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Old 10-15-2011, 07:19 PM   #1
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Contradictory Symptoms - Could it still be hyperthyroidism?

I have MANY of the symptoms of hyperthyroidism but some are the complete opposite... I am still awaiting the results of my bloodwork to confirm or exclude a thyroid problem - but while I'm waiting I'd like to prepare myself. I've had many other tests done and they are all coming back normal, so I'm running out of hope that they will find whatever is wrong with me. I'm tired of feeling so crummy and tired of not being able to put back on the weight that I lost. (I've lost about 20 pounds and at my lowest I was at 95lbs, which was really scary as I am 5' 6" - I desperately want the weight back but no matter how much I eat I gain nothing!)

Anyways, on to my questions about the "contradictory" symptoms:

1. Can you be hyperthyroid but be cold a lot of the time? (feels like this could be due to my severe unintentional weight loss - I have no fat left!)

2. Can you be hyperthyroid if your menstrual cycle actually gets shorter?

3. I have night sweats, but they come and go - is this typical of hyperthyroidism?

4. Does everyone with hyperthyroidism have a swollen or enlarged neck?

5. What is the itching like with hyperthyroid, and where does it occur? I used to have extremely itchy legs, mostly at night, but that has passed mostly but now I find my face, neck, back hairline, eyes and around my ears to be itchy. Is this normal with hyperthyroidism?

6. Does everyone with hyperthyroid has a fast pulse, all the time?

If you have answers to any of these questions - please let me know!!

I appreciate any insights you can offer. Thanks!

 
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Old 10-16-2011, 05:15 AM   #2
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Re: Contradictory Symptoms - Could it still be hyperthyroidism?

So sorry to hear of your struggles. As you will note from my signature, I started my thyroid disease journey with Graves'. Now, my hyperthyroidism was discovered during my annual physical and symptoms had only started to gradually come on a few months prior. I attributed them to stress, allergies or perimenopause. I then learned they were hyperthyroid symptoms. I will share my experiences as well as what I've learned through research

Quote:
Originally Posted by Lemonade123 View Post
1. Can you be hyperthyroid but be cold a lot of the time? (feels like this could be due to my severe unintentional weight loss - I have no fat left!)
I was never cold - heat intolerance was the norm. Being cold is traditionally a hypo symptom. However, in the early stages of Graves' Disease (the most common cause of hyperthyroidism), it's not uncommon to cycle through hypo and hyper symptoms.

Quote:
Originally Posted by Lemonade123 View Post
2. Can you be hyperthyroid if your menstrual cycle actually gets shorter?
This is a classic hyperthyroid sign.

Quote:
Originally Posted by Lemonade123 View Post
3. I have night sweats, but they come and go - is this typical of hyperthyroidism?
Yes.

Quote:
Originally Posted by Lemonade123 View Post
4. Does everyone with hyperthyroidism have a swollen or enlarged neck?
No.

Quote:
Originally Posted by Lemonade123 View Post
5. What is the itching like with hyperthyroid, and where does it occur? I used to have extremely itchy legs, mostly at night, but that has passed mostly but now I find my face, neck, back hairline, eyes and around my ears to be itchy. Is this normal with hyperthyroidism?
Yes....I had the exact same experiences you did.

Quote:
Originally Posted by Lemonade123 View Post
6. Does everyone with hyperthyroid has a fast pulse, all the time?
It's common but, some people "only" have palpitations at different times. Not having a fast pulse all the time in early-stage Graves' could again be that cycling between hyper and hypo.


I hope your doctors are doing some thyroid antibody tests for you since most cases of thyroid disease are autoimmune in nature.

These are the tests you need:

TPOab (thyroid peroxidase antibody) or anti-TPOab (anti-thyroid peroxidase antibody)

TGab (thyroglobulin antibody)

TSI (thyroid stimulating immunoglobulin) - although, in Canada, I think only TRAb (TSH receptor antibody) is done


Please feel free to post your thyroid lab results here (with ranges since they vary) and we'll help you interpret them.
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Last edited by sammy64; 10-16-2011 at 06:04 AM.

 
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Old 10-16-2011, 12:31 PM   #3
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Re: Contradictory Symptoms - Could it still be hyperthyroidism?

Thanks for the reply Sammy!

I should clarify - my period is the same length (5-7 days) but is getting closer together... used to be 28-29 days, for the past 10 cycles it's more like every 25-26 days. This is the complete opposite of what you would expect with either hyperthyroid or with extreme weight loss... usually it would get lighter, further apart or disappear completely. For me the opposite, I get it more often and it's heavier and more painful!? Odd...

