More texts about hypothyroidism and T3 supplementation,
TSH levels, >2 is too high
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Norsk Thyreoideaforbund

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dansk side

medfødt hypothyreose
THYRA artikkel
doktoronline T3
eyr 405
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eyr 441
stensby hypothyreose
senter for kvinneforskning sundhetsguiden
dansk side
aftenposten artkkel
Norsk Legeforening
fürst info
sider laget av pasienter: website
about TSH FAQ
thyroid information central
yahoo hypothyroidism
yahoo hypothyroid

Some collected snippings
From Mary Shomon interviev with Dr Derry:
The consensus of thyroidologists decided in 1973 that the TSH was the blood test they had been looking for all through the years. This was about two years after I started practice. Having been taught how to diagnose hypothyroid conditions clinically I was in a position to watch to see what the relation of the TSH was to the onset of hypothyroidism. What I found was many people would develop classic signs and symptoms of hypothyroidism but the TSH was ever so slow to become abnormal, rise and confirm the clinical diagnosis. Sometimes it never did. Finally I began treat patients with thyroid in the normal manner I was taught. I could not see why I had to wait for the TSH to rise for me to be able to treat them. The main ingredient of thyroid hormone, which distinguishes it from other molecules of similar size (molecular size), was the element which made thyroid hormone namely iodine. So I did a thorough search of the literature on iodine. This review led me to try to use iodine and thyroid therapeutically. The TSH had caused all research on the therapeutic use of both of these substances to stop dead. My biochemical and pharmacological background has allowed me to search in areas of the literature that are impossible for a normal physician or even a specialist to explore. If you remember it was a long time before the medical profession admitted that there were two new diseases to appear in the world that were not there before. Chronic fatigue and fibromyalgia were non-existent before 1980. This is seven years after the 1973 consensus meeting. So where did these two new diseases come from? The symptoms and signs of chronic fatigue and fibromyalgia were described in the literature in the 1930's as one way that low thyroid could be expressed. Treated early it was easily fixed with thyroid in adequate doses. But even then the clinicians had noticed that if a patient has low thyroid (chronic fatigue and fibromyalgia) for too long then it became more difficult to reverse all signs and symptoms regardless of what they were.
Mary Shomon: Why do you think that thyroidologists have decided that the TSH test is the most useful -- or in many cases - the only test for thyroid problems, versus a patient's clinical symptoms? How do you think this has come to be considered the "gold standard" for thyroid diagnosis and management?
David Derry: The thyroidologists have been looking for a reliable test for thyroid function since the beginning of the century. The first important ones were the Basal Metabolic Rate, the cholesterol and the creatine phosphokinase. (CK) . These were used mainly up to about 1960. If you had a high cholesterol in the first half of the century you got thyroid to lower it to normal. Details of using this method of treatment were still described in the 1950's. The Basal Metabolic rate became the fad in the 30s and 40s and almost every office had a machine to measure it. It was quite good but subject to difficulties of interpretation and interference by emotional factors. However it still remains the only test that actually measures the effects of thyroid medication on the human body. In the 1940's radioactive iodine became available from the Tennessee Valley Atomic Energy Complex. Hence the metabolism of iodine could be studied more closely. The radioactive iodine uptake by the thyroid became a frequently used test, which was said to be infallible like all the others when they first arrived. Every time there was a new test it was declared to be reliable for telling if a person was hyperthyroid or hypothyroid, but as with every previous test it turned out to not be clinically applicable in all cases. In the 1960's when I was studying medicine the PBI (Protein bound iodine) was heralded as the only test necessary, when it was low you had hypothyroidism and when it was high you had hyperthyroidism. This was written in some of the textbooks of the time. Eventually this test went the way of the rest -- useful sometimes-- but doesn't always agree with the clinical findings. Next came the T4 or total