Hypothyroidism runs in my family. I always figured I was pretty healthy - just having 'normal' changes as I aged.
for 15 years I struggled with adult acne (age 23 - age 38 years) the doctor told me to shower more Hmmm...
last 10 years achey sore joints (fingers, elbows and shoulder
dry itchy skin
high cholesterol past 4 years (I do not eat meat)
often tired - wake up and tired....
steadily gaining weight - hard to lose.
to name a few symptoms.
My mom had a major thyroid collapse - scared me enough to go get my levels checked. Here is where the confusion starts. My TSH is within 'normal' range 3.84, 2.51, 2.79, 2.09 (past 4 years). I asked for Free T3 and Free T4 tests, but doctor could not understand why when TSH levels normal.. and my Ferritin levels are 33 (low). So I went to a Naturopath doctor. I learned that my Free T3 is just below normal 3.8 (4.0 - 7.6 pmol/L) and T4 12.9 (9.0 - 23 pmol/L) is in the low range of normal. The N.D said I should treat my Thyroid before I have a bigger problem. She gave me options for natural steps or use of med's. I opted for Thyroid (same as Armour). I have been on 1/2 grain for 3 weeks and have returned to my acne stage (I have not had a break out like this for 5 years) Is this normal as my body adjusts - or do I NOT need to be medicated? None of the aches has gone away - I am slightly less tired.... I am also gaining weight??
My family doctor is not impressed that I am taking this med. since my numbers are not alarming...have I started medicating too early?
I have been on 1/2 grain for 3 weeks and have returned to my acne stage (I have not had a break out like this for 5 years) Is this normal as my body adjusts - or do I NOT need to be medicated? None of the aches has gone away - I am slightly less tired.... I am also gaining weight??
My family doctor is not impressed that I am taking this med. since my numbers are not alarming...have I started medicating too early?
Your FT3 was below range, your TSH on the high side and FT4 on the low side and you were symptomatic so clearly you needed something. 1/2 grain is a small dose, it most likely won't be enough. When are you going to have your next labs taken? I'm sure you could try a higher dose before giving up on the med.
Last edited by FinnMaid; 04-29-2012 at 10:20 PM.
The Following User Says Thank You to FinnMaid For This Useful Post: brusselsgriffon (04-30-2012)
Hi- I totally agree that you are hypothyroid, no question.
By the way, cholesterol levels are only about 10% dietary and 90% hereditary. Eating meat, especially lean meat, will not raise your cholesterol levels. In fact, eating a diet high in wheat and starch products, as many vegetarians do, will raise your risk of insulin resistance, which can further raise your cholesterol levels (especially LDL). A diet high in lean protein and low in simple carbs (or any grain) is best for stubborn weight loss. Here is a link to info about insulin resistance. I think you should review it, as this may be the case for you.
http://diabetes.webmd.com/guide/insulin-resistance-syndrome
The Following User Says Thank You to bee01 For This Useful Post: brusselsgriffon (04-30-2012)
Your FT3 was below range, your TSH on the high side and FT4 on the low side and you were symptomatic so clearly you needed something. 1/2 grain is a small dose, it most likely won't be enough. When are you going to have your next labs taken? I'm sure you could try a higher dose before giving up on the med.
Thanks for your response FinnMaid. I will have results in another 4 weeks. I am not giving up on meds, but after my Family Doctors response ("We do not medicate until peoples TSH is above 10" - she is obviously not well informed with Thyroid issues) I did start to doubt if am low enough to be treated and then fearful when I seen the acne return.
I sound like a whiney kid! I do want to deal with my symptoms and I am new to taking any kind of meds - some of it is that I am doing well besides some annoying/painful symptoms. But compared to other horror stories I have a great life. I am not depressed and I can function everyday for the most part....
Again thanks! I would leave you an official thanks for your ratings, but I am yet to figure out that step
The Following User Says Thank You to brusselsgriffon For This Useful Post: FinnMaid (04-30-2012)
Unfortunately, we can have a worsening of symptoms, return of old ones and/or the development of new ones after starting meds/dose adjustments. It's all part of moving thyroid hormone levels.
I am SO glad you sought another opinion - your labs indicated severe hypothyroidism. Healthy people have FreeT4/T3 levels in the upper half/upper third of the range.
I really wonder what doctors are thinking when they allow patients to suffer with obvious thyroid symptoms while waiting for a lab number to "tell" them the obvious.
Please know that, once your levels are similar to the types of levels healthy people have, you can look forward to being free from thyroid symptoms.
My levels have been optimized for a year now and I feel awesome - I can't wait to celebrate the same for you!
BTW - I have a thread on here about a petition for better thyroid care that was just started a few days ago - once 1000 signatures have been gathered, it will be sent to 5 endo/thyroid associations and the American Board of Internal Medicine.
