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Old 03-23-2012, 05:07 PM   #1
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Help with Labs- Anxiety, Hashimotos, but TSH low and Ferritin 11

I am trying to decipher my 20 year old daughter's labs as she is exhausted and has gained 60 pounds in a year and 1/2. My daughter got serious mono second semester of freshman year and had to return from college. Her Pediatrician said that the mono virus was affecting her thyroid at that time (January of 2011). The Thyroid portion of her labs said this:

FT4 (.93-1.60) 1.20
Thyroxine (T4) (4.5-12.0) 8.6
LCTSH (0.450-4.500) .877
Thyroid Perox AB (0-20) (77H)
ThyroGlobulin AB (0-40) 149(H)

At this point Her Pediatrician said they would just need to keep checking to see if the thyroid antibodies were permanently affected.

In the Summer when she rechecked them and was clear of Mono - the Results were:

Thyroid Perox AB: (0-20) 42 (H)
ThyroidGlobulin AB: (0-40) 55(H)
FT4: 1.19
TSH: 1.75

She was pleased that the antibodies were going down and the Thyroid seemed to still be functioning.

My daughter went back to College in the Fall and made it through the semester but was depressed, anxious, had gained a great deal of weight, exhausted and unable to focus on her work so we did not send her back in the Spring.

I took her to an Endocrinologist 02/12 one year from the Mono and Her results were:

Thyroid Perox AB: (0-20) 39 (H)
Thyroid Globulin AB0-20) 68 (H)
FT4 Direct,S: (.82 - 1.77) .93
Thyroxine: 5.4
TSH: (.45 - 4.50) 1.2

He said she has Hashimotos but does not have a Thyroid Disorder and that we will just have to keep checking on it through the years.

I took her next to see a Naturopath to get his take on her low energy and other symptoms and showed him the labs and he said that 5.4 is pretty low given that her T4 was 8.6 a year ago when she first got Mono. He felt the Hashimotos was destroying her Thyroid pretty rapidly. He did say she would not be given medication until she crossed the borderline number. He also did some other blood work and the things that stood out were that her Ferritin Level was 11 which is very low and she was low on Vitamin D (who isn't?). He suggested a Gluten Free Diet and various nutritional supplements and Ultra Hematinic for the low Ferratin.

This is all a puzzle but we would love to get this sorted out and get her back to school. She is feeling a little better with the nutritional aids but nothing dramatic and she is constantly yawning. Thank you for any input! I worry so much!

PS - Why doesn't anybody test her T3??? And what is the Ferritin Connection? Does it cause the Hashimotos? Will the Thyroid antibodies go away as the pediatrician implied? Does the Hashimotos make my daughter tired or is it the low Ferritin?

Last edited by manyamile; 03-23-2012 at 06:10 PM.

 
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Old 03-23-2012, 09:40 PM   #2
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Re: Help with Labs- Anxiety, Hashimotos, but TSH low and Ferritin 11

Your daughter has Hashimoto's, and she does have a "thyroid disorder" - hypothyroidism, resulting from the Hashi's. Her low FT4 proves it.

She been given bad advice on a couple of fronts. The antibodies will not go away and have begun to cause thyroid failure, as evidenced by the falling FT4 and multiple symptoms. There are more enlightened MDs around who would treat her now with replacement hormone. There is absolutely no need to wait for a magic abnormal "number". That "number", which is TSH, usually fails to rise abnormally for years to decades beyond when symptoms have arisen. There's no need to wait until sometimes irreparable body damage happens. She should continue looking for a progressive MD who will treat. Her health should not be allowed to spiral downward until it's harder to climb out of the hole while her doctors sit around twiddling their thumbs.

The FT4 level is much more important than thyroxine. You can see how it has fallen to just 11% of its lab range. A healthy person without thyroid disease would be expected to have FT4 in the 50-75% range.

Once the gland starts to fail due to Hashi's, nutritional aids won't replace the vital need for thyroid hormone. The gland can no longer make enough for itself; it has to be supplemented from a pill. The natural potions and special diets can serve as useful adjuncts to proper treatment, but they cannot replace the hormone itself.

