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    Old 10-18-2008, 03:44 PM   #1
    osteoblast
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    Anti-Thyroglobulin rising question - Also HRT and Thyroid Replacement

    I still have my thyroid--though expect it will be gone in a few months. I have 7 nodules and a 3cm mass like growth. Biopsy did not find cancer though. Anyway, my question is about the anti- Thyroglobulin reading that has gone from 4 to 7 in the past few months. Lab range is <4 is normal. What is the significance of anti-thyroglobulin?? My TPO reading has gone down about 25% to 936 --during this time. The TPO reading was over 2500 2 yrs. ago, then at 1200 or so for about the past yr. and then recently down. Over this same time , I started hrt, wonder if the estrogen has shifted the picture here ??I have had to raise my synthroid dose with the estrogen and probably as the estrogen dose has recently been raised again , I will have to raise synthroid again. I am awaiting lab results .
    Five months or so into the hrt, I have to say the estrogen is making me feel better. I kept hoping the better would come--thought the synthroid would do it--and it did somewhat . But, it seems it was the estrogen deficiency that really set me back.
    Anybody else with exp. with Hrt and thyroid replacement. What helped you to feel most like your old self-or, I should say your younger self???

    Last edited by moderator2; 10-21-2008 at 06:42 AM. Reason: to change the thread title - please post openly to all reader, not to specific members

     
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    Old 10-18-2008, 04:21 PM   #2
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    Re: Anti-Thyroglobulin rising question-Also HRT and Thyroid Replacement

    Quote:
    Originally Posted by osteoblast View Post
    I still have my thyroid--though expect it will be gone in a few months. I have 7 nodules and a 3cm mass like growth. Biopsy did not find cancer though. Anyway, my question is about the anti- Thyroglobulin reading that has gone from 4 to 7 in the past few months. Lab range is <4 is normal. What is the significance of anti-thyroglobulin?? My TPO reading has gone down about 25% to 936 --during this time. The TPO reading was over 2500 2 yrs. ago, then at 1200 or so for about the past yr. and then recently down. Over this same time , I started hrt, wonder if the estrogen has shifted the picture here ??I have had to raise my synthroid dose with the estrogen and probably as the estrogen dose has recently been raised again , I will have to raise synthroid again. I am awaiting lab results .
    Five months or so into the hrt, I have to say the estrogen is making me feel better. I kept hoping the better would come--thought the synthroid would do it--and it did somewhat . But, it seems it was the estrogen deficiency that really set me back.
    Anybody else with exp. with Hrt and thyroid replacement. What helped you to feel most like your old self-or, I should say your younger self???
    Well first let us get some background into what our bodies are attacking. You know that Hashimoto's is Autoimmune thyroiditis. This is when our body's immune system gets confused and sees the thyroid as a source of foreign attack. In most cases the TG and TPO are detected as harmful and attacked.

    Thyroglobulin protein is found in the thyroid gland. Thyroglobulin protein binds to iodine to form hormones, in particular Thyroixine. A thyroid condition occurs when too much or too little thyroglobulin protein in the thyroid binds to iodine. In the case of Hashimoto's your autobodies are attaking and killing the source of thyroid hormone now.

    Where does TPO factor? Well TPO is a gene. This gene provides instructions for making an enzyme called thyroid peroxidase. This enzyme plays a central role in the function of the thyroid gland. Thyroid peroxidase assists the chemical reaction that adds iodine to a protein called thyroglobulin, a critical step in generating thyroid hormones.

    I believe that Hashimoto's fights on a dual front. First it takes out the more active factor in thyroxine formation. TPO. This is the machine that adds TG and iodine to make T4. Now when the TPOs are suppressed or obliterated then the immune system will go after the major thyroxine component TG. As a result we most likely see a shift in what our immune system attacks. This is just a hypothesis on my part. I haven't found a factual study on it.

    MG
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    Last edited by moderator2; 10-21-2008 at 06:40 AM.

     
    Old 10-18-2008, 08:11 PM   #3
    osteoblast
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    Re: Anti-Thyroglobulin rising question-Also HRT and Thyroid Replacement

    Hi MG- Very interesting hypothesis that you have developed. Your idea of anti thyroglobulin rising being a later phase of the destruction of the thyroid.
    Isn't it the anti thyroglobulin that is the so-called tumor marker? And, would the rising of mine with a thyroid mean anything about a tumor? Or, is this test functioning only as a tumor marker test when the thyroid is removed?
    Do you think the supplementing estrogen may have tipped things towards more /final destruction? When I had a sestamibi the report indicated virtually no functioning thyroid tissue--isn't that lovely.
    So , maybe your idea of rising anti TG in the final phase of the thyroid in hashi's has some validity as I seem to be in the final phase.
    What's your story now-GOT THYROID?
    I am curious did the women in your family who have had thyroidectomy go on to hrt in menopause? As I said even with thyroid replacement meds, I have not felt anywhere near normal(?) until the estrogen was brought up to a decent level once again.
    Thanks for the informative response.

