test results

[Guest guest]

On Fri, 15 Oct 2010 18:10:55 +0100 (BST), you wrote:

>Any advice would be very much appreciated.

Based on that FT4 and TSH you are a bit on the hypo side of things.

Some daily average temperatures together with pulse readings would

give a better idea of what is happening at a cellular level though

than the levels of TSH (which tells the thyroid what to do) and T4

which is an inactive storage hormone.

FT3 would give some indication if you are converting the T4 into

anything potentially useful, a Reverse T3 (RT3) test might also be

beneficial, if you have had hyper episodes then the excess T4 may well

have converted to RT3 and blocked the T3 receptors.

without useful labs (and there is a trend that labs will do a FT3 if

the paperwork is marked " hyper " ) then temperatures and pulse will tell

us the most

http://thyroid-rt3.com/temperat.htm

talks about that

Nick

[Guest guest]

Hi Lorna, If you thyroid isn't working properly then there are ongoing repercussions with the rest of the endocrine system. I was just hypo, and the T4 wasn't ,this caused 2 months between periods which were long and very heavy when they came. It got so bad that I ended up with a hysterectomy- which was one way, albeit drastic of ending that problem. however I have heard that this can improve one the thyroid is properly treated/supplemented- which can be a very bumpy ride. You results show that the Graves is still active due to the high antibody levels ( should be absent or VERY low) and a TSh of 2 is too high with a midrange FT4 it's not that brilliant. Pity as always there is no FT3 result as that would show wether you can convert or not. Next time doc should write' hyper' or 'Graves patient' or similar as this will often trigger lab to actually do the test. Probably carbimazole should be adjusted as you sound very hypo to me. block and replace is one way to go- you won't know unless you try. thyroid treatment From: brown249@...Date: Fri, 15 Oct 2010 18:10:55 +0100Subject: Test Results

Hi,

I have found this site a valuable source of support in my darkest hour.

After taking advice from Sheila (thank you Shelia), I changed my doctor. Armed with a letter explaining why I wanted certain tests carried out which I specifically requested to be left in my medical notes. I talked positively about the benefits to my health if we work collaboratively to get my symptoms under control. Consequently, the new GP agreed to carry out a full thyroid profile, with vit D, B12, Ferritin, Folate, however could not guarantee that the lab will test my Ft3, magnesium, copper or zinc. It is a start none the less.

My last blood results in 2009 are:

Thyroid Paroxidase 792

T4 15.6 (9 -25)

TSH 2 (0.3 - 5.5)

Thyroid Paroxidase 513

There were no reference ranges for the thyroid antibodies, doctor turned the computer screen to show me.

I attended an emergency gyaenological appt this morning due to excessive unexplained blood loss which has been getting progressively worse. More recently, my period stopped for 6 months and started again on the 28th September. Last year it stopped for 7 months. I wont go into the details of my interactions with my old GP over this matter but I have since changed doctors. Could the ongoing bleeding be due to the excessive doses of carbimazole prescribed to treat Graves? To be honest my health has never been the same since going along with the recommendations made by a certain professor at Kings. The nu

Any advice would be very much appreciated.

Thanks in advance

Lorna

[Guest guest]

Go to our FILES section accessible from the Home page Menu of

this forum web site. Scroll down to the FOLDER entitled 'NHS Information for

Patients' and open that. Then click on 'First visit to Endocrinologist' and

read the information there. Your free T3 and TSH result shows that you are

hyPERthyroid, not hypothyroid, even though you have symptoms of hypothyroidism.

Luv - Sheila

After an emergency visit to a gynae dept, I have been given some test results

for my thyroid. It is not a full thyroid profile but sufficient for the doctor

I saw to recommend re-referral to an Endo Clinic.

The results are:- FT3 20.7 (12 -22)

TSH < 0.01 (0.24 - 4.2)

I take Lugols iodine 5 drops each morning, together with selenuium, magnesium,

vit C, Neals Yard beauty Oil containing flaxeed, avocado, hemp oil. I have been

experiencing hypo symptoms, tiredness, brain fog, some weight gain, joint pain

etc. Is there anything else I am missing and how can I prepare for my appt. at

the Endo Clinic.

Thanks in advance for any advice.

Lorna

No virus found in this message.

Checked by AVG - www.avg.com

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[Guest guest]

Hi Lorna,

Yes definitely heading hyper again, I know you want to avoid carb and you're

still not over the range yet (just) so what you could do before seeing endo is

to

go see your GP and ask for some beta blockers.

