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Old 01-03-2013, 02:41 AM   #1
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Is the doctor right? lab results

Hi... I am a fit and healthy 33 yo female in australia. For the past 4/5 months I have had extreme exhaustion, no loss of weight (even though working out daily), foggy memory/forgetfulness.

I went to doctor in November and he tested for thyroid (and everything else). My results came back as follows:

Free T4 = 12.8 (normal 9.0-25.0)
TSH = 16.15 (normal 0.5-5.00)
TG antibodies = 244 (normal <60)
TPO antibodies = >1300 (normal <60)

He said i probably had underactive thyroid and we were just delaying the inevitable but to re-test in a month.

I went back 21st December for re-test.

Free T4 = 12.0
TSH = 17.8
No antibody re-test

He said again even though TSH went up more, Free t4 hadnt dropped enough. He said my thyroid was making enough t4 but was working super super hard to do so...

He said again we were delaying, but re-test in 2 months.

I am over feeling this way, and if he is just delaying should I just start medication. My antibodies are off the chart which clearly means there is a problem- even I know this from my limited immunology units at university!...

Another related issue is that over the past 4 years I have had two false positive results for syphyillis which indicates (through research) that I have an auto-immune disease. Does this mean I've had this for 4 years? I have never been tested before, and have always put my tiredness down to shift work.

Any advice would be appreciated. Should I get a second opinion, or would it be suitable to wait two months for re-test?

Thanks

 
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Old 01-03-2013, 07:34 AM   #2
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Re: Is the doctor right? lab results

Hello Welcome to Thyroid Board
There's nothing "probable" about this - it's clear that you're hypothyroid because of autoimmune thyroid disease. Delaying treatment only means prolonged agony. It is quite possible you've had this for years - it can take decades for hypoT to develop. Absolutely get a second opinion, it's actually malpractise to leave you without treatment with such a high TSH and thyroid antibodies.

 
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Old 01-03-2013, 08:23 AM   #3
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Re: Is the doctor right? lab results

In this particular case, before going doctor-shopping, I'd assert myself and tell this one I want to start treatment now. I'm not sure what he's waiting for. Perhaps he thinks your FT4 will fall below range? That's unlikely to happen for years or decades. Absolutely no need to wait any longer. Tell him what you want. After all, he's your employee of sorts. If you get nowhere soon, "fire" him.
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Old 01-03-2013, 09:14 AM   #4
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Re: Is the doctor right? lab results

I would bet your TSH is so high because your T3 levels are subpar. You are clearly hypothyroid by your TSH. However with out a full picture of your thyroid function which would include a FT3 test in conjunction with the Ft4 tests you do not know how well you are converting t4 to t3 and if there are other issues like reverse t3 conversion issues and more.

It won't hurt to start md shopping for a more thyroid savvy MD, BUT I CONCUR with Midwest. Put your foot down request more thorough testing. Full antibody panel, reverse t3, and Ft3 test. Many have t4 to t3 conversion issues and need more than just a t4 supplement. Fine tuning what medication you need really does require a GOOD thyroid savvy MD.

Sincerely,
MG
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Old 01-11-2013, 10:36 PM   #5
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Thumbs up Re: Is the doctor right? lab results

Thanks for all your replies!

I gave my results to my best friend, whos step-dad is a doctor...

He confirmed everything you said, that I needed a new doctor, that it was clear i had autoimmune disease, that i needed medication asap.

I now have an appointment with him this coming Thursday!

Hopefully I can solve my symptoms which have been driving me insane..

Thanks again for the help

Monty

 
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Old 01-12-2013, 07:52 AM   #6
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Re: Is the doctor right? lab results

How lucky for you to find a smarter doctor relatively fast and easily!
Hope you'll give us a report on how you're doing as you progress in your treatment.
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Old 01-12-2013, 12:36 PM   #7
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Re: Is the doctor right? lab results

It is nice when you have a close family friend that knows you as a person and can take that into account with your treatment and diagnosis. I have a lot of family members that are MDs and RNs, but they do not believe in treating family members whenever possible. They did help me in finding MDs to treat me. Toward the end of the two year search even they were disgusted. One even told me they would treat me if my current md did not work out. Luckily for us both, Dr. Natalie Johnson knew her stuff and started my treatment day 1.

I am wishing you the best! Good luck and keep us posted on how you are doing.

Sincerely,
MG
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Old 01-16-2013, 10:33 PM   #8
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Re: Is the doctor right? lab results

Hi all...

Update! Today I had my appointment with my frinds step-dad... He went through all my results and symptoms, as well as family history (which my previous doctor didnt).

He then called a friend who is a endocrine specialist, while i was there, so i could hear what he had to say...

He confirmed I needed to be on thyroxine immediately and the doctor prescribed me 100mg of oroxine for the next 6 weeks, and then to come back and get my levels tested. He said we would also do a thyroid scan if necessary and said I could see the specialist if required.