I am waiting on the results from my endocrinologist. I believe he ordered the T3, T4, TSH and he mentioned adrenals, pituitary and something else (I think). I will post the results once I receive them (I think I need to wait a few weeks... blah). Thanks for the offer to review them. I am also due to do a 24hr urine test next week.

Thanks!

 
Old 10-16-2011, 04:57 PM   #4
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Re: Contradictory Symptoms - Could it still be hyperthyroidism?

Happy to help

Now that you've clarified your cycle, it does seem more hypo.

There are a few possibilities as to what might be going on with your thyroid and your labs will provide a very good clue.

It would be great if the endo also ran the antibody tests I mentioned because antibody results can help tell you what to expect symptom-wise and help confirm diagnosis (especially for the "trickier" forms of thyroid disease).

Have you had a thyroid ultrasound or will you be getting one?

Please know that you do not need an uptake scan - you can get more accurate information from the blood work and the ultrasound.
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Last edited by sammy64; 10-16-2011 at 05:00 PM.

 
Old 10-17-2011, 08:00 AM   #5
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Re: Contradictory Symptoms - Could it still be hyperthyroidism?

I had an u/s last week due to a lump in my posterior cervical lymph nodes. Doc also requested they check my thyroid. u/s tech said he couldn't see anything in the lymph node area (where the lump is) but didn't mention anything about the thyroid. I'll have to wait for the full results from my doc I guess.

My endo may have requested the antibody tests, but I'm not sure - I can't remember all the checkboxes on the bloodwork requisition I'll post my results when I get them.

Thanks again!

 
Old 10-20-2011, 04:17 PM   #6
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Re: Contradictory Symptoms - Could it still be hyperthyroidism?

Well here are my lab results. Not looking too promising in terms of finding the problem here. However, let me know your thoughts on the results:

TSH 2.24 mU/L (0.30-5.60)
FT4 10.6 pmol/L (7.0-17.0)
FT3 4.5 pmol/L (3.3-6.0)

 
Old 10-24-2011, 04:57 AM   #7
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Re: Contradictory Symptoms - Could it still be hyperthyroidism?

I'm just back from a long weekend away so, am getting caught up here with my promise to comment on your labs.

Before I comment further, I'm going to give you a quick lesson on thyroid function. Our thyroids produce a few different hormones - two of which we have lab tests for - T4 and T3.

T4 is our storage hormone and our bodies convert it to T3, the active hormone. 20% of that conversion happens in the thyroid. So, if our thyroids are sick, it's not uncommon for them to not only be deficient in production of T4 but, also with the conversion of T4 to T3.

The "free" T4/T3 tests are the best measurements of thyroid hormone since they measure the amounts of hormone that are fully usable by the body and not bound to proteins, etc.

That said, your doctor ran the right tests (many don't) and they indicate hypothyroidism, hands down.

TSH > 2.0 is suspect for hypothyroidism but, pituitary hormone TSH is not a reliable indicator of thyroid function. It's always best to look at the actual thyroid hormone levels - FreeT4 and FreeT3.

That said, most healthy people have FreeT4 and FreeT3 levels in the upper half, if not the upper third of the range.

Using your lab's ranges, this would mean that a healthy person will have FreeT4 at least 12 and probably closer to 14.....and FreeT3 level at least 4.65 and probably closer to 5.3.

Your FreeT4 level is well below the levels most healthy people have and this indicates hypothyroidism.

Your FreeT3 level is slightly below mid-range which shows that your body is trying very hard to convert the little T4 it has into usable hormone.

Since you are having symptoms, it's clear that your "normal" (aka in-range) thyroid levels are not YOUR normal.

I hope you can convince your doctor to start you on some levothyroxine.
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Last edited by sammy64; 10-24-2011 at 04:59 AM.

 
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Old 10-24-2011, 12:08 PM   #8
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Re: Contradictory Symptoms - Could it still be hyperthyroidism?

Thank you for your fabulous reply sammy64 - so very informative!

You mentioned in your other response (on the other thread) about explaining the different types of antibody tests and their affect on symptoms and lab results. I would love it if you explained it all to me. I'd love to go into the endo's office armed with knowledge so I can speak intelligently and be informed as much as possible so I can push for what I think is right and ask for the right tests (if there are more I should get that he doesn't mention). Thank you for the offer to explain it to me. Do you think it's worth me getting tested for them?

I've been doing a lot of reading and research on thyroid issues over the past week or so and have come up with some thoughts and questions. Any insight would be appreciated.

I'm starting to think maybe I started out hyperthyroid. All of my symptoms seemed to start after I lost a baby at 19 weeks in early 2008. What an emotional rollercoaster that was... :( then after we were able to get pregnant again, she was born 2 1/2 months early! in 2009 (she's perfectly healthy now!) then fell pregnant again but lost that baby at 15 weeks pregnant in 2010.

