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    Old 10-02-2008, 05:51 AM   #1
    Caroline1357924
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    Hyper-thyroid symptoms but...

    Hi. I've just had the following results:

    - Free T4 9.5 (range 7.5 - 17.5)
    - TSH 0.9 (range 0.4 - 4.6)
    - TPO antibodies 71 (range 0 - 12)

    In December 2007 my TSH level was 2.4 (the other tests were not performed), and I felt relatively 'normal'. Weight was at lower end of normal, but felt in proportion to appetite and amount eaten, and had been pretty stable for years.

    While my weight is still within normal limits, it is now a real struggle to maintain it and not to lose weight. I very quickly become dizzy on standing and if I am at all stressed when standing I develope an extremely noticeable tremor. I feel in a constant state of high emotion and stress - constantly on the verge of snapping - and have great difficulty controlling my emotions. I am constantly exhausted, and fall asleep easily, but generally wake 2 - 4 hours later and find it difficult to get back to sleep. I have extremely light periods.

    I'm not sure whether this is connected but for the past few months have had very itchy eyes, sensitivity to light, and visual disturbance like in the lead-up to a migraine (although the migraine does not materialise).

    I also have symptoms of low cortisone (allergic reactions) and am waiting for the results of a test for this. I am being tested for signs of auto-immune disease, and what has prompted this is that I am trying to conceive and my hormone levels indicating ovarian reserve (AMH) have dropped by two-thirds in nine months and are now extremely low for my age (35). So we're looking for an auto-immune explanation for this loss of reserve.

    In December I began taking bromocriptine for a slightly raised level of prolactin (level in the 30s). The dose was way, way too high (5mg) and I have since stopped taking it. This was the only explanation that was found at the time for my infertility.

    I am aware that bromocriptine can depress TSH levels. However, for the past three months I've been taking no more than 1.25mg per day, and now nothing.

    My own feeling is that my symptoms indicate a hyper-thyroid condition; however I'm not sure that the hormone readings stack up with that. Apart from the antibodies which are clearly elevated (although not as much as all that), it seems that my TSH has actually moved into the optimum range (although definitely in the direction of hyper-thyroidism) but my free T4 is on the low side, which would be associated with HYPO-thyroidism.

    Does anyone have any thoughts on whether there is a thyroid-related cause which stacks up with the above information, or does it seem like I am barking up the wrong tree? On reading about the symptoms of Graves Disease, I felt like a light had come on and recognised all the symptoms listed, except the huge goitre and noticeably protruding eyes.

     
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    Old 10-02-2008, 03:16 PM   #2
    Eagle
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    Re: Hyper-thyroid symptoms but...

    Can't answer but will bump this up for you.

     
    Old 10-02-2008, 03:55 PM   #3
    Meep
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    Re: Hyper-thyroid symptoms but...

    Quote:
    - Free T4 9.5 (range 7.5 - 17.5)
    - TSH 0.9 (range 0.4 - 4.6)
    - TPO antibodies 71 (range 0 - 12)
    Hmmmm... based on your labs, here are a few observations.

    You do have an autoimmune disease, or your antibodies would not be elevated. Thyroid PerOxidase (TPO) antibodies are attacking your thyroid gland and inhibiting its ability to produce thyroid hormone. This is PART of the reason for your Free T4 being low.

    Anything that lowers prolactin will also lower TSH, so your doc would be wise to ignore TSH and strive to keep your Free T4 and Free T3 above the middle of the lab range, as is standard practice for Secondary Hypothyroidism. The bromocriptine IS causing your second reason why your Free T4 is lower than optimal.

    Without seeing a T3 lab of any sort, I would say you are definitely hypOthyroid. It is possible, but very doubtful that your T3 is elevated to the point that you are hyperthyoird. If it were, your TSH woudl most likely be even more suppressed, so I am going to guess that you are hypo.

    Why the hypER symptoms, then? Adrenal insufficiency. If your adrenal glands can not produce enough cortisol (or don't produce enough because of a pituitary issue or med) then they compensate by making more adrenaline, instead. Where Cortisol has a calming effect on things, adrenaline is "fight or flight" and will cause symptoms that mimic hyperthyroidism. Bromocriptine suppresses ACTH (along with the TSH and prolactin and other things), which tells your adrenal glands to produce Cortisol, so it only follows that it might cause an issue, there, too.
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    Old 10-02-2008, 04:14 PM   #4
    GravesGirl73
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    Re: Hyper-thyroid symptoms but...

    yes I think meep is right but have your free t-3 checked too. My niece had labs like this and was diagnosed Hashi's.Usually with Graves your tsh would be non existant or like 0.005, like mine was at diagnosis.

     
    Old 10-03-2008, 05:54 AM   #5
    Caroline1357924
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    Re: Hyper-thyroid symptoms but...

    My most sincere thanks for your thoughts and comments. I'm hoping that the cortisol results will have come in the post today, and will let you know how this progresses.

    Thanks again

    Caroline

     
    Old 10-04-2008, 06:55 AM   #6
    Caroline1357924
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    Re: Hyper-thyroid symptoms but...

    I just got the results of my 24-hour urine test, and was extremely surprised to see that my cortisol level was in fact high - 307 nmol/24hours (norm 30 - 200).

    I did the test on a Sunday, and it was a pleasant, pretty-much stress-free day.

    This all seems pretty inexplicable. I have an appointment with the endocrinologist on Friday, and will see what she says.

     
    Old 10-04-2008, 11:55 PM   #7
    Meep
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    Re: Hyper-thyroid symptoms but...

    Quote:
    Originally Posted by Caroline1357924 View Post
    I just got the results of my 24-hour urine test, and was extremely surprised to see that my cortisol level was in fact high - 307 nmol/24hours (norm 30 - 200).

    I did the test on a Sunday, and it was a pleasant, pretty-much stress-free day.

    This all seems pretty inexplicable. I have an appointment with the endocrinologist on Friday, and will see what she says.
    Wow, that explains quite a bit. Next step would be getting proper screening to determine the cause of your high Cortisol.

    Cushing's Disease= high Cortisol caused by the pituitary gland over-producing ACTH, which tells the adrenals to produce Cortisol. This is most often caused by a Pituitary abnormality releasing the ACTH uncontrollably.

    Cushing's Syndrome= high Cortisol caused by an abnormality in the adrenal glands causing them to produce Cortisol, regardless of what the pituitary gland is directing them to do.

    If you do some reading up on those two, as well as Pseudo-Cushing's, you'll likely find an explanation for a great number of your current symptoms.
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