Things need to change....significantly. I hope you'll sign the petition and pass it along. I found out about it on another thyroid forum and am doing my best to spread the word.
I suffered under the care of 4 incompetent doctors before finding one that understood thyroid function. I still have to "lead" my care but, at least my doctor listens.
Hi sammy64! Thanks. I have much to learn! I can say that I have had one surprising and dramatic change the past 2 weeks I have had very large pores on and over my nose and forehead the past several years. I thought it was aging skin. It made me uncomfortable and self conscious when people stood close - as it was so obvious....last week I noticed them shrinking. I thought perhaps it was in my mind, but this week some of the pores are no longer visible to the eye!! Even my husband noticed! All of the other pores are shrinking and my skin looks pretty normal. No longer rough and dirty looking from the enlarged pores. So I am thrilled - just waiting for the acne to settle down else where I had never suspected large pores could be related to thyroid. Perhaps all the little white bumps under my eyes will go away in time too (I have had these for about 10 years)!
I appreciate your response - and the confirmation that I do need treatment - the conflicting info. from doctors did create doubt in me.
Perhaps all the little white bumps under my eyes will go away in time too (I have had these for about 10 years)!
Brussels- what do you mean by white bumps under your eye? Do they look like fat deposits? What you are talking about could be xanthomas, which can be caused by high cholesterol and or/ diabetes. Everyone I know who has xanthomas also has very high cholesterol.
Oh, oops, I see now that you do have high cholesterol. This could be the cause of the white bumps. I would search for images of eye xanthomas to verify. I think they would need to be removed surgically but they are harmless.
Hi bee01 - I believe these are called syringoma's. Harmless, but annoying. One the annoying conditions my skin has developed the past 10 years : ) Mine are mild under both eyes - so I am lucky. I have many, but they are small and flat.
Brussels- I am glad they are not xanthomas. Those can be very noticeable. I am often tempted to ask strangers if they've had their cholesterol levels checked when I notice them ;-)
I am wondering if as I adjust to 'better ft4 and ft3 levels' if this can disrupt my sleep patterns? I have always been a solid 8 - 9 hr a night person. These past few months I am up between 4 - 5 am every day I would normally wake up about 6:30 - 7:30. When I do wake up I still feel tired - not exhausted.
I am less tired in general and have less arthritis pain. I think I am getting thicker in the middle abdomen. I will be getting my cholesterol levels checked soon too -as they have been high and beyond....Hoping my ferritin levels have improved - also getting checked.
I was on a start dose of 30mg Thyroid the test results in late May were
TSH 2.25 (.20 - 4.0)
FT3 4.2 (3.5 - 6.5)
FT4 13.4 (9.0 - 23.0)
There are small improvements but still room to be better
My dose was increased to 60 mg over 2 weeks. I will be retested the end of this month.
Again currently my question is what is u with my sleep? Medication related?
Nothing else has changed, no new stressors, no other meds....I just miss sleeping for a a decent length of time!
I'm happy to hear you've noticed some improvements.
The sleep pattern you describe is a typical hypo. It's not uncommon to wake multiple times during the night and/or to wake early.
Becoming thicker in the middle and/or bloating is yet another symptom of hypothyroidism.
The meds titration process can cause an improvement in some symptoms, the worsening of symptoms or the development of new ones. The meds themselves aren't responsible for this - it's due to the fact that your thyroid hormone levels are moving.
Your levels in May showed much room for improvement so, I'm happy for you that you've had a dose increase.
Alright - I had my second dose increase 6 weeks ago and have my new blood results. My TSH has improved significantly, but my Free levels are sure sllooowwww at increasing! I am worried that the doctor will say - all is well - and we do not want you TSH to get too low!
What is the next logical step I can ask for?
April 2012 NO MEDS
TSH 2.79 (.20 - 4.00)
FT3 3.8 (4.0 - 6.5)
FT4 12.9 ( 9.0 - 23)
Ferritin 33 (12 - 300) started taking iron supplements in May
The TSH changed dramatically, but the Free levels.....I am not even mid range yet! Is it common for the FT4 to be so stubborn?? I have had some improvement of symptoms - certainly do not need naps on weekend anymore. But the joint pain is daily and skin acne (not as severe) but present. Weight struggles no change at all...
I have a consult on Tuesday re: review of numbers - doctor has not discussed them with me - as they arrived via fax.....
Help
Last edited by brusselsgriffon; 07-29-2012 at 06:51 AM.
Reason: wrong date
I'm not sure what brand of thyroid you're taking but, the treatment sections on the Armour and NatureThroid sites indicate that people optimally medicated on thyroid will have suppressed TSH. Your doctor should know this.
Most desiccated thyroid products are made from porcine thyroid that has a larger proportion of T3 than T4 compared to human thyroid.