thyroxine in the blood that is the free and the protein bound thyroxine measured together. This was also hailed as far superior to the PBI, but it too went the way of the rest of the tests --as not being reliable enough. Finally the TSH arrived in the late 60s and was boasted about as the final answer. The TSH was not only able to deliver all the thyroid diagnoses but it could be used as well for monitoring therapy. Over the following twenty years the TSH was made more and more sensitive and because of these improvements it was even more thought that it was the total answer for thyroid diagnosis and treatment. However as the TSH was so sensitive to orally-given thyroid hormone it meant literally everyone was going to end up with a low dose by comparison with previous doses. The new doses were about a third of the dose that had been found to be clinically effective for every patient for eighty years prior to the TSH. The TSH had a ring of scientific rigor for those who have a smattering of knowledge about thyroid metabolism. It was part of the pituitary feed back mechanism for monitoring the output of the thyroid gland. There is no doubt that it does accomplish this job. But unfortunately the TSH value has no clinical correlation except at absolute extremes with the clinical signs or symptoms of the patient. The reasons for this are complex and I only want to discuss one aspect but there are other important factors. To start with the thyroid metabolism is controlled locally in the tissue by each organ. That is the brain has one mechanism for controlling the amount of thyroid available to the brain but it is different from other tissues such as the liver. There are many mechanisms by which each tissue controls the amount of thyroid hormone which gets into the tissues. But to discuss one: there is an enzyme in the tissue which deiodinates (takes one iodine off the thyroxine T4) and makes T3 or triiodothyronine. These enzymes are called deiodinases. Every tissue has different types of deiodinases. To just give you one example: If you starve animals and study the deiodinases in the brain and liver you find that the activity in of the brain deiodinases go up by 10 times while at the same time the liver deiodinases go down--not up. This mechanism is obviously meant to preserve the functioning of the brain under starvation conditions and not metabolize too much thyroid hormone in the liver. Therefore the control of thyroid metabolism is in every individual tissue. The problem with this is-- if a tissue needs more (such as the brain with depression) there is no way for the brain to signal the thyroid that it needs more sent up to it. The thyroid merrily goes on putting out the same amount of thyroid hormone. So the patient can have symptoms related to low thyroid in the brain (for example) but the thyroid doesn't do anything about it. But if you give thyroid hormones in an adequate dose the brain symptoms will disappear. Meanwhile the other tissues and organs adapt to the increased circulating hormones that you have used to fix the brain with. The adaptation of the tissues to different levels of circulating hormones has been shown in the literature. The symptoms of low thyroid, which are numerous and variably expressed, can be related to any organ or system in the body and partly depends on the person's genes. But because of the all inclusiveness of the TSH medical students are not taught or only superficially taught the symptoms of low thyroid. The TSH was "scientific" and held all the answers to thyroid disease. If you have not lived through several versions of the ultimate test for thyroid then it is harder to grasp this phenomenon.
Mary Shomon: If, as Dr. Weetman suggests, the laboratory's reference range for "normal" TSH includes people who are in the process of developing hypothyroidism, do you feel that the reference range itself should be recalculated?
David Derry: This suggestion agrees with what I have been saying namely that the TSH can lag a long way behind the appearance of low thyroid symptoms. One clear case I remember is a lady who started to lose her hair at age 26 and had lost it all by the time she was 35 but the TSH did not turn up until she was 48. Then her TSH rose very high for the first time. (The TSH was several hundred). She was being treated for a heart condition at the time but when the cardiologist saw the TSH, he said just treat the low thyroid condition and her heart problems will go away. He was right. Her hair has not grown back yet. She has been taking thyroid for about 1 year now. So her TSH lagged her symptoms and signs by 22 years. In some cases the TSH appears never to turn up and confirm the clinical diagnosis.

