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mushroom

Can Someone Comment On Thyroid Tests?

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Hi all. This request made on behalf of a friend who is constantly cold, and who I suggested have her thyroid levels retested. She has been on low dose levothyroxine for a long time without retesting.

These are her results:

Free T4 15.3 (range 10.0 to 24.0)

TSH 6.21 (range 0.40 to 4.00) High

Free T3 1.9 (2.5 - 6.0) LowLow

THYROID FUNCTION MASTER: Comment: Elevated TSH suggests propensity to primary hypothyroidism.

Suggest repeat thyroid tests in 3-6 months.

Now WIH is going to change in 3-6 months. This woman has been cold for years! Her TSH is way too high, her Free T3 practically non-existent...... Her (and my) doctor does not seem inclined to do anything except follow the recommendations. I had to force her to put me on levothyroxine and what a difference it has made.

What is the significance of a normal T4 and very low T3? I know that the T4 has to be converted to T3, so obviously she is not doing that really well. Does she need to be on a T3 med?

Thanks for any responses.


Neroli

"Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted." - Albert Einstein

"Life is not weathering the storm; it is learning to dance in the rain"

"Whatever the question, the answer is always chocolate." Nigella Lawson

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

Caffeine free 1973

Lactose free 1990

(Mis)diagnosed IBS, fibromyalgia '80's and '90's

Diagnosed psoriatic arthritis 2004

Self-diagnosed gluten intolerant, gluten-free Nov. 2007

Soy free March 2008

Nightshade free Feb 2009

Citric acid free June 2009

Potato starch free July 2009

(Totally) corn free Nov. 2009

Legume free March 2010

Now tolerant of lactose

Celiac.com - Celiac Disease Board Moderator

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I wish I could help but I don't have an answer. I do have all the same symptoms and readings myself, except my TSH is low normal. I do know that iodine and selenium are required to convert T4 to T3, so a deficiency in these minerals may play a role.


2010- Gluten, Soy, Corn, Dairy, Eggs, Nut free. Sugar, non-gluten grains lite(Yes, still plenty to eat!)

2010-Doctor diagnosed me as Celiac then took diagnoses back, then said avoid gluten for life

2009

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She needs to up her levothyroxine WIH is he thinking??? I have to get my TSH levels checked every year and I (and my doc) keep them around .04 (if I remember correctly, it's below what the lab test calls low).


"But then, in all honesty, if scientists don't play god, who will?"

- James Watson

My sources are unreliable, but their information is fascinating.

- Ashleigh Brilliant

Leap, and the net will appear.

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Her dose of levothyroxine is too low. TSH rises before T4 levels fall, which is what her blood is showing. My doctor tries to keep my TSH at 2.0 or below. I don't know how to interpret the low T3, but it may change when she gets on the right dose of levothyroxine.

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Change Drs. Read some Mary Shomon info. Cytomel (T3)needed ! A normal TSH should be about 1, and many people still feel hypo even at that and need it lower. I am a poor convertor and T4 resistant and take 50mcg T4 and 40mcg T3. As a rough guide - 100mcg T4 = 20mcg T3.

Your friend needs T3 or she risks thyroid complications like heart damage.

Our own thyroid ( if they are working correctly) make T4 and T3 every day.Approx 80mcg T4 and approx 20mcg T3. For the last 30 years only Drs have replaced a thyroid deficiency with T4 only and have said that is all that is needed. And if you go back to Dr complaining of remaining hypo symptoms it is 'all in your head'. It is truly a modern day scandal. Don't be a victim. Get to a Endo or Dr that is up to date. Dr Theodore Friedman, Prof Thierry Hertoghe, any Dr from the International Hormone Society ( over 22,000 members)http://www.worldhealth.net/pages/directory/

Effects of Hypothyroidism and Subclinical Hypothyroidism on the Heart

Thyroid hormones, notably triiodothyronine (T3), affect the heart directly and indirectly. They are closely linked with heart rate and heart output. T3 provides particular benefits by relaxing the smooth muscles of blood vessels thus helping to keep them open so blood may flow smoothly through them.