They'll help with symptoms and they slow down the conversion of T4 to T3 so

just might get your levels down a bit before you see endo.

Great to have you here though sorry about the Graves. You've stopped the iodine

I take it, avoid goitrogonic (sp?) food as well.

Love Tess

>

> Hi Lorna

>

>

>

[Guest guest]

Hi,Not sure about why you would stop iodine, this is fron Dr P's speech, which is in the files under Iodine,"......In fact, I'm sorry to say, that radioactive iodine is a favourite course of treatment for anybody with an overactive thyroid, and this is, I've said elsewhere, a terrible, terrible, thing to happen. And most of you, given sufficient iodine, even with an over-active thyroid, may actually avoid the attentions of the surgeons or the physicians with their radioactivity........."He says that Iodine is used in other tissues too and should be taken with both under and over active thyroid.".....Iodized salt is actually widely used throughout the world, and even a small amount of what's called Lugol's Iodine, which is a mixture of iodine and potassium iodide, was found in the years before the war to reduce goitre and hypothyroidism quite remarkably, and that large amounts could be used to suppress over-activity, and was used to shrink the over-active goitre....." xx You've stopped the iodine> I take it, avoid goitrogonic (sp?) food as well.>

[Guest guest]

Hi,

Iodine can be a trigger for Graves disease, I'll leave a link, there's loads of

controversy on this one but the fact Lorna was/is taking iodine and the Graves

is

flaring up again can't be a coincidence.

The other one mentioned by Dr P in your post though, pottasium iodine, I had

that

through a drip when I went into thyroid storm.

http://www.suite101.com/article.cfm/graves_disease/71571

" How Iodine Contributes to Graves' Disease

Iodine is a well-known trigger of autoimmune thyroid disease. As long ago as

1956, Switzerland's Dr. H. C. A. Vogel explained that the introduction of

supplemental iodine to iodine-deficient regions caused a considerable rise in

the incidence of Graves' disease. According to Vogel, in Switzerland, once known

for its high incidence of iodine deficiency, Graves' disease was once unheard

of. Vogel noticed many patients troubled by palpitations shortly after iodine

was introduced. While the incidence of hypothyroidism caused by iodine

deficiency markedly declined, the incidence of hyperthyroidism escalated. Vogel

explains that it's the unnatural formulation of supplemental iodine that causes

the problem.

Recent studies by Dr. Rose of s Hopkins University confirm that

iodine does indeed cause autoimmune hyperthyroidism in genetically susceptible

individuals. Although few patients are ever tested for these antibodies, a

significant number of GD patients have antibodies to the iodide symporter

mechanism which regulates iodine uptake. Alterations caused by these antibodies

may be responsible for the sensitivity of GD patients to iodine. Iodine also

triggers thyroid antibody production since thyroid hormone contains

approximately 67% iodine.

While most physicians now warn their hyperthyroid patients to avoid iodine, many

hidden sources of iodine make this a near impossible feat. Besides iodized salt,

iodine is present in many medicines, such as the heart medicine amiodarone.

Furthermore, iodine is a component of most multi-vitamin and mineral

preparations. Iodine is used in the care and feeding of animals, as a

stabilizer, and/or safety element in food processing, and it is a component of

food dyes. The richest sources of iodine include kelp, seaweed, iodized salt,

dairy products, fish, processed meats, pudding mixes, candies, frozen dinners,

" fast " food and foods containing artificial colorings. "

Another couple of links http://graves.medshelf.org/Self_Help

http://www.suite101.com/content/graves-disease--foods-to-avoid-a298832

>

> Hi,

>

> Not sure about why you would stop iodine, this is fron Dr P's speech,

> which is in the files under Iodine,

>

>

> >

>

[Guest guest]

Hi Lorna, Are you sure that result is FT3- the range looks like FT4. If that is the case then these results look fine, but then the really important FT3 has not been done- to show if you are converting T4 to T3. The range for T3 is usually around 3.5 to 7.0 > thyroid treatment > From: brown249@...> Date: Thu, 28 Oct 2010 14:09:27 +0000> Subject: Test Results> > Hi,> > After an emergency visit to a gynae dept, I have been given some test results for my thyroid. It is not a full thyroid profile but sufficient for the doctor I saw to recommend re-referral to an Endo Clinic.> > The results are:- FT3 20.7 (12 -22)> TSH < 0.01 (0.24 - 4.2)> I take Lugols iodine 5 drops each morning, together with selenuium, magnesium, vit C, Neals Yard beauty Oil containing flaxeed, avocado, hemp oil. I have been experiencing hypo symptoms, tiredness, brain fog, some weight gain, joint pain etc. Is there anything else I am missing and how can I prepare for my appt. at the Endo Clinic.> > Thanks in advance for any advice.> > Lorna> > > > ------------------------------------> > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> >

[Guest guest]

An antibody result of '10' is nothing to worry about, so put

that concern to rest. however, you do have a problem with your cortisol output.