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QUESTION: "Hi Dr. Molino, I hope you can be of help. I have an appointment with Dr. Prager on Tuesday the 24 to discuss fatigue. I think I am hypothyroid: I am very fatigued, not getting my period (I am not pregnant), depressed for the last year, gained 1 lb a week for the last 15 weeks even though I have eaten less and tried to exercise as much as possible, been on 10mg Prozac for 4 wks and it's not helping. My TSH is 4.6 or 4.8 and I have been testing my morning temp as recommended and it's been from 96-97.5 for a week or more. Is there another test that you could recommend that could tell if I'm hypothyroid, so I could see if synthetic treatment will help? I also have SLE. Thank you for the time in reading this email." ANSWER: The TSH testing at the Student Health Center lab is supersensitive, so its probably accurate and suggests you are not hypothyroid. Hypothyroid individuals almost always have a TSH greater than 5(and usually greater than 10). There is a remote possibility that it was a lab error and could be repeated. There is no better test to pick up low thyroid activity. I think its still worth reviewing your history, having an exam, and looking for other causes besides thyroid disease for your fatigue, especially in view of your SLE (Systemic Lupus Erythematosus). Let me know how things turn out. Dr. bob
Thyroid eye disease is NOT exclusive to Graves disease and hyperthyroidism, but can and does occur in hypothyroidism. The result is your vision can be compromised. Doctors are not always aware that thyroid disease and eye problems can be "partners" that require diagnosis and treatment. This is how I know... I have been hypothyroid for 40 years. From 1961 to 1973, I was treated with natural thyroid replacement and then switched to a synthetic form in 1973. At this time, I began developing headaches and vision changes. I looked like I had ping-pong balls under my upper lids, yet for close to ten years, I could not get a diagnosis other than, "Just age." Well, age does change vision, but not like that. Eventually I went to a nearby university medical center and was told that my hypothyroidism was the root cause. As the years went by with my thyroid tests saying 'normal', the doctors were not looking at the complete picture. My headaches were due to swelling that was compressing my eyeball, my vision changed faster than I could get new glasses, and reading, well forget that! Driving was better left to someone else. At the university, a specialist in thyroid eye disease surgically removed excess tissue in and around my eyeballs. Surgical repairs were also made to my eyelid muscles due to swelling and eyelid retraction. My vision is now returning, I'm wearing my old eyeglass prescription and even look more normal! The doctors have since changed my thyroid replacement back to natural thyroid hormone and I have seen an overall improvement in my general health. University medical personnel told me there are many undiagnosed cases like mine simply due to lack of awareness. Don't let this happen to you! Assistance in the form of education, information and physician referrals is available from the American Foundation of Thyroid Patients. (Contact The American Foundation of Thyroid Patients for more information.)
About dessicated thyroid:
Westhroid Active Ingredients: Thyroid Representative Brand Names: Armour Thyroid, Dessicated thyroid, S-P-T, Thyrar, Thyroid Strong, Westhroid, thyroid extract, thyroid gland
Brand Name(s): Armour Thyroid, Dessicated thyroid, S-P-T, Thyrar, Thyroid Strong, Westhroid, thyroid extract, thyroid gland Generic Name Thyroid Phonetic: (thye' roid) Who is this for? Thyroid is a hormone produced by the body. When taken correctly, thyroid reverses the symptoms of hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone. Without thyroid hormone, the body cannot function properly, resulting in poor growth, slow speech, lack of energy, weight gain, hair loss, dry thick skin, and increased sensitivity to cold. Thyroid also is used to treat goiter (enlarged thyroid gland). This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. When should I be careful taking it? Before taking thyroid, tell your doctor and pharmacist if you are allergic to thyroid; foods such as pork, beef, soybean oil, or corn; or any other