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    Old 03-05-2009, 06:45 PM   #1
    Debbie680
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    Do I have Hashimoto's?

    12/31/08 Regular MD

    TSH 21.84 (0.34 - 5.60)

    Went to an endo she did labs results:

    1/21/09
    TSH 13.23 (0.34 - 5.60)
    Free T4 0.5 (0.6 - 1.6)
    Free T3 2.8 (2.5 - 3.9)
    Thyroid P'dase Ab 46 (<35)
    TSH, Receptor Ab <5 (0 - 9)

    The endo put me on 100 mcg. and 20 days later my TSH was 1.58 (is that to fast?) and the lab paper said TSH normal FT4 not done. I called her because I was having headaches every morning and that jittery feeling inside so she made me do the 100 mcgs. every other day and I feel better now. I asked her if I have Hashi's and she said she thinks so????? Either I do or I don't right? She also said I was hyper and hypo. Here in Hawaii it looks like they don't test Vit D or Ferritin or anything. I wish I understood all of this thyroid stuff but I don't really so it anyone can help me I would really appreciate it. I have also been losing my hair for the past 2 years and I really would like to get a handle on that.

     
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    Old 03-06-2009, 06:35 AM   #2
    mkgb
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    Re: Do I have Hashimoto's?

    Thyroid P'dase Ab 46 (<35)

    This says you have Hashimoto's antibodies of sufficient quantity for positive confirmation of Hashimoto's thyroiditis.

    Free T4 0.5 (0.6 - 1.6) Your negative 10% in range here. Subnormal and in need of supplementation.
    Free T3 2.8 (2.5 - 3.9) You are 21% of normal here. You are out of balance and need to test for adrenal fatigue. Jumping right to 100 mcgs may drive you hyperT if the cortisol levels are not right and the adrenal glands are not able to adjust to a sudden influx of T4.

    Hawaii should have the tests. They are just special order and the MD will have to write them in.

    You are not hyperT, but you may have an adrenal issue that will cause you some T3 toxicosis effects and make medicating your issues more difficult.

    MG
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    Old 03-06-2009, 07:50 AM   #3
    mkgb
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    Re: Do I have Hashimoto's?

    Your welcome. I am a teacher at heart and if I can cut ones suffering short after all I went through and my mom and her sisters went through.. well then maybe our journeys through the treatment of our own pain's in the necks served a purpose.

    Supplements?
    Selenium will help keep antibodies in check. Make sure that you are taking a multivitamin that has Selenium in it.

    You can check your vit D, B12, K, and ferritin levels. If any of these are low in range supplementation would probably help you feel better. I have to supplement all my B, Mg, K, D, Fe, Ca.. I am sure I am forgetting something. But when supplementing it is crucial that you make sure you are not over doing it. Test to make sure you need it and then monitor your levels every 3 months then 6 months when stable. Too much vitamins and minerals can be just as dangerous as too little.

    To test for adrenal issues the best starting panel is:

    Fasting 8 am blood draws for Cortisol, DHEA-s, ACTH
    For a adrenal rhythm study a 24 hour saliva cortisol study is also beneficial. Many MDs shy from this test because they do not know how to read it or advise their patients on the best testing protocols. it is an accurate and viable test though.

    Depending on the results of the adrenal panel additional testing may be necessary, but these are the ones you should get to start.

    T3 Toxicosis is where something causes an over production of T3. This results in as much T4 as possible being taken up and converted into T3. When you are hypoadrenal and do not have sufficient means to produce cortisol and check the T4 to T3 conversion process appropriately you can end up hypothyroid in T4 while being hyperthyroid in T3.. i.e. T3 toxicosis. This confuses MDs that refuse to look at both the FT4 and FT3 levels. Because they see a hyperT TSh and hypoT Ft4 level. This is really bad when supplementing your thyroid. MDs often keep adding T4 to the mix until you have some serious issues.

    MG
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    Old 03-06-2009, 08:32 AM   #4
    Debbie680
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    Re: Do I have Hashimoto's?

