Hypothyroidism question? (newly diagnosed)

Halziees

Hi all!

So, after feeling really unwell and running several labs, my doctor says it looks like I have hypo. But I am a bit confused with my labs. My doctor didn't explain too well (informed over the phone), so I am a little lost on what these numbers truly mean and was hoping someone could shed some light!

Here are my labs.

TSH 1.5 (range 0.24 - 4.20)
Free T4 0.77 (range .93 - 1.70)
Free T3 1.7 (range 2.2 - 4.0)

Anyone have numbers like these? How'd you feel? I have been sooooo lethargic, hair is quite brittle and split-endy, heart rate was mega low at 40 BPM (wish I conditioned it down that far with cardio but I don't think that is likely haha)… the way I described it to my doctor is that I feel like I am just trudging through the thickest mud every day. Limbs are heavy, everything takes effort to the extreme. I started on medication yesterday!

Nedra19455

Can you clarify your question a little? I am unsure what you're looking for with regard to understanding the numbers. The healthy range is given, and your low T4 and T3 numbers (or high tsh number, if you had one) are what tell your doc that you have Hypothyroidism.

The TSH level is for the hormone that stimulates your thyroid to produce Thyroid hormones. The fact that your TSH level is normal but your others are low is a sign that your body "thinks" it is making enough thyroid hormones, but it isn't.

My daughter has congenital hypothyroidism (much more serious in kids than adults -- she was diagnosed right away with newborn screening and has been treated since she was about 7 days old). For her, her TSH levels were extremely high and her T4 and T3 levels were about normal. This is a sign that her body thinks it needs more thyroid hormone and is demanding the thyroid to make more and more. Our endocrinologist described this as the pituitary gland "beating an exhausted horse." So without Levothyroxine, her thyroid would become more and more overworked.

So, in summary, your labs can flag for hypothyroidism if your TSH is high, or if your. T3 or T4 is low.

Glad you're on medication! I hope my response was helpful!

Halziees

Can you clarify your question a little? I am unsure what you're looking for with regard to understanding the numbers. The healthy range is given, and your low T4 and T3 numbers (or high tsh number, if you had one) are what tell your doc that you have Hypothyroidism.

The TSH level is for the hormone that stimulates your thyroid to produce Thyroid hormones. The fact that your TSH level is normal but your others are low is a sign that your body "thinks" it is making enough thyroid hormones, but it isn't.

My daughter has congenital hypothyroidism (much more serious in kids than adults -- she was diagnosed right away with newborn screening and has been treated since she was about 7 days old). For her, her TSH levels were extremely high and her T4 and T3 levels were about normal. This is a sign that her body thinks it needs more thyroid hormone and is demanding the thyroid to make more and more. Our endocrinologist described this as the pituitary gland "beating an exhausted horse." So without Levothyroxine, her thyroid would become more and more overworked.

So, in summary, your labs can flag for hypothyroidism if your TSH is high, or if your. T3 or T4 is low.

Glad you're on medication! I hope my response was helpful!

Thanks for the response! I am sorry to hear about your daughter, but glad that she has a good endocrinologist. I am still waiting to get in to see an endo… this was all through primary doc so far. But I do have an appointment next month (yay).

I guess my question is… is it REALLY hypo with a normal TSH? That's where my confusion came in. I am worried about taking these new pills if it's not really hypo… but I suppose I have to place some trust in the doctors (it's just hard sometimes).

My friend had mentioned that she thinks I caught it quite early, and that if left untreated for a few more months, my TSH would continue to rise (it's up since last month, and my Free T levels are lower since last month as well).

lindsey1979

Your Free T3 and Free T4 are more important than your TSH level. TSH is an indirect measurement, where Free T3 and Free T4 will be more direct as Free T3 is the actual usable form of the thyroid hormone. There are several conditions where your TSH level can be normal but you still have horrible hypo symptoms. You don't tend to get the high TSH levels for certain conditions until it's really advanced.

You can totally have a normal TSH and still be hypo -- I have that situation. I have Hashimoto's, which is an autoimmune thyroid condition (and also the most common). When you have Hashi's,, you have antibodies that bind up the Free T3 and Free T4. And there is no way to know how effective those free hormones are -- 20% could be inactive due to the antibody binding or 80% could be. So, most specialist go on symptoms. If you're feeling hypo, then that's a good indication. I don't feel good until my Free T3 and Free T4 are in the upper 1/3 of the normal range. If they're in the lower part of the "normal" range, I still have horrible hypo symptoms. My TSH levels have been all over the place -- sometimes high, but oftentimes in the "normal" range.

Halziees

Your Free T3 and Free T4 are more important than your TSH level. TSH is an indirect measurement, where Free T3 and Free T4 will be more direct as Free T3 is the actual usable form of the thyroid hormone. There are several conditions where your TSH level can be normal but you still have horrible hypo symptoms. You don't tend to get the high TSH levels for certain conditions until it's really advanced.

