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    Old 09-17-2007, 06:12 AM   #1
    donna70
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    Mostly normal labs? do I have thyroid problems?

    Hi,
    I just got thru a problem clearing up whether I had a liver lesion, I don't after ultrasounds and a review of an MRI. Now, I am trying to get some help with facial swelling and other problems from my internist. When I asked him about this facial swelling that started about 1.5 months ago, he told me without seeing me that it is probably old age. I had had a multitude of tests by an allergists after developing lip swelling and allergic reactions to food in May. The TPO came back greater than 1,000. My TSH was 0.9 and he says I am alright. My allergist wanted to know what my rheumy said since I have RA, she wanted me to ask the allergist who said my thyroid could be getting destroyed but offered no advice. This is different swelling from my allergic reaction. My eyelids have gone and it looks like my lids are swollen and I have two fatty pillows on my cheeks. I thought my voice is changing and I just had a party with friends who saw me in June and all the women were asking did I have a cold because my voice sounds funny to them. My DH can't see any difference. Sorry to be so long but I think I have Hashi's. I want to go back to my rheumy but I am afraid my internist is going to write me down as a nut case. I am tired and I can hardly open my eyes. I looked at an old lab, I had asked my rheumy to check my thyroid in December and the TSH was 3.9 then. Everything is supposed to be normal. Help!!
    Donna70

     
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    Old 09-17-2007, 06:56 AM   #2
    ChristineVA
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    Re: Mostly normal labs? do I have thyroid problems?

    You need to have a more thorough panel of thyroid tests. The TSH alone is not going to tell you much of anything. I don't know all the names of the tests but someone here will know. Also, has anyone felt your thyroid gland. Sometimes a gland that is swelling can cause a change in voice.

     
    Old 09-17-2007, 09:07 AM   #3
    Red Maple
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    Re: Mostly normal labs? do I have thyroid problems?

    There is a poster here by the sign in of "Midwest", that is a pro at Hashi's. Post with her name in the title and she will answer your questions. Hashi's can be a "moving target" to diagnose to treat. You probably will need a doctor who is well versed in thyroid disorders to help you, regardless of what his/her "speciality" is. Sometimes an internist understands hashimoto's, sometimes an ENT can do the job; some people find a DO is more understanding and knowledgeable; some, like me, have found a great endo who is able to give them results. I guess my point is a doctor's knowledge of thyroid disorders is more important than his/her so called "speciality" of practice. It may be difficult to find someone who you relate well to and can help you to feel better. Unfortunately the only method of finding that "right" doctor is through trial and error. In the mean time, do all you can to become as knowledgeable of thyroid disorders as you can. You local library is may be a great resource of understanding. Educate yourself as much as possible, not only to help you to understand the possible causes of your discomfort, but with understanding you can ask better questions of your doctor regarding your particular situation. Your own knowledge will help you to better communicate with your doctor, and thus enable him/her to better treatment.

    Best of Luck!

    Last edited by Red Maple; 09-17-2007 at 09:08 AM. Reason: poor grades in high school typing class...

     
    Old 09-17-2007, 05:21 PM   #4
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    Re: Mostly normal labs? do I have thyroid problems?

    I'd bet the farm you have Hashimoto's. Go with your gut instinct and find treatment.

    I diagnosed myself. The primary MD I had then thought I was loony and wouldn't treat me. I took myself to an endo who confirmed the diagnosis and began treatment based on the presence of antibodies and symptoms. She says that destruction of the gland is inevitible and that starting treatment sooner can prevent goiter and eliminate symptoms. She is probably in the minority with this philosophy, but it's worth finding yourself a practitioner who agrees with it.

    A TSH of 3.9 is not "normal" when you have obvious thyroid symptoms and antibodies out of range. A healthy person without thyroid disease has a TSH of 1, no more than 2. Do what you have to do to get treatment now.

    A great book that will give you the courage to pursue the issue and maybe even to convince a doctor you need treatment is Solved: The Riddle of Illness by Dr. Stephen Langer.