Hypothyroidism is associated with unhealthy cholesterol levels, mild high blood pressure, impaired heart muscle contraction, and heart failure in people with existing heart disease. There is some evidence that even subclinical hypothyroidism increases the rates of heart disease and heart attacks in older women.

Cholesterol and Lipid Levels. Hypothyroidism is significantly associated with high levels of total cholesterol, LDL (the so-called bad cholesterol), triglycerides, and other lipids (fat molecules) associated with heart disease. Treating the thyroid condition with thyroid replacement therapy can significantly reduce these levels. (Some experts are suggesting, in fact, that patients with high cholesterol should be assessed for thyroid function before they are given cholesterol-lowering agents, although this is controversial.) Even subclinical hypothyroidism poses a higher risk for unhealthy cholesterol levels. Research is mixed, however, on whether this association has any significance and justifies treating this mild condition.

High Blood Pressure (Hypertension). Hypothyroidism may slow the heart rate to less than 60 beats per minute, reduce the hearts pumping capacity, and increase the stiffness of blood vessel walls. All of these effects may lead to high blood pressure. Indeed, patients with hypothyroidism have a three-fold increased risk of hypertension. Blood flow may even be affected in patients with subclinical hypothyroidism. All patients with chronic hypothyroidism, especially pregnant women, should have their blood pressures checked regularly.

Homocysteine. Studies are finding that hypothyroidism is associated with elevated levels of homocysteine, an amino acid that is a suspect in heart disease. High levels can be prevented with supplements of vitamins B6, B12, and folic acid.

http://adam.about.com/reports/000038_5.htm

New Study Shows that the Addition of T3 is Superior to Levothyroxine/T4-Only Thyroid Treatment for Hypothyroidism

Monday May 17, 2010

There is exciting news for thyroid patients: a study published in a highly respected and reputable endocrinology journal says that the combination of T4/T3 is superior to T4 only/levothyroxine treatment for hypothyroidism! Here are the details.

http://thyroid.about.com/b/2010/05/17/t3-superior-t4-levothyroxine-hypothyroidism-thyroid.htm


Diagnosed May 2006 - Hashimotos Thyroid after being diagnosed in 1977 and told it didn't matter.

Diagnosed June 2006 with adrenal insufficiency.

Diagnosed June 2006 as Gluten Intolerant after I failed the Challenge Diet. Negative blood test.No biopsy.

Diagnosed June 2006 as B12 low. Needed weekly injections for a year.Still have them every 2 weeks.

Trialled Dairy Free Diet and reacted positively to that challenge in January 07.

News Flash! Coeliac Genetic Testing done April 08 . DQ2 Positive !

Diagnosed July 2010 FODMAP. Limits on Fructose, lactose, polyols, fructans. NO ONION! But I can have hard cheese, butter and cream again!!!

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At the very least she needs her levothyroxine increased. I felt so much better when my current endocrinologist started me on liothyronine (T3 or aka cytomel). I feel the best with my free T3 slightly above normal and a lower TSH. Mine right now is a little below the low number. I'm not symptomatic and the doc said everything looked good. Cytomel has a much shorter half life so you will start feeling the effects alot sooner (days to a week or so). It also makes it easier to adjust the dosage if overmedicated.


Me:
Celiac disease(positive blood work/biopsy- 10/2008), gluten free oat intolerent, Hashimoto's Thyroiditis/Disease, Raynaud's Disease


DS2(age 9):
celiac disease(positive IgA tTG, no biopsy- 11/2010)


DS1(age 13):
repeated negative bloodwork and negative EGD/biopsy. Started on a gluten free trial(8/2011). He has decided to stay gluten free due to all of the improvements he has experienced on the diet.

