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  • Fluctuating Thyroid Numbers?

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    Old 02-28-2013, 10:09 AM   #1
    MemeK42
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    Fluctuating Thyroid Numbers?

    Hi everyone!

    I'm new here! I went to the doctors yesterday and she said that my thyroid tests showed a number of .38. She said that it has, in the past, showed such a number, but they retested it and it was .75. They are going to wait 2 weeks to re-test and see if I do have Hypothyroidism. Over the past several months, I have been feeling increasingly more fatigued and I have all of the classic symptoms. They seem to be getting worse each day. Does anyone know what a fluctuating number could mean? She said that it could mean a lab error, but how do we know which number IS the error - the .38 or the .75? My tests have shown .38 several times. I'm concerned that I'll be restested and my number will be up again and the issue won't be addressed. Does anyone have any experience with this?

    Thanks!

    ~Melissa

     
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    Old 03-01-2013, 08:40 AM   #2
    midwest1
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    Re: Fluctuating Thyroid Numbers?

    I am assuming the only thing they're testing is TSH and coming up with those levels. Does "TSH" sound familiar as the name of the test?

    TSH can fluctuate up to 3 full points in a 24-hour cycle... like, from .5 to 3.5 for example. Typical fluctuation probably wouldn't be as dramatic, but 1.5 to 2 points is probably common. Early morning levels are generally the highest of the day, and they gradually fall during the day until their lowest near sundown; so the timing of the blood draw for the TSH test matters and could alone could account for your changes.

    The bottom line is, testing TSH over and over and over - no matter how many times you do it - isn't going to tell you enough about your thyroid status to ever be able to tell what's happening. Insist on having at least your free T4 tested. If you can manage to argue for a free T3 test, that would be useful, too.

    Sounds like you may be thinking you have "classic symptoms" of hypothyroidism, but your TSH is leaning toward hypERthyroidism. You can't tell by symptoms alone. Push for more tests, because TSH isn't enough.
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    Last edited by midwest1; 03-02-2013 at 10:32 PM.

     
    Old 03-01-2013, 10:36 AM   #3
    MemeK42
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    Re: Fluctuating Thyroid Numbers?

    Thanks so much for your help! I will definitely ask to take the other tests. I don't think my doctor has ever done the free T4 or free T3. It's weird - I do feel like I have the symptoms of hypothyroid: extreme fatigue, serious heart palpitations, inability to lose weight with diet & exercise, low body temp, lethargic, hair falling out, pains in my joints, hands & feet, carpel-tunnel like symptoms, restless, anxious, difficulty concentrating, forgetful, lightheaded, etc. Could hypo & hyper have similar symptoms like this?? I really want to get this under control!

     
    Old 03-02-2013, 09:32 AM   #4
    midwest1
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    Re: Fluctuating Thyroid Numbers?

    There are various reasons why you can have borderline hyperT labs with symptoms of hypoT.

    One is early Hashimoto's thyroiditis, in which auto-antibodies are working to destroy thyroid gland tissue and function. The damage to the gland can produce spurts of excess stored hormone; TSH can appear low and hyper symptoms result. Then it can suddenly reverse, presenting with hypo labs and symptoms. TSH and free T4 might fluctuate wildly until the gland failure is more advanced. Testing for the antibodies which cause Hashi's - anti-TPO and anti-Tg - might reveal the condition. Testing negative for both antibodies, however, doesn't rule out Hashi's. The tests have a false-negative rate of up to 20%.

    Another cause (which I can't elaborate on, because I don't know enough about it) is adrenal dysfunction.

    Another cause might be failure to convert enough of the stored T4 your gland has manufactured into the active hormone, T3.

    A less usual possibility is that your thyroid gland is fine, but your pituitary gland isn't releasing enough TSH to stimulate your gland to make hormone. This is known as "secondary" hypothyroidism. This seems a distinct possibility in your case, and it needs to be investigated. In this scenario, TSH will be low-range or below and T4/T3 will also be low-range or below. The only way to know is to test free T4 and free T3... A perfect example of how unreliable a sole TSH test can be.

    A much less common possibility is hypothalamus dysfunction. I've never seen a case of that here in the 10 years I've been a member.

    Next time you go to be tested, assertively insist on tests for TSH, free T4, TPO and Tg antibodies. If you succeed getting those, push a bit harder for the free T3. (Until you get a diagnosis, though, free T3 might not be strictly necessary.)

    I'd be surprised if you didn't have some kind of thyroid disorder, so don't give up until you discover which it might be.
    Let us know what happens!
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    Last edited by midwest1; 03-02-2013 at 09:34 AM.

     
    Old 03-02-2013, 06:11 PM   #5
    mayfliesmayfly
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    Re: Fluctuating Thyroid Numbers?

    I remember reading somewhere that numbers are actually higher in the morning, not in the evening.

    When I was first getting tested, it was usually around 5pm, and was around 2.7-2.3. And then after I returned to the US, I started getting tested around 8am and have been 2.03, 2.98, and 3.09.

    My doctor won't treat me yet until I show another 3.09 (it was 3.15 in 2009).

    I've heard that colder weather will cause changes in number, as well. All of the 2's have been while I was in a tropical country, or shortly after my return. 2.98 and 3.09 have been one and two months since being home. Could my low numbers possibly be from the weather?

     
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    Old 03-02-2013, 10:29 PM   #6
    midwest1
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    Re: Fluctuating Thyroid Numbers?

    Quote:
    Originally Posted by mayfliesmayfly View Post
    I remember reading somewhere that numbers are actually higher in the morning, not in the evening.
    Thank you so much for posting this, Mayflies! You are correct. I'm not sure what I was thinking when I typed the opposite... I will edit my post to avoid confusion from my error.

    People living in cold winter areas often do need an increase to their thyroid med dosage, so having higher TSH in winter is a distinct possibility.
    And for what my 2 is worth, your doctor is being very stubbornly arbitrary when it comes to numbers. There's precious little difference between 2.98 and 3.09.
    __________________
    "We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses." Abraham Lincoln
    ~~~~~~~~~~~~~~~~~~~~~~~~

    Last edited by midwest1; 03-02-2013 at 10:33 PM.

     
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