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Old 03-16-2010, 02:00 PM   #1
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High TSH - Please help!

Hello everyone!

3 months ago I saw my primary care doctor because I was losing large amounts of hair. She tested my TSH (1.90), Free T3, Free T4 and antibodies and also hormones. Everything was fine. The only thing that came back abnormal on my test was my CBC (showed severe anemia) and my ferritin was <5! My doctor said the anemia and low ferritin was probably the cause of my hair loss. I've been treating the low ferritin with Ferrex 28 iron supplements and re-checking ever 4-6 weeks. My levels have slowly been rising and the last time they were checked it was a 35. Last week I decided to see a hematologist to see if it was possible to do an IV Iron infusion to get my ferritin up a lot faster. He did another blood test and decided to check my TSH again. This time around my TSH came back 4.69 and Free T4 1.47. What causes the TSH to rise and fall? In July 2009 my TSH was 2.93, then December 2009 it was 1.90 and now March 2010 4.69. Should I be worried about this rise in my TSH? Or should it eventually go down? I've been under a lot of stress, dealing with the hair loss. Does stress have any effect on the thryroid function? When my hair loss began my TSH and thryroid function were fine...would a rise in my TSH cause me to have MORE hair loss? Please help!

 
Old 03-16-2010, 10:32 PM   #2
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Re: High TSH - Please help!

Quote:
She tested my TSH (1.90), Free T3, Free T4 and antibodies... Everything was fine.
If she's like most other MDs around, she isn't interpreting the results of these tests correctly. If your TSH is generally as high as that on your past tests, your free T4 and free T3 are most likely at the bottom of their reference ranges, which is abnormal for 98% of the population. In short, you are hypothyroid. If your doctor is saying that you can't be, because those levels are "in range", she's dead wrong.

TSH fluctuates on a circadian rhythm, higher in the morning, lower in late afternoon. Could be this last one was caught at a low ebb in the cycle. That means little. It's still higher than the average healthy person's TSH, which is around 1 or lower.

The fact that you tested negative for antibodies doesn't count for much, especially if she didn't run tests for both TPO and Tg antibodies. Not all MDs know which antibody tests to run. Do you know which you had? Besides that, the tests are only 80% accurate, having a 20% false-negative rate. You still might have autoimmune hypothyroidism.

Now, it's true that low ferritin could be the main reason for your hair loss. Once iron levels rise, it still can take several months for the hair regrowth cycle to normalize.

You don't mention any other symptoms. Thyroid disease presents with maybe 10 or more. Do you have more than just hair loss?

If you have past labs to share, including the levels and ref ranges for FT4/FT3, please do. Also, post which antibody tests were done.

Last edited by midwest1; 03-16-2010 at 10:35 PM.

 
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Old 03-17-2010, 06:30 AM   #3
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Re: High TSH - Please help!

Hi Midwest1,

Thank you for your reply.

Here are my lab results:

March 2010
TSH 4.69 uIU/mL (Reference 0.45-4.50)
T4, Free 1.47 ng/dL (Reference 0.82-1.77)

December 2009
TSH 1.90 uIU/mL (Referece 0.45-4.50)
Free T3 3.0 pg/mL (Reference 2.3-4.2)
Thyroxine, Free (T4, Free) 1.2 ng/dL (Reference 0.82-1.77)
Anti TPO Ab <10.0 (Reference 0.0-34.9)
Thyroglobulin Ab <20.0 (Reference 0.0-39.0)

August 2009
TSH 2.93 uIU/mL (Referece 0.45-4.50)

The symptoms I've been having are hair loss and fatigue. I associated both with my anemia and low ferritin since my hair loss began in November and the beginning of December when I had the blood test, my TSH, Free T4, Free T3 and both antibodies tests came out fine.

I'm going to start looking for an Endocrinologist and take it from there.

I tend to stress a lot and I'm terrified.

Thanks again for you help!

Pilar

 
Old 03-18-2010, 12:09 PM   #4
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Re: High TSH - Please help!

So today I went and saw an Endo. She was really nice and took over an hour and a half asking me questions and going over my medical history. She's having me do another blood test tomorrow morning, this time she wants it to be a fasting test (since the last one was done in the evening after eating). The last blood test I had just last week, Free T3 and antibodies weren't checked, so she's including those as well. She is also checking my ferritin, Vitamin D and Zinc. She said she's had a few patients with Zinc deficiencies that also had hair loss and once Zinc levels were restored, hair went back to normal. She's also checking all hormones including Total and Free Testosterone. Oh and she's also doing a insulin resistance test since I've suffered from ovarian cysts in the past....just in case. She also did an ultrasound of my thryroid and said it looked fine. She said even though it appears I have sub-clinical hypoT, she said she is very willing to treat it if I have symptoms and to prevent it from getting worst. I plan on going tomorrow morning to have the blood work done and she said she would call me Monday afternoon with my results. I'll update on Monday.

Thanks again Midwest1!

Pilar

 
Old 03-18-2010, 12:49 PM   #5
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Re: High TSH - Please help!

She sounds very promising, Pilar. Fingers are crossed for you!

 
Old 03-19-2010, 12:00 PM   #6
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Re: High TSH - Please help!

Quote:
Originally Posted by midwest1 View Post
She sounds very promising, Pilar. Fingers are crossed for you!
she does sound very promising! look forward to hearing the results

 
Old 03-30-2010, 09:11 AM   #7
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Re: High TSH - Please help!