All of your results throughout the day are below the bottom of the reference

range apart from the fourth sample, and at night, that is where your cortisol

secretion should be because it needs to be low to help you sleep through the night.

I would ask your GP, to be on the safe side, whether he will refer you for a

short synacthen test to make sure you are not on the verge of suffering with

's disease. What time exactly did they take your blood for the cortisol

blood test?

Dr Peatfield will want you to start taking adrenal supplements

for sure.

Luv - Sheila

I was wondering if you could shed any light on these - I have my results back

from Genova for my adrenal stress index this was before i started Dr P's

treatment programme.

cortisol levels:

sample 1 : 10.9 (12-22)

SAMPLE 2: 4.1 (5-9)

SAMPLE 3: 1.5 (3-7)

Sample 4: 1.5 (1-3)

DHEA levels:

Sample 1: 0.22 (0.40 - 1.47)

sample 2: 1.19 (2.0 - 6.0)

[Guest guest]

" All of your results throughout the day are below the bottom of the reference

range apart from the fourth sample, and at night, that is where your cortisol

secretion should be because it needs to be low to help you sleep through the

night. I would ask your GP, to be on the safe side, whether he will refer you

for a short synacthen test to make sure you are not on the verge of suffering

with 's disease. What time exactly did they take your blood for the

cortisol blood test? "

Thanks for the quick repsonse Sheila, it was a 9am serum cortisol level test -

though i think it was more like 8am that i had it in the end as I had the first

appointment of the day. it came up as 727nmol/L (250 -700).

I think the doctors have tired of me being 'tired all the time' but i will

definitely ask for the test x

[Guest guest]

,

The new results are moving nearer to normal because you have been taking

thyroxine.... Usually though people on meds have a tsh of less than 1 and T4

towards the top of the range, or slightly over it.

If you stop the meds, your results will go back to what they were, or

worse...... If you do have auto immune hypothyroidism (Hashimotos) then

you will need meds forever, along with about 2% of the rest of the population.

Raised cholesterol is a symptom of hypothyroidism and used to be one way that

doctors could confirm the presence of Hypo.

Contrary to stopping the meds, I would be asking for an increase... 25 mcg is a

baby dose.

> TSH 1.4

> T4 12.0

> T3 4.35

> Are the results OK and do I need to carry on with the Levo?

>(

[Guest guest]

Hi Tina, your latest results show that the levothyroxine is starting

to work, but just because your results look 'normal' doesn't mean that any

doctor can stop you taking any more. Rather, your levothyroxine dose needs

increasing to 50mcgs (25mcgs is for people with heart problems or the very young

and does very little). The average dose for people with the symptoms of

hypothyroidism is around 125mcgs to 150mcgs for women and this is reached by

gradually increasing by 25mcgs every 6 to 8 weeks.

You should be taking zinc 15mgs plus 200mcgs Selenium to help

convert the mainly inactive thyroxine to the active thyroid hormone T3. It is

T3 your body needs, not T4. Tell your GP that you are still tired and that you

feel you would benefit by having an increase. Ask also for him to test your

levels of ferritin, vitamin B12, vitamin D3, magnesium, folate, copper and zinc

as it is well known these go along with hypothyroid symptoms and if any are

low, the thyroid hormone can't be properly utilised at cellular level until

whatever is low has been properly supplemented.

Luv - Sheila

TSH 3.1 (0.35-4.94)

T4 11.0 (9-19.1)

T3 3.91 (3.6-6.5)

He agreed to give me a trial dose of 25mg levo as I felt so awful and I have 2

sisters who are Hypo and my mother was. Repeat bloods in 6 weeks, which I've

done. Called in for results to-day, receptionist says all normal, so I asked

for the numbers

TSH 1.4

T4 12.0

T3 4.35

Are the results OK and do I need to carry on with the Levo?

Heard the locum I saw is there tomorrow so hoping to see him, as I'm worried my

GP will take me off treatment and I will be back to square one!

