Hypothyroidism Support Group
Hypothyroidism is the disease state caused by insufficient production of thyrohormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. Advanced hypothyroidism may cause severe complications, the most serious one of which is...
I've been suspicious of an on and off Thyroid issue for years now.
I was diagnosed with Rhuematoid arthritis in 2007 and I am now on a treatment plan that is working for me (can't blame all my symptoms on the RA anymore).
I still have unresolved extreme fatigue and several other hypo and hyper symptoms (not necesarily at the same time of course), with the second most irritating symptom being COLD - freezing all the time - low body temp. I've been charting my temp for about a month now and its all over map but consistently between 35C & 36.2C which is quite low.
I asked my doctor to test my thyroid but all he ordered was TSH, I went backed and asked for T4 but it was normal. I guess this make me a "subclinical" case.
Dec 16/11: TSH - H 6.27 (0.30 - 5.50 mU/L
Jan 3/12: FT4 - 14 (11 - 22 pmol)
The more I read about autoimmune hypothyroidism the more I think I should definately have further testing done to rule out Hashimotos.
I have an ultrasound on Tuesday to check out my thyroid - but its not swollen right now so I doubt they will find anything. I have had issues with sore throat and difficulty swallowing within the last year - just not right now - go figure.
I asume I should ask for a complete thyroid panel on one blood sample - TSH, T4 and T3 then the antibody tests TPO and the other one I can't remember right now.
Should I also request my cortisol level be checked? I've read a little about adrenal fatigue? but I don't really understand it.
I'm also not sure how my RA and its medications my affect these test results. I'm on Enbrel, Leflunomide, Ultram 50mg at night, occasional course of prednisone, occasional NSAID.
Advice and suggestions.... my GP doesn't seem to up to date and I want to be prepared for my next appointment.
Cheers,
Lynne
I was diagnosed with Rhuematoid arthritis in 2007 and I am now on a treatment plan that is working for me (can't blame all my symptoms on the RA anymore).
I still have unresolved extreme fatigue and several other hypo and hyper symptoms (not necesarily at the same time of course), with the second most irritating symptom being COLD - freezing all the time - low body temp. I've been charting my temp for about a month now and its all over map but consistently between 35C & 36.2C which is quite low.
I asked my doctor to test my thyroid but all he ordered was TSH, I went backed and asked for T4 but it was normal. I guess this make me a "subclinical" case.
Dec 16/11: TSH - H 6.27 (0.30 - 5.50 mU/L
Jan 3/12: FT4 - 14 (11 - 22 pmol)
The more I read about autoimmune hypothyroidism the more I think I should definately have further testing done to rule out Hashimotos.
I have an ultrasound on Tuesday to check out my thyroid - but its not swollen right now so I doubt they will find anything. I have had issues with sore throat and difficulty swallowing within the last year - just not right now - go figure.
I asume I should ask for a complete thyroid panel on one blood sample - TSH, T4 and T3 then the antibody tests TPO and the other one I can't remember right now.
Should I also request my cortisol level be checked? I've read a little about adrenal fatigue? but I don't really understand it.
I'm also not sure how my RA and its medications my affect these test results. I'm on Enbrel, Leflunomide, Ultram 50mg at night, occasional course of prednisone, occasional NSAID.
Advice and suggestions.... my GP doesn't seem to up to date and I want to be prepared for my next appointment.
Cheers,
Lynne
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My 6mo twin DD's are EBF and just started rice cereal on the first. Everything has been going fine except this morning one of them had a diaper rash (lots of redness around her anus). I read this as one of the signs of an allergy. BUT I did just buy a different brand diaper yesterday (which they have used randomly before w/no issues). Do you think its the cereal or the diaper? Im ready to start...
Here are some essentials:
Free T4
Free T3
TSH
Vitamin D
Vitamin B12
Iron and Ferritin
If you do have a thyroid problem, then you can order the blood test that tests for Hashimoto's (which measures if you have anti-bodies that have attacked the thyroid).
Some thyroid panels are incomplete but make sure, if this is true for the panel you order, that you include the free t3 and free t4. (as opposed to a panel that has only TSH, Free T4 and total T3 for example. i.e., in this case, you'd have to order a separate free T3.).