He can't belive the other doctor just dismissed it and said "you'll have to be tired for 2 more months"

Thanks for all your help, it gave me the courage to geta second opinion and stand up for my health!

Will let you know how I go in 6 weeks!

Monty x

 
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Old 01-17-2013, 06:52 AM   #9
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Re: Is the doctor right? lab results

Nice to hear good news 100 mcgs is a high starting dose, I would not recommend starting on that dose. 50 mcgs (or even 25) would be more appropriate, and then increase the dose over time according to symptoms and labs.

 
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Old 01-17-2013, 03:34 PM   #10
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Re: Is the doctor right? lab results

In regards to the dose- the two doctors discussed it and thought since I was a very fit and healthy young (ish) female that I could start at that level. We'll see how it goes.

Did anyone else start that high? I feel okay so far (after 2 doses)


Monty

 
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Old 01-20-2013, 12:00 PM   #11
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Re: Is the doctor right? lab results

I posted my experience on that dose earlier but here it is for you:
Sept 26: TSH - 7.96

On Sept 27 I started 100mcg of Synthroid. - I go in tomorrow morning for new testing (no pill and fasting) ... TSH and Free T4 ... stupid dr. doesn't believe in Free T3 - one battle at a time.

3 hours after my first pill my heart rate had increased to a more realistic 66bpm (it had been sitting in the 40's and 50's and I really am not an Olympic athlete). At the same time my blood pressure dropped to 117 / 81 so yay!

However, this first pill made me high. Just talking a mile a minute and a bit loopy. It wore off in about 6 hours - fun while it lasted. I had a slightly muted reaction on the 2nd pill.

It has been 6 weeks on this dose. I find that there has been some improvements but it has been like 3 steps forward 2 steps back. Some days I feel great - ran 5k for the first time in 4 years, but when I got back the rest of the day (and a couple more) I was just exhausted. I know I probably pushed it but I want to get back to me.

I see sawed back and forth... one day I will feel OK the next few days I was a dead beat again. It has never gotten as bad as it was which is good. I don't have to nap during the day but I'm still sleeping 9 - 10 hours and I have to set alarm to get up at 9.

Positives - heart rate - in the 60s and 70s now. Blood Pressure stabilized - I know that it is not supposed to be related but mine seems to be.
Tingling in hands an feet - gone (Actually the 2nd week it got way worse but its gone now)
Muscle spasms gone (again it got really bad the 2nd week)
Itchiness gone
Headaches mainly gone - still drinking way too much caffeine trying to combat the tiredness.
Able to exercise more ... more endurance ... same horrible recovery.
Sweating - yup I now do this appropriately ... I haven't sweat for more than 4 years ... didn't notice that fact till it came back. ... could have lived without this.
Negatives - still tired and brain dead some days worse than others.
A clump of hair fell out yesterday ... was not impressed.

I have been carefully monitoring my symptoms and I don't seem to be going into Hyper territory at all.

.... continued

12 weeks on this dose and my TSH went to .13 and the free T4 at 100% of the range. I felt mostly great except my left eye started twitching. We agreed that I should drop down to 88. Been on this for about 4 weeks. First 3 weeks were pretty draggy but feeling better this week.

Summary: If I had to do it again I would have preferred to start lower - say 75 and work up. It is is less wonky that way.

Hope this helps

 
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Old 01-21-2013, 01:42 AM   #12
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Re: Is the doctor right? lab results

Thanks for your reply !

So far apart from the first day, where I had a highish heart rate, and the second day where I was a bit sweaty - not badly, but just kind of felt like a cold sweat (but it has been pretty hot here in oz!) ... I haven't had any side effects!

I have been super busy at work and had to go away for the weekend to work, didn't sleep well, but put that down to the hotel, not the meds.

Not as tired as usual. Still killing myself in the gym and not as exhuasted afterwards (I train over 1 hr per day 6/7 days a week at high intensity, plus beach/surf lifesaving training). No need for afternoon naps so far!

I have made my next appointment for blood test for 4pm. Should I be changing that to a morning so I can fast and not take tablet, or should I be ok if I take tablet in morning and eat lunch?

Thanks again

Monty

 
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Old 01-21-2013, 07:58 AM   #13
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Re: Is the doctor right? lab results

Lab work for thyroid meds is best fasting near 8 am. As it get later in the day your levels shift about. I do my best to get my blood work done between 8-9 am. However you test you should be consistent. Don't testing fasting in the morning one time and the medicated in the afternoon. It is best to see how you are changing by a consistent means of evaluation. Diet and many other things through out the day can change your levels that is why I prefer morning fasting testing.

Sincerely,
MG
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Old 04-23-2013, 06:32 AM   #14
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Re: Is the doctor right? lab results

I never knew this!!! I have always stopped off after work to get my Labs done. ..maybe this is why they think I'm within normal range! Its funny that we get excited about something like this!

Thank you for that piece of information!

 
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