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Old 05-30-2012, 07:14 PM   #1
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EMG79 HB User
Opinions on labs

Since 2007 I have had MANY debilitating symptoms...My main complaint has been exhaustion...extreme fatigue, but i have classic hypo symptoms and most of them. I, at first thought I was coming down with the flu...but didnt. I than thought maybe I had mono...but months later I still felt the same and the dr found nothing "off" in my labs with the exception of low potassium...at a 3.0 Normal value begins at 3.6? I was tested for Lymes disease, vitamin deficiencies, had a random cortisol...all the usual. I was told I have fibromyalgia....maybe I do...or maybe interpretation of test results isnt accurate. Just seeking opinions.. My mother is hypo, as are 2 of my sisters~ 1 has Graves (half sisters through my father so its on both sides of my family) My aunt (mothers sister) had thyroid cancer and had hers removed.

My thyroid has been tested many times since 2005 ish. results over the years are as follows

TSH lab value .34-4.82

1.04
.59
1.91
2.46
1.28
.996
1.14
.97
1.08
1.08 oldest to most recent if that matters

Free t4 lab value .5-1.5

.8
.60
.5

t4 lab value 4.9-9.5

9.3

Total T3 lab value 63-155

126

t3 uptake lab value 28-38%

24.4% Low

Free t3 lab value 2.5-3.9

3

clearly I should have had t3 tested more often as well but since tsh is always normal I think the drs get irritated when I ask them to check it every 6 months to 1 year. I question is borderline results (as a whole) may indicate hypo. I asked to be treated with a low dose of thyroid meds on a trial basis to see if it improved how I feel because maybe "normal" isnt "normal" for ME. Dr said no but was willing to write ADDERALL for my lack of energy/motivation and memory issues~ go figure! Any advice would be GREATLY appretiated. Im a 32 year old mother of 4.

 
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Old 05-30-2012, 11:03 PM   #2
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ABQpam HB UserABQpam HB UserABQpam HB UserABQpam HB UserABQpam HB UserABQpam HB User
Re: Opinions on labs

Hello EMG -

Welcome to the thyroid family.

You are right, your TSH is perfectly normal. Healthy people have TSH of 1.0-1.5.

BUT, your Free T4 and Free T3 are at rock bottom! No wonder you are feeling as poorly as you are. ((hugs)) Most people need their Free levels to be at least mid-range, but usually 60-80% of range to feel well.

You are, without a doubt, hypothyroid. No one feels well with their Free T4/T3 so low. You would benefit greatly from starting thyroid hormone replacement.

It will require more detective work to figure out why your TSH is so "normal" with those dismal Free levels. Have you had any thyroid antibody testing done? There are some antibodies that can falsely lower or suppress your TSH. These tests are TSI, TRAb and TBII. The antibody tests for Hashimoto's (most common cause of hypothyroidism) are TPO Ab and TG Ab.

HYPOthyroidism = low thyroid hormones (FT4/FT3) & TSH will be high or over range.
HYPERthyroidism = high or over range thyroid hormone levels & low or below range TSH

Unfortunately too many doctors are stuck in the dark ages when it comes to thyroid Dx. They may run the right tests, but ultimately only look at the TSH to make their decision that you are "normal". TSH is a Pituitary hormone and not an accurate indicator of actual Thyroid function.

My thyroid journey was similar to yours. My PCP (now former) also refused me thyroid hormone and instead prescribed, you guessed it, Adderall. This was the end of a long term relationship with that doctor and the beginning of the hunt for a thyroid savvy one. It took me many months and 4 more doctors before I found my new angel of an MD. She "got it" (my below mid-range Frees) and started me on Levothyroxine. I eventually found out that I have high in range TSI (Thyroid Stimulating Immunoglobins). This explained my falsely low TSH along with low FT4/FT3.

If your current doctor can't see the obvious in your lab work, you will likely never convince him/her. If a doctor can't interpret lab results properly, they probably won't ever prescribe proper treatment either.