Still tried, but my mood is lighter and I'm no longer constipated

[Guest guest]

>

> Hi Tina, your latest results show that the levothyroxine is starting to

> work, but just because your results look 'normal' doesn't mean that any

> doctor can stop you taking any more. Rather, your levothyroxine dose needs

> increasing to 50mcgs (25mcgs is for people with heart problems or the very

> young and does very little). The average dose for people with the symptoms

> of hypothyroidism is around 125mcgs to 150mcgs for women and this is reached

> by gradually increasing by 25mcgs every 6 to 8 weeks.

>

> Luv - Sheila

>

Hope I've cropped reply right

Saw the locum gp again, he was very nice, asked how I was feeling and what

symptoms had got better, if any. He said he had the dilemma of T4 being in range

but, still on the low side. Never the less he has upped the dose to 50mcgs and

I'm to go for bloods again in 2 months. He said then he, or whoever I see (I

will try and make sure it's him!) will decided whether to put it on repeat

prescription or not.

He didn't want to test the things you mentioned Sheila and I didn't push it as

I'd got myself all stressed out while in the waiting room, thinking he would

stop meds.

I started taking selenium months ago and Q10 (120mg), will start on zinc.

Another question -sorry.

Does it matter that the brand of levothyroxine is different from the last lot?

It was goldshield and now it's almus

Thanks

Tina

[Guest guest]

Yes, it does

matter. Many people are very sensitive to the different brands of

levothyroxine. Unless your GP specifies a particular brand on the prescription,

the pharmacist will give you whatever brand he has in. Whatever is written on

the prescription, the pharmacist has to prescribe. The brand most people talk

about as being the best is apparently Eltroxin.

Luv - Sheila

Another question -sorry.

Does it matter that the brand of levothyroxine is different from the last lot?

It was goldshield and now it's almus

Thanks

Tina

[Guest guest]

Hi Sheila

I believe that Genova have sent my reverse T3 results to you? Anway, I

have a copy and it reads 32.8 Ref range 9.0-35ong/dl There is nothing

more on the sheet than that so I have no idea as to what these results

mean. Please will you advise.

Cheers

Love

Audrey

[Guest guest]

Hello Audrey, the results are not sent to me by Genova, they are

sent direct to the patient - and that is what you have got. Your test result of

32.8 is within the reference range for Reverse T3.

Luv - Sheila

I believe that Genova have sent my reverse T3 results to you? Anway, I

have a copy and it reads 32.8 Ref range 9.0-35ong/dl There is nothing

more on the sheet than that so I have no idea as to what these results

mean. Please will you advise.

,___

[Guest guest]

Hi Audrey,

The important thing with reverse T3 is to see if the ratio between reverse t3

and t3 is ok. It should be over 20. If it's lower than there is a problem.

The results I have for you are that your reverse T3 is 32.8 ong/dl and T3 is

8.5 pmol/L. I don't know how to work out the ratio from these two figures

as they use different measuring systems...... it's been explained but I just

don't get it.....

Does anyone know what they're doing with the working out of the RT3 ratio

please?

XX

[Guest guest]

Hi, I would have thought Nick on the RT3 forum would be the best person to ask about this. > thyroid treatment > From: galathea@...> Date: Sat, 19 Feb 2011 11:41:57 +0000> Subject: Re: Test results> > Hi Audrey,> > The important thing with reverse T3 is to see if the ratio between reverse t3 and t3 is ok. It should be over 20. If it's lower than there is a problem. The results I have for you are that your reverse T3 is 32.8 ong/dl and T3 is 8.5 pmol/L. I don't know how to work out the ratio from these two figures as they use different measuring systems...... it's been explained but I just don't get it.....> > Does anyone know what they're doing with the working out of the RT3 ratio please?> > XX> > > > > > ------------------------------------> > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> >

[Guest guest]

Thyroid autoantibodies HI 495.4 iu/mL range (0.0 -5.0 U)Serum free T4 level 12.4 pmol/L range ( 9.2 - 24.5 U )Serum TSH level HI 7.66 mu/L range (0.20 - 4.50 U )Above were 30/09/2010Latest blood results on 02/01/2011 ;Serum TSH level 2.42 mu/L range (0.20 - 4.50 )Hello ,

The above results from September 2010 show that you suffer from Hashimoto's disease. Your TSH (thyroid stimulating hormone) is elevated above the ref range, which diagnoses you as hypothyroid anyway and your FT4 is low. In addition you have a positive count of thyroid auto-antibodies (are they TPO or TgAB btw ?) – a positive count of thyroid auto-antibodies classifies your type of low thyroid disease as autoimmune thyroiditis (or Hashimoto's disease).

