TSH

[Guest guest]

-> Hi Bob

> perhaps you could help me on this one I'm just being curious.

>

> I know the half life of T4 is a week, what would happen to the TSH in

> that week would it double? would this depend on the amount of T4

> replacement needed in the first place. How long does it take the TSH

to

> change and at what rate.

>

> Many thanks Cec

Hi Cec,

I'm sure Bob will answer shortly, but to the best of my knowledge it

takes the TSH about 4-6 weeks to change significantly when there are

altered circumstances. Of all the parameters, the TSH is the slowest to

respond to any changes. T3 only has a half life of a few hours (about

7), T4 - as you say- about 7 days, but the TSH is slow.

This is one of the reasons (the other is cost) that many GPs only do a

TSH for their patients and tell us that's all that is needed. Not every

patient is religiously taking their medication at the same time - some

even forget the odd pill - all of that won't show up in a TSH ... it

will give you the overall picture. But T4 and T3 measurements are

expensive, and their levels depend very much (particularly the T3

level) on the time the thyroxine had been taken to the hour you have the

blood draw.

Hope this helps,

[Guest guest]

Hi Cec,

Half-life of TSH is about a week so you would see the main effects of

change in the first couple of weeks and less change thereafter. It

reaches equilibrium about 4-6weeks later, for any given change.

However, the effects (amelioration of symptoms) on the body may take

much longer to show up.

It depends on how long you've been hypothyroid initially and how long

it is since you've started taking any replacement thyroid hormones, as

to how fast the TSH changes. Daily variations in TSH value will see it

suppressed at night, inversely with the elevating level of FT4.

The relationship between Log TSH and –1x FT4 shows an inverse graph

where the higher the TSH the lower the FT4.

p329 of Review of Medical Physiology by WF Ganong 2003, 21st edn

can be seen via Amazon (Look Inside # ) which needs you to register

with Amazon.

This diagram also shows the reason that the TSH values spread somewhat

above and below TSH=1 and according as the values of FT4 lie between

about 10 – 25 ng/L.

Work by Ross ( 2008 ), at Sheffield University, has confirmed the

circadian rhythm of TSH and both FT4 & FT3.

best wishes

Bob

>

> Hi Bob

> perhaps you could help me on this one I'm just being curious.

>

> I know the half life of T4 is a week, what would happen to the TSH in

> that week would it double? would this depend on the amount of T4

> replacement needed in the first place. How long does it take the TSH to

> change and at what rate.

>

> Many thanks Cec

>

[Guest guest]

Louise, when I was taking Armour my TSH was always 0.01, my T4 was about the middle of the range or just slightly over middle and so was my T3. I was taking 5 grains. I felt at my best then. My body was working in perfect harmony.

Lilian

[Guest guest]

Blimey, 5 grains! But if you felt alright :0) How are you now, are you

not still on Armour?

My added T4 is still at the experimental stage BTW that's why I

started with only 12 1/2 mcgs.

Louise.

>

> Louise, when I was taking Armour my TSH was always 0.01, my T4 was

about the middle of the range or just slightly over middle and so was

my T3. I was taking 5 grains. I felt at my best then. My

body was working in perfect harmony.

>

> Lilian

[Guest guest]

Louise, I was on 4 grains for a long time but always felt 90%. I was scared a bit to put it up more, but when I did and finally got to 5 I realised that was my 'sweet spot'.

However, about nearly a year ago now my GP told me that if I carried on supplementing with Armour, or T3, he would not be my doctor. He insisted that I was hyper because of the TSH and would not take into consideration that I did not have hyper symptoms, nor was I hyper according to T4 and T3 tests.

Not only was I to go on thyroxine alone, he put me on only 100mcg a day. Needless to say after a month I was so ill. I decided to change endo's, because the one I had (for diabetes) agreed with the GP.

I looked on Sheila's list and found that there was a new endo at the very hospital near me.

I went to see him and he is prescribing T3 - although at a very low dose.

I put on more weight, I am breathless all the time, in pain - even lying down in bed, IBS symptoms and erratic sleep pattern to name but a few. My hair was falling out too (loads on my pillow in the morning) but since taking even that small dose of T3 that seems to have stopped.

Armour was definitely good for me, although thyroxine alone was fine for 15 years before things started to go wrong.

