previous and only 7.5 mph now with occasional walking) I did not notice my neck as much. It was still cold when I touched it though...

 
Old 12-24-2009, 01:34 PM   #14
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Re: Startling New Symptom??

Re the jump in levels, yep, mine did. I kept records and when I "finally" got diagnosed, it was 7.66. But, the few yrs b4 it was 3.55, normal, yeh right. Because it was so called "normal" they never re checked me. Well, from all my ultrasounds, my thyroid is crapped out, big time, pretty nasty looking. That doesn't happen over night! One endo told me I've had this since my teens! I'm now 53. I wish I had my older records! wonder how many times it flucuated??? or then again, did they ever even check? I am so ticked off! so many yrs of suffering and needless surgeries due to my body struggling so hard. I was actually thrilled to get diagnosed! but then the battle continued to get adequat treatment. I'm now on "nature-throid" and feeling 75% better, even my back issues are better! sleep, thank God, I can sleep now!~ So many yrs of HELL. Study all you can and insist on good care,
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Old 12-25-2009, 05:21 AM   #15
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Re: Startling New Symptom??

Paseo, I can relate. I am (was) a distance runner. I work(ed) out 7 days a week, alternating running one day with gym (EFX for an hour and weights) the next. I finished top 5% in the Houston half-marathon. My last run was in September. I too was getting that throat feeling. I also was getting the feeling that my body was telling me to stop and slow down. Naturally I didn't listen at first. My TSH has been as high as yours and as low as yours. It was inflamed earlier this year but that seems to have resolved. I finally found a smart MD who tested adrenal function (after I ordered and performed my own saliva cortisol test which was revealing). I have low aldosterone and the only way I am feeling better these days is to do only gentle exercise and incorporate salty foods in my diet. I know I will get better and I plan to be a distance runner again but for now I have to walk 4 miles instead of run 8-10. I may mix a very short jog into this (I am only talking perhaps 25 yards tops, (sad, I know) but that is all I can do before I get the throat feeling and my body rebeling on me. I too had the normal EKG, Holter, and echo. I have cut back from 7 days to maybe 4-6 tops. If I am on the EFX and I get that feeling, I stop. I strongly urge you to really listen to what your body is telling you. I sprinted 100 yards with my dog while she was chasing a squirrel about two weeks ago and paid the price for days. My thought is I may do damage to the heart muscle if I push myself so I won't. You may want to do further cortisol/adrenal testing. Start with the saliva as the blood test, particularly depending on the time of day you had it done, may not be all that revealing. Find an MD who understands the role of the adrenal gland because it all ties in with the thyroid and pituitary.

 
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