New here and latest test results.

shadesofidaho

My latest test results, the only two he ran this time.
Component Standard Range Your Value
T4, FREE 0.78 - 2.19 NG/DL 0.63
Component Standard Range Your Value
TSH, 3RD GEN 0.47 - 4.68 uIU/ML <0.02

It again appears my TSH is low as usual for me but this time my T4 is below range.

Last test in January and again he never runs the same thing. I asked him to run the FULL panel and this is what I got.
T4, TOTAL THYROXINE 5.5 - 11.0 UG/DL 7.7
TSH, 3RD GEN 0.47 - 4.68 uIU/ML <0.02


This is Novembers test and ALL he ran.
Component Standard Range Your Value
T3, FREE 2.3 - 4.2 pg/mL 2.9

Again in the low range but to him as long as I fit in the numbers I am fine. AND he did not run the TSH.

I like this guy. He is very nice but nice does not do the right thing to control my thyroid. I am concerned to get the proper care. Do I try to educate a doctor? Thoughts any one.Any suggestions on what I could take to him to help educate him?

lindsey1979

Do you have Hashi's, Shadesofidaho? If so, this article may help explain the limitations of the tests for folks with Hashi's -- essentially, it's impossible to tell how much of your hormones are being blocked or rendered ineffective due to the antibodies/autoimmune response. So, your raw number may be 'within range' but you still feel terrible and experience hypo symptoms. I don't get relief from my symptoms until my T3 is in the upper third of the "normal" range. I still feel terrible and have many hypo symptoms if it's in the low-normal area.

The TSH being so low generally indicates hyper or overmedication (if you still have reasonable thyroid function), but I know it can be wonky with Hashi's as well.

http://www.thyroid-info.com/articles/woliner.htm

Try educating your doctor and start the discussion. If he's not open to such things, then it's probably time to find another doctor, unfortunately.

shadesofidaho

@Lindsey, thank you so much. this is exactly what I need to talk to my doc about. The last good Doc I had did exactly the same. He based it on how I felt. I am NOT one to just take medication to be taking it and I know upping thyroid does not automatically make you lose weight. BUT over all if you do not feel good and hurt because you are not on the right dose for you/me you do not stand a chance to lose weight eating in front of the TV. Not that I am doing that.

If I can get my printer to work I will print this off or send the link to my PCP this AM. hopefully he will have time to read it. In fact I will just send him the link. It was written by an MD. It is not just internet hype. I do not want to make enemies with this PCP; And he did let me choose to take the NP Thyroid verses the synthriod on my past experience with Armour.I am on the NP Thyroid 90MG. NP is like Armour.

Well I guess I will see what happens Wednesday. Doing the test on the link I am doing fairly well maybe a6 or 8 on the scale most things. Energy is better but I am sure some of that is the change in my diet eliminating carbs down to 20 or below daily. He lowered my dose last test/6 weeks ago by taking half a pill two days of the week so not by much but now my skin on my hands is starting to crack and split again. That all went away when I was on the higher dose. And maybe this skin thing /psoriasis ? is not related. I just want all of this to go away. I want to be normal again. So tired of fighting all of this. It is wearing me out. I do know I have never been tested for hashis. I might ask him to do so. IF he will.

lindsey1979

It is strange how some doctors are about withholding thyroid medication. I understand the desire to not overmedicate, but some hold onto them as if they were prone-to-additional pain meds rather than thyroid meds.

shadesofidaho

I just have so much stress in my life with hubby dealing with pancreas cancer. He is fine now. We find out his last CT scan results tomorrow afternoon. I think it has to have a little bit to do with some of my feeling depressed. I have a right to be depressed after 2 years of this. And do not get me wrong I am thrilled hubby is still with me but it is taking it's tole. But it is time to take care of me now that I have insurance.. I really am staying as active as possible. I have built amazing things all by myself. Fencing cat kennel remodel potting shed and all the work around here even snow removal shovel and plow.

I just hope this guy will listen to me. I do find it interesting the T4 is below normal after he lowered my dose slightly. I can live with this lowered dose. I am doing ok. The fatigue gets to me some times though. And I also have fatigue from the psoriasis when I am having a flair. It is part of the psoriasis. It is 9 PM here and I am ready for bed. Just a couple more chores and I am hitting that pillow. I go out like a light and I hate getting up at 8 AM. The worst time for me no matter how many hours I have slept at night. Takes me at least an hour to wake up. I do not let myself nap during the day even if I really want to.

And I do still have some pain but some of that is from my back and I have had for 45 years. It is not going away. He x-rayed my hands and I do have osteoarthritis. But I do NOT want to start on pain meds.

Thank you for your information and advice. I really appreciate it.

shadesofidaho

Weirdly interesting day with the doc about my thyroid and many other issues. First he said there is no point to test for Hashimitos because the treatment is the same if I have it or not.

He said my tests were crazy and did not make any sense. Numbers above. Then he said well maybe my TSH was so low because my T-3 was taking over right then and suppressing it. Then he said the T-4 was slightly low ,and back again to it does not make sense and trying to explain how TSH regulates the thyroid. And then I asked him what if my TSH was not working properly which we both know can happen.

He asked me how long I had been on thyroid meds and I said since 1982 and I have almost always had this low TSH but when the doctors would lower my dose all the symptoms would come back. Then I said maybe I need to see an endocrinologist. That was the end of the conversation.

He kept my dose as is. He can see I am so much better than I was when I first saw him in August. It is so obvious my skin is better and I feel better and losing weight I can move with out terrible pain.