Lilian

[Guest guest]

Hi Louise,

Yup! I've had a TSH of 0.01 undetectable for the past 9 years

since I changed to Armour and a large dose of T3. My frees have always

been in range FT4 14 FT3 3.8 except when I have had a blood test sprung

on me and have therefore taken that days dose already. When on Armour or

other T3 containing med it is perfectly normal to have no TSH so panic

ye not!

--

Subject: TSH

Has anyone here got a completely suppressed TSH and if they have would

they mind sharing their last free T4 and T3 results as well?

Louise.

------------------------------------

TPA is not medically qualified. Consult with a qualified medical

practitioner before changing medication.

[Guest guest]

Thanks for that :0) it does make you panick a bit when you first see a

result like that but my GP's surgery started to panic when the TSH had

gone down to 0.35! They don't mention it anymore and just tell me to

discuss it with my private Dr. I think they're happy to have someone

to pass the buck to. Hmm...

Louise.

>

> Hi Louise,

> Yup! I've had a TSH of 0.01 undetectable for the past 9 years

> since I changed to Armour and a large dose of T3. My frees have always

> been in range FT4 14 FT3 3.8 except when I have had a blood test sprung

> on me and have therefore taken that days dose already. When on Armour or

> other T3 containing med it is perfectly normal to have no TSH so panic

> ye not!

>

>

>

>

> ------------------------------------

>

> TPA is not medically qualified. Consult with a qualified medical

> practitioner before changing medication.

>

>

[Guest guest]

Hi Lilian,

Is there a transition from Primary to Secondary hypothyroidism at

some point down the 'L-Thyroxine only' line?...and most doctors

and/or endos don't know where or where it happens?

Just an idea....!

best wishes

Bob

>

> Louise, I was on 4 grains for a long time but always felt 90%.

I was scared a bit to put it up more, but when I did and finally got

to 5 I realised that was my 'sweet spot'.

>

> However, about nearly a year ago now my GP told me that if I

carried on supplementing with Armour, or T3, he would not be my

doctor. He insisted that I was hyper because of the TSH and would

not take into consideration that I did not have hyper symptoms, nor

was I hyper according to T4 and T3 tests.

>

[Guest guest]

I'm sorry you're feeling c£$%! Lilian, is there no way you could go

back on Armour? Although I realise that it's difficult if you need to

see Drs for other things like diabetes.

I think my experiment with adding in some T4 is over now. It made me

feel better in some ways to begin with but then worse in others the

longer I took it, until eventually I was getting a lot of the old

familiar side effects back and I was only taking 12 1/2 mcgs of it. So

it's back to the drawing board and after things have settled a bit

I'll try putting up the Armour again a crumb at a time.

Louise.

>

> Louise, I was on 4 grains for a long time but always felt 90%. I

was scared a bit to put it up more, but when I did and finally got to

5 I realised that was my 'sweet spot'.

>

> However, about nearly a year ago now my GP told me that if I carried

on supplementing with Armour, or T3, he would not be my doctor. He

insisted that I was hyper because of the TSH and would not take into

consideration that I did not have hyper symptoms, nor was I hyper

according to T4 and T3 tests.

>

> Not only was I to go on thyroxine alone, he put me on only 100mcg a

day. Needless to say after a month I was so ill. I decided to

change endo's, because the one I had (for diabetes) agreed with the GP.

>

> I looked on Sheila's list and found that there was a new endo at the

very hospital near me.

>

> I went to see him and he is prescribing T3 - although at a very low

dose.

> I put on more weight, I am breathless all the time, in pain - even

lying down in bed, IBS symptoms and erratic sleep pattern to name but

a few. My hair was falling out too (loads on my pillow in the

morning) but since taking even that small dose of T3 that seems to

have stopped.

>

> Armour was definitely good for me, although thyroxine alone was fine

for 15 years before things started to go wrong.

>

> Lilian

>

[Guest guest]

I've often wondered that; but I think I must've had some kind of

conversion problem in the first place.

Louise.

>

> Hi Lilian,

>

> Is there a transition from Primary to Secondary hypothyroidism at

> some point down the 'L-Thyroxine only' line?...and most doctors

> and/or endos don't know where or where it happens?

>

> Just an idea....!