    All the best to you! Let us know how it goes.

     
    Old 09-18-2007, 04:42 AM   #5
    donna70
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    Re: Mostly normal labs? do I have thyroid problems?

    Hi,
    Thank you all for your responses, they are helpful, I just hate getting started with another dr since I had to have the allergy workup, GI workup etc this year and every three months have to see my rheumy, who I will probably get an appt with about whether I have Hashi's, since it is autoimmune and probably happens with RA. When I had the 3.9 TSH, the antibody test was not done at that time. I do appreciate this feedback, I feel like I am always apologizing to my internist for bothering him and truthfully, I see my rheumy and depend on her more than on him. Thanks again!!
    Donna70

     
    Old 09-18-2007, 06:35 AM   #6
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    Re: Mostly normal labs? do I have thyroid problems?

    Dito on Midwest. I am early Hashi's. Age 32 and wanting to pounce on top of my thyroid and kick it back in line ASAP. See if you can get a new round of blood work done. TSH, FT3, FT4, T3-uptake and TPOAb and TGAb. TPOAb is a 95% indicator of Hashimoto's thyroiditis and it has the classic facial puffing and swelling as a side effect. You are Hypo at 3.9 and your thyroid has failed given my Endo's standards.. warranting you need to start a medication regime. The question is whether you need just T4 or T4 and T3 because you do not efficiently convert your T4.

    If you get the blood work done and post the results and ranges here.. many can tell you what your MD's should do as a result of their own experiences. Keep us posted and best wishes finding the right thyroid doctor.

    Sincerely,
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    Old 09-23-2007, 07:46 PM   #7
    waratah
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    Question Re: Mostly normal labs? do I have thyroid problems?

    Quote:
    Originally Posted by midwest1 View Post
    I'd bet the farm you have Hashimoto's. Go with your gut instinct and find treatment.

    I diagnosed myself. The primary MD I had then thought I was loony and wouldn't treat me. I took myself to an endo who confirmed the diagnosis and began treatment based on the presence of antibodies and symptoms. She says that destruction of the gland is inevitible and that starting treatment sooner can prevent goiter and eliminate symptoms. She is probably in the minority with this philosophy, but it's worth finding yourself a practitioner who agrees with it.

    A TSH of 3.9 is not "normal" when you have obvious thyroid symptoms and antibodies out of range. A healthy person without thyroid disease has a TSH of 1, no more than 2. Do what you have to do to get treatment now.

    A great book that will give you the courage to pursue the issue and maybe even to convince a doctor you need treatment is Solved: The Riddle of Illness by Dr. Stephen Langer.

    All the best to you! Let us know how it goes.
    Hi midwest1, I'm a newbie, but was wondering if thyroid tests for TSH T3 and T4 are the same in USA as Australia? Your last post stated TSH 3.9 is not normal, but our Australian interval range for so called normal TSH is 0.4 to 4.0. My TSH is just outside this 'normal' interval of at 4.5, but I've had horrendous and debilitating symptoms as far back as 2004, which recently escallated, so hubby took me to see a new GP, then sent to Ednocrinologist. Subsequently discovered many instances of marked Hashimotos in family tree, + other endocrine disorders. But the message I'm getting from the Endocrine medico's is that only scientific blood pathology results matter, and after feeling my swollen thyroid gland, that a TSH of 4.5 is nothing to get too excited about, despite all the well documented symptoms I've been collecting on paper for the past two months.
    Next round of bloods will be available on this Wednesday 26th Sept, and another dreaded trip to see my origial GP of 12 years who wrote me off a long time ago with the DMO diagnoses. (Depressed, menopausal and over-anxious) If I post the results of these tests, would it be possible for you to give me your view too? I'd really appreciate another perspective - because right now I'm being driven completely crazy by these symptoms and no one seems to be willing to hear. Many thanks, and Regards, waratah

     
    Old 09-23-2007, 07:57 PM   #8
    waratah
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    Question Re: Mostly normal labs? do I have thyroid problems?