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Interesting stuff. My grandmother always liked Armor thyroid better than Synthroid. My own T3 comes up when the TSH and T4 are right. That article on About mentioned timed release T3, which would be nicer than Cytomel or Armor.

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I have used time release T3 but prefer straight Cytomel ( T3). I think anyone with bad gut absorption may not get the best effects from time release formulas. Just my experience and from listening to a few complaints - my guess. You could work around the problem by increasing the dose - which is what we tried to do but some days ( after dairy for instance) I would not absorb as well as a good day. So I could not get an accurate dose.

I also tried Natural Dessicated Thyroids. I was lucky enough to remember the old Armour. Those were the days !

The new Armour has cellulose and is now 'slow release' and many seem to be doing badly on it. Erfa Thyroid from Canada seems the most like the old Armour. It can be melted under the tongue if you have really bad absorption issues. 1 grain or 60mg of Natural Thyroid has about 38mcg T4 and 9mcg T3.

Her dose of levothyroxine is too low. TSH rises before T4 levels fall, which is what her blood is showing. My doctor tries to keep my TSH at 2.0 or below. I don't know how to interpret the low T3, but it may change when she gets on the right dose of levothyroxine.

But her Free T4 level is perfect. Any increase of a T4 med would simply push this higher. The problem is she is either not converting T4 to T3 , or has a Reverse T3 problem. Either way - she needs T3.

If I was on a desert island and had to choose between T4 or T3 - I would always choose T3. I would happily throw my T4 in the bin. I know of many that live on T3 alone. Faced with a choice it would always be T3.


Diagnosed May 2006 - Hashimotos Thyroid after being diagnosed in 1977 and told it didn't matter.

Diagnosed June 2006 with adrenal insufficiency.

Diagnosed June 2006 as Gluten Intolerant after I failed the Challenge Diet. Negative blood test.No biopsy.

Diagnosed June 2006 as B12 low. Needed weekly injections for a year.Still have them every 2 weeks.

Trialled Dairy Free Diet and reacted positively to that challenge in January 07.

News Flash! Coeliac Genetic Testing done April 08 . DQ2 Positive !

Diagnosed July 2010 FODMAP. Limits on Fructose, lactose, polyols, fructans. NO ONION! But I can have hard cheese, butter and cream again!!!

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But her Free T4 level is perfect. Any increase of a T4 med would simply push this higher. The problem is she is either not converting T4 to T3 , or has a Reverse T3 problem. Either way - she needs T3.

Interesting. I convert OK, so for me high TSH and normal or low-normal T4 is an indication that I'm not on enough levothyroxine. I'll have the dry skin, hair, cold hands, and whatnot too. Adjust the dose and my T4 doesn't go up, but my TSH falls to normal levels and I feel good again. The few times I've had T3 tested, it tracked T4 so they don't usually bother.

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Interesting. I convert OK, so for me high TSH and normal or low-normal T4 is an indication that I'm not on enough levothyroxine. I'll have the dry skin, hair, cold hands, and whatnot too. Adjust the dose and my T4 doesn't go up, but my TSH falls to normal levels and I feel good again. The few times I've had T3 tested, it tracked T4 so they don't usually bother.

Levothyroxine works well for a lot of people. But there is a certain percentage where it doesn't. We are all different and it can take a while to find the one that works best for you. Some Drs do not try to do this. Many Drs are trained by drug company reps that 'one size fits all'. It is important for people to know that there are choices of thyroid meds and there is no reason for not feeling better. Some Drs are open to research and discussions and communicate with their patients. Some do not and take the minimum care.

Why Some Doctors Are Threatened by Knowledgeable, Empowered Thyroid Patients

http://ht.ly/1M1oT


Diagnosed May 2006 - Hashimotos Thyroid after being diagnosed in 1977 and told it didn't matter.

Diagnosed June 2006 with adrenal insufficiency.

Diagnosed June 2006 as Gluten Intolerant after I failed the Challenge Diet. Negative blood test.No biopsy.