>

> best wishes

> Bob

[Guest guest]

Hi Louise

That adds to the confusion, of course; neither the doctors or the

endos can really point to one or the other, though they seem to be

saying that 95% of hypothyrodism is Primary......

so 50 out of 1000 patients don't matter ~ 'only' 50,000 out of

1,000,000

best wishes

Bob

perhaps the Patient Survey only picked up a small proportion of that

50,000 ~ ie only 78% of 1500 respondents who didn't recover their

former wellness on 'just L-Thryoxine', or were bamboozled into

not 'pestering the doctor' to resolve the remaining symptoms....that

may well have been fixed by the extra T3; happens in Germany where

T4/T3 combos are available.

That one of those remaining symptoms may be brain fog and

essentially 'disabling' from employment is irrelevant to a well-

remunerated doctor..... a trifling matter....bahh.

>

> I've often wondered that; but I think I must've had some kind of

> conversion problem in the first place.

>

> Louise.

>

[Guest guest]

>

> Hi Lilian,

>

> Is there a transition from Primary to Secondary hypothyroidism at

> some point down the 'L-Thyroxine only' line?...and most doctors

> and/or endos don't know where or where it happens?

>

> Just an idea....!

>

> best wishes

> Bob

>

I was wondering about this. As I went from being 'ok-ish' on levothyroxine

(although

never quite right) to feeling very ill and numerous symptoms popping up. My FT3

was low

in the range even when my FT4 went too high. Now I'm on Armour alone and I am

well

again.

If we're talking primarily about Hashimoto's does it have anything to do with

how much

thyroid is left unattacked? Or the dose of levothyroxine you get to? Do the

antibodies start

to damage elsewhere once their job is done on the thyroid? I don't know, but

would love

to know... Why are the medical establishment not trying to find out...? Oh yeah,

that's right

- it's all in our heads!

Cat.

(Who is shocked beyond belief to read the RCP statement when she returned from

abroad

:-O )

[Guest guest]

Hi ,

Often, an innocent question gets us to belated answers.

Can anyone access this paper?

Acquired hypothyroidism after switching from thyroid USP to levothyroxine

PAUL S. JELLINGER MD, MACE

in Clinical Cornerstones: 2005

Volume 7 June 2005 Suppl 2

Bob

>> Hello,> > I am a newbie an joined to try to educate myself. My mother had > thyroid disease and eventually had both nodules removed....> > I have always gotten full bloodwork every year since 1995....I am in > excellent health but always feel tired and cold (BP 106/60... > Resting HR 48, Chol 179 LDL 61, HDL 109, TRIG 44...Chol/HDL Ratio > 1.6..I lost 60 pounds in a 3 year period 4 years ago by diet and > exercise 5 days a week!

[Guest guest]

Hmm...wonder how many people that is world wide; and how much it's

actually costing in benefits and treatment for symptoms and other

complaints caused by untreated/undertreated hypo-T? You'd think that

making a cash saving of that size would be incentive enough to help

us. But then as you say the Dr. is still getting paid. :0(

Louise.

>

> Hi Louise

>

> That adds to the confusion, of course; neither the doctors or the

> endos can really point to one or the other, though they seem to be

> saying that 95% of hypothyrodism is Primary......

> so 50 out of 1000 patients don't matter ~ 'only' 50,000 out of

> 1,000,000

>

> best wishes

> Bob

>

> perhaps the Patient Survey only picked up a small proportion of that

> 50,000 ~ ie only 78% of 1500 respondents who didn't recover their

> former wellness on 'just L-Thryoxine', or were bamboozled into

> not 'pestering the doctor' to resolve the remaining symptoms....that

> may well have been fixed by the extra T3; happens in Germany where

> T4/T3 combos are available.

>

> That one of those remaining symptoms may be brain fog and

> essentially 'disabling' from employment is irrelevant to a well-

> remunerated doctor..... a trifling matter....bahh.

[Guest guest]

--- In thyroid treatment , " ankhansata " < or were

bamboozled into

> > not 'pestering the doctor' to resolve the remaining

symptoms....that

> > may well have been fixed by the extra T3; happens in Germany where

> > T4/T3 combos are available.

> >

> > That one of those remaining symptoms may be brain fog and

> > essentially 'disabling' from employment is irrelevant to a well-

> > remunerated doctor..... a trifling matter....bahh.

>

So how come Germany are allowed T3 and T4/T3 combos????