    Last edited by moderator2; 10-21-2008 at 06:40 AM.

     
    Old 10-19-2008, 11:54 AM   #4
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    Re: Anti-Thyroglobulin rising question-Also HRT and Thyroid Replacement

    I am not in the Big M yet but getting close.......I am on an Estrogen patch very tiny dose and I LOVE IT. the BioIdentical topical creams gave me headaches and bloating and constant spotting..........I love my patch. No hot flashes and feel great as far as that goes......

    I have up to 12 nodules and 4 being dominant......I have Hashis with a history of thyroid cancer in my family (mother). I am trying to keep my thyroid.

    I had the thyrogobulin test done also and was told here on the board that is was useless as a tumor marker unless you had had an TT done.......but my Endo drew it on me along with a Calcitonin and CEA and several other cancer tests........all of these were done initially when my nodules were found and then about 1 year later..all were normal on me..... So not sure if my Estrogen patch has had an impact since I have only been on the patch less than one year.

    Not sure I helped but find out why they drew this on you in the first place.

    Oleander

    Last edited by moderator2; 10-21-2008 at 06:40 AM.

     
    Old 10-19-2008, 06:52 PM   #5
    osteoblast
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    Re: Anti-Thyroglobulin rising question-Also HRT and Thyroid Replacement

    Thanks Oleander-I will see endo in about a week and will def. ask why she did the antiTG.She just started adding routinely last few times after mass found.
    I will let you know her answer.
    What patch are you on? I am on vivelle-it works for me. Some say their patches come off-I haven't had that happen.
    With all that you have going on with your thyroid--why do you want to keep it? Our situations seem similar except no thyroid cancer in the family. The thyroid has been such trouble for me -I just want it out. I know there are risks too though. I am just curious as to why you want to keep yours. I should say mine is functionally gone--that is what the sestamibi scan showed-virtually not functioning thyroid tissue.

    Last edited by moderator2; 10-21-2008 at 06:40 AM.

     
    Old 10-19-2008, 07:31 PM   #6
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    Re: Anti-Thyroglobulin rising question-Also HRT and Thyroid Replacement

    Osteo,

    Isn't it the anti thyroglobulin that is the so-called tumor marker? The anti-thyroglobulin is not the tumor marker the TG.. thyroglobulin that is attacked by the anti-TG is. It is used in to detect if new thyroid tissue is growing in the case of thyroid ectomy patients or in the case of patients that have a thyroid obliterated by RAI. TG levels rise only in the presence of functional thyroid tissue. If you have lost your thyroid function then your Tg should be low. In the case of Hashimoto's patients with TGAb their TG is surpressed and low by default. My TG is ALWAYS low.

    And, would the rising of mine with a thyroid mean anything about a tumor?
    A rise in TGAb just means your body is aggressively attacking TG with greater intensity.

    Or, is this test functioning only as a tumor marker test when the thyroid is removed? It works best after a TT. However if you have had an RAI for Graves or hyperthyroidism it will work as well. The main kink in TG as a tumor marker is if you have Hashimoto's. If you have TGAB the TG will not rise in the presence of a tumor. It is killed off before it can really make an impression.

    Do you think the supplementing estrogen may have tipped things towards more /final destruction? I know estrogen can increase TGB thyroid binding globulin and thus transport of T4. This in turn would increase demand for T4. Which would make your natural TPO and TG kick in or increase your need for T4 supplementation. The addition of this increase in demand may have kicked your thyroid into a downward spiral. Then again it may have just been time. I really can not say. It is possible.. but anything is possible. Even finding an MD that can treat thyroid issues properly.

    When I had a sestamibi the report indicated virtually no functioning thyroid tissue--isn't that lovely. So , maybe your idea of rising anti TG in the final phase of the thyroid in hashi's has some validity as I seem to be in the final phase.
    I would love to know my thyroid is dead. But I know it is not. It likes to throb and let me know that it is still kicking at the worst of times. But it is dying quicker these days. My TPOABs have dropped by a half and my TGAbs are up 4 fold. This shift in TPOAB and TGAb dominance corresponded to a plummet in thyroid hormone and an increase in T4 supplement need. However my antibodies are killing my thyroid function, they are determined and relentless.