You can totally have a normal TSH and still be hypo -- I have that situation. I have Hashimoto's, which is an autoimmune thyroid condition (and also the most common). When you have Hashi's,, you have antibodies that bind up the Free T3 and Free T4. And there is no way to know how effective those free hormones are -- 20% could be inactive due to the antibody binding or 80% could be. So, most specialist go on symptoms. If you're feeling hypo, then that's a good indication. I don't feel good until my Free T3 and Free T4 are in the upper 1/3 of the normal range. If they're in the lower part of the "normal" range, I still have horrible hypo symptoms. My TSH levels have been all over the place -- sometimes high, but oftentimes in the "normal" range.

Thank you so much; this is exactly what I needed to hear/read. I was confused by the normal range TSH… but if you have the same situation, then I will rest assured that the medicine is right (for now anyway).

lindsey1979

Your Free T3 and Free T4 are more important than your TSH level. TSH is an indirect measurement, where Free T3 and Free T4 will be more direct as Free T3 is the actual usable form of the thyroid hormone. There are several conditions where your TSH level can be normal but you still have horrible hypo symptoms. You don't tend to get the high TSH levels for certain conditions until it's really advanced.

You can totally have a normal TSH and still be hypo -- I have that situation. I have Hashimoto's, which is an autoimmune thyroid condition (and also the most common). When you have Hashi's,, you have antibodies that bind up the Free T3 and Free T4. And there is no way to know how effective those free hormones are -- 20% could be inactive due to the antibody binding or 80% could be. So, most specialist go on symptoms. If you're feeling hypo, then that's a good indication. I don't feel good until my Free T3 and Free T4 are in the upper 1/3 of the normal range. If they're in the lower part of the "normal" range, I still have horrible hypo symptoms. My TSH levels have been all over the place -- sometimes high, but oftentimes in the "normal" range.

Thank you so much; this is exactly what I needed to hear/read. I was confused by the normal range TSH… but if you have the same situation, then I will rest assured that the medicine is right (for now anyway).

My doc doesn't track TSH for me anymore for the normal reasons. The only thing he looks for in regard to TSH is that some is being produced as that's a sign that you're not being overmedicated (when you still have some thyroid function like I do). Otherwise, he goes by (1) how I feel/symptoms and (2) my Free T3 and Free T4.

Sadly far too many docs just look to TSH levels and they miss a lot of people in earlier stages of thyroid disorders. As I mentioned, I first suspected things over 10 years ago and saw a few doctors in the interim. All told me that I was "fine" or "within range" despite my sporadic symptoms (with Hashi's, you fluctuate so can be normal, hypo or hyper at different times). It wasn't until I really started educating myself and biting the bullet to pay out-of-pocket for a specialist, that I finally got all the tests I needed done (before no one else had even checked for antibodies and only one checked for Free T3 and Free T4 -- and they were low then too). They just relied on the TSH, which was all over the place for me.

Also, stopthethyroidmadness.com is a great resource. And here is a good article on it: http://www.thyroid-info.com/articles/woliner.htm

AmmyP

bump

Halziees

Your Free T3 and Free T4 are more important than your TSH level. TSH is an indirect measurement, where Free T3 and Free T4 will be more direct as Free T3 is the actual usable form of the thyroid hormone. There are several conditions where your TSH level can be normal but you still have horrible hypo symptoms. You don't tend to get the high TSH levels for certain conditions until it's really advanced.

You can totally have a normal TSH and still be hypo -- I have that situation. I have Hashimoto's, which is an autoimmune thyroid condition (and also the most common). When you have Hashi's,, you have antibodies that bind up the Free T3 and Free T4. And there is no way to know how effective those free hormones are -- 20% could be inactive due to the antibody binding or 80% could be. So, most specialist go on symptoms. If you're feeling hypo, then that's a good indication. I don't feel good until my Free T3 and Free T4 are in the upper 1/3 of the normal range. If they're in the lower part of the "normal" range, I still have horrible hypo symptoms. My TSH levels have been all over the place -- sometimes high, but oftentimes in the "normal" range.

Thank you so much; this is exactly what I needed to hear/read. I was confused by the normal range TSH… but if you have the same situation, then I will rest assured that the medicine is right (for now anyway).

My doc doesn't track TSH for me anymore for the normal reasons. The only thing he looks for in regard to TSH is that some is being produced as that's a sign that you're not being overmedicated (when you still have some thyroid function like I do). Otherwise, he goes by (1) how I feel/symptoms and (2) my Free T3 and Free T4.

Sadly far too many docs just look to TSH levels and they miss a lot of people in earlier stages of thyroid disorders. As I mentioned, I first suspected things over 10 years ago and saw a few doctors in the interim. All told me that I was "fine" or "within range" despite my sporadic symptoms (with Hashi's, you fluctuate so can be normal, hypo or hyper at different times). It wasn't until I really started educating myself and biting the bullet to pay out-of-pocket for a specialist, that I finally got all the tests I needed done (before no one else had even checked for antibodies and only one checked for Free T3 and Free T4 -- and they were low then too). They just relied on the TSH, which was all over the place for me.

