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Old 07-05-2012, 08:01 AM   #1
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Am I definately hypothyroid?

I recently had some tests ordered to check cortisol and other hormone levels, as well as thyroid levels, and these were my results:

TSH 2.6 (was 3.05 last time was checked)
Free T4 .8 (.7-2.5 range)
Free T3 1.8 (2.5-6.5)

My doctor has only run TSH in the past when I have said I wanted thyroid checked, so I ordered these tests myself through ZRT labs, and am going to take them to my doctor tomorrow. I have been exhausted for about 3 years now and have gone through a lot of autoimmune testing b/c my ANA has been positive several times (1:320), but nothing else has come back positive with the autoimmune testing. I am now wondering if I have just been hypothyroid for a while now and that is the cause of my symptoms. (no energy, always tired, joint pain, extremely dry eyes and rosacea, have gained 10 pounds that I cannot get rid of, especially around my middle). If my doctor tells me tomorrow that it is not my thyroid I think I will have a fit as I keep getting more and more tired and worry about being able to do my job...

 
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Old 07-05-2012, 08:23 AM   #2
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Re: Am I definately hypothyroid?

I'm sorry you're struggling like this.

Yes, if you look at your FT levels, FT4 is near bottom, FT3 below range.

As you might know, TSH is thyroid stimulating hormone produced by the pituitary gland and not an actual thyroid hormone. FT4 and FT3 are the actual thyroid hormones, when those drop too low for the needs of your body, symptoms will arise. Unfortunately a lot of doctors are TSH focussed, so I hope your doctor recognized your hypoT.

Did you have your thyroid antibodies tested? I mainly think of antithyroglobuline and antiTPO? (which would indicate hashi's).

good luck at the doctor and hope you get to feel better soon.

 
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Old 07-05-2012, 08:31 AM   #3
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Re: Am I definately hypothyroid?

Thanks! I hope he will agree tomorrow to treat me for hypo or at least refer me to an endo. I was going to ask about armour since I have read a lot of good experiences with it...since my t3 is so much lower than t4 does that mean it is a conversion problem? or my t4 is too low as well? I had TPO antibody test and it came back at 30, with reference range saying 70 is considered positive. I haven't had the other one though.

 
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Old 07-05-2012, 08:31 AM   #4
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Re: Am I definately hypothyroid?

Thyroid test interpretation is more of an art than science. No one here can tell you without equivocation that you're hypothyroid, but most of us would say you almost certainly are.

Even though your TSH is not as elevated as most MDs would need to see before diagnosis, it's higher than the average healthy person's. Much more telling are the basement-low levels of FT4 and FT3. These - plus symptoms - are what show that you would benefit from thyroid hormone supplementation.

Have you never had TPO or Tg antibody tests run? Positive ANAs diagnostically mean little. A positive result only means an autoimmune process is going on; it doesn't tell you which one. Positive TPO and/or Tg Ab means that it's a specifically thyroid one going on.

I hope you convince your current MD to treat you. If you can't, though, you have plenty of evidence to convince a smarter one to help you.

Good luck!
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Old 07-06-2012, 10:32 AM   #5
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Re: Am I definately hypothyroid?

So doctor put me on 15mg Armour today, at his suggestion because of the t3 being low, but he was scared to death to put me on anything because of my TSH not being very high, and free t4 still being within range. Will this dosage do anything?? I have read that too low can be just as bad as too high with the dose. I am going back in 4 weeks to check levels.

 
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Old 07-06-2012, 01:55 PM   #6
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Re: Am I definately hypothyroid?

I'm glad he saw the need for Armour, but don't expect much from this doctor. He doesn't appear to know much about hypothyroidism or Armour.

For one thing, FT4 doesn't have to be out of range to be too low. Almost no one I've seen in the years I've been here had below-range FT4 when they started treatment (me included). Almost all have been at the very low end, just barely inside the range, like you.

Think of it this way. Lab ranges are arranged on a "bell curve", meaning that 90% or better of the population is clustered around the mid-point of the range. Less than 5% will be "normal" at the bottom (or top) of the range. The fact is, almost everyone would have symptoms of basement-level FT4. I cannot fathom why MDs don't get that!

Fifteen mgs of Armour is an okay starter dose. I'm glad he's checking in 4 weeks instead of making you wait months to re-check. But don't expect too much from it. Another thing your doctor doesn't seem to know is that the TSH becomes moot with Armour or other T3 drug. T3 suppresses TSH to abnormal levels when it's optimally dosed. If your MD doesn't get that, you will never ever be allowed a true therapeutic dose. He will be "treating to" the TSH instead of to your health and well-being.

Take the Armour for now. See if you'll be allowed a dose increase after the 4 weeks is up. But in the meantime, be prepared to find a more knowledgeable thyroid MD if you want to pursue wellness.
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Old 08-29-2012, 02:09 PM   #7
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Re: Am I definately hypothyroid?

So, I know it has been a while since I last posted, but I have been on 30 mg of Armour for about 6 weeks now, and last blood work was about 3 weeks ago, showing:
TSH: 1.26
Free T4: 1.0
Free T3: 3.2
Reverse T3: 27

So, it looks like everything is in range but then my reverse T3 ratio is high. I have an appt with an endocrinologist for the first time tomorrow because neither my GP or the internist I tried has seemed to know a lot about thyroid if you don't have the typical bloodwork. Do endocrinologists usually pay attention to reverse T3 issues? or will I eventually have to find a more natural based practitioner? I know there are tons of things that can cause that... I also have noticed a little improvement on the Armour but definately still not back to normal. Thanks!

 
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Old 08-31-2012, 10:30 PM   #8
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Re: Am I definately hypothyroid?

Typical endos do not pay attention to reverse T3, and they definitely don't like to prescribe Armour. How did your visit with this one go?

An optimal dose of Armour usually suppresses TSH to near zero. Yours is too high still. Your free T3 is just shy of mid-range, which is still probably slightly low. Your FT4 is well-below mid-range. All this adds up to a needed dose increase. I hope the new endo gave you one. But if not, you may be much better off with the doctor who prescribed Armour in the first place.
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