I assume that you are on thyroid medication? (Levothyroxine ?) - although your latest TSH result shows a lower level, a TSH alone is not enough to monitor a patient on thyroid medication – you need to know your FT4 and FT3 levels as well. However, a THS level of 2.42 is still much too high, a `good' level would be 1 or below – 0.something would be better. But a TSH is just a rough indication – it does not tell how a patient is actually feeling, and in the absence of FT4 and FT3 the TSH is a pretty useless parameter for establishing the correct dose of thyroid medication ... unfortunately doctors have been taught to disagree with this, but that does not make them right.

You did not say which medication you are taking and how much or what your doctor has told you when giving you your latest result, but in my opinion you are nowhere near "there" yet. You very likely need a higher dose of whatever you are taking. How are you actually feeling?

With best wishes,

[Guest guest]

I am feeling gradually worse as the days go by. Low mood, extreme tiredness,forgetfulness, aching limbs and all over body, difficulty in concentrating, hairloss, sensitivity to heat/cold, insomnia,..the list is endless. She keeps sayingthat they could be depression, to which I added, that I was depressed as nooneis helping me feel better! Its a symptom rather than the cause.

I have been reading a lot online, and apparently my usage of ADs for so longcould have contributed to getting this. Dr says I should keep taking them. Ijust dont know what to do anymore. I try to exercise but when I do I get extremeaching in my muscles all over my body..yesterday was bad, and I was so down andfed up.

Hi ,

Sadly, we read this kind of story only too often on here – it really makes me angry how little doctors know – or want to know – about thyroid disease....

I can't tell you what to do , but I can tell you what I would do in your situation – I would ask the GP for a referral to an endo of your choice and I would ask to be weaned off the antidepressants. Presumably you would need to see a psychiatrist for that, but I have no experience with ADs, so I am just guessing that you need professional help to get off those drugs. I find it mind-boggling that a mere GP should prescribe long-term antidepressants without having had any training or knowledge to diagnose or treat so-called depression. You need to be assessed by a specialist to determine if you are really suffering from depression, or – more likely – your depression is a sign of your thyroid condition... which would fit the bill much better.

Your GP is useless, . You need to see someone who actually knows something about treating Hashimoto's effectively. There are so many things that might stop your thyroid hormone from working.... not least the Sertraline, I suspect, because this drug is heavy on the liver and heavy on the intestines – the very places where T4 to T3 conversion takes place and the last thing you need is a liver full of toxins and a compromised bowel. Your body clearly is not utilizing the Levothyroxine as it should and the question arises if a T4 therapy alone is sufficient for you.

Please ask Sheila to send you a list of good endo's privately and then ask your GP for a referral to a specialist of your choice. In my opinion you also need a referral to a psychiatrist to get assessed if you really need those ADs – I suspect that you don't. But after 2 years on ADs I would be a bit scared to wean myself off without the back-up of a doctor who knows what he or she is doing. I don't suppose you can just stop the drug without risking withdrawal symptoms.

It is difficult to suggest what to do thyroid-wise. An alternative for seeing an endo would be to make a private appointment with Dr. Peatfield. Would it be possible for you to see him? (for Dr. P. you would not need a referral). What you are currently taking is clearly not working and it needs to be found out what in particular is preventing the thyroid hormone from working and the list is long. I will copy and paste Dr. Peatfield's explanation below for you to read.....

With best wishes,

The Peatfield Clinic

Understanding Treatment of Lowered Metabolism

Contrary to cherished beliefs by much of the medical establishment, the correction of a thyroid deficiency state has a number of complexities and variables, which make the treatment usually quite specific for each person. The balancing of these variables is as much up to you as to me – which is why a check of morning, day and evening temperatures and pulse rates, together with symptoms, good and bad, can be so helpful.

Many of you have been ill for a long time, either because you have not been diagnosed, or the treatment leaves you still quite unwell. Those of you who have relatively mild hypothyroidism, and have been diagnosed relatively quickly, may well respond to synthetic thyroxine, the standard treatment. I am therefore unlikely to see you; since if the thyroxine proves satisfactory in use, it is merely a question of dosage.