In looking at the labs you already posted, I can tell you that, without a doubt, you don't have subclinical hypothyroidism - you *have* hypothyroidism.
Any doctor that knows anything about thyroid function knows that TSH greater than 2 is suspect for hypothyroidism.
Since TSH is a pituitary hormone, a thyroid-savvy doctor knows to look at the actual thyroid hormone levels - FreeT4 (FT4) and FreeT3 (FT3) to judge thyroid status.
That same thyroid-savvy doctor knows that each of us has his/her own optimal FT4/FT3 levels within the ranges of normal.
And, this same doctor knows that most healthy people have FT4/FT3 levels in the upper half/upper third of the range.
That said, your TSH glaringly indicates hypothyroidism and your below-mid-range FT4 confirms it.
Based upon your lab's ranges, a healthy person would have FT4 above 17 and most likely closer to 20 so, you can see just how low your result is.
Your GP needs to read some thyroid textbooks and he/she will realize that you are hypothyroid and should be started on treatment.
You might want to review the symptoms list on the following link and prepare your own list to share with your doctor:
http://www.hypothyroidismrevolution.com/hypothyroidism-symptoms/
Best of luck to you moving forward!
The antibodies most commonly seen in Hashi's are the TPO you mentioned and also TGab (thyroglobulin antibody).
Since you mention hyper symptoms, I suggest you get checked for TSI (thyroid stimulating immunoglobulin).
Now, the last I heard, the TSI test wasn't available in Canada. The alternate test that would be acceptable is called TRab (TSH receptor antibody).
Hashi's is the most common cause of hypothyroidism and it's not uncommon for people to test negative for the antibodies. Biopsy is truly the only definitive way to diagnose Hashi's.
Your doctor is lacking in the clinical skills to diagnose you - sorry.
I hope you can convince him/her to start you on some Eltroxin "just to see if you feel better".
I'm on 150 mcg now from 25 mcg years ago. I really needed to know what vitamins help the thyroid I never knew that Vitamin D and B12 would have any affect on the thyroid hormones. I just got a great lesson from you, thanks so much!
I also agree with everything you said about what the levels ought to be. When mine was first flagged, it was 7.5, this last time it was 12. My weight is terrible, I want to lose it but the dang hormones don't seem to be enough. Know I know what to try. Thank you SO much. You are very big asset to the group and I'm so glad I found you all. Big hugs,
Rosey
The canadian lab that did my test said "normal range" for TSH was
(0.30 - 5.50 mU/L) - so the 2 CD mentions is within the lab's normal range.
I looked up some Canadian guidelines from Health Canada (recomendations to GP's) and they stated that between 5.6 and 10 mU/L is above normal but not necessarily indicated of a problem that needs treatment. They said to get a FT4 and if its "normal" then treatment is likely not necessary - its why I asked for a FT4. Great to know the Canadian Governement is giving out such great advice to doctors.... EYE ROLL!
I'm thinking I need to find a new doctor to help diagnose this and treat it properly. I even mentioned the result to my Rheumy and he said the same thing.... that result 6.27 "doesn't mean there is a problem".....?
Guess that's why its always best to be your own advocate and be informed. Anybody here know of a Thyroid-Savy doctor in Vancouver, BC or surrounding area? I'm actually in Surrey.
I know I have low vit D - have had it tested every 6 months, due for another test soon. Supplementing doesn't seem to bring it up and that may have more to do with the Autoimmune disease I already have - RA.
Oct/2010Vitamin D, 25-Hydroxy 58 nmol/L (normal 75-199)
June/2011Vitamin D, 25-Hydroxy 55 nmol/L (normal 75-199)
I was supplementing 4,000 IU per day and my Vit-D went down.
My doc tested for Iron & Ferritin a couple of years ago... don't remember the specific results. He did put me on some iron pills then sent me for the test the next day (checking absorption I guess)... I took the pills for a week. He said the result normal nothing to worry about.
PS - the head radiologist consulted on my Ultrasound. The first tech thought she saw something. The head guy said no - just a small nodule in my left lobe -common. I don't think it was enlarged as I suspected. I'll have to get the final results from my Doc.
Thanks again!