drugs. tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially amphetamines, anticoagulants ("blood thinners") such as warfarin (Coumadin), arthritis medications, aspirin, cholesterol-lowering resins such as cholestyramine (Questran) or colestipol (Colestid), diabetes medications (insulin and tablets), digoxin (Lanoxin), estrogens, oral contraceptives, steroids, and vitamins. if you take cholestyramine (Questran) or colestipol (Colestid), take it at least 4 hours before or 1 hour after taking your thyroid medication. tell your doctor if you have or have ever had diabetes; hardening of the arteries (atherosclerosis); kidney disease; hepatitis; cardiovascular disease such as high blood pressure, chest pain (angina), arrhythmias, or heart attack; or an underactive adrenal or pituitary gland. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking thyroid, call your doctor. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking thyroid. tell your doctor if you drink alcoholic beverages. It is important not to drink alcohol while taking thyroid. What side effects should I watch for? Although side effects from thyroid are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away: weight loss tremor headache upset stomach vomiting diarrhea stomach cramps nervousness irritability insomnia excessive sweating increased appetite fever changes in menstrual cycle sensitivity to heat temporary hair loss, particularly in children during the first month of therapy If you experience any of the following symptoms, call your doctor immediately: severe skin rash difficulty breathing or swallowing chest pain (angina) rapid or irregular heartbeat or pulse What happens if I miss a dose? Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. How should I take it? Thyroid comes as a tablet and a capsule to take by mouth. It usually is taken as a single dose every day before breakfast. To control the symptoms of hypothyroidism, you probably will need to take thyroid for the rest of your life. It may take about 2 weeks before you notice any change in your symptoms. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take thyroid exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Continue to take thyroid even if you feel well. Do not stop taking thyroid without talking to your doctor. Where should I keep it? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. more about dessicated thyroid
from article Because levothyroxine was already in use prior to 1962 legislation that dramatically tightened the approval process for new drugs, it (and many other prescription drugs still used today) was allowed to remain on the market without filing a New Drug Application. Those applications provide scientific and manufacturing data to prove the drug's safety and effectiveness. In 1997, however, the FDA cited numerous problems with the production of almost every brand of levothyroxine—ranging from recalls of sub-potent or super-potent medication to inferior manufacturing facilities to arbitrary changes in formulation. The agency ordered manufacturers to resolve their problems and prove the safety and efficacy of their products, says Bradbard
Medical Care: Treatment consists of replacing the deficient hormone with synthetic T4, T3 or dessicated thyroid. Low doses are used initially, 50 µg of T4 or ½ grain (30mgr) of dessicated thyroid. The dose can be increased every month by 25-50 µg of T4 or ½ grains dessicated thyroid based on clinical response and /or laboratory valves. End points in treatment are clinical improvement or a TSH in the normal range. A controversy remains, whether one should lower the TSH values below the normal range. Most patients will become euthyroid with ranges between 100-200 µg of T4 or 1-3 grs of dessicated thyroid. Clinical benefits start in 3 to 5 days and level off after 4-6 weeks. Start with one forth to one half the dose in the elderly or those with known ischemic heart disease and use lower incremental increases. Achieving a normal range of TSH levels maybe slowed due to a delay of the hypothalamopituitary axis readaptation. After adequate response to treatment, patients can be followed with annual clinical evaluations and TSH monitoring. Patients should be monitored for symptoms and signs of over treatment: increase of vital signs, palpitations, nervousness, tiredness, headache, increased excitability, sleeplessness, tremors and possible angina.