For many of you, the outstanding problem is not that the diagnosis has not been made – although, extraordinarily, this is disgracefully common – but that is has, and the thyroxine treatment doesn't work. The dose has been altered up and down, and clinical improvement is variable and doesn't last, in spite of blood tests, which say you are perfectly all right (and therefore you are actually depressed and need this fine antidepressant). There are some good reasons for this, and I'm going to list them.

1. Your thyroxine dose is too low.

Often this is the case, and the doctor or consultant won't increase it, since the blood levels appear perfectly okay. Sometimes, though, the dose of thyroxine is quite high – 200 mcg – 300 mcg – but you still don't feel well.

2. Partial response to the single synthetic thyroxine replacement.

Your thyroid produces four other hormones apart from thyroxine, and most of us need them all. Without them our response is limited and synthetic thyroxine may not suit the system as well as the natural thyroid hormones.

3. Adrenal fatigue or exhaustion.

This is very commonly met with indeed. The production of thyroxine (T4), its conversion to liothyronine (T3), and the receptor uptake (called `binding') requires a normal amount of adrenal hormones, notably, of course, cortisone. (Excess cortisone can shut production down, however.)

4. Failure of the 5 dei-iodinase enzyme.

This is what happens if the adrenals are not responding properly, and provision of cortisone usually switches it on again. But sometimes it doesn't. If the illness has been going on too long, the enzyme seems to fail. This conversion failure (in explicably denied by many endocrinologists) means the thyroxine builds up, unconverted. So it doesn't work, and T4 toxicosis results. This makes you feel quite unwell, toxic, often with palpitations and chest pain. (I refer to this further on.) If provision of adrenal support doesn't remedy the situation, the final solution is the use of the thyroid hormone, already converted, T3.

5. Receptor resistance.

Being hypothyroid for some considerable time may mean the biochemical mechanisms which permit the binding of T3 to the receptors is downgraded; the T3 just won't go in. With slow build up of T3, with full adrenal support and adequate vitamins and minerals, the receptors do actually come on line again. But this can be quite a slow process, and care has to be taken to build the dose up gradually.

6. Food allergies.

The most common food allergy is allergy to gluten, the protein fraction of wheat. The antibody generated by the body, by a process of molecular mimicry, cross reacts with the thyroperoxidase enzyme, (which makes thyroxine) and shuts it down. So allergy to bread can make you hypothyroid.

There may be other food allergies with this kind of effect, but information on these is scanty. Certainly allergic response to certain foods can affect adrenal function and imperil thyroid production and uptake.

7. Presence of systemic candidiasis.

This is where candida albicans, a yeast, which causes skin infections almost anywhere in the body, invades the lining of the lower part of the small intestine and the large intestine. Here, the candida sets up residence in the warmth and the dark, and demands to be fed. Loving sugars and starches, candida can make you suffer frightful sweet cravings. (I wouldn't be surprised if it can synthesize a neurotransmitter, which causes such craving that you have to have chocolate, on pain of death.)

Candida can produce toxins which can cause very many symptoms of exhaustion, headache, general illness, and which interfere with the uptake of thyroid and adrenal treatment. Sometimes the levels – which we usually test for – can be very high indeed, and make successful treatment difficult to achieve until adequately treated. (More of this further on.)

8. Hormone imbalances.

The whole of the endocrine system is linked; each part of it needs the other parts to be operating normally to work properly. An example of this we have seen already, with cortisone. But another example is the operation of sex hormones. The imbalance that occurs at the menopause with progesterone running down, and a relative dominance of oestrogen is a further case in point – oestrogen dominance downgrades production, transportation and uptake of thyroid hormones. This is why hypothyroidism may first appear at the menopause; the symptoms ascribed to this alone, which is then treated – often with extra oestrogen, making the whole thing worse. Deficiency in progesterone most especially needs to be dealt with, since it reverses oestrogen dominance, improves many menopausal symptoms like sweats and mood swings, and reverses osteoporosis. Happily natural progesterone cream is easily obtained: when used it has the added benefit of helping to stabilise adrenal function.

When you have been quite unwell for a long time, all these problems have to be dealt with; and since each may affect the other, it all has to be done rather carefully.