    The endo must think that the FT3 levels are ok because she is only checking the FT4 and TSH on this next labs I have to do. I'm scared. We don't have much choice on doctors here. I am on one of the islands that have no endos. I have to wait until they fly here once a month from Oahu. I think I went undiagnosed for many years. I went into menopause at age 41, had severe anxiety attacks for many years. It seemed to me like my body was on overdrive but the doctors just diagnosed me with anxiety disorder. could this all be tied to the thyroid? Is taking the 100 mcgs every other day ok? How long should it take for your TSH to go down after being on the medicine? Was that 20 days to fast? I am so sorry for all these questions but you know how it is at the doctors. They just want to rush you in and out I was adopted by my grandparents at age 2 so never really knew about what my mother had healthwise. I do know that she had hyperthyroidism and she was only 89 pounds. She passed away recently after surgery on her stomach at age 77. They said it was half dead?????? I also had a hysterectomy 3 years ago and that is when all hell broke loose!

    Last edited by Debbie680; 03-06-2009 at 08:59 AM.

     
    Old 03-06-2009, 10:49 AM   #5
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    Re: Do I have Hashimoto's?

    Why are you taking your meds every other day? Why not just take 50 mcgs or half of your 100 mcgs tablet everyday. The every other day scheme is not as good on your body's ability to equilibrate blood levels.

    This is the regime that my aunts went through after their thyroid was removed. They started on 50 mcgs of T4. They stayed on it daily for 2 weeks THEN they increased to 75 mcgs and held there for 2 weeks THEN they moved to 100 mcgs and held there for 6 weeks and had their blood levels test afterward. This cut down on the hyperT sensations and allowed the body to readjust gradually to the increasing thyroid hormone supplement.

    Now here is some basic blood chemistry facts, you asked a chemist.. so sorry if I get too technical.. just ask me to clarify after the fact.

    Your body takes time to adjust to any medication. It is a system of checks and balances. It takes time for medication levels to build and stabilize in your system, be they anti-biotics, anti-histamines or in our case thyroxine (T4) supplementation. Each drug has a different rate of absorption and time in which it will achieve equilibrium.. BALANCE in your body. Once the drug has reached that state.. THEN the systems dependent on the drug must adjust to determine whether or not the amount is sufficient. After this time has passed the TSH and FT3 and Ft4 levels will reflect whether or not you have reached an optimal thyroid state.

    Now thyroid medication comes in two forms:
    T4 - thyroxine
    T3 - triiodo..you don't want that name... T4 missing an iodine

    T4 is the common supplement regime because it is stable and easy to transport and slower acting. There is less chance of being driven hyperT with it. T3 is 4x as reactive as T4. As a result T3 supplementation requires closer monitoring.

    T4 takes 2 weeks to reach equilibrium in your blood. At two weeks you could check your Ft3 and Ft4 levels and know where you are in normal range on the dosage you are taking. However the TSH is slower to react. It takes another 2-4 weeks to adjust and show how the pituitary gland and hypothalamus feel about your thyroid hormone levels. SO on average the MDs make you wait 6-8 weeks before they test your blood with each medication dose change.

    SO what should you experience? After 2 weeks on a steady dose you will manifest symptoms according to your Ft3 and Ft4 levels. If you do not have enough supplementation yet you will experience hypothyroid symptoms. If you have too much hyperthyroid symptoms will arise. If the dose is just right you should feel.. Normal.

    You went through Meno at 41? Humm
    My mother and her sisters had early menos.. when their thyroid issues were caught and medicated.. their menopause was reversed and they went through it again around 55-60. You will want to test to make sure that this doesn't reverse or you may end up with a late in life bundle of joy 15 years younger than any of your other children. My Aunt N did that. That was a surprise and not the expected stomach flu.

    Your mom had hyperthyroidism.. was it Graves Disease? Graves can cause whole lobes of the thyroid to burn out. Think of Graves as an overseerer making a horse run in a circle over and over with out a break.. eventually if not checked the horse dies. Same with the thyroid.

    In Hashimoto's the hypothyroid counterpart to Graves the overseerer sends out demolition crews to level the thyroid. In the end nothing survives. You should be tested for the autoimmune markers given your family history. If you have Graves/Hashimoto's in your family line your children are at an increased risk to develop the same condition.

    The tests are:
    TPOAb and TGAB for Hashimoto's
    TSI and TRAb for Graves

    Given your symptoms Hashimoto's is the most likely IF you have an autoimmune component to your thyroid dysfunction.

