Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Welcome Sheila, Could you please post the normal ranges for this lab, next to your results ? Different labs have different ranges. I can go to the same doctor and he will send by blood out to different labs out of his one office, and they each have a different range for normal. Now if any of us were to really figure out what 'normal, categorically feels like, we will all send up a cheer and take copious notes. :-D Since we have both hyper and hypo folks here, you are not required to get Graves' to benefit. TED can occur with or without hyper. It is the autoimmune nature of the beast, and I am sorry to hear you have been required to collect knowledge on this subject. -Pam L-. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Pam, Ref. Range TSH is 0.11 L 0.20-6.00 FT3 is 4.7 2.7-5.7 FT4 is 11.2 8.0-22.0 Anti Thy Peroxidase is 65.9 reference range is < 60.0 Sheila Re: TED? Welcome Sheila, Could you please post the normal ranges for this lab, next to your results ? Different labs have different ranges. I can go to the same doctor and he will send by blood out to different labs out of his one office, and they each have a different range for normal. Now if any of us were to really figure out what 'normal, categorically feels like, we will all send up a cheer and take copious notes. :-D Since we have both hyper and hypo folks here, you are not required to get Graves' to benefit. TED can occur with or without hyper. It is the autoimmune nature of the beast, and I am sorry to hear you have been required to collect knowledge on this subject. -Pam L-. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 No to both . I see the endo tomorrow. Perhaps this is some of what he will suggest. Sheila RE: TED? Hi Sheila, Have you had a test for TSI? These are the antibodies that are responsible for Graves' -- they stimulate the thyroid to produce more hormone. And have you had an ultrasound? This test is to detect nodules. At 05:48 PM 10/7/2003, you wrote: >Pam, > > Ref. Range >TSH is 0.11 L 0.20-6.00 >FT3 is 4.7 2.7-5.7 >FT4 is 11.2 8.0-22.0 >Anti Thy Peroxidase is 65.9 reference range is < 60.0 > >Sheila Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Hi Sheila, Have you had a test for TSI? These are the antibodies that are responsible for Graves' -- they stimulate the thyroid to produce more hormone. And have you had an ultrasound? This test is to detect nodules. At 05:48 PM 10/7/2003, you wrote: >Pam, > > Ref. Range >TSH is 0.11 L 0.20-6.00 >FT3 is 4.7 2.7-5.7 >FT4 is 11.2 8.0-22.0 >Anti Thy Peroxidase is 65.9 reference range is < 60.0 > >Sheila Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 I have recently suffered a great deal of stress so I also wondered if it might be the reason for the suppressed TSH (too much cortisol as cause). But that still leaves me with unilateral proptosis which is getting worse each day... I have found that it is important as one who suffers from a variety of autoimmune problems, some rare, to educate myself as much as possible. This is sometimes threatening to physicians. It is however, my body. Thanks for the help, Sheila RE: TED? Sheila, This is a good site to help you with lab tests and much more, if you poke around. http://snurl.com/2lek ( You will love it ) The Anti Thy Peroxidase is 65.9 reference range is < 60.0 are what we term TPO antibodies, for reference as you sift through the archives. These antibodies show that you have autoimmune thyroid disease. They are the ones that cause Hashimoto's, and are also present in about 70 plus % of Graves' patients. So you would benefit from a TSI to see if the nature of your thyroid disease should happen to be changing. With normal FT numbers, you do want to discover WHY the TSH is surpressed this much. Since the FT numbers are not 'that' high. Within the link I have given you here, you will find a very good list of other causes of TSH being surpressed. Other medications that you may be on top the list, with steroids being #1. Severe depression can even be the cause. -Pam L- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Sheila, This is a good site to help you with lab tests and much more, if you poke around. http://snurl.com/2lek ( You will love it ) The Anti Thy Peroxidase is 65.9 reference range is < 60.0 are what we term TPO antibodies, for reference as you sift through the archives. These antibodies show that you have autoimmune thyroid disease. They are the ones that cause Hashimoto's, and are also present in about 70 plus % of Graves' patients. So you would benefit from a TSI to see if the nature of your thyroid disease should happen to be changing. With normal FT numbers, you do want to discover WHY the TSH is surpressed this much. Since the FT numbers are not 'that' high. Within the link I have given you here, you will find a very good list of other causes of TSH being surpressed. Other medications that you may be on top the list, with steroids being #1. Severe depression can even be the cause. -Pam L- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Here is one on vision that I had saved. It has a list of drugs that can cause eye problems. http://snurl.com/2let This one could help. It says right up front TED