[Guest guest]

Hi , Results are much improved, but most healthy folk have a TSH of around 1.0 so you probably need a dose increase. That orininal high antibody results shows that you thyroid will eventually be deastroyed completely, thought antibody levels do not remain constant. > thyroid treatment > From: melanie_woodbridge@...> Date: Mon, 28 Feb 2011 18:23:06 +0000> Subject: Test Results> > Hi all, I was told to post my results here, to get them interpreted?> > Thyroid autoantibodies HI 495.4 iu/mL range (0.0 -5.0 U)> > Serum free T4 level 12.4 pmol/L range ( 9.2 - 24.5 U )> Serum TSH level HI 7.66 mu/L range (0.20 - 4.50 U )> > Above were 30/09/2010> > Latest blood results on 02/01/2011 ;> Serum TSH level 2.42 mu/L range (0.20 - 4.50 )> > > Hope someone can help with them! > > thanks.> > > > ------------------------------------> > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> >

[Guest guest]

Dorothy,

So they don't do the t4 and t3 unless something is amiss? Ah ha!! well why

have they done them then? I'll tell you why, it's because last year your tsh

was 2.75 (they told you it was T4 but I think it was TSH) and despite being on

50 mcg of T4 (a pathetically small dose) your tsh is rising and your t4 is

scraping the bottom of the range.

The good news is that considering how low the t4 is, your t3 is not bad so

chances are, if you had a normal dose of t4, then your t3 would rise.

If you are taking thyroid meds, then the ideal range is actually that which

makes you feel well but the doc won't believe that. There is a paper in the

files section called pulse article. Go to files and scroll down until you see

it.

thyroid treatment/files/

there is a section in there which says: that you should take enough t4 to make

your TSH go to the lower part of the reference range and your t4 to the upper

part of the reference range.... (pasted below)

I suggest you print out the whole article and tell your doctor he can do a

continuing professional development module on thyroid dosing, if he reads it and

answers questions on pulse magazine... here is the link for him:

http://www.pulsetoday.co.uk/story.asp?storycode=4126143

Ok it's a bit cheeky, but he's not exactly helping you to stay on top of this is

he? A normal TSH is 1 and a normal replacement dose of thyroxine is 125 - 150.

Have you a reason for the hypothyroidism? Ask him to check your thyroid

antibodies if it hasn't been done before.

Go to the doctor on Monday and tell him you have been undermedicated for long

enough. There is no reason to wait for another few months, your tsh has

increased since last year, it was too high then and it is certainly too high

now. If he feels uncomfortable or scared to increase your dosage, ask to be

referred to a specialist of your choice.....

GRRRRRRR!!!!

x

6

The appropriate dose of levothyroxine is that which restores euthyroidism and

serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference

range or even slightly elevated – 18-22pmol/l. Most patients will feel well in

that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the

serum-free T4 concentration will be elevated at around 24-28pmol/l.

This `exogenous subclinical hyperthyroidism' is not dangerous as long as serum

T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference

range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of

patients continue to complain that a sense of wellbeing has not been restored. A

trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of

levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of

10µg (half a tablet) daily added.

>

> I phoned for test results (as I asked the nurse to do T3s the other day) & was

told by the receptionist that they don't do anything other than TSH unless there

are other indications but they had done them this time :-)

>

> TSH - 3.11 (0.27 - 4.2)

> FT3 - 3.7 (3.1 - 6.8)

> FT4 - 11.5 (12 - 22)

>

> She said the Dr said they were normal except the FT4 & as it's borderline

she'll check in 3 months. I had already made an appointment for Monday & wonder

should I go.

>

> Are the bloods pretty as normal as I can expect - should I stick with Levo or

should I try NDT which is what I've wanted to do for several years?

>

> Thanks in advance & thanks for previous responses - have taken all onboard!

>

> Dorothy

>

[Guest guest]

These results

are OT normal by any stretch of the imagination. Your TSH should be at 1.0, and

yours is almost at the top of the reference range which means your pituitary

gland is working flat out secreting TSH because it recognises that your free

thyroxine (fT4) and free triiodothyronine (fT3) are right at the bottom of the

reference range. The TSH is secreted to tell the thyroid gland to start

secreting more thyroid hormones. Why don't these lab technicians know what the

results of the tests they do actually mean.

If you are not

regaining your normal health with synthetic levothyroxine (which is a

prohormone and is mainly inactive and has to convert to the active thyroid

hormone T3), then you might well be right in asking either for a combination of

synthetic T4 with T3, T3 alone or natural thyroid extract. We have found that

with our thyroid health, many of us get well only by taking this into our own

hands, but you need to learn as much as you can and know about the association

with other conditions that might also need treating. All you really need to

know is in our web site www.tpa-uk.org.uk

under Hypothyroidism and read especially the information in Associated

Conditions.