IAS is currently offering Armour (as described by Dr. Dean) and a desiccated thyroid supplement manufactured by VitOrgan of Germany called Thyrium™. VitOrgan was founded in the 1950's by Dr. H. Dyckerdorf; he was the "founding father" of glandular and RNA therapies, and in fact is generally considered to be responsible for the discovery of freeze-drying (so you can think of him every time you drink a cup of instant coffee!) As such, VitOrgan are considered to be the "king" of glandular supplements, having both extensive experience and an extensive range of glandular products. The VitOrgan Thyrium™ is a bovine extracted desiccated thyroid supplement in a D6 base. Whilst each tablet is 280mg in size, we estimated that its equivalency to the Armour™ thyroid mentioned here by Dr. Dean is "half-a-grain" per Thyrium™ tablet. It is interesting to note that the Thyrium™ regime suggested by VitOrgan is 1-3 tablets three times a day (after meals and dissolved in the mouth) to treat asthma, migraine, gout and fat loss. VitOrgan suggest that Thyrium™ can be used prophylactically every 2-3 weeks for several days at a time. Use for hypothyroidism is probably not suggested, because (like many other countries) the Germans have approved synthetic T3 and T4 thyroid hormones for hypothyroidism, but as VitOrgan states in their Thyrium™ insert "the bio-molecular agents regenerate damaged organs and tissue and inspire the body's self healing processes and normalize cell functions. ALL INFORMATION IS EDUCATIONAL
Hypothyroidism- why Armour™ Thyroid? Synthroid™, the most commonly-prescribed hormone for hypothyroidism, contains only one fraction of thyroid hormoneT4. T4 is normally converted by the body into T3, the active form. I believe that many hypothyroid patients are unable to efficiently perform this conversion. Armour™ thyroid, on the other hand, is a desiccated preparation of porcine thyroid, containing all thyroid hormone factorsT2, T3, and T4. I have found that it is very difficult to provide adequate thyroid supplementation with Synthroid™ without causing patients to become thyrotoxic. On the other hand, most patients who switch from Synthroid™ to Armour™ thyroid, report that they feel much better with the Armour™ product. The dramatic improvements that many of my patients have achieved on thyroid therapy often appear miraculous. It is very gratifying to hear a patient who has suffered for decades express how their lives have been totally turned around by a few cents worth of thyroid. Unfortunately, most physicians have been bamboozled by the manufacturers of synthetic thyroid hormone (Synthroid™) into thinking that the Armour™ Thyroid product is an inferior, non-standardized drug. Nothing could be farther from the truth. Most patients who switch from Synthroid™ to Armour™ thyroid find that they feel much better when taking the Armour™ product
33773.44 in reply to 33773.6 I just don't understand why doctors won't prescribe Armour!! It has been around for AGES - if there was something wrong with it, I'm sure we would know by now and it would be history. I started Synthroid in 1996,put on tons of weight, felt awful - then found this group. Last fall my Dr. dropped me as a patient when I took facts from here to my appt and had the nerve to argue with him about switching meds. Happily I found a WONDERFUL doc who really wants to help me feel my best. I noticed major improvements within the first week of starting Armour and didn't even have to get tested to know I was doing fantastic - that was last Fall and today I got my first results. My TSH was .7 - confirms to me that most of us do best at that lower number!! All other numbers were good,too. I would NEVER let anyone put me back on Synthroid..... Good luck, deb

TSH Levels

- Non-relevant portions have been snipped in the interests of space. - Not everyone develops hypothyroid symptoms when their TSH is higher than 2 but "in range." The purpose of this collection is to show that there are a lot of us who need to have our TSH under 2 to feel well, and that symptoms can seriously affect our lives even when the TSH isn't very high. - Unless otherwise specified, all posts were posted to the newsgroup ___________________________________________ From: "Mike T." Sent: November 23, 2000 Subject: Re: TSH results and questions Most people here and current research shows that your TSH should be a 2 or lower. The lab ranges are just too wide. I've been taking thyroid meds for a year now and if my TSH was a 4.5 I would feel like crap. ___________________________________________ From: "LuvARabbit" Sent: November 21, 2000 Subject: Re: TSH? >>doctors often don't let patients try getting their TSH >>almost completely suppressed. > >Right. They seem to be concerned about the person going hyper, >thinking maybe more