General Medicine

» Elaine Moore - lab results

In response to lab results posted by kpato:
Hi,
Your FT4 of 1.9 with a usual range of 0.8--1.8, along with a low TSH suggests mild hyperthyroidism. Your uptake of 53% at 24 hours also suggest mild hyperthyroidism. The elevated TPO antibody suggests that your hyperthyroidism is autoimmune. But because you have a nodule, the hyperthyroidism could be caused by either Graves' disease, the hyperfunctioning nodule, or a combination of both.
Hyperthyroidism can cause fatigue because food metabolism and digestion occur so quickly, nutrients aren't absorbed from food as efficiently as they should be. Hyperthyroidism also increases muscle activity and this can lead to fatigue.
Both conditions often improve on a low iodine diet, especially a diet low in processed or fast foods. A low iodine diet can also shrink the size of nodules.
Certain nutrients also help reduce symptoms in hyperthyroidism, particularly 200 mcg selenium and 500 mg acetyl-carnithine daily along with a good multivitamin that's free of iodine. Add this to a nutrient-rich diet and you should benefit all around. Best, Elaine

» zvago - Euthryroid GD

In researching symptoms, I came across Suite 101. My 24 yr old daughter has had thyroid tests done regularly-- all normal.(I have hypothyroidism for 20yrs---totally normal on synthroid.)My daughter has lost considerable weight on WW and excercises regularly. I am noticing transient bulging of her right eye,which even seems to restrict normal movement.This is more obvious at times, and seems normal at others. I dont want to panic her, but am concerned. It sounds like Euthryoid GD, and I have observed this since March 06..She does not live at home. How to proceed? Her last thyroid tests were in Sept 06. We were with her last weekend, her eyes appeared normal on Saturday, but the right one was hugh on Sunday. ANy thoughts? Ana

-- posted by zvago

» Elaine Moore - Euthryroid GD

In response to Euthryroid GD posted by zvago:
Hi Ana,
There are several other conditions that cause symptoms similar to those of thyroid eye disease. However, among the autoimmune causes, TED is the most common. And with your history of autoimmune thyroid disease, euthyroid Graves' disease (thyroid eye disease with normal thyroid function) is certainly something your daughter should check into.

If you can tactfully bring up your observations by mentioning that.....probably no one else notices these changes.... but because of your familiarity with thyroid disease you suspect there could be a problem.

The important thing is to have her see an opthalmologist who specializes in thyroid orbitopathy. If her gaze is restricted, she may even be experiencing other symptoms like transient double vision.

The eye doctor can run imaging tests that help diagnose congestive changes, and he can order blood tests for TSH receptor antibodies to confirm euthyroid GD.

If your daughter balks at seeing an eye doctor she might consent to seeing an endo, who could also order the blood tests and, if assess whether treatment is needed. Let us know how this works. Best, Elaine

» free2ridejones - In need of understanding

Hi all

I am hoping someone can help me please. I am sure some of you have read this request in other forums and I am sorry to repeat myself but I just can not understand my results and would appreciate so advice of how I can tell my doctor that I may not be hyper but hypo.
I have some results which over time have
been changing. I am from NZ so our range is no doubt different.
I have had weird symptoms since I was 5 months pregnant in 2000.
Since then my health has been up and down.
Our range for free t4 is (10 - 23.0)
tsh is (.30 -5.00)
t3 is (2.8 -6.8)

My results over time are
28 Nov 03 tsh .87
23 Sep 04 free t4 16.5 tsh 1.1 free t3 4.6
15 Oct 04 free t4 13.1
11 Apr 05 tsh .47
08 Dec 05 free t4 12.5 tsh 0.14 free t3 4.0
16 Oct 06 free t4 14.5 tsh 0.75 free t3 4.7
Microsomal Antibodies Positive 1:400 range (1:100)

Not really sure what to make of these. Also I have taken low dose naltrexone for the fatigue which help alot but things are going down hill there so the doc tried me on low dose hydrocortisone for adrenal fatigue which I stopped after 7 days as my feet became very
sore and my legs felt like tree trunks to carry around. I nana nap most days anywhere from 5 mins to 2 hours) I am at this stage semi refreshed on waking but I am thinking this might be the naltrexone. I seem to have energy (quite hyper)in the morning also get the shakes for a short time, other symptoms too, fatigue sets in from about 12pm, heart beats faster have a nap around 2pm then I am ok. Also I get really cold really tired and then drop off to sleep
Your thoughts would be much appreciated on my results. I for a few days restarted the HC but it made me worse in the afternoon needing a sleep more than when not taking it.