I know pregnancy can wreak havoc on hormones and can affect thyroid function - so I thought it would be worth mentioning as a potential clue as to the cause...

It seems that my symptoms were more hyperthyroid back then (large weight loss, ravenous appetite, severe GI issues, anxiety, insomnia, itchiness, heart palpitations etc.), and then in the past year they have sort of swung around back and forth... sometimes anxiety sometimes depression, GI issues started to ease up at bit about 6 months ago, but 8 months ago I developed very noticeable shortness of breath (Like I can't get a good deep breath). Not during exertion, but all day long. (had a chest xray and asthma test done - all fine) - still happening now. Also, if I remember correctly, I started having intermittent night sweats about a year and half ago. My menstrual cycle has also gone screwy over the past year or more. Instead of it getting lighter and less frequent (like you'd expect with weight loss) it's actually getting heavier and more painful and comes about every 25 days now instead of every 28-29 like it used to. (although there have been some odd month when it's been lighter and not painful and one month when it didn't come for for 34 days which is way long for me). My neck and head are itchy off and on all day, sometimes it feels like the itching jumps around my body... I'm cold a lot of the time (but I figured it was due to my weight loss). I've noticed that I'm feeling more depressed these days - just TOTALLY unmotivated for seemingly no reason (not like me). My appetite seems to ebb and flow too... some days ravenous others not so hungry at all.

Is it possible that I was hyperthyroid, but after years of abuse my thyroid is giving up and I'm now going hypothyroid? I've also done a lot of reading on adrenal fatigue. Pretty much all the symptoms fit me. What's the best way to have this tested? I know that any thyroid treatment won't work well if the adrenals are drained. Thought it might be worth investigating with my endo at the same time to ensure thyroid treatment (if needed) would work better.

Sorry, I know this is a lot of questions :) Thanks for any input.

x

Last edited by Lemonade123; 10-24-2011 at 02:27 PM.

 
Old 10-24-2011, 03:50 PM   #9
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Re: Contradictory Symptoms - Could it still be hyperthyroidism?

First off, I'm very sorry for your losses. And, while it's very hard to determine the cause of miscarriages/premature births, hyperthyroidism can definitely contribute to these things.

It's not uncommon for people to start their thyroid disease journey with one type of manifestation (in your case, possibly hyPERthyroidism) and ultimately "settle in" with another type (in your case, hyPOthyroidism).

While our TSH levels should never be used for diagnosis/treatment, they can give us some idea of what might be going on as far as antibodies are concerned.

You see, there is a class of antibodies called TSH receptor antibodies (TRab) and they take on different forms - one form stimulates the thyroid to produce excess hormone, causing hyperthyroidism. Another form of TSH receptor antibodies blocks the production of thyroid hormone and can make a person hypothyroid.

All TSH receptor antibodies suppress TSH.

Since your TSH is > 2.0, I don't think you are dealing with TRAb.

There is a chance your body is producing one or both of the antibodies most commonly seen in any type of autoimmune thyroid disease. Those are TPOab (thyroid peroxidase antibody) and TGab (thyroglobulin antibody).

And, people with Hashimoto's thyroiditis, the most common cause of hypothyroidism, will often have elevated levels of either or both of these antibodies. But, maybe not. Some people with Hashi's will test negative for the antibodies.

The only definitive test for Hashi's is biopsy....although, a thyroid ultrasound might reflect some of the cellular changes ofen seen with Hashi's.

Since hypothyroidism is treated the same, regardless of the cause, biopsy isn't necessary.

However, positive antibody results *can* help with diagnosis - especially with a doctor that doesn't easily recognize hypothyroidism when the patient has "normal" (aka in-range) labs.

Now that you have detailed your symptoms, it is very clear to me that they are all hypothyroid. While people tend to associate weight gain with hypothyroidism, weight loss isn't uncommon.

Please know that, when a person has Hashi's, he/she is basically dealing with hypothyroidism but, can experience hyper symptoms as the thyroid dies off from the antibody attack. This might explain the vacillation in symptoms that you've experienced.

Some people have a rare form of Hashi's called Hashitoxicosis and they are basically hypothyroid but, deal with periods of hyper symptoms due to stimulating TSH receptor antibodies. But, again, if a person has TRab, his/her TSH will be suppressed.

At the end of the day, a thyroid-savvy doctor will look at symptoms in conjunction with the FreeT4/T3 levels to make a diagnosis and treat.

Unfortunately, I know nothing about adrenal issues since my research has been confined to the issues I've had to deal with.

Hope this helps.
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Last edited by sammy64; 10-24-2011 at 04:44 PM.

 
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