Also, stopthethyroidmadness.com is a great resource. And here is a good article on it: http://www.thyroid-info.com/articles/woliner.htm

Many, many thanks for your knowledge. You have completely calmed my mind!! I will go forth feeling much more confident now. I have a follow-up in a month, so with any luck things will just keep getting better. My mother is hypo-thyroid as well (and took forever to find her diagnosis), and our family history is chock full of auto immune, so this is not really a "surprise", per se. Though the diagnosis was still hard to receive.

One last question for you… do you find that you can eat as normal? My normal is healthy 98% of the time, with occasional steps off the path about 1x/month (a piece of cake, a few chips). Do I now need to cut out all not healthy/clean foods entirely?

Thank you!!

lindsey1979

Your Free T3 and Free T4 are more important than your TSH level. TSH is an indirect measurement, where Free T3 and Free T4 will be more direct as Free T3 is the actual usable form of the thyroid hormone. There are several conditions where your TSH level can be normal but you still have horrible hypo symptoms. You don't tend to get the high TSH levels for certain conditions until it's really advanced.

You can totally have a normal TSH and still be hypo -- I have that situation. I have Hashimoto's, which is an autoimmune thyroid condition (and also the most common). When you have Hashi's,, you have antibodies that bind up the Free T3 and Free T4. And there is no way to know how effective those free hormones are -- 20% could be inactive due to the antibody binding or 80% could be. So, most specialist go on symptoms. If you're feeling hypo, then that's a good indication. I don't feel good until my Free T3 and Free T4 are in the upper 1/3 of the normal range. If they're in the lower part of the "normal" range, I still have horrible hypo symptoms. My TSH levels have been all over the place -- sometimes high, but oftentimes in the "normal" range.

Thank you so much; this is exactly what I needed to hear/read. I was confused by the normal range TSH… but if you have the same situation, then I will rest assured that the medicine is right (for now anyway).

My doc doesn't track TSH for me anymore for the normal reasons. The only thing he looks for in regard to TSH is that some is being produced as that's a sign that you're not being overmedicated (when you still have some thyroid function like I do). Otherwise, he goes by (1) how I feel/symptoms and (2) my Free T3 and Free T4.

Sadly far too many docs just look to TSH levels and they miss a lot of people in earlier stages of thyroid disorders. As I mentioned, I first suspected things over 10 years ago and saw a few doctors in the interim. All told me that I was "fine" or "within range" despite my sporadic symptoms (with Hashi's, you fluctuate so can be normal, hypo or hyper at different times). It wasn't until I really started educating myself and biting the bullet to pay out-of-pocket for a specialist, that I finally got all the tests I needed done (before no one else had even checked for antibodies and only one checked for Free T3 and Free T4 -- and they were low then too). They just relied on the TSH, which was all over the place for me.

Also, stopthethyroidmadness.com is a great resource. And here is a good article on it: http://www.thyroid-info.com/articles/woliner.htm

Many, many thanks for your knowledge. You have completely calmed my mind!! I will go forth feeling much more confident now. I have a follow-up in a month, so with any luck things will just keep getting better. My mother is hypo-thyroid as well (and took forever to find her diagnosis), and our family history is chock full of auto immune, so this is not really a "surprise", per se. Though the diagnosis was still hard to receive.

One last question for you… do you find that you can eat as normal? My normal is healthy 98% of the time, with occasional steps off the path about 1x/month (a piece of cake, a few chips). Do I now need to cut out all not healthy/clean foods entirely?

Thank you!!

I think the diet really varies on individual. I eat a Primal diet, which is a more permissive version of Paleo where you aim for 80/20 compliance (though most of the time, I'm more 95/5) and includes dairy if you tolerate it well (which I do, but stick to full fat versions -- butter, cream, cheese, full fat yogurt, etc.). I've read that gluten, lactose, casein and lechtins are triggers for many autoimmune disorders. I find that to be true for me for gluten, but don't notice it with either lactose of casein (primarily in dairy). I don't eat a lot of legumes bc I just don't like them so don't know about lechtins. Some also have trouble with night shades but I seem okay with them.

I'd recommend eliminating these common culprits and see if you feel better, them try adding them back in later. That's how I discovered I was fine with dairy but terrible with grains/gluten. Then adjust as necessary. I eat non Primal stuff from
time to time but it's pretty rare. I find that I've been able to find a lot of alternatives that work just as well if not better -- like spaghetti squash instead if pasta.

I'd also make sure your doc checks for related issues, like common vitamin deficiencies (D, magnesium, iodine, iron/ferritin), adrenal issues (DHEA, cortisol, etc.), liver, glucose metabolism (fasting glucose, insulin, A1C, etc.). My doc found a couple of these and I was shocked by some -- like I had insulin resistance at pre-diabetic levels (and was only 30-40 lbs overweight). He told me that a lot of issues like that can arise with a long untreated thyroid issue and if you don't get them all sorted out, you can still feel not that great or struggle with weight loss,

Good luck! And feel free to friend or PM me.