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  • What is the deal with TSH Testing?

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    Old 10-20-2009, 01:03 AM   #16
    FinnMaid
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    Re: What is the deal with TSH Testing?

    Quote:
    Originally Posted by shelley1 View Post
    I work out 5 to 6 days a week, and many times that is a struggle because of lack of energy. I just want what I'm entitled to, and that is the best care possible. I just believe there may be other solutions to this problem.
    Yes, the medication needs to be ajusted to each individual's personal needs - if someone gets HyperT symptoms with levels "within range" of course the dose has to be reduced a bit and vice versa.

    Now that you mentioned it - this year I started running and ran my very first 10K run last month - couldn't have done it without T3 and high free thyroid levels (and a vit D supplementation after a year of Vit D deficiency). My sister has already planned a race together next spring (and she thinks I should run a marathon - I do believe it's quite possible)

    I "lost" over ten years of my life before thyroid medication so I'm not going to settle for poor treatment and "range worshipping".

     
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    Old 10-21-2009, 12:26 AM   #17
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    Re: What is the deal with TSH Testing?

    I don't disagree with the gist just with the particuliarities.

    There are some reasonable questions that can be asked about the methodologies used to come up with the scales for TSH, and true, some new data indicates that TSH levels sub 1 with T3/T4 levels close to "max" (on scale) might be preferred for some patients.

    But, there is a sliding scale (in other words, higher and higher t3/t4 levels with lower and lower TSH levels cannot be extended beyond certain limits without other consequences). The goal of T3/T4 treatment is to restore the "natural" body's balance of thyroid hormones when there's a problem with the thyroid (or pit/hyp in some cases).

    There is no case (as in this one) of "natural" healthy balance where the TSH is below .01 and the T3/t4 levels are MAXED out.

    So, what the person is asking for here is to have an improved "feeling" based on un-natural balance of hormones. There are a LOT of hormones which can be taken in greater dosages than the body naturally produces (testosterone, HGH, etc..) and which will produce great results, and make the user feel good.

    However, the doctor's job (especially the endo) is to "restore" the body's altered balance (caused by disease or in some cases age) - which is tougher than just giving patients ever greater dosages in order to make them feel good.

    As a note, I used (for more than 20 years) to participate in triathlons and competed in lots of other competitive sports (still in the gym 6 days a week min 45min/day). I always did it without any medication. If the T3/T4 you are taking are restoring your body's balance - then GREAT - if you are using them because you "couldn't do them (10Ks) without T3/T4" then - without passing judgment on you - this is CERTAINLY NOT an issue doctors should weigh when determining treatment.

    I will let you know that in any professional sports there is TSH / T3 testing and results outside (slightly larger scales) "normal" will disqualify you (or worse) since it is a BANNED substance.

    Last edited by othello; 10-21-2009 at 12:41 AM.

     
    Old 10-21-2009, 06:44 AM   #18
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    Re: What is the deal with TSH Testing?

    FYI I'm taking T3 just to live a normal life (have done it for close to 4 years). T3 supplements easily suppress TSH - that's not our fault - just a known fact. What good does it do if the medication is adjusted based on TSH when that way it doesn't give you the results you hoped for (the normal life) - well I guess then you can always say "T3 products are useless - your symptoms aren't thyroid related - here are some antidepressants" . I need to have my free T levels at the highest end of the range. It's not the most "normal" case but in my case the only way to go - obviously some thyroid hormone resistance going on. Hers weren't even particularly high. I thought our medication is supposed to aim to make us feel symptom free (= balanced) - not just to get those levels just somewhere "within range". Aren't you feeling good when you're symptom free? I am

    Last edited by FinnMaid; 10-21-2009 at 08:38 AM.

     
    Old 10-21-2009, 07:23 AM   #19
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    Re: What is the deal with TSH Testing?

    Even though standard teaching in every med school in the US runs contrary to this, here's the deal:
    TSH does not correlate with T4/T3 levels in many (if not most) cases. TSH should not be used as a guide to determine the dose of replacement T4/T3.

    I've been perusing this board for many years, ever since I was looking for information in order to find an MD who would confirm my diagnosis. In all that time, I've seen probably hundreds of people with FT4 at the bottom of its range, .8 in most instances. Their TSH levels varied from between 100+ to .6 - all with FT4 of .8. If .8 is hypothyroid for a person with TSH of 100, it's just as hypothyroid for someone at .6 due to pituitary dysfunction.
    [Some so-called professionals don't even consider that TSH of .6 can possibly be hypothyroid. There was a woman here with low TSH just a few months ago who was prescribed anti-thyroid med when she was actually hypOthyroid; it nearly put her into myxedema coma. I can hear that stupid "doctor" now: "But, by by George... Her TSH was low! She must be hyperthyroid! The Almighty TSH cannot lie!!!"]
    FT4 of .8 needs thyroid replacement exactly the same when TSH is 100+ and when it's .6. That's how I know that TSH does not correlate with T4/T3 and should never be used as a reliable guide for thyroid treatment.