    What's your story now-GOT THYROID?
    Of course. I can not get rid of it. But I have more FNA/US slots timed AND I am on the books for an ovary US. That is supposed to be fun. Not looking forward to that nether region experience.

    I am curious did the women in your family who have had thyroidectomy go on to hrt in menopause? As I said even with thyroid replacement meds, I have not felt anywhere near normal(?) until the estrogen was brought up to a decent level once again.
    All went through replacement during menopause. My mom got back off of it after the phase passed. As her thyroid function has died of late, she is going back on it. SHe felt better on small doses of progesterone and estrogen. My Aunts also supplement. The only Aunt not on supplementation is my pure Graves afflicted Aunt. She gets ill on the estrogen. SHe has recently started adding DHEA which your body can convert into estrogen and testosterone. This seems to be giving her relief. ALways check your DHEA levels before supplementing.

    I think you have to test and try. FInd what works for you and go slow with it. There are lots of options. It just takes a while to cover them all and give them a chance.

    MG
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    Last edited by moderator2; 10-21-2008 at 06:40 AM.

     
    Old 10-20-2008, 01:40 PM   #7
    osteoblast
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    Re: Anti-Thyroglobulin rising question-Also HRT and Thyroid Replacement

    MG-You really did it once again . Thank you so much for you response. Really quite helpful!
    Interesting that all the hashi's afflicted women in your family did the estrogen--I wonder if for us thyroid sufferers that meno is more difficult. The thyroid loss and the estrogen loss just seems too much for the system to bear and keep on going.
    This will really be the test to see if my hair /skin quality comes back. I do have to say skin seems to be looking better and 2 independent sources --my derm and a phys. asst. stated this unasked for. Just stated your skin looks great--well, this is not a comment I have heard in years. Now, I would just like to see my brain get back online.
    It has been odd for me hearing people on this board who talk about feeling so much better with thyroid replacement--when it has just not been so for me.
    Well--I see the endo in a wk. and will ask her about your anti TG theory about the last phase of destruction.
    Are you no longer pushing for TT?? Or, have you accepted that it will just have to be in awhile?

    Last edited by moderator2; 10-21-2008 at 06:40 AM.

     
    Old 10-20-2008, 07:40 PM   #8
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    Re: Anti-Thyroglobulin rising question--Also HRT and Thyroid Replacement

    Osteo,

    I want a TT, but my ENT gave me the red light until I find an Endo to give the green light OR my nodule grows significantly for an FNA and.. SO I am in a holding pattern just waiting. Nope I haven't given up, I am bidding my time til my next US. The Endo routes have been dead ends.

    My brain issues are clearing even more with the treatment of my insulin resistance. It has taken treating every little thing to get everything back on line. I am not sure if everything is there yet, but it is getting closer.

    MG
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    Last edited by moderator2; 10-21-2008 at 06:39 AM.

     
    Old 10-21-2008, 06:37 AM   #9
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    Re: Anti-Thyroglobulin rising question - Also HRT and Thyroid Replacement

    I am suprised they will not take your thyroid out if you want.....Every Doctor I have been to has offered to take mine out if I am "worried" or because of my Mother's cancer history.. Sorry you are having this problem. I am trying to keep mine.

    I want you to know since I have had treatment for my RI it is like a light has come back on for me. In fact I look around and wonder where I have been for the last 2 years. My IR symtpoms which I thought were thyroid symptoms have really cleared up and I am feeling so much better......low glycemic diet and Janumet twice a day. Also a Magnesium supplement daily for IR. I am no longer napping during the day and seem to be so much more in the Now instead of in a fog.

    I take Armour and Cytomel for Hashi's and Nodules
    Janumet for Insulin Resistance
    Vivelle dot patch for pending menopause....
    No Dairy or milk in diet due to allergy and try to stay to low glycemic diet
    I am like a new woman...........

    I owe it all to my Endo who is Fab....7th Doctor I went to and I hit the jackpot.

    Oleander

    Last edited by moderator2; 10-21-2008 at 06:39 AM.

     
    Old 10-21-2008, 08:29 AM   #10
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    Re: Anti-Thyroglobulin rising question - Also HRT and Thyroid Replacement

    I have only been on Metformin for three weeks now. It has made a big difference. I am hoping that it will continue to make a difference. So now I am on Levothyroxine for my Hashimoto's hypoT, cortisol for my hypoadrenalism, metformin for the IR/PCOS, and all my other allergy, gerd, dermatological, malabsorption meds and supplements. All in all despite having to take pill after pill through out the day.. I am getting better. I am just glad generics are working for me AND I can get 90 day scripts.