My advice to you is to find another doctor. Endos are often the worst for thyroid disease. You should look for a doctor that has a whole body approach. Like Internal Medicine, an Internist or a DO. You could also try searching online for "Top Thyroid Doctors" in your area. Many people here have had success contacting local pharmacies and asking for names of doctors that prescribe dessicated thyroid hormones (ie; Armour) or Cytomel. Not that you will need to take a T3 containing med, but doctors that Rx these meds are far more thyroid savvy.

Hang in there. Keep searching for a new doctor until you find one who will give you the treatment you need and deserve. Please keep us updated.

Pam

 
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Old 05-31-2012, 12:38 AM   #3
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Re: Opinions on labs

I am going to respond more thoroughly in the morning but your suggestion to ask a pharmacist about drs prescribing T3 meds (indicating knowledge) is absolutely genius Thank you!!!!
Adderall....a controlled substance over a hormone medication! I have seen 6...yes SIX, doctors (general drs) in the past 5 years as well as 1 rheumy and 1 ENT. (ENT sent me to the rheumy for specific autoimmune testing for Wegeners Ganulamotosis.sp? ~ that was all neg.
Adrenal "fatigue" was my impression with research Ive done....which led me to pituitary issues causing thyroid issues or hormones like estrogen. I am currently seeing a nurse practitioner working under a D.O (with a wonderful reputation~ although Ive never met him personally) who was not accepting new patients...The Np is not rushed, seems to listen to me although doesnt always agree, and is the furthest thing from a drug pusher. My plan is to have a list of past test results prepared (done and always on hand for years!) along with a list of what tests I would like for my "piece of mind". Keeping in mind I have a fibromyalgia diagnosis from the rheumy (who also tested my thyroid and told me I was normal). I am going to explain my symptoms again and tell her there are certain tests that would put my mind at ease if performed and if all those are "normal" my last resort is fibro drug therapy.I feel pretty confident she will run any test I request (that she can do) over giving me medication. ~I also use her for my 3 month old baby so I know her pretty well...she wont even recommend tylonol. My daughter seems to have mild reflux and she was very against the idea of reflux meds...which are VERY common for babies now a days. Im great with this as I like to use more natural methods for my children and myself.
I will make a note of the tests u suggested and do some of my own research as to not go into the apt uneducated! Any other suggestions/thoughts/ideas are welcomed. I did not go over my every symptom as this would take forever and leave me with sore hands and wrists but after the fatigue I would say my skin is the second bothersome. I have constant rashes that turn my skin very dry and thick. It flakes and eventually sheds to new skin...but the process just happens all over again. Hands and legs are most effected. I seem to be prone to cysts? maybe?? I get lumps under the skin in my armpits...I nearly always have 1. They responded well to Erithromyacin gel until recently...which leads me to believe they are NOT a lymph node (as I was assured they are not and did have a ultrasound on 1 it said normal tissue)Im sure Im immune to the antibiotic gel at this point. ~ maybe completely unrelated but I wanted to give a bit more info on whats most bothersome for me.

Again THANK YOU...and I guess I dont need to continue tomorrow...lol

 
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Old 05-31-2012, 04:54 AM   #4
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sammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB Usersammy64 HB User
Re: Opinions on labs

Welcome!

Sorry for the reason you're here but, glad you found us.

I can only agree with everything ABQPam said and add that a progressive school of thought says that fibro is actually a manifestation of undiagnosed/improperly treated hypothyroidism. The late Dr. John Lowe wrote extensively about this.

My TSH was below-range at the time of my hypoT diagnosis due to my Graves' antibodies. I know that, had any of my 4 former thyroid doctors been caring for me at the time, I would not have received the treatment I desperately needed.

Thyroid textbooks confirm that healthy people have FT4 and FT3 levels in the upper half/upper third of the normal range - doctors seem to forget this and bow to the almighty TSH.

Don't give up until you find a doctor who recognizes your obvious hypoT. Replacing natural hormone is a lot better than taking pharmaceutical products with side effects.
__________________
Graves' 2007...remission 2009....hypo 2010

 
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