    My own TSH has never been higher than .02 in the 5+ years that I've been optimally treated with first Armour then Nature-throid thyroid. My FT4 has never exceeded 40% of its range; FT3 never exceeded 70%. These levels are not excessive and therefore not hyperthyoid, despite the .02 TSH. I'm fortunate to have an MD who understands that TSH is moot once treatment begins, since it has no purpose in the body except to provide a signal the thyroid gland. If the thyroid gland can no longer respond to the signal due to disease or an exogenous hormone supply, TSH serves no longer serves a purpose. It then becomes vital to pay attention to the free levels of actual thyroid hormones, T4 and T3, at that point - the ones that matter to bodily functions. Until they are at optimal levels, normal bodily functions aren't going to happen.

    When people are overtreated, and their FTs are excessive, they feel just as terrible as when hypo. Hyper is in no way preferable to hypo, and few want to be ramped up constantly. So the argument that we want excessive amounts of hormone as a substitute for Speed - because it "feels good" is invalid, and frankly, demeaning.
    The optimal treatment we want does not equate to overtreatment.

    The TSH test is minimally, at best, a screening tool for thyroid disease. It is not gospel and shouldn't be treated as such.

     
    Old 10-21-2009, 07:32 AM   #20
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    Re: What is the deal with TSH Testing?

    Per Othello's post,
    Quote:
    "There is no case (as in this one) of "natural" healthy balance where the TSH is below .01 and the T3/t4 levels are MAXED out"
    First of all, there are many, many of us who have extremely suppressed TSH while on proper hormone replacement. Yes, our pituitary isn't signalling the thyroid to function, but it is a moot point when we are getting our thyroid hormones elsewhere. Especially in the case of Hashi's when the goal is to suppress the thryoid completely to prevent the antibody attacks, which happen against a functioning thryoid.

    Secondly, when I go back and look at Shelly's labs I see:

    Quote:
    My T4 was 1.33 in a .71-1.85 range and my T3 was 3.87 in a 2.30-4.20 range unfortunately my tsh was .01
    These say that her T4 is at 54% of its range and her T3 is at 82% of range. These numbers are hardly "maxed out", in fact they are pretty good levels and if she is not experiencing hypo or hyper symptoms then these are the numbers that work for her. Many of us need our FT3 to be up at 100% of range to be free of the disabling hypo symptoms.

    Likening getting up to the level of thyroid hormones that are necessary for us to function normally in our lives to taking stimulants or enhancement drugs is not what we are talking about here. Healthy people can run in half marathons and if Finnmaid is able to do this then this means she is simply that-- healthy. To that I say Bravo!

    Last edited by javelina; 10-21-2009 at 07:36 AM. Reason: Sorry Midwest, it seems you and I reply at exactly the same times sometimes LOL!

     
    Old 10-21-2009, 08:35 AM   #21
    shelley1
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    Re: What is the deal with TSH Testing?

    Wow! Thanks for all the support. I want to add that my thyroid was radiated about 18 years ago, so it is non-existant. Thanks to all of you who really get what I'm trying to say. I'm not trying to be athlete of the decade just a normal person who should be able to feel good and have the energy to work out if I need to. I think we have come into an age where it is okay to question our health care. The medical community as a whole does not deal with well with the layperson questioning what it is and why it is they do what they do. I believe it's important that each individual question what is right for you, because we are not all the same. What works for one person may not work as well or at all for another. Thank you again, I'm just smiling inside and by the way I'm going to switch endocrinologist.

     
    Old 10-21-2009, 08:46 AM   #22
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    Re: What is the deal with TSH Testing?

    Quote:
    Originally Posted by shelley1 View Post
    by the way I'm going to switch endocrinologist.
    Good for you

     
    Old 12-22-2009, 11:24 AM   #23
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    Re: What is the deal with TSH Testing?

    Quote:
    Originally Posted by tigger67 View Post
    I had an endo who dosed my Synthroid based on TSH. She kept lowering it and lowering it until it got to 1, where she thought it should be. By that time, I felt so lousy I could barely lift my head off the couch.