    I have yet to have a MD offer to remove my thyroid because I want the pain in my neck gone. My mother's partial thyroidectomy results and medical records were lost. So there is no documentation that she had a condition at all after Katrina. As a result I no longer have a documented precondition of a direct line to thyroid cancer. Sucks huh. My Aunt is an indirect tie and the cancer was papillary.. SO all my MDs prefer to error on the side of caution. At least they are checking me every 6 months with US's and I can get my blood work done every 4 weeks if I wanted. All in all they are managing me well. They are just trying to be conservative on the side of surgery. I know I am not a surgeon or an MD and I trust these MDs that are working with me now NOT to do anything that would jeopardizee my health. My Endo's seemed to cause me harm by refusing to look beyond the basics. What is with the majority of MDs wanting to practice minimalist care? *snort* MDon'ts make me want to chew nails.

    MG
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    Old 10-21-2008, 09:22 AM   #11
    osteoblast
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    Re: Anti-Thyroglobulin rising question - Also HRT and Thyroid Replacement

    MG-Are you unable to get your mom to get the dr. who did her thyroid surgery to write a letter regarding what he did. Did you check the drs. office for records or are they washed away too. Maybe it was too long ago for the drs. office. But,What about the hospital records? They have to keep these records for a long time don't they?It would seem there must be something?
    Sounds like you are getting a handle on your issues though. I know you have had a mega project with it. Has it taken--years?
    Now I see why I have been feeling sluggish lately, just got latest labs:tsh 4.57( .34-5.60) and the rest looks equally bad free t3 2.9 (range 2.3-4.2) and free t4 .93 (.58-1.64). This is due to recently having to supplement iron because of low ferritin and also having to increase estrogen. Synthroid dose has been moved up from 88 to 100 ea. day. This should not make me go hyper- I don't think. In fact, I wonder if it will do the job. But, after going hyper 2 x with too great an increase in dose, I am willing to take small steps and wait for next labs.
    Getting really tired of working out my dose over the past 2 and a half yrs. --besides the hashi's fluctuations, it has been trying to pull up the ferritin , getting it up and stopping the iron and now a yr. later having to go back at the project since ferritin fell AGAIN. And, then deciding to start hrt and having to work that dose up to where it should be.
    MG-do you know why it is that us hashi's people have such a hard time keeping our ferritin at a decent level?

     
    Old 10-21-2008, 09:47 AM   #12
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    Re: Anti-Thyroglobulin rising question - Also HRT and Thyroid Replacement

    My mom's Endo gave up his practice before Katrina. All her records were stored at Keesler Hospital on the coast and the SeaBee base. Even the MDs old office was on the coast. Katrine literally washed away the existance of MANY people. ALL records including my records prior to college went out to sea with Katrina for military and retired military personal were kept in locations on the coast. My mom and I are one of Thousands in this boat.

    As to the Endo writting a letter. He is no longer practicing medicine and didn't even bother to notify his patients or referr them to another Endo. My mom was one of his last patients. She had surgery a partial thyroidectomy and never saw another Endo. Talk about a MDUD! Yeah the situation is a pain. Since she is one Tricare she is having issues getting them to even schedule a US of the remaining half of her thyroid or to referr her to a ne ENdo for an evaluation. The latest garabage they spilled in her lap was that Tricare will only pay for one thyroid test panel a year. EXCUSE ME? That sounds like a wheel barrel of cow flop! I am working on getting her competent care, but she is unwilling to go outside of the tricare network. Going to minute clinics that are following obscure guidelines are not going to cut it. Maybe I can get her a visit with my MD as her Christmas present and cover her costs.

    I found out my thyroid issues July 2007. It took some rapid boot application and processing of MDs to get one to treat me and listen to my symptoms and theories. I started treatment in January 2008. It has been a constant every 4-6 week tweek and test, step forward hop back, crawl forward slide back, Hop forward roll back process. I think I have made it a few steps forward now. It has only taken 10 months of spitting, fighting and clawing on the inside.

    Now I see why I have been feeling sluggish lately, just got latest labs:tsh 4.57( .34-5.60) and the rest looks equally bad free t3 2.9 (range 2.3-4.2) and free t4 .93 (.58-1.64).
    Yeah You pituitary gland is sending out it sflares for MORE THYROID HORMONE PLEASE! Your T3 levels are at 31% of the normal range. This is pretty low and you probably are dragging because of this alone. Your T4 is at 33% of normal range. You are balanced beautifully in your levels. Only have a 2% deviation. Boosting your T4 to 100 should help, but if you do not feel relief in 4 weeks get another boost to 112. It looks like you are doing the undertreated dance again. I have been there.. at least in the T4 level more times than not. Taking it slow is not a bad thing. when you get close to optimal you have to tweek things slowly.