I would really like to get onto some form of treament so I can hopefully become normal again.

Thanks for your help
Margo

-- posted by free2ridejones

» Elaine Moore - In need of understanding

In response to In need of understanding posted by free2ridejones:
Hi,
Your positive TPO test results show that you have an autoimmune thyroid condition. You'd need to have a test for TSH receptor antibodies to confirm this, but I suspect you probably have these antibodies and that they're falsely lowering your TSH result. You can have either blocking or stimulating TSH receptor antibodies: stimulating abs order thyroid cells to produce more thyroid hormone, and blocking abs prevent TSH and also stimulating abs from latching onto cell receptors--so they block thyroid hormone production.

When people have both types of antibodies in about equal amounts it's common for thyroid hormone levels to appear normal although you have symptoms of both hypoT and hyperT. If one type of antibody predominates, you have the symptoms mostly that follow that antibody types' actions.

Since both FT4 and T3 are on the low side you may have more blocking antibodies and primarily have symptoms of hypothyroid.

As for TSH, the pituitary gland recognizes TSH antibodies as if they were TSH. So thinking that you have enough TSH in your blood circulation, the pituitary stops or slows down secreting TSH. This causes the result to be misleading. In this case, treatment has to be based on your thyroid hormone levels.

You could ask your doctor about a low dose of thyroid replacement hormone to raise your levels closer to or slightly above the reference ranges. This can also help reduce thyroid gland inflammation, lowering thyroid antibody levels.

Many people experience the symptoms you describe when they're prescribed cortisone for adrenal fatigue when there isn't any indication of adrenal insufficiency. Hydrocortisone also lowers TSH levels, falsely lowering results and adding to the confusion.

Low-dose naltrexone, which I plan to write an article about in the next few weeks, offers benefits in a number of different autoimmune disorders, but I haven't yet seen indications that it benefits autoimmune thyroid disease. Best, Elaine

» saucywench - New here w/ GD. Questions!!

Hi! I am a 47 yo female, 5'2" & 125 lbs. and I live in Washington state. I'm a married SAHM with an 8 year old son.

I have no unusual health problems other than these (which are enough)!

My doctor ordered thyroid testing due to symptoms I have been having: no libido (over the last year), dry skin and brittle nails, hair loss (what's that huge hamster in the bottom of the shower after I shampoo?), major fatigue (UGH!), weight gain (or, rather, it won't go away despite exercise & healthy eating), insomnia and trouble sleeping, muscle aches (mainly my shoulders and thighs), sore ankle joints, cold intolerance, and constant hot flashes (ALL night long!!).

My hormone tests all came back normal so it isn't menopause.

The TSH, Free T3 & Free T4 tests came back as follows:

TSH: 0.01 LOW (one month ago this was 0.07)
Reference range: ulU/mL 0.40-5.00

Free T3: 5.0 HIGH (I don't remember the previous results for this one) Reference range: pg/mL 2.3-4.2

Free T4: 2.0 HIGH (I don't remember the previous results for this one either)
Reference range: ng/dL 0.7-1.5

So, my test results say Hyperthyroidism. But, my symptoms just don't jive with what we have been reading as relating to Hyper: I do NOT have a high libido (I wish!), rapid heart rate or weight loss (again, I wish).

They all relate to HyPOthyroidism instead (as I described at the beginning of this note).

I am very confused about this (the tests say hyPER but my symptoms say hyPO). Can you have symptoms of both??