    Hope this answered those questions.. sorry I ran on a bit.
    MG
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    Old 03-06-2009, 12:00 PM   #6
    Debbie680
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    Re: Do I have Hashimoto's?

    I tried to do that but it didn't look equal when I cut it but I will try again. I was always normal with my periods and then it just stopped at 41...bet it has to do with the hypo thing. I don't have to worry about anymore babies cause I had a hysterectomy 3 years ago. Still kind of angry about that as I feel it wasn't necessary but was told it was. Doctor said when he cut me open everything was normal except that I had a fibroid the size of a baseball attached to the outside of my uterus. He took out everything but my cervix. My body did not like that at all. I went through alot and it took about 2 years to level out somewhat. I have 3 sons no daughters. Should I have them checked for thyroid also or does it just apply to daughters? I will have to try and get my sister to see if she can get my mothers medical records because I don't think that even she really knows much about any of this. I told her to get herself checked and she did and of course she has hypo too. No antibodies were checked so I told her to do that. Funny I don't feel tired like most people do I just can't stay asleep at night......
    TSH, Receptor Ab <5 (0 - 9) what is this for?

    Last edited by Debbie680; 03-06-2009 at 12:01 PM.

     
    Old 03-07-2009, 12:24 PM   #7
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    Re: Do I have Hashimoto's?

    THere is an 80% dominance from female to female. Female to male is 20%. They are at increased risk so they should have it checked in their yearly exams. Things that activate it in males are puberty, certian environmental exposures, certain drugs.. and the biggest viral source... Mono. My son is 6. I have had him tested twice for thyroid antibodies so far. He will have a TSH, FT3, Ft4, and TPOAb and TGAb done once a year as part of his physical. If he does contract Hashimoto's... the MDs will know when and what his levels were like BEFORE the thyroid died off.

    TSH Rec Ab - TRAb - This is a Graves marker test.

    MG
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    Old 03-10-2009, 07:30 PM   #8
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    Re: Do I have Hashimoto's?

    My mother and her sisters suffered in silence for years and then they suffered undertreated for many more. I won't settle for half-donkey measures. I insist on optimal treatment for me and my family. If I run into an unwilling MD.. well I go through or around them. So far I have assembled a decent team... I am just missing an Endocrinologist still.

    MG
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    Old 03-10-2009, 09:02 PM   #9
    Debbie680
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    Re: Do I have Hashimoto's?

    Well, I hope you can find a good endo but I bet you might be smarter anyway. I'm not sure about my endo as I've only seen her once so far for just a short time. Only time will tell I guess. My regular doctor wanted to treat me but she didn't even have the antibody test checked off on the list so I thought ok she is one that just treats the TSH and I want this done right for sure. Can you have normal TSH with Hashimoto's?

     
    Old 03-11-2009, 05:43 AM   #10
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    Re: Do I have Hashimoto's?

    Yes. You can have a normal TSH and still be hypothyroid with or with out thyroid antibodies. The TSH is the pituitary gland's take on your thyroid health. If there is an issue in the adrenals causing a thyroid hormone imbalance the pituitary response can be suppressed. If there is an issue with hypopituitarism or an communication issue between the hypothalamus and pituitary gland the TSH may be suppressed as well. Then you have drug effects on TSH generation and more. The TSH is NOT the be all measurement for thyroid health and understanding. It IS the cheapest way to get an APPROXIMATE snap shot of how the thyroid is doing. However if there are symptoms a TSH alone is insufficient a MINIMUM of a TOTAL T3 and T4 test should be run in addition to the TSH. I prefer the free T3 and Free T4 because I am female and I have elevated estrogen and testosterone. I am also taking medication that suppresses my TSH. My last thyroid results from 3/5/09 were:

    TSH 0.17 LOW.... ARRRGGGGHHHH I am hyperT.. NOT! (0.3-2.5) My MD and I laugh at my TSH all the time.
    FT3 317 (230-420) SO where am I? Not hyperT and not in the optimal 60-80% of normal recommended for fertility and the like... Calculation: (317-230)/(420-230)*100 = 45.7% of normal range. SO I am still 14.3% shy of the 60% mark.