Vitamin and mineral deficiencies are common to hypothyroidism. It's the hypoT which causes the low ferritin, and the low ferritin can exacerbate the hypoT. Fatigue is number 1 on both symptoms lists. I would venture to guess it's the low FT4 coupled with low ferritin that is causing your daughter's fatigue.

Doctors who won't test T3 refuse to believe that it's as important as T4. They have been taught that the body naturally converts exactly as much T4 to T3 as it needs and that nothing ever goes wrong with that process. They're wrong. Many people do have conversion issues, and really smart doctors know that. If you decide to insist upon a test for T3, make sure it's for free T3. That's the most accurate.

I really hope she'll be able to turn her health around soon. Best of luck to her!
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Old 03-24-2012, 05:58 AM   #3
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Re: Help with Labs- Anxiety, Hashimotos, but TSH low and Ferritin 11

Thank you for explaining this. I was never sure which of these numbers were the important ones. I am in a major medical center in Houston so I'm sure there is an enlightened Doctor here! I'll start the search. This entire debacle has really opened my eyes to the slaves some doctors are to lab numbers. Her Endocrinologist was sure she just needed to eat less. I know what she is eating and is on a gluten free diet and works out with a personal trainer 2 times a week. She fainted after exercise last week. Its a big deal to leave college and not know if you can return because your concentration is shot. I really appreciate your response.

 
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Old 03-24-2012, 07:49 AM   #4
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Re: Help with Labs- Anxiety, Hashimotos, but TSH low and Ferritin 11

Believe me, we here understand the TSH and lab sheet worshipping mentality!

Please let us know when she gets her diagnosis. We have practical experience with the ups and downs of treatment she may not be told about.

Again, best of luck.
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Old 04-21-2012, 04:47 AM   #5
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Re: Help with Labs- Anxiety, Hashimotos, but TSH low and Ferritin 11

Based on suggestions here, I sent my daughter for a second opinion to a Doctor who is associated with a Women's Reproductive institute here in Houston. His first thought was that she probably did have Hashimoto's but did not believe her thyroid was responsible for her current fatigue and weight symptoms. He suggested weight watchers and asked her to come back for some blood tests the following Monday and then again to have blood taken on the third day of her period. He said he wanted to wait another month before checking her thyroid. The office called yesterday and said the doctor wants to give her a TRH test because she had a high prolactin level. He wants her off the supplements the homeopath gave her. She is also borderline celiac. Do you think this means he is suspecting thyroid after all or is he going after something else?

 
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Old 04-21-2012, 05:20 AM   #6
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Re: Help with Labs- Anxiety, Hashimotos, but TSH low and Ferritin 11

I think it means that he suspects secondary hypothyroidism, in which the pituitary is failing to send out enough TSH to stimulate production of thyroid hormones. TRH is the hormone made by the hypothalamus to stimulate the pituitary- I guess he wants to see if the pituitary will produce more TSH in response to TRH. If it TSH goes up, then he may suspect tertiary hypothyroidism (dysfunction of hypothalamus). TRH levels in blood are too small to measure, which is why they have to do the TRH test by administering TRH and then measuring TSH.
Totally makes sense to me that he would perform this test, though it's weird that she has Hashi's on top of that. Is it possible to have primary AND secondary hypothyroidism? I have no idea about that; hopefully someone with more knowledge will offer their opinion on this.
The good news is that I think he is taking her condition seriously. I have to admit, the weight watchers comment irritated me. How could he suggest that a sudden 60 lb weight gain was due to overeating, especially in the face of those lab values!!

 
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Old 04-21-2012, 05:25 AM   #7
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Re: Help with Labs- Anxiety, Hashimotos, but TSH low and Ferritin 11

I would consider a liquid, non-constipating iron supplement, like Floradix iron and Herbs. I have had good luck with it. Also, she should be taking Vit C at the same time as her iron and a B Complex 50 mg couldn't hurt either. It's necessary to have a healthy B12 level to properly absorb iron and the best way to get it is with B Complex.
Though, if she starts thyroid hormone, make sure she leaves at least 3 or 4 hours between taking iron and thyroid pills because iron and calcium affect thyroid hormone absorption.
I've actually started taking my synthroid late at night, 3 hours after eating, because my vitamin regimen was interfering with my medications.

 
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