Jane

[Guest guest]

Hi Louise,

Me too- never did get back to being really well on T4, but

slowly deteriorated over the years until I found the internet and had a

revelation! I shall never forget the third day on Armour- like the first

day of spring after a long hard winter.

Subject: Re: TSH

I've often wondered that; but I think I must've had some kind of

conversion problem in the first place.

Louise.

------------------------------------

TPA is not medically qualified. Consult with a qualified medical

practitioner before changing medication.

[Guest guest]

Hi Jane,

We'd better dig out the information on that.

Bob

>

> So how come Germany are allowed T3 and T4/T3 combos????

>

> Jane

>

[Guest guest]

I think you are probably right Bob.

Lilian

Is there a transition from Primary to Secondary hypothyroidism at some point down the 'L-Thyroxine only' line?...and most doctors and/or endos don't know where or where it happens?Just an idea....!

[Guest guest]

Phil can testosterone shots interfere with synthroid? My tsh came back 3.7 which

is surprising because it normally is below 1. I didn't take my dose that morning

and I am surprised especially since I am already taking a high dose 250mcg of

synthroid.

[Guest guest]

I hate Synthroid it is a sinthic T4 that Endo's and the drug Co's push on people

and most people don't do good on it or don't know they can do better unless they

try a natural dessicated thyroid med like the old Armour we us to use. Try

going on this and see if you don't feel better. But first check your Adrenals

for low Cortisol levels most people on Synthroid have bad Adrenals do to the

Synthroid. Read this link about it.

http://www.erfa-sa.com/thyroid_usa.htm

http://www.universaldrugstore.com/medications/Thyroid/60mg

http://www.stopthethyroidmadness.com/

http://livingnetwork.co.za/hormones/adrenal-fatigue/

My wife kept telling me to mind my own business about her thyroid she wasted 15

yrs of her life on Shythroid until she stopped seeing Endo's and found a Dr.

that would treat her with Armour. She never knew she could feel this good.

Your TSH being this high tells me your Synthroid is not working TSH is the

message sent to your Thyroid to tell it your body needs more. I don't feel it

could go up this fast not taking your meds that morning. And you not to do

Thyroid meds the morning of labs.

Testosterone has very little to do with Thyroid levels. But Thyroid can lower

Testosterone levels.

Co-Moderator

Phil

> From: andrenym007 <no_reply >

> Subject: TSH

>

> Date: Tuesday, April 6, 2010, 1:09 PM

> Phil can testosterone shots interfere

> with synthroid? My tsh came back 3.7 which is surprising

> because it normally is below 1. I didn't take my dose that

> morning and I am surprised especially since I am already

> taking a high dose 250mcg of synthroid.

>

>

>

> ------------------------------------

>

>

[Guest guest]

Is this then also the case with TSH? As if someone hadsuffered for many years with underactive thyroid (as I suspect I have) then ifTSH eventually gives up surely blood tests will not pick it up and be acurate?

Hello Sue,

No, I'm afraid that is not what will happen with the TSH. The FSH, which is produced by the anterior pituitary gland just like the TSH, has the role of developing and regulating the reproductive processes in the body. During menopause there is less and less restricting feed-back from the sex organs, hence the FSH first rises and then declines post menopause.

The TSH is, as the name suggests, a thyroid stimulating hormone. If the thyroid gland becomes unable to respond to the TSH signal, then the TSH will rise higher and higher every time the cells are signaling to the hypothalamus in the brain that they need more T3. The TSH will just go on rising, but if no T3 is forthcoming one way or another, we will eventually die.

The way it works is as follows:

Every cell in our body needs T3 to survive. If the cells get low in T3, they will signal to the hypothalamus that they need more T3. The hypothalamus then releases TRH (thyrotrophin release hormone) to the pituitary gland. For the pituitary this is the signal that it must release a signal to the thyroid gland that more thyroid hormones are needed in the body – hence it secretes TSH (thyroid stimulating hormone). This is now the signal for the thyroid gland to release T4 and T3 into the blood stream. If this happens, then the cells will immediately take up the T3 and the remaining T4 will circulate in our blood stream (like fuel in a car tank) until more T3 is needed to fuel the cells. The remaining T4 is then quickly converted into T3, which will also be taken up by the cells….the cells are then happy until the T3 is getting low and they need more – so the cycle starts again….. This is the scenario when the endocrine system works normally and the thyroid gland is able to co-operate.