thyroid will help them lose weight, >and/or osteoporosis (especially with women). My doc lets me be suppressed (latest tsh was 0.17 and I was cold with a temp of 97.0 so he allowed me to raise my armour dose by 1/16th which will likely bring it back down to around 0.08 which is where I feel my best). However, the hyper and osteoporosis thing still concerns him, so I reminded him last visit that I'd had a bone density test and been told my bone density was great...that of a 35 year old, whereas before I was thyroid suppressed I was at beginning bone loss (osteopenia). No hyper symptoms either...latest BP was 118/70 and pulse was 72. If I hadn't found this guy I'd have been up the creek...the other couple of docs thought I was just a hypochondriac because my beginning tsh was 3.3. ___________________________________________ From: "Magda" Sent: November 19, 2000 Subject: Re: TSH? When I was diagnosed, my TSH was 2.5, but the T4 was quite low. Today my TSH is undetectable, and the T4 and T3 are just on the upper side of the scale. Any endo would scream that I'm hyper, but I'm not... Magda ___________________________________________ From: "Mary MacTavish" Sent: November 19, 2000 Subject: Re: TSH? My initial TSH reading was only 5 something, and my doctor put me on Synthroid and started treatment right away -- he considered it urgent. Since then, even on treatment, I've swung between 3 and 15. but with a downward trend. My doctor says he won't consider me under control until I'm at 0.5, because my upswings will push me higher anyhow, and because of the intensity of my physical symptoms. I'd consider "slightly elevated" to be 2.5. I think you need to start treatment now, and if your doctor refuses, it's time for another doctor. ___________________________________________ From: "Stuart Harris" Sent: November 17, 2000 Subject: Re: Very Aggravated For what it's worth my doctor refused to increase my dose past .1 mg even though I still felt fatigued because my TSH was down to 2.4. He also wasn't willing to add T3. I went to another doctor and then another and now I'm at .132 mg T4 + 15 mcg T3 and feel better than I have in years. My TSH is completely suppressed and my current doctor is fine with that - seems to be a by product of being on T3 but I don't care . . . I feel 90% normal and will never go back. ___________________________________________ From: "LuvARabbit" Sent: November 17, 2000 Subject: Re: TSH? >Would it be prudent to treat a TSH of 3.26 and a FT4 of >13.4? I was treated with similar results. I'm up to almost 1-1/2 grains of armour now (gradually). ___________________________________________ From: "John Riggs" Sent: October 30, 2000 Subject: Re: Ted(not TED) ElaineP Kevin Mag Lois Rochelle CB Sara John BL Jeanne Yup, my TSH stays about 0.026 while my T3 and T4 stay dead on. TSH is NOT what we go by any longer, especially since I am on T3/T4 regimen. ___________________________________________ From: "KC" Sent: October 28, 2000 Subject: Re: Undetectable TSH in people on thyroxine not necessarily overdose My TSH was less than 0.03 on 175 mcg T4, but had jumped up to 2.17 on 150 mcg T4 (at that level I'm tired and gaining weight). I am trying to convince my doctor to try a T4/T3 combination -- thinking that the level you are at might work for me as well, since our numbers appear to be similar. ___________________________________________ From: "BL 1204" Sent: October 28, 2000 Subject: Re: how can you tell what T3/T4 ratio is good? daughter has to have almost undetectable TSH for her to have T4 and T3 levels that are in the middle of normal. Really Dr. Domisse says get Free T3 in the upper half of the range. ___________________________________________ From: "Neville UK" Sent: October 28, 2000 Subject: Re: Undetectable TSH in people on thyroxine not necessarily overdose After 8 years: My TSH was 0.02 when I was on 175mcg T4. However any lower dose gave me back my sluggish, treacle brained syptoms. I changed to 125mcg T4 10mcg T3 (Tertroxin). This allowed my TSH to improve to Doctor Happy Levels whilst improving my general well-being feelings. I theorized that the high dose of T4 was to provide the brain with sufficient T3 to keep the brain-fog away. That high T4 did cause other parts of the body to have problems which also went away. Hair is growing quicker... Neville UK ________________________________________________________________________________ From: "Gregory Rice" Sent: October 25, 2000 Subject: Is THIS central hypothyroidism?? My endo called me and told me to cut back on my cytomel because my TSH was under 0.01 . He told me that my free T4 was 1.5 (range = 0.8 - 2.7) and total T3 was 108 (range = 70 - 205). I asked him why worry about TSH if the T4 and T3 were within the range for the "normal" person? I told him that I am finally