BellaOnline Forums Health and Fitness Thyroid Health Share Your Thyroid Story

Marge,

As you know, there can of course be other causes for depression, including simply being the emotions without underlying disease but thyroid disorders are a major cause!
I commend you for taking a proactive stance in wanting to have thyroid issues considered as a possible cause. I would suggest however, that a doctor not test TSH only because though it is the most sensitive of thyroid function tests, it can miss certain types of thyroid disorders. I would ask that the doctor order TSH, Free T-4 and Free T-3, plus "thyroid antibodies" (the TPO and TG antibodies).
This suggestion comes from five years of corresponding with hundreds of patients. Some were tested for TSH only and found later on, by adding tests of the Free T-4 and Free T-3, that they had "Central Hypothyroidism" (normal or low TSH with low thyroid hormones) because their pituitary gland was failing to stimulate the thyroid.
Other patients attested to being found "normal" after having a thyroid panel ran but a later test of thyroid antibodies, showed them to be experiencing "thyroid autoimmunity" (disease process that eventually leads to hypothyroidism, also called "Hashimoto's thyroiditis). There are still doctors who swear thyroid symptoms cannot manifest unless TSH and/or thyroid hormone levels become abnormal but medical research articles and patient testimonials say otherwise!
In my opinion if thyroid is tested, it should be done thoroughly because non-thorough missses some cases of developing thyroid disease and it only takes an extra stroke-of-the-pen for a doctor to add these tests. Why some doctors stubbornly refuse to order more than the TSH test to diagnose thyroid, is a mystery because it's nothing out of his pocket and is afterall the patient's life & health we're talking about.
Certainly there's nothing wrong with antidepressants if an underlying medical condition is not being ignored. In my opinion, thyroid, glucose and a complete blood count, are all important tests when trying to diagnose or rule out causes of symptoms.
I wish you the best with it!

I'm bumping this topic up, for new post/reply opportunities.

Evening all - I'm 48, diagnosed in 1994 with a TSH of 12. I was working 8-4:30 m-f then a p/t job from 5-9 for months, couldn't understand why I was SO tired, couldn't concentrate, cold all the time, always felt there was a lump in my throat. Well after that TSH of 12, md put me on 150 mcg of Synthroid. Wow, after a bit the weight came off, I perked up, but still had symptoms. After the md moved me back and forth between 150 and 175 mcg I was sure he didn't know what he was doing so I requested an endocrinologist. I was extremely annoyed that even after seeing a small nodule on the U/S, he blew off my swallowing problems on "anxiety", I'm surprised you could feel it". I told my md's nurse I was angry and she suggested I ask to see this other endo that their patients had raved about. The endo had other bloodwork done, sent me to a different facility for the U/S and by that time it showed I had multiple larger nodules. Aspiration biopsy/bloodwork showed I had Hashi. Their plan was to put me on suppressive dose of Synthroid. Kept me on 175, bumped me up to 200mcg. I started having anxiety attacks in the p.m. after dinner, shakes, BP thru the roof, ER visits, etc. I was losing weight as I couldn't eat, couldn't sleep well. Hot flashes at night, during the day, dizzy spells. Sent for a Stress Test, nothing wrong with my heart - the nurse practitioner at the endocrinologist (NP's rotate thru there for training I guess) never connected the high dose with OVERDOSAGE. Duh. I went to a new md, who saw it was way too high, dropped me down to 150. After reading up more saw that depression and anxiety were part of the disease and part of peri/menopause, I requested Xanax so I had a chance of getting thru work and getting some sleep at night. No problem. It helped with the shakes, hot flashes, lack of sleep, but not happy with the md brushing off my concerns with "your TSH is normal, so its peri/menopause", live with it, etc. I switched to another md, who upon hearing my after dinner/evening problems sent me for an abdominal U/S - bingo - gallstone. Removed. No more evening problems. He also did bloodwork and suprisingly said my 150mcg was too high still and dropped me to 137mcg. So far no more anxiety attacks, thankfully. No more Xanax, and I can eat again. He insisted on Paxil, saying depression was common with Hashi, so that's worked out ok. Cold intolerance is back, low energy is back, sleeping too much is back. He tells me to exercise, but when you don't have any energy, how can you exercise? Seems like he's missing something with the Hashi treatment, different drug? Thanks for any info

