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.
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.
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.
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.
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.
__________________ "We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses." Abraham Lincoln
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The Following User Says Thank You to midwest1 For This Useful Post: LPD (07-24-2012)
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.
The following user gives a hug of support to Mollie1972: mrB (07-24-2012)
The policy here used to be if you were a medical person you could not or should not disclose that. I have gotten a warning before about it. It was explained to me that they wanted the advice to be strictly Peer and not Professional. Just letting you know that. The Rules may have changed. Just a friendly heads up so it does not catch you off guard.
I wanted to share that I saw 5 to 6 Doctors before I found one that I was happy with treatment. #5 was a Wonderful General Surgeon !!! He was older and very experienced....After crying in his office he sent me home with a prescription of Armour and moved me up rapidly on it, said If I was his wife? He would not take my thryoid out, and he told me I had Hashi's and not to worry it would all be okay. My labs were always in normal range and I was loaded with nodules and a goiter. Dr Ford was great and he sadly passed away last year. #6 Icelandic Endo who I adored who has sadly moved back to Iceland. He was brilliant and he agreed with Dr Ford. I miss them both. I go to my Family Doctor now for an US and labs once a year and my Armour Refills. Nodules are suppressed. I feel great !!
I want to thank all on the board Midwest and Others who helped me through that tough time.
I and countless others can testify to weeding out all the many clueless doctors, usually endos, ironic, eh? I finally found "Dr. Right" (regular family doctor w/more of a non-traditional approach to medicine) at #5 as well. Such a pain in the arse but don't give up in finding him/her. It 'only' took me about 5 months :-)!
What do I take with me to my new doc appointment? Meaning what information? I have my labs, old bbt charts that indicate low body temps, list of symptoms...
What is a good amount of info and how much is too much?? I imagine that depends on the doctor but let's (hope) he is a keeper. What do you all recommend.
I would bring everything in an organized and easy-to-read fashion....and then use the documents to confirm your suspicions while sharing copies of any that interests the doctor.
For whatever it's worth, I was just reading on the American Academy of Family Physicians site about the treatment of hypothyroidism.
It had this to say: "TSH results have to be interpreted in light of the patient's clinical condition. A low TSH level should not be misinterpreted as hyperthyroidism in the patient with clinical manifestations of hypothyroidism."
Guess the endo skipped right over those family practice guidelines - huh?
I am new to the board and by no means a seasoned expert. My heart goes out to you and all the people on the board trying to put together the puzzle of their health in collaboration with their doctors.
God Bless
The Following User Says Thank You to Cjayw For This Useful Post: Mollie1972 (07-25-2012)
I have a couple of more questions. I am still trying to educate myself and wrap my brain around the topic of hypothyroidism. One question that came up is related to my mother. With the current discussion regarding my thyroid levels, etc. we have come to realize she has had issues with her thyroid in the past. She was getting scans for nodules (which to the side thanks to a crappy GP) and now she has a myriad of Hypo symptoms (thyroid, MS???). She also has Reynaud's which again previously mentioned crapologist GP told her to live with it basically. Anyway, she is going to her neurologist (who is a keeper doctor- and will go above and beyond her MS stuff). I am thinking she needs to have her thyroid tested. So, the tests she would request are: TSH, free T4, Free T3, and the antibodies? If someone could list out all that she should have I would appreciate it. I am still a little unclear with the antibodies. This way, at the minimum, the right labs are ordered. Also, is there anything with her MS that would affect her labs, etc? She was on Beta Seron for years. Anyway, any insight would be helpful.
I have a question regarding myself. I am getting prepared with labs, etc. to go see the internist/endo doctor who was listed on the top doc web page this coming Thursday. My question is (assuming he is a keeper doctor and can interpret my labs appropriately) what would be an appropriate plan of care as far as medications go? I just want to know what would be a good starting point (if I get there) and what should I expect? I have not much knowledge regarding the medications at this point and what is prescribed for what, etc.
Thanks again, for all the advice and support from everyone. I am totally in the dark about a lot of stuff (other than the symptoms). What is weird I am finding new symptoms the more I think about it... things I have just passed off as a me thing. My hair is always on the bathroom floor, in the drain, my husband pointed this out a while ago. Why is your hair all over the place?? I just was like I dunno ... don't you lose hair as well?? Also, vague aches and pains (nothing to go to a dr about or take ibuprofen) but just achey. Again, he pointed out. You should see a dr. you are always complaining of your shoulders and back,etc. Again, just thought don't you have this as well??? Amazing at how you simply adjust. I now think my body is done adjusting.
Anyway, I am very appreciative of any thoughts or responses.
So sorry to hear of your mother's issues! I think you know that, the fact that she's already dealing with autoimmune disease predisposes her to having another one.
Yes, the FreeT4, FreeT3 and TSH tests are the best to evaluate thyroid function.
The antibody tests she'll need are:
Most doctors start their patients off on some type of levothyroxine (Synthroid, Levoxyl, Unithroid or a generic)....levothyroxine is a synthetic T4 med.
Some doctors (usually "non-endos") prefer desiccated thyroid products such as Armour, Naturethroid, etc. Desiccated thyroid was the first type of thyroid hormone supplement ever invented and is made from porcine thyroid that contains both T4 & T3.
No matter what med you start on, we all have to start slowly. Common levothyroxine starting doses are 25-50mcg and common desiccated thyroid starting doses are 15-30mg.
You are proof positive that hypothyroidism symptoms creep up insidiously. I look forward to celebrating the elimination of them with you.
Well, I think I may be on the better track if not the right track. I went to see this new internist/endo physician today. My god he actually listened to me and even ... listened to my heart, etc. WOW.
I was able to tell my "hormoan" tale so to speak. Listed out my symptoms, etc. provided copies of my recent labs. He didn't jump onto any bandwagon with any theory thyroid or not and wanted some blood work completed first.
Free T4
TSH
FSH
LH
Prolactin
Ferritin
Iron plus Iron Binding Cap
He did say, he doesn't think it is a Thyroid problem but possibly a pituitary problem (which will affect my thyroid). However, he wants to look further into my hormones from a different angle. He seemed to understand my thyroid hormones are low but wants to further look into why they are low. He was really nice and listened to me. So, I feel like I am in good hands for right now anyway. My iron levels are whacky and everyone is blowing that off too... so he is looking at those as well.
Does this sound like a better plan over an ecocardiogram, sleep study, and a perscription for Orlistat *rolling eyes*?
What is underconversion?? and do my labs point in that direction? I am must admit I am flipping back and forth as to what to expect from this new doctor. He definitely listened and agreed that something seems wrong... but...
I guess I won't know until the labs come back and he actually tells me what he is thinking. Why can't this be an easy fix?