But when the thyroid gland is – for whatever reason – unable to respond to the TSH demand and can't produce and release any more thyroid hormones, then the bug stops here…. The demand for more thyroid hormones is there, but nothing happens… ergo the cells will complain to the hypothalamus that nothing is coming their way. The hypothalamus then instructs the pituitary to make more TSH, and the pituitary obliges…. Still nothing happens at the thyroid gland end …. So the cells complain louder and even more TSH will be produced…the TSH rises and rises…. And this will go on until either thyroid hormones are supplemented, or the person dies. (I have, of course, simplified the above to demonstrate the mechanism)

However, this process is not straight forward. The thyroid gland will still be able to produce some thyroids, even if it is attacked by autoantibodies or is malfunctioning for other reasons. The thyroid levels will not become critical until more than 70% of the thyroid gland is either destroyed or atrophied. To die from untreated Hypothyroidism can take decades – 20 or 30 years or even more. As the cells get less and less T3, some die off, others become very weak. The immune system is rock bottom and can't fight off any more "intruder cells" from the outside (cancer cells, viruses, bacteria – you name it). The person gets ill. ANY part of the body can get affected in this way – this is why Hypothyroidism has countless, seemingly unrelated, clinical symptoms. Those illnesses then get usually treated as illnesses in their own right and often the treatment does not work… hardly surprising, since the cause for the illness in the first place does not get addressed.

Dr.Mark Starr states in his book "Hypothyroidism, Type 2" (quote) `If hypothyroidism and environmental illnesses were properly treated, most medications consumed by our chronically ill society would no longer be necessary' (unquote) …. And I can only say "Amen" to that ! But then the cynic in me thinks perhaps that this is the aim of the game? Less patients, less drug sales, less work for doctors? …. Hmmmm

Anyway – back to the TSH and your question…. The short answer is no, the TSH will not give up. Unless there is some malfunctioning of the pituitary gland, it will just go on climbing until some thyroid hormones are forthcoming – it is the body that will give up eventually. I have read about patients with TSH's in their hundreds .... To my mind the TSH has one useful function as a lab figure – it will indicate in the first place when the thyroid is not functioning as it should. However, even that has two major flaws –

a) the ref ranges for the TSH in this country are set wayyy to high, and

the TSH is only a useful diagnostic tool as long as the pituitary gland is in good working order - if the pituitary gland malfunctions, the TSH will be low.

The accuracy of the other thyroid blood figures for diagnostic purposes is also not guaranteed, because to make a relatively reliable assessment, a full thyroid panel would be needed, including TSH, T3, FT3, T4, FT4 and TPO & TgAB (autoantibodies). An NHS thyroid check usually consists of a TSH only, or if we are lucky, a TSH and FT4. – so it's all a bit hit and miss; but the really sad thing is that most of our doctors are convinced that they can rule out Hypothyroidism on a TSH figure alone, because that is what they have been taught.…

Sorry, a rather long answer - I hope I haven't muddied the waters now.

With best wishes,

[Guest guest]

Hi sue, bit of a can of worms here! TSH is released to the bloodstream,by the pituitary to tell the thyroid to work harder. now it depends if you think that this system never fails. The pititary, like any other organ can fail for various reasons so it's output to the body is then shut off- so no stimulus to the thyroid ( and other organs) this is type 3 hypothyroidism . If thyroid output is very low it can also be so low that the metabolism does not have the energy for the pituitary to work either- so no TSH again- this may be why sometimes it does not rise in the presence of a failing thyroid. The TSH is a flawed test. There a long list of factors that render it inaccurate including the effects of some medications. This is why TSh should be backed up with fT4 and FT3 together with presenting symptoms- all of which should be given proper weight. > thyroid treatment > From: hughessusan64@...> Date: Sun, 8 Aug 2010 17:59:49 +0000> Subject: TSH> > Hi all> I am new to all the thyroid thing but just wanted to ask a question which I hope isn't too stupid!> When going through the menopause us women have FSH happening for some time but surely not for ever? Is this then also the case with TSH? As if someone had suffered for many years with underactive thyroid (as I suspect I have) then if TSH eventually gives up surely blood tests will not pick it up and be acurate?> Sue> > > > ------------------------------------> > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> >