    FT4 1.2 (0.8-1.8) Calculation is the same: (1.2-0.8)/(0.8-1.8)*100 = 40%

    So:
    88mcgs : TSH 0.45*** FT3 40%**** FT4 40%
    100mcgs: TSH 0.17** FT3 45.7%** FT4 40%
    So my MD snorted and giggled with me over the TSH and upped my dosage to 112 mcgs. I go back in 6 weeks for a retest of thyroid blood work.

    Antibodies are known when in really high quantities to suppress the TSH. The next TSH suppressor is hypoadrenalism Mild or severe. In this case your body produces inadequate cortisol levels and the T4 to T3 thyroid hormone conversion goes unchecked. The result being HIGH levels of T3 and LOW levels of T4. Since most MDs do not look at the T3 levels this is oftimes over looked.

    Hopefully your Endo will be a good one. My last Endo admitted I had read more recent research information than he had.. he also conceded that I should continue my treatment plan according to what I had discovered so far and that he would check in with me in six months. Since he wasted my time and I had to educate him on how to calculate levels and how one could tell adrenal health issues from thyroid balance... I have yet to decide whether to waste another 4.5 hours driving to see him again. I might go back if my nodules turns cancerous.. but if that is the case, my ENT will handle it. I really have no need for the Endo, it is not as if he was willing to manage my care.


    MG
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    Old 03-11-2009, 09:51 AM   #11
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    Re: Do I have Hashimoto's?

    Nodules turn cancerous? Oh man that scares me big time. That will set off my anxiety attacks again for sure if I have to worry about that! I have to do bloodwork today and she only checked off the TSH and FT4 so she is probably thinking that since my FT3 is in range that she doesn't have to check that. What do you think? Wrong huh? Was my antibody count at 46 very high? I've been doing alot of reading these days (my co-workers think I shouldn't) but anyway I read today that a hysterectomy and or gallbladder removal can be the cause of the hypothyroidism and I've had both! I also ready that we can have celiac disease...man oh man what else can happen. I know I shouldn't stress on it but I can't help it......

    Last edited by Debbie680; 03-12-2009 at 09:13 PM.

     
    Old 03-13-2009, 05:40 AM   #12
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    Re: Do I have Hashimoto's?

    The chance that a nodule goes cancerous is VERY small, like 1%... and of that 1% less than 1% have the nasty aggressive kind of thyroid cancer. The most common thyroid cancer is papillary and that is a slow grower that tends to stay contained with in the thyroid. Cure? Simple hack out the thyroid and irradiate the leftovers. There is over a 95% permanent remission rate.

    Thyroid antibodies of 46 being high? Well they are not normal, but they are not on their way to the moon either. I had levels that topped out a 1675 and 567 before finally getting medication. Once medicated my thyroid antibodies began to drop. Now I am balanced around 500 in both TPOAb and TGAb. I hope the levels continue to fall.

    What can go wrong with a thyroid issue? Well if you are not optimally treated you can suffer the hypoT or hyperT side effects and symptoms. If you are optimally treated the thyroid is not to blame for anything else. When dealing with ANT autoimmune condition you are predisposed to develop other AIs. It is a matter of the genetic lottery. Some more commonly over looked AIs: allergies, dermatitis, rheumatoid arthritis, and more.

    Many things can trigger a latent autoimmune thyroid condition. Most are linked to your hormonal flux and estrogen levels. Thyroid Ais are most likely to develop during puberty, pregnancy, and menopause. Other instigators are environmental pollution and chemical exposure and certain viruses (Mono is the biggie). Now women go through more hormonal flux than males and we have an 8 to 1 chance of developing the thyroid diseases as a result. When you had your hysterectomy that induced a hormonal flux and shock to you system that could have been the trigger to your thyroid issues. Mine developed during pregnancy or 2 years before when my husband gave me Mono. In either case my pregnancy was ROUGH with the untreated thyroid issues making it a horrible experience for me.

    Many things can happen, but if you stay calm and self-aware you can fix most of them quickly with minimal trail and suffering.

    MG
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    Last edited by mkgb; 03-13-2009 at 05:41 AM.

     
    Old 03-13-2009, 10:30 PM   #13
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    Re: Do I have Hashimoto's?