happens in 10% of non Graves patients. http://www.thyroid.ca/Guides/HG07.html So glad you are going in tomorrow. My lived with TED for so long, anytime I see others feelings this, I swear I can feel their pain in my own eyes once again. It is not easy, but your eyes can get better. Slow and sure wins the race. Do not jump into any aggressive treatments until you have time to research very carefully. -Pam L- oh... yes, stress does affect my eyes still. You are correct in this assumption, that there CAN be a cause that is the final straw, to something we might have been lucky enough to avoid. :-( Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2003 Report Share Posted October 7, 2003 Pam, Interesting: in pregnancy, it says FT4 should be normal and TT4 should be elevated. Just in case... I am still afraid to get pregnant, because I don't trust anyone to monitor me properly. At 06:40 PM 10/7/2003, you wrote: ><http://snurl.com/2lek>http://snurl.com/2lek ( You will love it ) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 Hi Sheila, You have been thru it and I am so sorry for this. =( Even tho your TSH is low, your FT3 is also low although in normal range. I suspect that you may have TSI antibodies and that they are mimicking TSH and giving you a false low reading. TSI antibodies are generally found in GD and TPO are generally found in Hashimoto's.....but any of us with autoimmune thyroid disorders can have a combination of both. I was very hypothyroid when I was diagnosed and within a year, I became hyperthyroid and later developed TED. I would suggest that you continue to have your FreeTs tested and add a TSI antibody test, AKA stimulating TrAb. You are having trouble converting T4 to T3 and would probably benefit thru the addition of some T3 (Cytomel) to your Armour. 5 or 10 mgs per day should do it. Also, supplementing with selenium could help. God bless, <A HREF= " http://hometown.aol.com/lisareynolds64/myhomepage/personal.html " >http://ho\ metown.aol.com/lisareynolds64/myhomepage/personal.html</A> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 Sorry Sheila, But you need a new doctor. This one does not know what he is talking about! God bless, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 In a message dated 10/7/2003 3:37:31 PM Eastern Daylight Time, seisele@... writes: > I have recent unilateral proptosis with some pain and swelling > around the eye. And I feel very unwell. I am also losing hair once again. > Recently I have had a poor appetite. My blood pressure remains normal and I > do not feel jumpy or restless. Do not have weight loss. My basal temperature > remains low as usual at 97.3 (tops). > Sheila, Have you ever seen an ophth? You need to, for sure. You have more than just lid retraction....you have proptosis, blurring vision, pain and swelling around the eyes. You have several symptoms of TED and if your doc says it is not thyroid related, he is wrong. " he thinks I just have lid retraction and that it's not related to thyroid. He suggested I see another opthalmologist as he doesn't agree that I have proptosis by his measurements (good news) and can't explain why I don't feel well or why I have blurred vision and my appearance has changed. " This is bull, Sheila. You need a TPO and a TSI test. If you don't have Hashi's, then what is causing your hypothyroidism? Does he even want to investigate that? Most cases of hypothyroidism are autoimmune in nature, meaning Hashi's. You already have an autoimmune disorder, so your thyroid and eye problems are most likely autoimmune in nature as well. Please read these articles: <A HREF= " http://www.suite101.com/profile.cfm/daisyelaine " >http://www.suite101.com/p\ rofile.cfm/daisyelaine</A> I strongly urge you to find a new endo and an ophth or neuro ophth who has experience in treating TED. Best to you, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 Hi et al, Well, the endo thinks I'm doing just fine with my thyroid. He didn't order any blood work. After the physical exam, history and last weeks' blood work, he thinks I just have lid retraction and that it's not related to thyroid. He suggested I see another opthalmologist as he doesn't agree that I have proptosis by his measurements (good news) and can't explain why I don't feel well or why I have blurred vision and my appearance has changed. I do have an MRI ordered, though not yet scheduled as the system here is very slow. He feels that more blood work is not warranted as the antibodies in the peroxidase test were too low to indicate either Hashimoto's or Graves' in his opinion. He thought that the low TSH was either too much armour thyroid (but no weight loss, sleeplessness, anxiety, hand tremor, muscle weakness, skin changes etc..) so only mildly raised and because of my recent stress as a possible contributing factor, decided to leave the dosage as is. If it continues to be low in 4-6 months or the MRI shows him to be wrong about the eye, then we will revisit. Thanks everyone, for your input. You are a lovely, caring community. Sheila Re: TED? Hi Sheila, You have been thru it and I am so sorry for this. =( Even tho your TSH is low, your FT3 is also low although in normal range. I suspect that you may have TSI antibodies and that they are mimicking TSH and giving you a false low reading. TSI antibodies are generally found in GD and TPO are generally found in Hashimoto's.....but any of us with autoimmune thyroid disorders can have a combination of both. I was very hypothyroid when I was diagnosed and within a year, I became hyperthyroid and later developed TED. I would suggest that you continue to have your FreeTs tested and add a TSI antibody test, AKA stimulating TrAb. You are having trouble converting T4 to T3 and would probably benefit thru the addition of some T3 (Cytomel) to your Armour. 