NOW my problem is NP thyroid is not available. So for now I am onto Armour. The pharmacist said he will continue to try to get the NP. It is half the cost of Armour. So I am not sure this is all good or not. I hope so.

lindsey1979

First off, Total T4 is totally worthless -- that test from January was a complete waste. You want the FREE T4 and FREE T3 tests. To me, this shows that your doc doesn't know all that much about thyroid.

---

I think this is generally a rare pituitary (secondary) hypothyroidism -- see chart in article:
http://labtestsonline.org/understanding/analytes/t4/tab/test/

Or this could also be NTIS (Non-thyroidal Illness Syndrome) -- I think that's essentially the same thing as pituitary hypothyroidism. Kesser goes through possible manifestations and explains how it works in this 5 part article series:
http://chriskresser.com/low-t3-syndrome-i-its-not-about-the-thyroid

---

The pituitary (secondary) hypothyroidism makes sense for the extremely low TSH and and low T4.

So, if you have low T4, your pituitary is supposed to pump out more TSH to stimulate the thyroid to create more T4 that can be turned into the active T3. But if you have a bum pituitary, this can't happen -- the pituitary literally can't make more TSH.

So, you end up with low TSH and low T4 (and probably low T3) along with hypo symptoms -- which seems to be exactly what you have. I know there can be other manifestations and complications, but that seems to make sense to me.

If you're in the "normal" range for Free T4 and Free T3 but still experiencing hypo symptoms, I'd bet you have an autoimmune response that is blocking some of your hormones from being effective -- just like you see in Hashi's. So, your doctor should probably supplement to symptoms AND tests (not tests alone).

You may be like some Hashi's people like myself that don't get symptom alleviation until we're much higher up in the "normal" range. I don't see my hypo symptoms recede until I'm in the upper third of the "normal" range -- if I'm low-normal like where you are, I still have AWFUL hypo symptoms.
_________________________________

I'm not familiar with NP thyroid, but you may also want to look into Naturethroid. It's another natural dessicated thyroid option like Armor. There are other natural dessicated options out there besides Armour and NP thyroid (whatever that is) -- Naturethroid, Erfa, Thyroid-S, etc.

http://www.stopthethyroidmadness.com/armour-vs-other-brands/

shadesofidaho

@Lindsey, Thank you. I will watch read as soon as I am more awake. I am in my first wake up fog. Anxious to check all this out. I just HATE my early AM. I will let the pharmacist know about the Naturethroid. He said as long as it is like Armour I do not have to get a different script. I did get 30 of the Armour and it might be fine. I had not been on it for 20 years. I was just told it was not as god as it was back in the 80's.

More in a bit. Thank you

shadesofidaho

I am still working on taking all of this in. I need to catch up around here from being gone for two days. I am not ignoring this at all I just need time to read it slowly. It is so hard some times to get this all sorted in my thick brain.

I think my doctors point of view was not to worry about what is causing the low thyroid just give me meds to make me feel better. Well I am feeling better. Much better. I can live with this. Feeling like I should not complain. Maybe I need to accept I am no longer 30. Except I do still have symptoms I would rather have go away. I do not want to be totally bald. I would like my fingernails to quit splitting to the quick. Ouch. I would like to not have to deal with this brain fog. Maybe just the two years of hubby being sick adds to my issues. I have been working on de-stressing as much as possible.

Thanks Again!! I really appreciate the information.

lindsey1979

shadesofidaho wrote: »

I am still working on taking all of this in. I need to catch up around here from being gone for two days. I am not ignoring this at all I just need time to read it slowly. It is so hard some times to get this all sorted in my thick brain.

I think my doctors point of view was not to worry about what is causing the low thyroid just give me meds to make me feel better. Well I am feeling better. Much better. I can live with this. Feeling like I should not complain. Maybe I need to accept I am no longer 30. Except I do still have symptoms I would rather have go away. I do not want to be totally bald. I would like my fingernails to quit splitting to the quick. Ouch. I would like to not have to deal with this brain fog. Maybe just the two years of hubby being sick adds to my issues. I have been working on de-stressing as much as possible.

Thanks Again!! I really appreciate the information.

I think the treatment is likely the same -- thyroid supplementation -- I just wish your doctor would pay attention more to your symptoms (i.e. still hypo symptoms, give more meds) rather than befuddled by the tests. I hope that Chris Kresser article has more good info on treatment -- I'm not that familiar with the condition so can't offer much more at this point.

I hope you feel better soon!

allergictodiets

In Germany, if you have a non-autoimmune hypothyroidism you are treated with synthetic thyroid hormones + iodine, if you have Hashi's - just the thyroid hormones. You are also sometimes told to limit your intake of foods containing iodine.

shadesofidaho

I am still slogging along. My brain is mud and my eyes are wanting to slam shut the last two days. I am functioning by pure force alone. This is not like I felt a week ago. I was feeling great. I can hardly believe a reduction in dose 6 weeks ago from one 90 NP or Armour 7 days a week to 5 days a week and one half a dose Monday and Friday can make thing much difference? It might be the stress of hubbies test results and just the stress leading up to it. I feel like I could curl up and sleep for a week right now. I do not dare. I am using up the last of the NP thyroid before going over to the Armour. Not sure if there will be much of a change ,if any, Pharmacist said they are exactly the same stuff. I did not check to see how many of the NP I still have.

I will have to look up the foods containing iodine. I used to know them right off. It has been a long time since I worried about that.

Still working on the articles given. I had several things I had to take care of yesterday after being gone two days. Hopefully this afternoon after we get back from the dump I can do some more reading.

Thanks for the help.

chris