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TSH a bit high, to treat or not to treat?

Discussion in 'Hormones' started by Thinktank, Sep 15, 2015.

  1. Thinktank

    Thinktank Senior Member

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    I've been having a weird feeling around my thyroid area for a while now so i decided to have some thyroid hormones and antibodies tested.

    TSH = 3.49 (ref. range 0.35 - 4.94)
    Free T4 = 1.16 (ref. range = 0.70 - 1.48)
    Free T3 = 2.70 (ref. range = 1.71 - 3.71)

    Anti-TPO = 0.33 (ref. range = 0 - 5.61)
    Thyroglobulin antibodies = 0.32 (ref. range = 0 - 4.11)

    Cholesterol = 209 (high) (ref. range = < 200)
    HDL = 43 (low) (ref. range = > 60)
    LDL = 160 (high) ref. range = < 100)
    Triglycerides = 66 (ref. range = < 150)

    FT3 and FT4 look alright i guess but TSH is elevated according to the new standard.
    Last time i checked my thyroid hormones TSH came back at 2.2 or so and i didn't have that pressurized sensation in my throat.
    Also my LDL has increased by approx. 50% in 2 months.

    I have many hypothyroid related symptoms, would it be a good idea to just do a trial of thyroid meds to see if it makes me feel better?
     
    Last edited: Sep 15, 2015
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  2. A.B.

    A.B. Senior Member

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    My opinion: go for it. It looks like mild hypothyroidism. Small doses of T4 are well tolerated and are easy to come off too. You need to try them for a few weeks at least to really see if they help.
     
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  3. barbc56

    barbc56 Senior Member

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    What is your physician saying? Are you seeing an endocrinologist?

    The range for normal in the USA, assuming the same standard of measurement is used is .358 - 3.74.

    Good luck.

    Barb
     
  4. Maria1

    Maria1 Senior Member

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    I had that weird sensation in my throat/ neck. I thought I could see a goitre but my GP at the time couldn't (the endocrinologist confirmed goitre straight away just by looking at it, so good to feel I wasn't going crazy). My TSH was 4. something at that time but GP said it had been higher in the past and it was worth trialing the thyroxine, as it was very slightly out of range. Sub clinical hypothyroidism is how he referred to it. This was 18 months after being diagnosed with CFS/ME.

    If a different doc had taken a different course at the time of the CFS diagnosis I probably wouldn't have the CFS diagnosis, as TSH of 4.6 was ignored. I'm now diagnosed with both autoimmune thyroiditis (Hashimotos) and CFS/ME. I'm not complaining necessarily, just saying how we are labelled by a group of symptoms, depending on what investigations are or aren't done at the time.

    I felt better initially on the thyroxine, and every time the dose went up. I'm now on a higher dose than my GP is aware of, as I feel better when my TSH is suppressed, and I'm considering trialing T3. My feeling is that I get flashes of feeling 'normal' from the thyroxine treatment. I am not sure I'd get that feeling if my thyroid wasn't treated by medication.

    I don't know where you live but I use the Thyroid UK website for info, really useful.
     
    Last edited: Sep 15, 2015
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  5. Thinktank

    Thinktank Senior Member

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    @A.B. , Yes i probably will, but first i want to do a bit more testing, lab and imaging just to be sure. As far as i understand a low dose is quite harmless.

    @barbc56 I'm looking for a new endocrinologist, so far they have all been utterly incompetent.
    My LLMD will probably say the root cause is my dysfunctional hypothalamus.
     
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  6. justy

    justy Senior Member

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    You could give meds a go, but need to be aware that some have weird reactions to thyroid meds. How are your adrenals? if they are in any way not good then thyroid hormones may make the situation worse. How are your ferritin levels and selenium levels? if these are low it will make the thyroid sluggish.

    Ive been there with trialling thyroid meds and in the end, despite a promising start, had to abandon them. My TSH is now over 2.5 and my T4 is the lowest it can be and be normal, I have symptoms of Hypo, but taking meds has really not helped - LLMD (same as yours I think) believes it is a downstream effect of other processes....good luck with whatever you decide - TSH of that level does indicate a trial of thyroxine or NDT as fr as I can see.

    I would check out Stop Thyroid Madness website for the low down on the complexity of treating thrypid issues.
     