    [QUOTE=midwest1;3213250]I'd bet the farm you have Hashimoto's. Go with your gut instinct and find treatment.
    Many thanks for your support to you both midwest and mgbrook - sorry, I think I just misspelled that one! I will buy the book, and post next blood results as they are available. Regards, waratah

     
    Old 09-24-2007, 05:56 AM   #9
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    Re: Mostly normal labs? do I have thyroid problems?

    The TSH accepted normals have fluxuated many times in the past. There are many studies out there determining the gaussian statistical normal cures on the standard deviation of the instrument measurements as well as the statistical spread of patients with normalling functioning thyroids.

    As to the TSH testing it can be done by three different analytical techniques. Depending on the technique there is a +/- 5,10, 20% deviation in the results.

    In normal functioning patient studies TSH tends to peak its gaussian between .66-1. We still have labs in the US that state 0.45-5.5 is normal for TSH.. however it is the lab that is not keeping up with the American Thyroid Association or Society for Endocrinology recommendations. Unfortunately some of our MDs trust the lab ranges and stick with them.. trusting the lab to keep on top of things for them.. what a downward spiral. ::sigh::

    Thus Waratah, your TSH should be valid and applicable to our numbers as well. With a 4.5 TSH you are definitely hypothyroid and are hopefully getting the medications that you need.

    Sincerely,
    MG
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    Last edited by mkgb; 09-24-2007 at 05:58 AM.

     
    Old 09-25-2007, 04:12 PM   #10
    waratah
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    Red face Re: Mostly normal labs? do I have thyroid problems?

    Quote:
    Originally Posted by midwest1 View Post
    I'd bet the farm you have Hashimoto's. Go with your gut instinct and find treatment.

    I diagnosed myself. The primary MD I had then thought I was loony and wouldn't treat me. I took myself to an endo who confirmed the diagnosis and began treatment based on the presence of antibodies and symptoms. She says that destruction of the gland is inevitible and that starting treatment sooner can prevent goiter and eliminate symptoms. She is probably in the minority with this philosophy, but it's worth finding yourself a practitioner who agrees with it.

    A TSH of 3.9 is not "normal" when you have obvious thyroid symptoms and antibodies out of range. A healthy person without thyroid disease has a TSH of 1, no more than 2. Do what you have to do to get treatment now.

    A great book that will give you the courage to pursue the issue and maybe even to convince a doctor you need treatment is Solved: The Riddle of Illness by Dr. Stephen Langer.

    All the best to you! Let us know how it goes.
    Hi Midwest1, After reading your post, I'm a little bashful about posting Endocinologists blood results becuse the result has hit me heavily and now I'm feeling quite ANGRY with my GP of some 12+ years who despite my atttempts at informing her of her my symptoms, the GP has been telling me for years that I'm depressed, peri-menopausal, and over anxious, but here goes!
    Thyroglobulin Ab *1924 IU/ml ref (0-40)
    Thyroid Peroxidase Ab *>1000 IU/ml ( 0-35)
    Mild Vitamin D Deficiency *29 nmol/L
    Presence of elevated Growth Hormone *15.1 mIU/L (0-15)
    in addition to the above there are many other results that are "borderline" right on the cut-off "normal interval"
    p.s. Blood tests reveal there is still plenty of oestrogen in this old chook, just no periods!
    p.p.s. I am 46 years 'young', and have had some of the milder symptoms for the past 6 years. But the past 3 years I have been chronically unwell, unable to work, do anything much at all, and feel that these past 3 years have been lost to myself, my husband, and my 2 children ( 1 is special needs ASD/Aspi) So, many important and life changing things have slipped through the cracks because I didn't have the physical and emotional energy to do better. E.G. Recently ASD kid was not interviewed then overlookked and did not get offered place at great school despite being on enrolment list for 10 years (other kids on wait list shorter time were offered interviews & places) but I didn't have the energy or confidence to go in and do battle with the school. (sorry for the ramble - but hopfully other Hashi people understand this too) It just breaks my heart to know that a diagnoses has 'possibly' been missed consistently because of the GP's failure to investigate further (another GP recognised that symptoms were more than just DMO), and to my dismay, she just seeminlgy dismissed my symptoms as a neurotic middle aged woman. I should note that during this time when I have been unable to work I have very nearly completed a 4 year university double degree in Economics/Commerce by distance education (external). But I am in my last unit of study, and my brain is really struggling, I've asked for extensions, but academic rules apply, so It looks like they may fail me on this last unit, and then I will not be able to graduate and thus work, until the unit is offered again in 2008 semester 2.
    Am I justified in feeling so upset with my GP of 12+ years? What does one say to this GP? I feel that if I start to say something, I won't be able to stop! What do other people think? Please let me know . . . . . .
    I'm new here so not yet well skilled in navigating the boards, but I do hope to make contributions of more than a place to have a jolly good whinge , but I am currently feeling quite overwhellmed by all this.
    Thanks for all your support. Kind Regards, waratah 'hashimoto's forlorn'