    Wow, MG I am learning so much from you...thank you. I didn't realize antibodies could go as high as yours did! I wish I knew when my kicked in but I'm not so sure because #1 I had early menopause, #2 my mother had it and #3 the hysterectomy. I also had a very mild case of psoriasis from the age of 8 which is another AI. Three months after the hysterectomy I got spots on my arms and legs that I never had before and I was so devastated about it. It seems everything was going wrong and I had a really hard time with that surgery for about 2 years and no one believed me. They thought I was just being a cry baby. If I could go back I wouldn't have done it. It was only a fibroid that never gave me any trouble but the doctor convinced me that nothing should be growing at my age and it had to come out. I've learned a big lesson from that one. Can't do anything about it now but I will be in charge of me from now on. So you didn't know about your thyroid issue before you were pregnant? I have another question for you. I seem to be having alot of issues with joint pain and my skin being tender to the touch, is this associated with hashimoto's also? The weird thing is even my feet hurt on the top, the side, underneath, limping around for the past 2 days.....

    Last edited by Debbie680; 03-14-2009 at 10:57 AM.

     
    Old 03-16-2009, 06:14 AM   #14
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    Re: Do I have Hashimoto's?

    I am glad that my experiences are helping you.

    That is true I had no clue before or during pregnancy. I knew I was at risk, because I knew my mom had a thyroid issue. I didn't research that issue until another OB pointed out all my issues could be thyroid related. WHat makes me the most angry was I told my OB of my mother's thyroid issue and that she had to have a partial thyroidectomy. I told her that I was not normal and that something was wrong. I requested while I was pregnant for my MD to test my thyroid, but I was blown off. My MD even wrote that I requested thyroid testing in my file, but she didn't test me until 2 months after my baby was born.. and that was a TSH only. When I got my records and reviewed them i could have seriously demolished her. The symptoms I had matched Graves and Hashimoto's pregnancy effects to a T. It also explained why I was having liver and kidney failure issues, heart issues.. and ended up stuck in the hospital for 21 days post delivery. My son was fine.. me well it sucked for a LONG time. I am glad that I moved from Mississippi and that particular OBs care.

    Another question? Hit me with it. Joint and skin issues?
    OH YEAH! Joint pain especially in the hips and knees and wrists is very COMMON in Hashimoto's sufferers, foot and ankle pain occurs in some as well. I have had the full body bone pain on occasion. Normally thyroid supplementation helps relieve the pain. One new label for the untreated hypothyroid joint issues in my opinion is this fibromyalgia they keep tossing about. I seriously think it is as simple as under treated or untreated hypothyroidism. Another thing to rule out is your Calcium, Potassium, and vit D levels here. If you are low in any of these you can have joint/bone pain.

    Skin issues? Yes ma' am. They go hand in hand with Hashimoto's. I developed rosacea and my contact dermatitis became VERY sensitive. If my allergies are acting up my whole body itches. I can shower and certain locations will be more susceptible to the temperature of the water. It is odd and I feel like I live with the constant urge to scratch only holding that in check with the knowledge that the scratching will hurt.

    MG
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    Old 03-16-2009, 08:00 PM   #15
    Debbie680
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    Re: Do I have Hashimoto's?

    I feel so bad for you MG, my problems seem so trivial compared to what you went through! Maybe my thyroid hasn't gone completely kaput yet and that is why I don't have a whole lots of symptoms? I think I was hyperT alot before they found it. I kept explaining my symptoms to my doctor and she kept telling me you are describing hyperT and hypoT symptoms, you can't have both...oh yeah. The endo says I can and I did years later! I don't get the hyperT symptoms anymore and that is worse than the hypo I think. It was like my body was on full speed ahead. Dr. did check my calcium level which was 9.4 (8.4-10.2) and potassium 4.3 (3.3-5.1). Do those look ok? Yep, have that hip, knee and wrist pain sometimes. I took a fall also last week and my whole left side is hurting so I'm not really sure if this is from the hashimoto's or my fall, it just feels different. I see the endo on Wednesday so I am anxious to see what she tells me now about everything. I just hope I can get her to check my B12, D and Ferritin because I mentioned it the last time and she brushed me off.........

     
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