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  7. beaker

    beaker ME/cfs 1986

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    my tsh is up and other measures fine. I have seen very good endo at a university health center who has PHD and MD and specializes in thyroid issues. My tsh bounces around since post menopause and that happens and once
    went back to norm on it's own. last measure was 6 something( not sure what your situation is there so just throwing that out there )
    As long as my tsh is under 10 and my t4 and t3 and other thyroid measures are normal we are not treating.
    BTW My primary care doc felt same prior to my seeing her, and sent me off to endo thought, b/c of all my complications.
    I have been sick a long time and feel no different.
    If I took thyroid med, it could be negative for my bone health
    I am considered subclinical.

    There was a lot more but I don't remember. I just know I am very comfortable w/ this dr. expertise and decision.
    I would highly recommend seeing a good endocrinologist.
     
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  8. barbc56

    barbc56 Senior Member

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    I can only give you my experience and this should not be taken as medical advice but more like advice from an old worry wort, so that parts on me

    Please, please be careful about taking more thyroid medication than needed or your doctor knows.

    I was in my mid thirties, became hyperthyroid and almost had a heart attack from what is called a "thyroid storm" which can be deadly. I had no idea I was having thyroid issues. I was fine one day, woke up in the middle of the night with a heartbeat of 160, though I may be misremembering the exact number. Finally, after six hours of this, I went to the emergency room. They thought I was having an anxiety attack and didn't even do bloodwork until I was ready to go home, so I didn't get the results until three days later, but was given a beta blocker. Hyperthyroidism/graves disease runs in my family. It finally resolved and in my fifties, I became hypo.

    If your doctor doesn’t know the right amout of meds. any symptoms may be misinterpreted.

    I have had quite a few increases of my synthroid over the last five years and only a slight improvement in symptoms other than maybe a slight lifting a bit of depression.

    Ironically, it was a psychiatrist who discovered I was hypothyroid. It was the first time I saw him after a move. He likes to run a complete physical as part of his diagnostic workup! Thank goodness!

    Good luck.

    Barb
     
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  9. Maria1

    Maria1 Senior Member

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    Thanks for your concern but there is more to the story than I have told here, so I should probably explain.

    The endocrinologist I saw was less interested in symptoms than blood results. He has discharged me to the care of my GP, requesting that my TSH be kept between 0.2 and 2. He was also treating me with ferrous sulphate and vitamin d, as I was low in ferritin and vitamin d.

    My GP recently changed my dose of levothyroxine to 88mcg as my TSH was creeping up again. I decided to change to 100mcg one month ago. I feel better on the higher dose. There is evidence that many hypothyroid patients feel better with a TSH close to 0.

    I do plan to tell my GP I've been taking the higher dose, and that I feel slightly better on it. I also plan to get a private blood test just before that GP appointment as I want my T3 testing and the NHS is reluctant to test for it here. I have the name of a local endocrinologist who is apparently more sympathetic to possible trialling of t3 medication, and I will request a referral to him also.

    My experience with thyroid issues is that I could present in front of five different doctors and they would all tell me different things. So I've done quite a bit of research, and now have my own plan to try, but I do want to be safe.

    It's interesting that there are people on the thyroid websites with symptoms very similar to those here, but they just have a different label/ diagnosis. They are also sure that, if they can only get their thyroid right, with the right combination of meds, they will get better. There are also many, many people who do feel better, and are advising others on how to self medicate safely.

    For myself I can only say that my flashes of feeling 'normal' (they don't last long) did and do seem to coincide with adjustments to my levothyroxine. Whether or not that's what's working, I can't help thinking it's worth a try.
     
    Last edited: Sep 15, 2015
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  10. Gondwanaland

    Gondwanaland Senior Member

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    There could be something in your diet with a goitrogenic effect.
     
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  11. digital dog

    digital dog Senior Member

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    I had a TSH of 14 then the week after it was 2.2!
    I tried thyroxine and got very sick, very quickly. That being said if I was you i would try it.
    I plan to try armour if my TSH goes up again. A quarter of a quarter to start with so that I don't go insane.
    The strange thing was that at some points taking thyroxine it was the best I had felt. The only time I have really ever felt ok...but then things got very nasty indeed.
    I can NEVER balance my hormones.
    I have been gluten free for four months and my antibodies have gone from 240 to 61.
    I don't feel any better though.
     
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  12. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine.

    When I had SCH, three months later my endocrinologist repeated the TSH and free T4; my TSH came back down to a normal range. I didn't have to be treated.