    Last edited by waratah; 09-26-2007 at 12:07 AM. Reason: need to add a key word

     
    Old 09-26-2007, 06:16 AM   #11
    donna70
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    Re: Mostly normal labs? do I have thyroid problems?

    Dear Wartah,
    Please check my other post the Update one Donna70. Thank God for this board because it gave me courage to go over my internists head and go to my rheumy with my symptoms. I thank all who told me to pursue the Hashi's dx. I know how you feel about confronting the GP, I don't know how I am going to talk to mine since my rheumy called him and faxed my TSH of 69 over to him. She said as I was ranting and raving about his unkind remarks while I was trying to tell him my complaints only on the phone he never once offered to have me come in the office and see what my face looked like, that I should give him another chance, he will be in charge of my thyroid meds, so I am hoping that it will work, if not I am off to another dr. Do you have the chance to go to another dr and be tested properly and then they can deal with your GP. If I had listened to him that I just had fat face from old age and carpal tunnel syndrome, I would be sitting here getting an even higher TSH. So, that is my response, I am sure the other posters who are so knowledgeable will be able to give you more suggestions. My rheumy apologized for her error and told me "You know your own body." good luck!!
    Donna70

     
    Old 09-26-2007, 06:36 AM   #12
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    Re: Mostly normal labs? do I have thyroid problems?

    Waratah,

    I understand your frustration and anger. Write it down... all of it.. then revise the letter into a professional form and give it to your GP. Then request an immediate referral to another top of the line GP and endocrinologist do to lack of faith..

    However, with your new knowledge and knowledge of the GP's follies.. you might be able to guide your old GP in your care better. The treatment for Hashi's hypothyroid is medication.. you can thus most likely get your GP to prescribe medication and work through the dosages in a timely fashion.. versus having to deal with a new MD and the hoops they may want you to jump through. While the GP may work to get you on medication you do need to get to an endocrinologist for a thyroid physical and further evaluation. You may have nodes or a groiter that may require surgery or a biopsy.

    I am so sorry that you got the put off. My family females have been told menopause time and time again.. the latest was my youngest aunt at the age of 36.. well not menopause.. she got preggers with child number 4 when her current youngest was 12. It was a real kicker of a pregnancy too.. she had Graves!!! You are not alone with your thyroid follies. The issue is thyroids produce so many symptoms that over lap with allergies, dermatology, cardiology, ENT sinus funk.. that unless you are in the right age group or have an orange growing on your throat.. they would rather treat the symptoms.. well heck! Treating the symptoms doesn't find and solve teh source of the problem in some cases.. if the symptom cures don't work.. the MD should have the sense to look for another cause.. you would think they were trying to do rocket science and launch our backsides to the moon and back. Wheew! Just realized I was venting for you.

    I am glad that you know have identified the problem and can get the treatment you deserve.. best of luck to you.
    Sincerely,
    MG
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    Last edited by mkgb; 09-26-2007 at 06:37 AM.

