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Old 07-20-2012, 12:17 PM   #16
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Re: Secondary Hypothyroidism? Advice.

You'll only find Dr. Right if you make appointments with new doctors.

Best of luck to you - please keep us posted!
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Old 07-20-2012, 07:57 PM   #17
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Re: Secondary Hypothyroidism? Advice.

Well I got my free t3 back.

So far, my levels are:
TSH 1.23 Range (0.3 to 5.0)
Free T4 .9 Range (.8 to 2.2)
Free T3 3.1 Range (2.8 to 5.2)

Still waiting on my antibodies. Does this paint a fuller picture one way or the other?

Mollie

 
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Old 07-20-2012, 09:51 PM   #18
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Re: Secondary Hypothyroidism? Advice.

Oh wow.
Your FT4 is 7% of its range. Your FT3 is 12.5% of its range.
As a comparison, the average thyroid-healthy person would have each FT level between 50 and 70-75% of their ranges. Almost everyone who has FTs at your levels would have symptoms.

Your main two problems are that MDs are taught that the TSH test is infallible, and your TSH is painfully "normal". That's why you can't get anyone to pay any attention to those abysmal FT levels.

Keep at it... Don't give up until you find treatment. I hope you have antibodies, because that sometimes will 'prove' to an MD that there is a problem. The endo who diagnosed me treats when there are antibodies and symptoms, even if TSH is still in normal range. She's progressive as far as most endos go, although I had to abandon her when her standard treatment plan didn't work for me.
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Old 07-21-2012, 04:45 AM   #19
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Re: Secondary Hypothyroidism? Advice.

I'm with Midwest1 on all counts...

To add to that, please know that not everyone with Hashi's tests positive for the antibodies. Sometimes, the cellular changes seen in Hashi's will be evident in a thyroid ultrasound. The only definitive test is biopsy. Since hypothyroidism is treated the same, regardless of the cause, biopsy isn't necessary.

Bottom line, you are hypo and would benefit from treatment.

Please don't give up until you find a doctor that recognizes this.
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Old 07-21-2012, 09:56 AM   #20
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Re: Secondary Hypothyroidism? Advice.

How are you factoring the percentage rates? I am totally new to the thyroid stuff other than knowing I have a lot of symptoms of hypoT. I was also reading that iron levels can be affected as well? Do you know anything about relevance of iron and thyroid levels? I am asking because my last iron levels came out goofy in my last yearly in February of 2012. I have asked all docs but everyone says they are normal. I am thinking, at that time anyway, I was borderline anemic.

Thanks for your help.

Mollie

FERRITIN 15 10 - 120 ng/ml
IRON 187 37 - 170 mcg/dl
TIBC 450 240 - 430 mcg/dl
% SATURATION, CALC. 42 15 - 50 %

WBC 4.0 4.0 - 11.0 k/ul
RBC 4.37 4.0 - 5.2 M/ul
HGB 13.7 12.0 - 16.0 g/dl
HCT 40.4 36.0 - 46.0 %

 
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Old 07-22-2012, 04:57 AM   #21
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Re: Secondary Hypothyroidism? Advice.

Here is the formula for determining what percentage a result is of the range it's being compared with. I will use your lab's FT4 range [.8 - 2.2] and your .9 as the example:
1. Subtract the bottom of the range from the top (2.2 - .8 = 1.4)
2. Subtract the bottom of the range from your value (.9 - .8 = .1)
3. Divide #2 by #1 (.1 / 1.4 = .7) and turn the result into a percentage = 7%.

Anemia can be a manifestation of hypothyroidism and low iron/ferritin levels can worsen hypothyroidism.
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Old 07-23-2012, 01:16 PM   #22
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Re: Secondary Hypothyroidism? Advice.

Hello again,

Well I have some more labs that came back. Not all but I do have:

THYROGLOBULIN 8.6 0 - 35 ng/ml
THYROGLOBULIN AB <1 0 - 3 IU/ml


I am not sure what this measures? Is this a cancer marker?

Thanks,
Mollie

 
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Old 07-23-2012, 01:45 PM   #23
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Re: Secondary Hypothyroidism? Advice.