That's why the FreeT4 level of people taking desiccated thyroid is always proportionately lower in the range than their FreeT3 level. Most people are fine with this as long as both levels are adequate.
It's clear that both your FreeT4 and FreeT3 levels need improvement so, I hope you ask your doctor for the dose increase you obviously need.
I hope you're having bloodwork done at least 8 hours after your last intake of thyroid - that's the only way to get accurate labs.
In addition, I hope you're taking your thyroid at least one hour before/two hours after last food/drink other than water (and definitely not with any caffeinated beverage)....and four hours away from any iron and/or calcium supplements.
Thanks Sammy64. I am taking Thyroid/EFRA I have been doing all the things you mentioned - I have been diligent.
What would be a normal next step? gradually increase another 30mgs or sit at 15mgs for 6 weeks? I was shocked my THS took such a big jump, but the free levels did not - is that common?
I have been taking large amounts of DGL and mastic gum since January ( 1 hr. separate from thyroid med) - which both help the intestines heal - as I have been dealing with ulcers in my duodenum. I assume if my TSH is improving it should mean that these supplements are not negatively affecting the FT3 and FT4 levels??
Per the prescribing information, desiccated thyroid is usually increased in 15mg increments with another 15mg dose increase after two weeks....and then labs 6 wks. after that.
Since your levels show much room for improvement, I hope your doctor will approve a 30mg dose increase as just described.
Now, I'm a little confused with your history. Just how long were you on 60mg before those June labs? We need to be on a particular dose for a full 6 wks. to get accurate labs.
And, it seems as if you should have had a dose increase after those June labs....maybe you typed "June" when you meant to type "July"?
Since you've only recently (in thyroid time) started meds, it's common for the TSH to be really the only thing to move....your body is getting enough hormone for it to lower it's production of TSH but, not enough to make any progress with your blood levels of T4 and T3.
I wouldn't make assumptions about supplements not affecting blood levels. I know that fiber is best taken at least 4 hours away from thyroid meds. I suggest you take your "digestion-related" supplements at least 4 hours away, just to play things safe.
To my relief the doctor gave me a 30 mg does increase (15mg for 2 weeks and then add the full 30 mg which equals 90 mgs as a full dose) - her idea
Although she did say - the FT4 does not matter as long as it is in range- she only worries about the FT3???????
Also she felt that the ferritin levels are good enough - anything over 50?
March (2012) I was at 33 (12 - 300)
July (2012) I was at 71 (12 - 300)
What is a healthy range for Ferritin?
This doctor is a temporary as my regular doctor is on maternity leave.....
Perhaps this last dose increase will be all I need! Fingers crossed
I have purchased 2 books - What your doctor may not tell you about Hypothyroidism and The complete Idiots guide to Thyroid Disease. These books do a great job explaining TSH and the 'new' levels for healthy TSH. But I cannot find references to healthy Ft3 and Ft4 levels- just that they are important. I would like to have back up in writing/referenced that I can share if need be - with health professionals. Is there a well recognized researcher or writer that I can access this information from?
Thanks!
Last edited by brusselsgriffon; 08-01-2012 at 06:21 AM.
Reason: missed info
It seems that doctors who don't suffer with hypothyroidism themselves think we only need adequate FreeT3 levels since T3 is the active hormone.
They fail to realize that certain parts of the body require "fresh" T4 to convert to T3 so, we need adequate stores of T4 (as measured by the FreeT4 level).
Since you are taking desiccated thyroid, you could be like most people and be fine with a FreeT3 level that is proportionately higher in the range than your FreeT4 level.
If your doctor optimizes your FreeT3 level (gets it to the upper third/quarter of the range) and you have ongoing hypo symptoms, that's a sign your FreeT4 level is inadequate. The addition of a small dose of synthetic T4 (levothyroxine) can help in situations such as this.
Dr. Leslie DeGroot, noted endo and co-author of thyroid textbook "The Thyroid and Its Diseases" maintains an online thyroid textbook called "Thyroid Disease Manager".
The section on hypothyroidism mentions the types of levels healthy people have - it make sense that any doctor treating hypothyroidism would try to achieve similar levels for his/her patient.
The doctor says she is okay with this if I feel fine - which I do. I see others say their TSH is this low and it is okay as long as you are not feeling hyper...the number does worry me though.
I am thinking if staying at this dose for 3 months and seeing how my body adjusts. If the TSH stays low then I could try lowering to 75mgs.
Any thoughts?
My improvements: skin not as dry, not painful hands at night waking me up, no night sweats, drastically improved menstrual cycle, not as tired, cholesterol numbers improving ( get newest results for those tomorrow).
New side effects: really bad acne on forehead, chest and back. They seem to be like boils - the same pimple will last for months!
Hmmm...
Is this normal as my body adjusts - or do I NOT need to be medicated? None of the aches has gone away - I am slightly less tired.... I am also gaining weight??