     
    Old 09-26-2007, 06:54 AM   #13
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    Re: Mostly normal labs? do I have thyroid problems?

    Totally agree with Mid-West & everyone else that TSH of 3.9 isn't NORMAL. Before enlarged, non-cancer Thy surgery, my TSH ran 1.3 +/- which falls right into that 1-2 range.

    THE PROBLEM is that when we fall within "normal" ranges (that are H-U-G-E from bottom to top) a Doctor will say NORMAL when we feel anything but that. And we the patient don't know TO QUESTION our DOCTOR.

    I've heard "normal, at top of your meds" from a Specialist (Endo) when my free T4's were ONLY .2 in range (w/ .8-1.8 being THE range). I wanted to shoot for mid-range and see how I felt then. But the Endo wouldn't budge

    At the beginning of my Thy nightmare, I also heard NORMAL when my TSH was 4.73. That is NEARLY 4 times *my* normal and it SHOULD of been a clue to my primarycare-Doc. But it WASn't & back then I didn't KNOW to QUESTION what a medical professional tells THEIR PATIENT.

    For obvious reasons, I've learned not to trust NORMAL & try talking them into tweaking my meds so that I feel the way the labs suggest

    Quote:
    Originally Posted by ******** View Post
    Waratah,

    I understand your frustration and anger. Write it down... all of it.. then revise the letter into a professional form and give it to your GP. Then request an immediate referral to another top of the line GP and endocrinologist do to lack of faith..
    Waratah ~ I was patient of GP#1 for 5 years before leaving because she refused to Rx me Armour, but wouldn't take me off Synthroid either (KNOWING I was having HORRID side-effects) I called my medical group & asked for Doc suggestions. I still see the Osteopathic, today (who was GP#3 for Thy care by that point)

    I also wrote a well worded, non blaming letter to GP#1 a month after I left. In it I politely gave details of how she'd dropped the ball in my Thy care.

    (don't believe this IS the norm ~>>) Later, I recieved an APOLOGY from GP#1 (who is still hubby's GP)

    Last edited by Suey77; 09-26-2007 at 07:13 AM. Reason: note to Waratah

     
    Old 09-26-2007, 10:15 AM   #14
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    Re: Mostly normal labs? do I have thyroid problems?

    Hello waratah...
    (Donna, apologies to you for addressing W on your thread. I hope you won't mind.)

    W... You need treatment now] Your antibody counts are off the chart, and your TSH screams that you need additional thyroid hormone now. Don't let your MD make you think you're crazy! The one I was seeing when I first began to think I was hypothyroid blew me off too, but I didn't put up with it. I became proactive in my cause and found a doctor who confirmed I had Hashi's and began treating me for it. I know your health system is very different there from mine, but do what you have to in order to get treatment. You have an excellent patient advocate org there called Thyroid Australia. Contact them; they may keep a list of doctors who are more thyroid-friendly.

    This is just my opinion, but I say don't waste time being angry with your long-time doctor. She's wrong... but you will never prove to her she is, so it isn't worth the time and aggravation to argue it with her. It isn't that your anger is unjustified - I was very angry with mine, after all; but as long as there are other fish in the sea, it's just a lot simpler to cut bait and fish, you know?

     
    Old 09-26-2007, 04:36 PM   #15
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    Re: Mostly normal labs? do I have thyroid problems?

    Quote:
    Originally Posted by ******** View Post
    Waratah,

    I understand your frustration and anger. Write it down... all of it..

    I treating the symptoms doesn't find and solve teh source of the problem in some cases.. if the symptom cures don't work.. the MD should have the sense to look for another cause.. you would think they were trying to do rocket science and launch our backsides to the moon and back. Wheew! Just realized I was venting for you.Sincerely,MG
    MG, a big thank you for your kind words, and by all means "vent" away all you desire, because my brain is so incapacitated at the moment, I can't even construct gramatically correct sentences - and let me tell you this is a very bad thing if you're a teacher. lol
    Regards, waratah

     
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