My doctor has suggested I start on a supplement called Thyrostim (Biotics Research), 2 tabs a day, and test again in two months, rather than going on more serious medications now.

I have been on it for a week now, no changes. I am losing sleep because of the hot flashes and I don't know if I can go two months more like this. I am hoping the Thyrostim will kick-start my thyroid (or whatever it is supposed to do!).

Any comments or suggestions are welcome and appreciated!

-- posted by saucywench

» free2ridejones - In need of understanding

In response to In need of understanding posted by daisyelaine:

Thank you, I am still not overly clear about it all but I will take your note to my doctor and I am sure she will understand. As for naltrexone I took this for fatigue thinking this might be my problem. I found it great, at least I had more energy and could stay awake all day and did not have the aches and pains. I don't take it every day now just when things go down hill. It was prescribed by quatering a 50mg tablet crushing 1/4 and mixing with 14mls water then taking 3.5mls in the evening before bed. Hope that was of some used to you.

Thanks again Margo

-- posted by free2ridejones

» free2ridejones - In need of understanding

In response to In need of understanding posted by free2ridejones:

Hi all
Sorry to be a drag about these results of mine. I was wondering if I take the suggestions given to my doctor and this does not put some doubt in her mind (which I can understand with our lab results)is there a medication or natural product I can take which would be safe for both hypo and hyper. Also would it be worth my while sending tests to Great Smokies (I think they have another name now)I am very worried about getting treated for the wrong condition. With this been going on for me since Nov 2000 do you think I still have a chance of remission or recovery or has it been too long for me.

Thanks again Margo

-- posted by free2ridejones

» Lorrie76 - Medication

In response to Medication posted by daisyelaine:

Hi Elaine
I finally did receive my September results
TSH - 0.76 MU/L
T4 Free - 11.1 PMOL/L
Free T3 - 3.4 PMOL/L
Are these ok ??

Thanks
Lorrie

-- posted by Lorrie76

» Elaine Moore - New here w/ GD. Questions!!

In response to New here w/ GD. Questions!! posted by saucywench:
Hi,
Most everyone with Graves' disease has an initial period of hyperthyroidism. If you have GD it could be that you were hypothyroid in the past and are still having residual symptoms. Your doctor could run a blood tests for thyroid antibodies to see if your hyperthyroidism is autoimmune, which means that it's caused by Graves' disease.

Another scenario would be that you've been hypothyroid for some time, and 1) you're in the hyperthyrodi phase of hypothyroidism now or 2) the hypothyroidism has caused multiple thyroid nodules that are secreting thyroid hormone, causing hyperthyroidism. This would be called toxic multinodular goiter. In either case this could cause symptoms of hypothyroidism...although you will eventually start having symptoms of hyperthyroidism if your thyroid levels continue to rise

Another possibility is that you've had thyroiditis and are now moving from hyperthyroidism into hypothyroidism. In thyroiditis people usually have a period of hypothyroidism or hyperthyroidism lasting about 2 months followed by the opposite condition, which also lasts about 2 months although the hypothyroid phase can become permanent.

I'd definitely not use ThyroSlim or any product designed to stimulate the thyroid gland because if you have an auotimmune thyroid disorder, iodine can worsen it. And if you're truly hyperthyroid, you could run into serious problems. I'd ask for a referral to an endocrinologist or start a low-iodine diet, avoiding fast and processed foods and any foods high in iodine content. And then have your tests repeated and get the thyroid antibody tests too.

Without the antibody tests it's difficult to say for certain what's going on.
And since many symptoms of hypothyroidism and hyperthyroidism overlap, you could have true hyperthyroidism. Symptoms seen in both hypoT and hyperT include; weight gain, weight loss, hair loss, insomnia, palpitations, depression, and fatigue.
Joint pain and muscle pain are more common in hypothyroidism.
In hypoT hair tends to become dry, thick and coarse and the outer 1/3 of the eyebrows can become thin or bald. In hyperT, hair tends to become thin and fine and brittle and hard to keep a curl. Let us know about the other test results if you have them. best, elaine