    A low TSH can mean many things. It can be a pituitary dysfunction, adrenal fatigue, high cortisol, taking T3 meds. You need to find a doc who doses based on your symptoms as well as labs.
    This might be the information I've been looking for
    My TSH levels have been extremely low for years, but my t3 and t4 were fine. Most doctors would tell me I was hyperthyroid, and they would check my blood periodically, but with no treatment plan. I am going to an endo now, and through much blood testing, and sonograms of my thyroid, he diagnosed me with hashi. My thyroid had major damaged spots on the sonogram, which to me was upsetting, seeing how my own antibodies destroyed it. I asked him why I was told I had hyperthyroidism for years from other doctors, because of my extremely low TSH levels. Through all the testing he has done on my blood, and my symptoms, and my mutinoduler goiter, he says that it all boils down to my pituitary gland not sending the right signals for me to produce enough TSH. So he had an MRI done on the pit. gland, w/wo contrast. The findings were normal. I can't tolerate even the smallest of doses of Synthroid,( it makes me go to sleep, or just barely drag myself around all day.) So my endo checked my cortisol levels and saw that they were very low. He has scheduled me for further cortisol testing. Now to the point of my babbling: is it possible that my low TSH levels could be caused by adrenal fatigue, or a pituitary dysfunction, and is it a bad idea for me to take Synthroid with my already very low TSH levels?

     
    Old 12-22-2009, 02:13 PM   #24
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    Re: What is the deal with TSH Testing?

    Have you had your free T3 and free T4 tested? These give a much better read of the levels of thyroid hormone in your blood than total T3/T4 and TSH.
    If you have adrenal fatigue you may have normal levels of thyroid hormones but your adrenal function is so low that you won't have enough cortisol to move T3 into the cells where it needs to go. That's why you end up hypo despite normal looking labs and why you can't tolerate more thyroid meds. Often we also have low functioning thyroids or have Hashi's with accompanying AF and this is a double problem. You must treat AF before you can tolerate thyroid hormones or get any benefit from them because without adequate levels of cortisol your thyroid hormones will just pool in your blood and not go where they need to go.
    So get the FT3 and FT4 tested (and also get your ferrtin levels and vitamin D and B12 done, very often deficient as well) and to diagnose adrenal fatigue you must do saliva cortisol testing because a single serum cortisol level won't tell you much. The saliva tests check levels four times during the diurnal cycle and are much more sensitive.

     
    Old 12-23-2009, 10:43 PM   #25
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    Re: What is the deal with TSH Testing?

    Quote:
    Originally Posted by javelina View Post
    Have you had your free T3 and free T4 tested? These give a much better read of the levels of thyroid hormone in your blood than total T3/T4 and TSH.
    If you have adrenal fatigue you may have normal levels of thyroid hormones but your adrenal function is so low that you won't have enough cortisol to move T3 into the cells where it needs to go. That's why you end up hypo despite normal looking labs and why you can't tolerate more thyroid meds. Often we also have low functioning thyroids or have Hashi's with accompanying AF and this is a double problem. You must treat AF before you can tolerate thyroid hormones or get any benefit from them because without adequate levels of cortisol your thyroid hormones will just pool in your blood and not go where they need to go.
    So get the FT3 and FT4 tested (and also get your ferrtin levels and vitamin D and B12 done, very often deficient as well) and to diagnose adrenal fatigue you must do saliva cortisol testing because a single serum cortisol level won't tell you much. The saliva tests check levels four times during the diurnal cycle and are much more sensitive.
    I don't know if I've had FT3 & 4 tested, I'm sure I have, my endo is very thoughro....and yes my vit. D and b12 are also defiecient, I've been on rx supplements for that. I will have to ask about the Ft3 & 4 results.....I had no idea cortisol played the role it does, thank you for that info. Today I went to my endo and he drew blood as usual, then gave me a shot that he called adrenal stimulating hormone, "possibly a shot of adrenaline, I don't know". Then my blood pressure, heart rate, pulse were checked every 30 minutes, along with drawing my blood every 30 minutes. This went on from 4:30 to 5:30pm. I won't know the results until I go back next week. I don't know if a saliva test will be done or not. He did tell me that if I had an AF problem I would have to treat that with medication before going back to me thyroid problem. I suppose because, as you said, the thyroid meds will do know good if I don't treat the AF. Thank you so much for your reply, it really shed some light on my understanding of the whole AF, cortisol, thyroid, triangle.

     
    Old 12-28-2009, 12:26 PM   #26
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    Re: What is the deal with TSH Testing?

    Try Armour Thyroid!!! After 10 years of the synthetic junk... I finally did and I have now been on it for maybe 8 or 9 years..... a new life, positively a new life!!

    I can say enough good about it. I haven't been on a message board since starting Armour.... I am here today only because I can't get Armour... because the distributors aren't buying from the manufacturers because they can't get the volume deals they want because Forest is behind in production. Long story... but really try it, you have nothing to lose and everything to gain.

     
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