    Ferritin levels tend to be the result of malabsorption. I think it is a hypothyroid thing.. not just a Hashimoto's thing. I wonder how many are afflicted by it. I hate to think on it. if I have such an issue getting it tested. How many millions suffer because an MD refuse to check the box or write in the name on a lab slip. *snort*

    Well I am wishing you the best.
    MG
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    Last edited by mkgb; 10-21-2008 at 09:48 AM.

     
    Old 10-21-2008, 11:02 AM   #13
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    Re: Anti-Thyroglobulin rising question - Also HRT and Thyroid Replacement

    Well that is a mess caused by the loss of medical records. Thanks for letting us know about more real world pain caused by Katrina-it just seems to never end. I guess you can only be thankful that it was just records not your family washed out to sea!
    I hope you can help your mom get the medical care she needs. You are so good to be helping her follow up. I cannot believe they cover only ONE thyroid test panel a year. Like you, I need testing just about every 4-6wks. Not that I want blood draws so frequently but I NEED testing that often. It does hurt to just imagine all the people like your mom who are not getting adequately tested and proper follow ups esp. after cancer surgery. I talked to a local woman who is in an hmo and after her Partial thyroidectomy because of cancer. They left the other half in?? Anyway she had vocal cord damage and because she is a singer and so got fixated on her vocal cord injury . And, she had to work through thehmo system to advance to the next specialist and then to go outside the system to find out her options for vocal cord , grafting, implant etc. I think it was over 2 yrs. that passed and then she sees a new endo at the hmo and he says where is your last u/s and she says ....I didn't have one after the surgery. Well, now she got her new u/s and there is cancer on the other side of the thyroid and she was getting ready for surgery. She is just holding it together. So.......I shudder to think of all the people who are getting such poor care and then....all those not getting any care. Sometimes I think the myth of the crazy old lady was not just sexist but had some reality with women who were actually losing a grip on it because of untreated hypothyroid and estrogen deficiency--both can do a significant number on your brain and emotional well being!
    I might do a thread on the crazy old lady thing sometime cause I really believe there are reasons why that myth was perpetuated. Also , besides my issues and the insight that has given me, I live next to a 60 yr. old woman who def. acts like a crazy person, she has hashi's . And, my brother tells me he lives next to an angry old woman-he said she is prob. in her 50's.
    I do not want to be a crazy/angry old woman. I want to be as fit as possible, retain humor and be kind to all.Here's hoping!

    Last edited by osteoblast; 10-21-2008 at 11:13 AM.

     
    Old 10-21-2008, 11:20 AM   #14
    mkgb
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    Re: Anti-Thyroglobulin rising question - Also HRT and Thyroid Replacement

    Yes my family is full of flighty tempermental old woman. The young ones? Well we are always PMSing. DO not forget the myths applied to the young. I can not help it if I have testosterone that is on the level of some guys. Maybe that is why I like making the whine and plead for mercy in Martial Arts. Yes, I think that hormonal issues are much more widely spread; but our MDs are not bothering to catch it. So maybe we should try and vindicate the crazy old ladies and PMSing women. What other sexist sayings do they toss about that can apply to women? Humm? What about the woman driver thing? Maybe that has to do with mom's having to haul their kids about.. I know my son sometimes makes me want to drive off the road.

    MG
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    Old 10-21-2008, 11:48 AM   #15
    osteoblast
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    Re: Anti-Thyroglobulin rising question - Also HRT and Thyroid Replacement

    HA HA........Please try to stay on the road!! You are so right... there are alot of those female things out there... like the woman driver thing. Some nasty little phrase about when women have their period about " on the ^&**"Well, I started the crazy old lady thread.... I think I am sort of immobilized by the 4.5 tsh and if I don't watch it the day is going to pass me by while I sit here at the computer. Anyway, gotta get my butt up and do something while I wait for the 100mcg. dose to kick in. How soon do you think until I feel some uptick from the 88 daily to the 100? I know to wait at least 4 wks for testing--but when do you think I could feel the change? Guess I will get on the treadmill now and see if I can get my brain and other vital functions moving. Later---and tell your son he better watch it in the car or mommy might go ballistic

    Last edited by osteoblast; 10-21-2008 at 11:52 AM.

     
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