5 or 10 mgs per day should do it. Also, supplementing with selenium could help. God bless, <A HREF= " http://hometown.aol.com/lisareynolds64/myhomepage/personal.html " >http: //hometown.aol.com/lisareynolds64/myhomepage/personal.html</A> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 Hi et al, Well, the endo thinks I'm doing just fine with my thyroid. He didn't order any blood work. After the physical exam, history and last weeks' blood work, he thinks I just have lid retraction and that it's not related to thyroid. He suggested I see another opthalmologist as he doesn't agree that I have proptosis by his measurements (good news) and can't explain why I don't feel well or why I have blurred vision and my appearance has changed. I do have an MRI ordered, though not yet scheduled as the system here is very slow. He feels that more blood work is not warranted as the antibodies in the peroxidase test were too low to indicate either Hashimoto's or Graves' in his opinion. He thought that the low TSH was either too much armour thyroid (but no weight loss, sleeplessness, anxiety, hand tremor, muscle weakness, skin changes etc..) so only mildly raised and because of my recent stress as a possible contributing factor, decided to leave the dosage as is. If it continues to be low in 4-6 months or the MRI shows him to be wrong about the eye, then we will revisit. Thanks everyone, for your input. You are a lovely, caring community. Sheila Re: TED? Hi Sheila, You have been thru it and I am so sorry for this. =( Even tho your TSH is low, your FT3 is also low although in normal range. I suspect that you may have TSI antibodies and that they are mimicking TSH and giving you a false low reading. TSI antibodies are generally found in GD and TPO are generally found in Hashimoto's.....but any of us with autoimmune thyroid disorders can have a combination of both. I was very hypothyroid when I was diagnosed and within a year, I became hyperthyroid and later developed TED. I would suggest that you continue to have your FreeTs tested and add a TSI antibody test, AKA stimulating TrAb. You are having trouble converting T4 to T3 and would probably benefit thru the addition of some T3 (Cytomel) to your Armour. 5 or 10 mgs per day should do it. Also, supplementing with selenium could help. God bless, <A HREF= " http://hometown.aol.com/lisareynolds64/myhomepage/personal.html " >http: //hometown.aol.com/lisareynolds64/myhomepage/personal.html</A> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 Hi Sheila, Armour causes TSH to stay a little lower than a comparable dose of levothyroxine, so yours isn't unusually low. If the range for FT4 in Canada is 10-20, your FT4 would be on the low side. I'm not sure what your FT3 range is, but if it's as high as 5.0, your FT3 would also be ok. Your TPO antibodies confirm autoimmune thyroid disease. You want to avoid FT4 and FT3 levels that are too low as they can contribute to your proptosis. Take care, Elaine Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 , please say more...I'm too new to all of this to understand why you say he doesn't know what he's talking about. Sheila Re: TED? Sorry Sheila, But you need a new doctor. This one does not know what he is talking about! God bless, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 Sorry, I hadn't read this. I agree. This visit was less than satisfactory. He is however, sending me to an ortho with experience in TED. I saw an ortho last week who didn't even know that TED can be unilateral!!! Then, after I told him the leading cause of unilateral proptosis was TED that ortho decided it was TED, based on the blood work, so cancelled the MRI!! Now the endo doesn't think it's thyroid because I'm not hyper and my thyroid is soft (though small) and I said, " but thyroid autoimmune disease can just affect the eye can't it? " He agreed and said he may be wrong and suggested that I see this other ortho who specializes in TED and get an MRI. But he didn't suggest the bloodwork because he feels that the blood tests indicate only mild elevation of the antibodies and I am a poor candidate for steroids (serious osteoporosis). He measured the eyes and his measurement disagrees with the ortho's from last week. He says no proptosis, just lid retraction and blurred vision and pain--etiology unknown at this time. Go figure... I am concerned and I don't feel well, but.... Waiting, Sheila Re: TED? In a message dated 10/7/2003 3:37:31 PM Eastern Daylight Time, seisele@... writes: > I have recent unilateral proptosis with some pain and swelling > around the eye. And I feel very unwell. I am also losing hair once again. > Recently I have