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Lab results question and sypmtoms


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Old 01-22-2010, 04:38 PM   #1
Reflection1121
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Unhappy Lab results question and sypmtoms

I have posted this on a couple of other boards, but after reading some of your all's responses to others I thought I would try here too.

I went to the doc at the end of Dec due to severe "brain fog", weight gain (40 pounds in about 6 months). He had me do a normal blood work up. I hadn't heard back but my brain fog was getting much worse and I also developed numbness/tingling in my face. I went back to the doc two days ago. He said that I was hypo and prescribed me levo 125mcg.

Since then the numbness is worse. My face, neck and arms. He said that it would take 6 to 8 weeks before I saw true improvement. He would retest then and if my hormone levels were normal and I still had symptoms he would move onto doing an MRI.

HOWEVER, I have been researching my lab results (maybe I shouldn't have) because now I am confused. My TSH is not high but on the lower end of normal and my FT4 is low.
TSH 1.58 (.5-5.0 range)
FT4 .58 (.61-
I am really concerned because I can barely function! Your opinions are greatly appreciated.

 
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Old 01-22-2010, 05:47 PM   #2
javelina
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Re: Lab results question and sypmtoms

Your TSH is not really low at all, it's actually a pretty lousy test for hypothyroidism because it's too variable and not a good indicator of thyroid function. Your FT4 is low and that indicates low hormone levels.

The thing about T4 therapy is that it does take a long time before any results are noticed. T4 is a slow acting hormone and must convert to T3 (the active hormone) before you will have any relief. Many prefer to go on hormone replacement that contains T3 because of this, as well as the fact that not everyone can convert T4 well and will need supplimental T3 to get well. Not all doctors agree with this and many refuse to prescribe T3, either in the form of desiccated thyroid hormones, or with synthetic T3 given in addition to T4. So you have to decide if you want to ask your doc for T3 or if you want to wait it out.

See about getting your free T3 and free T4 levels to help monitor your treatment. Again, TSH is not a test to be relied on for treatment monitoring because often it needs to be quite low, below range before we are optimal. We need to go more by symptom relief than just lab numbers. Also you need to make sure your vitamin D, B12 and ferritin levels are good for hormone replacement to be successful.

 
Old 01-22-2010, 06:43 PM   #3
Reflection1121
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Re: Lab results question and sypmtoms

Thank you Javelina. I do realize that the TSH was in the normal range. It was just below the 50% range of normal..thus I stated it was the low range of normal...sorry if I was in error. Still very new to this and just trying to get a sense.

Besides my symptoms. My concern was that since my TSH was not raised at all and my Free T4 was low is it really primary Hypothyroidism or secondary that doc should be considering. I didn't know if others had similar lab results and had it be primary.

I really really appreciate the info.

 
Old 01-22-2010, 06:46 PM   #4
Lugrita
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Re: Lab results question and sypmtoms

I had many of the same symptoms of brain fog (still do!) and have been dealing with off and on numbness and tingling in my face for a couple of years. I got to the point over the summer where I was driving (with my four kids!) on a street that I have driven on every week, sometimes every day, since I got my driver's license 18+ years ago, and I suddenly had no idea where I was, what town I was in, etc. The street looked wholly unfamiliar to me, and I usually know every single tree, flower, and building on that street by heart. But I was kind of lost for about a mile.

They did a brain MRI, and that came out clear. I have also had symptoms of TIA's and I did have evidence of that in a carotid artery scan (plaque build-up which points to TIA's, apparently), but I didn't have any other evidence that I was headed towards a stroke. I was just diagnosed yesterday with Hashimoto's, and I am highly suspecting that these other symptoms are related to Hashimoto's.

Word of advice: if you get a brain MRI and you have a PPO, it's reaaaallly expensive. I am still paying for mine. If you have an HMO or some other sort of good insurance, then it's not such an issue.

 
Old 01-22-2010, 06:58 PM   #5
Reflection1121
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Re: Lab results question and sypmtoms

Lugrita, I know exactly what you mean. I have found myself confused many times. Not to the extent of where I am at but mainly what I am doing or what I was going to say. Makes working very difficult. I run a business, but thankfully my employees know that I am having some "medical" issues and are really understanding and picking up where I can't.
But what does TIA stand for??? Sorry


I haven't had a brain mri before, but I have had mri's for other issues (had a severe foot injury) and I had a ppo then and I paid on it forever. Thankfully I have an HMO now and won't have to pay anything as long as I am not admitted to the hospital. Then I have a deductible but no copays...yeah...

 
Old 01-22-2010, 07:50 PM   #6
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Re: Lab results question and sypmtoms

A TIA is a transient ischemic attack. It's basically a mini-stroke in the way that it happens, but there isn't a blood clot to make it a true stroke. It can be a precursor to a real stroke, but I've had a few of them in the past several months and though I get superficial blood clots in my legs and feet, I don't have any evidence of true, life-threatening blood clots. And my clotting factors are all normal as well. I'm 35 but apparently my internal organs think that I'm much older. Oy. LOL!

I will suddenly have an issue with the vision going in one of my eyes, slurring speech, confusion, etc. along with tingling and such. The slurring speech and balance/coordination can last up to 24 hours sometimes, but not always. I'm definitely more prone to them when I am sleep deprived, but I have little ones so sleep deprivation goes along with my job description. ;-P

I'm glad that you have an HMO now. Our PPO is killing me but we're stuck with it due to pre-existing conditions (we pay for our own medical because the plan through my hubby's company is super-expensive). So in that case, run any tests that need to be run! LOL!

 
Old 01-22-2010, 09:01 PM   #7
javelina
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Re: Lab results question and sypmtoms

The testing you've had is not sufficient to point to secondary hypothyroidism. Again, TSH is a hugely inaccurate test for many reasons and there are many with primary hypo who have levels as low or lower than you. People with Hashimoto's often have very low TSH or TSH all over the board.

See about getting the antibody tests for Hashi's: TPO and TG. Hashimoto's is the most common cause of hypothyroidism in the US so it's very possible this is what is going on.

 
Old 01-22-2010, 09:13 PM   #8
Reflection1121
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Re: Lab results question and sypmtoms

Quote:
Originally Posted by javelina View Post
The testing you've had is not sufficient to point to secondary hypothyroidism. Again, TSH is a hugely inaccurate test for many reasons and there are many with primary hypo who have levels as low or lower than you. People with Hashimoto's often have very low TSH or TSH all over the board.

See about getting the antibody tests for Hashi's: TPO and TG. Hashimoto's is the most common cause of hypothyroidism in the US so it's very possible this is what is going on.
Thanks that is a relief. You read so much on the internet, but I always give real life exsamples more weight. I will alk to my doc about getting referred to an endo and get the rest of the tests.

 
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