Krys

While I'm not a Dr. but rather a Thyroid Patient Advocate, I feel I am fairly well studied and have corresponded with 100s of patients over the past five years. I've formed some strong opinions in regard to hypothyroid treatment & monitoring it.
I feel that newly treated hypothyroid patients need to be tested for TSH, Free T-4 and Free T-3, for at least the first couple of blood test repeats/follow-ups to monitor their thyroid hormone therapy. I say this because there are some patients whost TSH levels are not accurate in reflecting thier thyroid hormone levels. Some patients see their TSH suppress very low before their thyroid hormone levels from the replacement therapy, place their T-4 and T-3 at adequate levels for them (above mid-range and higher-normal). I'm an example of TSH that needs suppressed more than the average patient. My latest TSH blood restest result was at 0.001 which for the average patient, would be at seriously hyperthyroid level but this only puts my T-4 at mid-range and my T-3 at between mid-range and high-normal, where I need to be to see symptom relief.
On the other hand, some patients need a TSH that seems a little high for a treatment level but they experience toxicity (thyroid med induced hyperthyroidism) if their TSH goes below a 2.0.
It's difficult to know which patients may be in these uncommon situations, unless the free T-4 and T-3 are tested along with TSH. By testing these together for the first couple of follow ups, it can also detect another uncommon condition called "impaired conversion". This one means that a patient is not converting enough T-3 in the body, from a T-4 only hormone replacement medication. In these cases, TSH may be well suppressed from an adequate T-4 level but the even more active T-3 hormone is staying low. These are the types of patients who need a combination T-4 and T-3 medication or need a T-3 added to the T-4 they are already taking.
I'm not saying you fit into any of these categories but the possibility of these type problems are why I feel more thorough lab evaluation is needed to monitor new patients on thyroid hormone therapy. Once it is established that their TSH accurately reflects their T-4 and T-3 levels, their thyroid hormone therapy can afterward be monitored with TSH-only testing.
If the more thorough testing is done and levels are shown to all be adequate or even best-optimized and you still experience symptoms, other blood tests may need to be done, to rule out other causes. Tests for anemia (CBC) or pre-anemia states such as lowering iron and/or ferritin levels and tests of B-12 level, glucose (HB A1C), inflammation, other autoimmunity, adrenal hormones, sex hormones etc... may all need to be done in patients with significant unresolved symptoms.

BTW: Welcome to the forum, it is good to see you aboard!

I am a 24 year old female, and recently I had made some blood tests due feeling sick with fever for a whole week and tired for the last 5 years always feeling fatigue.
The results came wonderful according to my doctor but I am not 100% convinced especially on my thyroid result. The result came out TSH- 3.010 mIU/L and FreeT4- 19.80 pmol/l. Here in my country ranges are the old one till 5, and as I am reading I found out that I am on the high side. I am sure that my tiredness is coming from my thyroid it is not normal to feel always tired my age whilst my friends always having lot of energy and me need to do weekend sleeping cause if not feel exhausted.

mgal,

It's good to see you here!
I would like to post my reply to you, that I sent in response to your comment sent via the contact form because it might be helpful to some of the members here.

"You are smart and wise in doing enough search & research to know that a TSH of 3.0 and over, is not necessarily normal. This is especially true if you have thyroid autoimmunity going on, meaning the antibodies that cause autoimmune hypothyroidism, are active in attacking your thyroid. The tests you need in my opinion, are the "TPO" (anti-thyroidperoxidase) and "TG" (anti-thyroglobulin) antibodies. These are the ones that cause "Hasimoto's thyroiditis", the most common cause of hypothyroidism and research articles on PubMed (U.S. Gov./NIH) and by other medical groups state that thyroid autoimmunity can begin causing symptoms before thyroid hormones are out of range.
It's not always easy to get Dr.s to agree to tests suggested by the patient but I would be very firm about getting him to order these for you and if he refuses, find a Dr. who will order them.
Here's a quote from the NIH/NLM (U.S. Gov.) website and the link, that states that a TSH at 2.0 and above, is suspicious for developing hypothyroidism.

"Normal values are from 0.4 to 4.0 mIU/L for those with no symptoms of abnormal thyroid function. However, those without signs or symptoms of an underactive thyroid who have a TSH value over 2.0 mIU/L but normal T4 levels may develop hypothyroidism sometime in the future. This is called subclinical hypothyroidism (mildly underactive thyroid) or early-stage hypothyroidism. Anyone with a TSH value above this level should be followed very closely by a doctor."

LINK>>BellaOnline ALERT: Raw URLs are not allowed in these forums for security reasons. Please use UBB code. If you don't know how to do UBB code just post here for help - we will help out!

Dear Jim Lowrance,

First of all would like to thank you loads for your prompt reply and all the detailed information you gave me.

Definitely, without doubt I would try to make all my best to find a doctor to order me those test ,by doing tests I am not going to loose anything so that if I have any problem with my thyroid I would start taking treatment now, not when things would be more complicated.