Luv - Sheila

TSH - 3.11 (0.27 - 4.2)

FT3 - 3.7 (3.1 - 6.8)

FT4 - 11.5 (12 - 22)

She said the Dr said they were normal except the FT4 & as it's borderline

she'll check in 3 months. I had already made an appointment for Monday &

wonder should I go.

Are the bloods pretty as normal as I can expect - should I stick with Levo or

should I try NDT which is what I've wanted to do for several years?

Thanks in advance & thanks for previous responses - have taken all onboard!

Dorothy

[Guest guest]

> Got my blood results back today. I was told it would be a full thyroid test but all that is listed is:> Free Thyroxine 16 pmol/L (9 to 21)> TSH 5.7 mU/L (0.2 to 5.0) > I can see my TSH has risen again and is now outside the range but don't know what the free thyroxine means.> I know the TSH isn't exceptionally high and some people have it much much higher but is mine high enough to go back to my GP and request he starts me on treatment now. I've been told to get it tested in a year again but I'm so sick of feeling so awful all the time.

Quite right Gillian - get in there quick and claim your diagnosis of hypothyroidism and demand to be treated. Doctors can't have it both ways - insist that all is normal when the TSH is inside the range and still claim that same when it's outside the range....

you are right, of course, the results are marginal, but so what !! Positive is positive - beat the iron whilst it is hot

Thyroid results tell you little of how a patient is actually feeling, but if the doctors want to play it by the book, thank your lucky stars that the wretched TSH has finally topped the upper limit. The 'free thyroxine' is the FT4; your result is somewhat in the middle (so not too bad), but only this once when you see your GP put the emphasis on the TSH, which is outside the norm range, complain about your clinical symptoms and that should secure you a diagnosis of hypothyroidism and treatment.

Good luck

[Guest guest]

Gillian

Ask your GP for a referral to an endocrinologist, preferably one

of your choice. I will send you my doctors list. your GP is a GP - and that is

all, which is obvious by his dismissal of you telling you to come back in

another year when your TSH showing to be outside the top of the range. You

should be started on a trial of thyroid hormone replacement - without this, who

knows what you might be like in another year (

You also need to know whether you have thyroid antibodies, which

set out to completely destroy your thyroid gland, so insist that he tests for

TPO and TgAb. If he refuses to refer you, then report this matter to the Head

of Practice. Have you reported symptoms and signs of hypothyroidism to your GP

- if you have members of your family with a thyroid or autoimmune disorder,

have you told him?

Even the BTA, RCP 'Statement'

on the diagnosing and management of hypothyroidism state " The symptoms of

hypothyroidism are very common, both in many other conditions and even in

states of normal health. It is therefore essential that thyroid function is

tested biochemically alongside a careful clinical assessment of the individual

patient. Clinical symptoms and/or signs alone are insufficient to make a

diagnosis of hypothyroidism. "

It is also recommended in the

BTA Thyroid Function Test Guidelines that subclinical hypothyroidism is

characterised by a TSH above the reference range with a FT4 measurement within

the reference range - which is what yours show….and…depending on

the age and gender of the population studied, sublinical hypothyroidism is

present in 1.3-17.5% of the UK and US population. Subclinical hypothyroidism

should be confirmed by repeat thyroid function testing 3-6 months after the

original result. http://www.british-thyroid-association.org/info-for-patients/Docs/TFT_guideline_final_version_July_2006.pdf

- NOT in a years time as suggested by your GP.

Luv - Sheila

> Got my blood results back today. I was told it

would be a full thyroid test but all that is listed is:

> Free Thyroxine 16 pmol/L (9 to 21)

> TSH 5.7 mU/L (0.2 to 5.0)

> I can see my TSH has risen again and is now outside the range but don't

know what the free thyroxine means.

> I know the TSH isn't exceptionally high and some people have it much much

higher but is mine high enough to go back to my GP and request he starts me on

treatment now. I've been told to get it tested in a year again but I'm so sick

of feeling so awful all the time.

[Guest guest]

Hi Sheila,

Thanks for your advice. I've tried telling my GP about my symptons but she

wasn't very interested, it was a case of " you're TSH isn't too high so you're

fine! " .

Do you have the name of an endocrinologist in Scotland, preferably the Glasgow

area?

I've printed a copy of the sympton list from the site and ticked the ones I

have. I'm taking my temp every morning and when I have the name of a doctor who

specialises in thyroids I'm going back to request the blood tests you mentioned

and to ask to be started on treatment.

Gillian xx