Quote:
Originally Posted by midwest1 View Post
If she's like most other MDs around, she isn't interpreting the results of these tests correctly. If your TSH is generally as high as that on your past tests, your free T4 and free T3 are most likely at the bottom of their reference ranges, which is abnormal for 98% of the population. In short, you are hypothyroid. If your doctor is saying that you can't be, because those levels are "in range", she's dead wrong.

TSH fluctuates on a circadian rhythm, higher in the morning, lower in late afternoon. Could be this last one was caught at a low ebb in the cycle. That means little. It's still higher than the average healthy person's TSH, which is around 1 or lower.

The fact that you tested negative for antibodies doesn't count for much, especially if she didn't run tests for both TPO and Tg antibodies. Not all MDs know which antibody tests to run. Do you know which you had? Besides that, the tests are only 80% accurate, having a 20% false-negative rate. You still might have autoimmune hypothyroidism.

Now, it's true that low ferritin could be the main reason for your hair loss. Once iron levels rise, it still can take several months for the hair regrowth cycle to normalize.

You don't mention any other symptoms. Thyroid disease presents with maybe 10 or more. Do you have more than just hair loss?

If you have past labs to share, including the levels and ref ranges for FT4/FT3, please do. Also, post which antibody tests were done.

So I got my results from my latest blood test and my TSH this time around came back 3.52. My FT3 and FT4 both came back in the upper third of the range which my Endo said were good. TPO and Tg antibodies both came back negative. My endo doesn't want to start me on any medication now since she's scared it might cause more hair loss. She also said that she'd like my ferritin to reach 100 and see if that has an effect on my hair. She also tested my Vitamin D and it's gone up to 32. When the hair loss started it was at a 12. Problems with low Vitamin D didn't start until I moved to NYC from sunny Southern California. So she wants both my ferritin and Vitamin D levels to be towards the higher ends of the range. She wants me to come in and have another blood test in a month and see where my numbers are at.

My Free and Total Testosterone were towards the lower end of the range and my FSH/LH ratio were normal.....most likely not PCOS. I'm still waiting on the insulin resistance test which I'll get in a week or so. She said even if it was PCOS, hair loss due to PCOS usually occurs gradually.

During my visit with my endo I mentioned to her that I had been on YAZ for a 1.5 months in August-September (my GYN put me on YAZ to shrink my 5.2 cm cyst...by Dec. 2009 the cyst had dissappeared) but since I didn't want to be on BCP, I decided to go off of them. She said the hair loss might also be caused by the cessation of the pills and the drop in hormones.

I'm just so tired of the shedding and want it to stop. I'm lucky to have a lot of hair so it's not noticable to others, but I notice it. I've lost about 35-40% of my hair and it's so depressing. Even though I'm still shedding, I do have a lot of little hairs growing in. Some are still small, but some are now 2 inches long! It just sucks that the shedding is so much faster than what's growing in.

Before the hair loss began in November 2009, I was always tired and cold....but I associated that with being anemic for so many years. I've been diagnosed with anemia since 2004 and I just never bothered to take iron supplements. Or sometimes I would start and then stop after a few weeks. I wonder if being anemic for so many years could have caused this major shed.

So now I just have to wait and figure out what my next step will be.

Thanks again!

Pilar

 
Old 01-11-2011, 02:24 PM   #8
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Re: High TSH - Please help!

Hi Pilar,

I came across your post because I am experiencing the exact same thing. I quit smoking in January of 2007 and about 6 months later I started losing my hair. I had blood work done and outside of my TSH being slightly elevated, everything else came back fine. While there was the presence of new hair growth, I continued to lose my hair rather quickly and ultimately had to cut it short. It grew back immediately and everything was fine. Well about 2 months ago, it started happening again. I also began experiencing extreme fatigue. Since then I have had 2 physicals and my TSH level went from a 4.3 to a 6.5 and now back to a 3.7. They tested everything else that comes with thyroid testing and everything was normal - My endo said it is highly unlikely that my slightly elevated TSH would cause hair loss or my severe fatigue. I live in So Cal and am also a stress case by nature...I'm working on that. The first time I lost my hair I had put on a lot of weight because I quit smoking, and a few months ago I lost all that weight I put on from smoking. I am told that sudden weight gain/weight loss can cause hair loss. I am at wits end, because I feel like if my symptoms were in fact caused by stress, I would have been bald and sleepy my entire life. I have been to 2 endos, 2 internal medicine doctors and am about to make an appointment with a nutritionist in hopes of resolving my issues. I don't want to keep losing my hair...yes, it always comes back but its insanely annoying and I am tired of be tired . I was wondering if you have received any further information or updates regarding your situation bc we sound like 2 peas in pod. Thanks! Winnie

 
Old 01-11-2011, 03:53 PM   #9
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Re: High TSH - Please help!

No matter what you were told, Winnie, your TSH is NOT "normal". Healthy people have TSH around 1. My own was 4.83 when I started treatment... Not much more than your own.

"Everything else that comes with thyroid testing" isn't standardized. There are several useless thyroid tests that are still being ordered by inept MDs. Could be you got some combination of those. Or maybe you had the most useful ones but your MDs don't know how to interpret them.

Long story short, do NOT rule out thyroid trouble as the origin of your symptoms.
You can list your lab tests and their results here if you want help interpreting them. (Start a new thread though, instead of tacking them here.)

Last edited by midwest1; 01-11-2011 at 03:54 PM.

 
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