Thyroglobulin is a protein produced entirely within the thyroid. Measurements of it are only done after treatment for thyroid cancer. The presence of thyroglobulin often means there is still some thyroid tissue left. You obviously have thyroid tissue.

Thyroglobulin AB's, on the other hand, are obviously antibodies that attack thyroglobulin. They are often seen in elevated numbers in Hashi's patients. You obviously tested negative.

Please remember that not everyone with test positive for either/both of the antibodies most commonly seen in Hashi's

If the doctor ordered comprehensive antibody testing, you'll also have a TPOab or anti-TPOab (thyroid peroxidase antibody) test to report.....along with a TRab (thyrotropin receptor antibody) test to report.
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Last edited by sammy64; 07-23-2012 at 01:54 PM.

 
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Old 07-23-2012, 01:48 PM   #24
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Re: Secondary Hypothyroidism? Advice.

So, then I am don't have antibodies? Is this how to interpret the results??

Mollie

 
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Old 07-23-2012, 01:54 PM   #25
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Re: Secondary Hypothyroidism? Advice.

oh Sorry... I have too many things going on here.

I also have the other test back.

THYROPEROXIDASE AB <1 0 - 8 IU/ml

So, this means I don't have the antibodies then.

Mollie

 
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Old 07-23-2012, 01:57 PM   #26
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Re: Secondary Hypothyroidism? Advice.

OK...you don't have the two antibodies most commonly seen in Hashi's.

As I mentioned earlier, another antibody - TRab - is also seen in Hashi's and this is the antibody that can cause TSH to be lower.

Bottom line - even if you test negative for all of the antibodies, you are still dealing with hypothyroidism.

The only definitive test for Hashi's is biospy. Since hypothyroidism is treated the same, regardless of the cause, there's no need for this.

A thyroid-savvy doctor will recognize your obvious hypothyroidism just based upon your symptoms and very low thyroid hormone levels..... and will start you on treatment.
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Old 07-24-2012, 08:17 AM   #27
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Re: Secondary Hypothyroidism? Advice.

This is my Endo's email reply to my labs that came back. I really want to reply to this. However, I would like it to be a productive reply as opposed to sounding like a poor sport so to speak. What do you think? Let it go? be a poor sport? go for a teaching moment?

Thyroglobulin antibody, thyroid perxodase antibody (TPO), T3, and thyroglobulin are all normal. There is no evidence that there is anything wrong with the thyroid. Thyroid treatment is not indicated, I am sorry.
Screening for lupus and Rheumatoid arthritis also negative.
Liver function tests are normal.
Overall labs look very normal.
Continue current treatment plan and follow up as scheduled.



If everything looks very normal? Why do I have chronic symptoms of Hypothyroid??? What a mess.

Mollie

 
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Old 07-24-2012, 08:37 AM   #28
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Re: Secondary Hypothyroidism? Advice.

Sorry to hear about yet another clueless endo.

I tried educating endo #2 and only increased my level of frustration.

Somebody shared a video with me recently and it told the story many of us have to tell: "Our Holy Miracle of the Infallible TSH Test"

Just remember that the average person with an autoimmune disease sees 6 doctors before finding one that can properly diagnose/treat.

I'd channel whatever energy you have into an effort that will have positive results: finding a thyroid-savvy doctor.
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Old 07-24-2012, 08:53 AM   #29
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Re: Secondary Hypothyroidism? Advice.

I might be a sassier sort than Sammy... lol... and opt for the teaching moment, if I could think up a biting enough way to say it. Although, trying to educate an endo is like trying to teach a pig to sing. It wastes your time and annoys the pig.

I wouldn't argue, that's for sure. It won't get you anywhere. Move on, but don't think it has to be to another endo.
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Old 07-24-2012, 08:56 AM   #30
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Re: Secondary Hypothyroidism? Advice.

HAHAHAHAHA... too funny!

I think I will send him that link and reply you are fired! I guess I would go down the poor sport avenue! LOL

I should mention I am a health practitioner. I am not a physician. However, I do have my own patients and understand patient care. This is my main motivation to make a point with my "former" endo. I know he will not change his thinking... but ... if you tell him to go to hell appropriately, he will ask for directions! LOL

Thanks for all the advice!

Mollie

My next appointment is August 2nd with Dr. number ... 5 technically.

 
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