I am really health conscious and at the same time very disappointed, due to the fact that here in my country labs are still using the old version range, which is not healthy.

regards,

Marica

Thanks a lot for inviting me to join the forum, for sure I am going to join :-)

thanks loads for the useful information well to give you some more information i am on contraceptive pill for the last 5 years due to suffering from severe acne,could that effect my tsh also?? and also i passed from lot of stress periods where from the last 5 years i lost about 7 kilos due not eating because of stress..first university than my job, etc but now thank god i am trying to take life as easy as possible cause i was suffering from acid in my stomach, the antibodies test are the tpo and tg?? i had also done the rickettsia antibodies test which came negative, could that effect my tsh

i`ll hope that i will find a doctor in my country which would order the tests for me..i had already went to 2 doctors and told me eveything is normal and not to worry..i have to worry only if my thyroid was over 5 :-) they r bit crazy hehe

well for your benefit and also in order maybe to give me more information
i am going to send you all my blood test results that i had done
white blood cell count 5.30 * 10^9/l
neutropholis 2.57 * 10^9/l
lymphocytes 2.08 * 10^9/l
monocytes 0.53 * 10^9/l
eosinophils 0.09 * 10^9/l
basopils 0.03 * 10^9/l
red cell count 3.80 * 10^9/l
haemoglobin 12.0 g/dl
haematocrit 36.7%
mean cell volume 95.6 fl
mean cell hb 31.3 pg
mean cell hb conc 32.7 g/dl
red cell distribution 11.5%
platelets 218 * 10^9/l
mean platelet volume 11.1 fl
glucose 4.91 mmol/l
bilirubin 7.0umol/l
alkaline 36u/l
ggt 12.5u/l
alt 13 u/l
urea 5.6 mmol/l
creatinine 77 umol/l
c-reactive protein (crp) <6 mg/l
epsteing barr virus igg positive
epsteing barr virus igm negative
rickettsia antibodies negative
tsh 3.01 miu/l
fee t4 19.80 pmol/l

Wondering how you all deal with the weight issues from thyroid disease. Had thyroid removed 03/06 and have had tooo many problems to list. The one I find most frusterating is weight gain as I am very careful about what I eat and work out all the time. Before thyroid removal it was so easy, now it seems no matter what I do nothing works.The heart doctor is very concerned about weight gain (35 lbs since surgery, endo says I'm eating to much and not getting enough exercise. Labs always within normal range. The endo does not want me on Cytomel bacause of history with heart disease. Wondering if there might be some natural supplement that would help. Any ideas considered and greatly appreciated. rtylutki@uncnepa.org

hello

today I had went to the doctor to show hin my blood result test of a tsh 3.01 and told me that everything is normal the fact that is within range, no worry. I told him that from research done on internet i found that a tsh over 3 might be a suspect of hypothroidism.
what should i do??


thanks loads for the useful information well to give you some more information i am on contraceptive pill for the last 5 years due to suffering from severe acne,could that effect my tsh also?? and also i passed from lot of stress periods where from the last 5 years i lost about 7 kilos due not eating because of stress..first university than my job, etc but now thank god i am trying to take life as easy as possible cause i was suffering from acid in my stomach, the antibodies test are the tpo and tg?? i had also done the rickettsia antibodies test which came negative, could that effect my tsh

i`ll hope that i will find a doctor in my country which would order the tests for me..i had already went to 2 doctors and told me eveything is normal and not to worry..i have to worry only if my thyroid was over 5 :-) they r bit crazy hehe

well for your benefit and also in order maybe to give me more information
i am going to send you all my blood test results that i had done
white blood cell count 5.30 * 10^9/l
neutropholis 2.57 * 10^9/l
lymphocytes 2.08 * 10^9/l
monocytes 0.53 * 10^9/l
eosinophils 0.09 * 10^9/l
basopils 0.03 * 10^9/l
red cell count 3.80 * 10^9/l
haemoglobin 12.0 g/dl
haematocrit 36.7%
mean cell volume 95.6 fl
mean cell hb 31.3 pg
mean cell hb conc 32.7 g/dl
red cell distribution 11.5%
platelets 218 * 10^9/l
mean platelet volume 11.1 fl
glucose 4.91 mmol/l
bilirubin 7.0umol/l
alkaline 36u/l
ggt 12.5u/l
alt 13 u/l
urea 5.6 mmol/l
creatinine 77 umol/l
c-reactive protein (crp) <6 mg/l
epsteing barr virus igg positive
epsteing barr virus igm negative
rickettsia antibodies negative
tsh 3.01 miu/l
fee t4 19.80 pmol/l