    Subclinical Hypothyroidism: An Update for Primary Care Physicians
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664572/

    Subclinical Hypothyroidism: Deciding When to Treat
    http://www.aafp.org/afp/1998/0215/p776.html
     
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  13. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    @Thinktank, I don't know if you could nudge your current endocrinologist to repeat just the TSH and freeT4, but at least that would tell you if your TSH has gone up or down since your last measurement. A three month wait between blood tests is what my endocrinologist wanted after I had a pattern like yours.

    Even if you think your endo is useless, I think they might see the value of repeating these two tests after a three month interval has passed. Good luck.

    ETA: If your TSH has gone up, your endo may decide to treat you. If it's gone down, then that's a good sign.
     
    Last edited: Nov 30, 2015
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  14. Thinktank

    Thinktank Senior Member

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    I've been eating a lot of goitrogenic foods for the past 3 days in an effort to clean up my diet. Last night i developed that annoying lump in my throat again. Today I couldn't complete my morning walk because i was too fatigued and my asthma was playing up.

    Does anyone else here have a problem with greens? I think i have really overdone it on the goitrogenic foods, even sweet potatoes seem to be goitrogenic.

    @CFS_for_19_years , the TSH hovers between 2.5 and 3.5.
     
  15. brenda

    brenda Senior Member

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    @Thinktank

    Cooked goitrogenic foods are fine. Just don't eat them raw. I am on a autoimmune paleo diet for the five autoimmune conditions l have including Hashimotos and am eating a LOT of greens every day even for breakfast, and my thyroid has shrunk. A recent tsh shows that it is not slowing it down at all. No antibodies tested but they went right down in the past when l quit gluten and dairy.

    Before this diet l felt uncomfortable in the neck region while lying down and was sure that l could feel nodules.
     
  16. Thinktank

    Thinktank Senior Member

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    @brenda , I've not seen any evidence that cooked brassica contain less Isothiocyanates than in raw form. I've seen some websites mention it but no proof.

    Anyway, nice to hear your thyroid is doing better on an autoimmune paleo diet.
    How long have you been on it?
     
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  17. brenda

    brenda Senior Member

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    I do not look for scientific proof where there is much evidence to the contrary amongst patients who are providing it. I need to recover now not at some time in the future when science catches up, if they do, and know my body enough to experiment. I was told that iodine was safe to take and even an integrative doctor prescribed it, but within a short time l knew it was bad for me so stopped.

    Four months on the diet.
     
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  18. Gondwanaland

    Gondwanaland Senior Member

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    From my personal experience what seems to happen is that the high sulfur content in those foods might antagonize B6 and this might impair T4>T3 conversion.

    What happened after I took B6 was that I felt the need to lower my hormone replacement, but also after a few days taking ~6mg of P5P I had serotonin syndrome (lack of B2). So now I am taking only a few micrograms daily from B6/B2 to keep my hands and feet warm because temperatures are very low right now where I live.

    Hormone replacement therapy or Selenium never warmed up my hands and fett like this.

    I think @brenda 's diet approach is wiser though, but when I tried it a couple of years ago I think I didn't have enough B2/B6 in my body for it to work.

    EDIT - also in my own experience, seet potatoes will antagonize B6 because they are very high in oxalates.
     
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  19. Thinktank

    Thinktank Senior Member

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    Hmmm T3 and T4 are and have always been fine in serum, might it block cellular uptake?

    Unfortunately i'm very sensitive to B-vitamins, i do have a very low dose B-complex coming my way so i'm eager to know how it will affect me.

    I've been playing around with foodgroups the past few days and i'm now certain that i absolutely NEED some form of glucose / simple carbohydrate. Without it i get polyuria, my thyroid swells up, my muscles hurt / feel empty and i get this stabbing pain around my brainstem.

    It goes like this:
    Change in diet to low glucose / medium complex carbs -> stabbing pain in brainstem -> muscles feel sore -> excessive urination / significant drop in weight loss -> thyroid swells up -> flu-like feeling.

    Increasing complex carbs doesn't help, it's as if i can't digest them and they end up in my colon for fermentation.

    When i eat a tablespoon of honey or drink some sugary soda i get relief from above symptoms.
    This has been going on for nearly 4 years now since i got poisoned with ciprofloxacin, i really want to know what is going on!
     
  20. Gondwanaland

    Gondwanaland Senior Member

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    This happens because you need either carbs OR salt to hold water. Check this out
    Edit -- OTOH if my husband eats a low carb breakfast, his thyroid won't start (chest pain and depression). A low carb dinner makes him sleepless.
     
    Last edited: May 16, 2016

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