I've been bad. :(

bathsheba_c

Hi everyone. I'll try to keep this simple. Doctor #1 did a blood panel, determined that I was borderline hypothyroid, and, given my family history, decided to put me on a supplement regimen. Before he could do a follow up panel, my insurance changed and I went to Doctor #2, who said that everything was normal (ha, right) and who cares. As a result, I dumped him and found Doctor #3, who wants me to do the follow up panel.

Here's my problem. I was so discouraged by Doctor #2 that I have been a very bad girl and not done any of the stuff I was supposed to do. I have some flexibility in scheduling the blood work, and obviously I'm going to go back on the vitamins now. How far out should I schedule the blood test to see if they're effective?

islandmonkey

It sounds like you're just on supplements and not on thyroid medication? What vitamins did they put you on? It's unlikely that just vitamins would bring you out of hypothyroid. Did they also test for antibodies to see if you have autoimmune thyroid disease?

Is Doctor #3 just testing your TSH? TSH is a pituitary hormone, not a thyroid one, so I would push to have your free T3 and free T4 tested as well.

The range for TSH is controversial; the top used to be 5.0 but 11 years ago was dropped down to 3.0. Many educated thyroid doctors argue that the max should be 2.5 or even 2.0. (as when the ranges were first established they included many hypothyroid people, which skewed what was considered "normal").

bathsheba_c

The panel included TSH, T4, and vitamin B12, plus two or three other things I can't remember off the top of my head (definitely not T3, though). The hormones were within the normal range, but just barely, with 5.0 as the upper limit. B12 levels were too low.

The doctor told me to take vitamin B12, vitamin D, and a kelp supplement. I don't have fatigue or trouble losing weight, but I do have a bunch of the other conditions that are more common in hypo people, such as menstrual issues. He also printed out a hypothyroidism diet guide for me to read an incorporate into my eating habits.

islandmonkey

The panel included TSH, T4, and vitamin B12, plus two or three other things I can't remember off the top of my head (definitely not T3, though). The hormones were within the normal range, but just barely, with 5.0 as the upper limit. B12 levels were too low.

The doctor told me to take vitamin B12, vitamin D, and a kelp supplement. I don't have fatigue or trouble losing weight, but I do have a bunch of the other conditions that are more common in hypo people, such as menstrual issues. He also printed out a hypothyroidism diet guide for me to read an incorporate into my eating habits.

I don't necessarily think it's bad to try supplements and others things first - I would just suggest getting semi-regular labs so you have a sense of whether it's working, and how well it's working. I would request free (not total) T3 and free T4, probably every 8 weeks or so. TSH is a pituitary hormone, not a thyroid one, so on its own isn't a very good measure of thyroid function.

Kelp (iodine): the building blocks for your T3 and T4 hormones
B12, iron (and ferritin, your iron stores), and selenium: all used in the process of converting the "storage" T4 into the "active" T3 hormone
Vit critical for the T3 hormone to be expressed at the cellular level

For each of these, especially Vit D, you want to be at optimal levels and not just "barely in normal range". Ex: minimum for Vit D is 30, optimal is 60-80.

Also, the upper limit for TSH is controversial, but in 2002 the recommendation was that the upper limit be 3.0, with many educated professionals arguing for 2.5 or even 2.0. If your TSH is at 4.5 I would consider that pretty hypo.

Final note: since you mentioned irregular menstrual cycles, just a note that hypothyroid is a common cause of miscarriage or infertility. I have no idea of your life plans but just an FYI in case there's any planned baby-making any time in the near future.

I hope the vitamins and diet routines work well for you!