had a poor appetite. My blood pressure remains normal and I > do not feel jumpy or restless. Do not have weight loss. My basal temperature > remains low as usual at 97.3 (tops). > Sheila, Have you ever seen an ophth? You need to, for sure. You have more than just lid retraction....you have proptosis, blurring vision, pain and swelling around the eyes. You have several symptoms of TED and if your doc says it is not thyroid related, he is wrong. " he thinks I just have lid retraction and that it's not related to thyroid. He suggested I see another opthalmologist as he doesn't agree that I have proptosis by his measurements (good news) and can't explain why I don't feel well or why I have blurred vision and my appearance has changed. " This is bull, Sheila. You need a TPO and a TSI test. If you don't have Hashi's, then what is causing your hypothyroidism? Does he even want to investigate that? Most cases of hypothyroidism are autoimmune in nature, meaning Hashi's. You already have an autoimmune disorder, so your thyroid and eye problems are most likely autoimmune in nature as well. Please read these articles: <A HREF= " http://www.suite101.com/profile.cfm/daisyelaine " >http://www.suite101.c om/profile.cfm/daisyelaine</A> I strongly urge you to find a new endo and an ophth or neuro ophth who has experience in treating TED. Best to you, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2003 Report Share Posted October 9, 2003 Thanks for all of the help and concern folks. I'm learning slowly... Normal range for FT4 is 8-22 so I am a little low at 11.2. FT3 is 2.7-5.7 so 4.7 is ok, I think. TPO is < 60 and the endo thought that 65.9 would not be producing the eye problem. I think that he's expecting that if I have thyroid eye problems I should be hyper and his exam indicated otherwise. But, my research indicated that I could be hypo and still have eye disease. I think that to make that case the endo was looking for a TPO at a much higher range. He mentioned somewhere in the 80's. Then, the other factor is treatment. He stated that standard treatment would be steroids and I'm not a good candidate. I have pretty severe osteoporosis from previous steroid therapy for the other autoimmune disease. I don't want a spontaneous hip fracture. Hopefully I can see the other opthalmologist soon. And I'm on the urgent list for an MRI (should happen within 6 weeks). Since he found only lid retraction today and not proptosis, even though my vision is blurred, I think he's taking a 'wait and see' approach. See how this progresses (is it mild thyroid eye disease?). See what the optho says. See what the MRI shows. I think he could have done a TSI in the meantime... And it is possible that I have something else going on behind the eye. I don't like waiting but I'm not sure what else I can do. To get an MRI done privately would cost $1000.00 and I'm unemployed at the moment. (If you hear of any good positions for psychospiritual counselors with hospice and crisis training let me know ;-)) Do you still think I should press for something more with either my endo or my GP? Sheila Re: TED? Hi Sheila, Armour causes TSH to stay a little lower than a comparable dose of levothyroxine, so yours isn't unusually low. If the range for FT4 in Canada is 10-20, your FT4 would be on the low side. I'm not sure what your FT3 range is, but if it's as high as 5.0, your FT3 would also be ok. Your TPO antibodies confirm autoimmune thyroid disease. You want to avoid FT4 and FT3 levels that are too low as they can contribute to your proptosis. Take care, Elaine Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2003 Report Share Posted October 10, 2003 Hi, TPO antibodies don't cause thyroid eye disease. Most people with severe TED do not have TPO antibodies. Yours are borderline but positive. The antibodies that cause TED are TSH receptor antibodies, both blocking and stimulating ones. People with TED have these antibodies. They can have TPO antibodies but usually don't when TED is severe. Their presence, though, does show that you have an autoimmune thyroid condition. When eye symptoms like yours occur in people with thyroid autoimmunity, the usual cause is TED. Hopefully, the new doc will order the correct tests. Elaine Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2003 Report Share Posted October 10, 2003 Thank-you Elaine. This post was very helpful to my understanding. I will forward it to my GP and try to speed up the referral to the ophthalmologist that specializes in TED. Appreciating you, Sheila Re: TED? Hi, TPO antibodies don't cause thyroid eye disease. Most people with severe TED do not have TPO antibodies. Yours are borderline but positive. The antibodies that cause TED are TSH receptor antibodies, both blocking and stimulating ones. People with TED have these antibodies. They can have TPO antibodies but usually don't when TED is severe. Their presence, though, does show that you have an autoimmune thyroid condition. When eye symptoms like yours occur in people with thyroid autoimmunity, the usual cause is TED. Hopefully, the new doc will order the correct tests. Elaine Quote Link to comment Share on other sites More sharing options...
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