Diagnosed June 2006 as B12 low. Needed weekly injections for a year.Still have them every 2 weeks.

Trialled Dairy Free Diet and reacted positively to that challenge in January 07.

News Flash! Coeliac Genetic Testing done April 08 . DQ2 Positive !

Diagnosed July 2010 FODMAP. Limits on Fructose, lactose, polyols, fructans. NO ONION! But I can have hard cheese, butter and cream again!!!

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Thanks everyone, for your replies. I have given her the link to this forum page so she can see for herself what you all have to say. Apparently, the medical clinic has called to set up an appt. regarding the results.


Neroli

"Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted." - Albert Einstein

"Life is not weathering the storm; it is learning to dance in the rain"

"Whatever the question, the answer is always chocolate." Nigella Lawson

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

Caffeine free 1973

Lactose free 1990

(Mis)diagnosed IBS, fibromyalgia '80's and '90's

Diagnosed psoriatic arthritis 2004

Self-diagnosed gluten intolerant, gluten-free Nov. 2007

Soy free March 2008

Nightshade free Feb 2009

Citric acid free June 2009

Potato starch free July 2009

(Totally) corn free Nov. 2009

Legume free March 2010

Now tolerant of lactose

Celiac.com - Celiac Disease Board Moderator

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I'm not sure where you are located or your friend for that matter... I went to a dr in New york City JOHN SALERNO. He was phenominal! Plus, I am on a natural thyroid med. The first one was Natur-Throid & now I am on P-Thyroid (half grain capsules).

A group of us read Suzanne Somers' book BREAKTHROUGH which was a wealth of information! There are doctors listed in her book in many different States that are attentive to the thyroid, bio-identical hormones, celiac, etc., etc. Check it out. After more than 5 years of being misdiagnosed with the "Within normal range" answer being given to me, I am FINALLY feeling better :) Hooray!

Best of luck with this. It can be so frustrating, but DON'T give up. That is the key... that you press on! YOU are paying THEM... get your monies worth ;)

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I can't comment too much on the technical stuff. My thyroid has been high (too much thyroid med) and low and is now normal. For me, all it took was to stop eating soy (I used to eat a lot of it) and really limit the amount of goitrogenic foods I eat. I am not on thyroid meds now.

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I can't comment too much on the technical stuff. My thyroid has been high (too much thyroid med) and low and is now normal. For me, all it took was to stop eating soy (I used to eat a lot of it) and really limit the amount of goitrogenic foods I eat. I am not on thyroid meds now.

The problem with controlling thyroid through diet (not many people can accomplish this....thyroid problems have to be pretty mild) is that the goitrogenic foods are the ones that are really good for you. Brussel sprouts, broccoli and cauliflower, to name a few. No way am I going to give up these veggies and I eat them everyday. I also consume soy, not in great quantities but as I am mostly dairy intolerant, I drink soy milk.

I think it great if you can accomplish this but with the food restrictions most Celiacs have to deal with, cutting out healthy veggies is not an option for me.

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I have used time release T3 but prefer straight Cytomel ( T3). I think anyone with bad gut absorption may not get the best effects from time release formulas. Just my experience and from listening to a few complaints - my guess. You could work around the problem by increasing the dose - which is what we tried to do but some days ( after dairy for instance) I would not absorb as well as a good day. So I could not get an accurate dose.

I also tried Natural Dessicated Thyroids. I was lucky enough to remember the old Armour. Those were the days !

I also had problems with the time release capsules...they worked horribly for me. I have pretty fast motility in my gut, along with Celiac, and when I tried the time release thyroid meds last year, my TSH shot up to 31. Rule of thumb for me is TSH suppressed and keep T3/T4 in the upper range of normal.

I also agree with your philosophy about T3 being more important than T4...I tank when T3 is omitted. So now I am on Nature-throid and what a kick that stuff has! I love it! :D

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