felling normal after 8 yrs. He kept repeating "the standard of care is the TSH value." He told me that my body thinks that the T4 and T3 values are too high and if I don't cut them back then I will pay for it when I'm older. This summer I tried skipping 2 levothyroxin pills per week and I went back into a confusing mental fog. I lost my wallet twice in 25 days and I have police reports to prove it! I'm a 38 yr old male, 5"8' 230 lbs, mesomorph (heavily muscled, but fat as well). I take 200 micrograms of levothyroxin and 25 micrograms of cytomel (split dose) per day. I work full time as a patient care tech, go to school full time as a nursing student, and raise three school age children, and power lift (a type of weight lifting). With the large amount of metabolically active tissue, the active lifestyle and the need for mental acuity, I believe that my thyroid hormone doses are not excessive. What should I do? Cut back during the school year and fall behind? Ask for a trh test? Can anybody offer any theories on why the TSH is undetectable while th T4 and T3 ranges are still in the middle? ___________________________________________________________________________ From: "CDA" Sent: October 22, 2000 Subject: Block & Replace for Graves I was diagnosed with Graves October 1999 and saw an endocrinologist about one month later in November. By then, I felt terrible. My lab results were: T4: 15.2 T3: 237 TSH: .03 T7: 5.9 T Up: 39 ... when I went to my first appt. with the endocrinologist, he said, "There are three forms of treatment." I interrupted (easy to do since I was very hyper) and said, I already know what I want to do. I want to try the medication. So he didn't bother to tell me about RAI or surgery. He said the success rate for medication is 50%. He then prescribed 40 mg tapazole, which I took in two 20 mg doses each day. In Feb., he prescribed 100 mg levoxyl, and reduced my Tapazole to 20 mg daily, but I had already become hypo and felt terrible. Since then, I have felt like I've been digging myself out of a hole. My dosage of levoxyl has been steadily increased. Currently I take 10 mg Tapazole and 150 mg levoxyl (actually levethroid because the pharmacy switched on me). As of three weeks ago, I no longer feel hypo and my TSH is now 0.86. My T4 is 10.2. My doctor is not measuring anything else at this time. He has me at a fairly low TSH because he thinks that helps people who have problems with GED. Also, I just don't feel good if it's much higher. ___________________________________________ From: "Nancy N" Sent: October 4, 2000 Subject: Re: At what TSH does your balance go "out"? I start to get hypo symptoms when my TSH starts moving up towards 1.0. I feel best and have no hyper symptoms when my TSH is at about 0.13 or less. I do take T3 and T3 in combination, which seems to supress the TSH, so we (my doctor and I) look at Free T3 and Free T4 levels to determine how I'm doing. I only had hyper symptoms once for a few hours when I first started with theT3 in addition to an increase in T4 replacement. We lowered the dosage of T4 for a couple of weeks, then increased it again and I was fine. Nancy N ___________________________________________ From: Sent: September 18, 2000 Subject: Re: TSH You need a doctor who understands that a TSH of 4 is NOT normal if you have hypothyroid symptoms! For some people it is normal, for others it most definitely is not. See Dr. Ridha Arem's book, "The Thyroid Solution", for more details. I had hypothyroid symptoms at a TSH of 1.8, last spring, and for years before - my TSH tests were always "normal" - but apparently that is not normal for *me*. I had a TRH stimulation test which was resoundingly positive for hypothyroidism, when my baseline TSH was only 2.4 to 2.8. Dr. Arem lists anything over 2.0 as being suspicious for hypothyroidism, in the presence of any symptoms. Paula ___________________________________________ From: "Lois" Sent: September 17, 2000 Subject: Re: At what TSH does your balance go "out"? I've never had a TSH test when my TSH was in this area, but based on the tests before & after my several trips up and down the TSH road, I can say that I feel at my best when my TSH is between around 1 and 2. While I don't know exactly where the line is for me, I do get hyper symptoms when my TSH is low. I've been both hypo and hyper, and I get a lot of symptoms, but the first thing to change for me--going hypo or hyper--is my appetite. Going hyper, my heart rate also increases before some of the other symptoms develop. --- Other symptoms that start when my TSH is above 2 are brain fog (confusing concepts in my mind, reading one thing and having it register as something else in my mind, feeling like cobwebs are in the way of my ability to comprehend), difficulty concentrating, feeling cold when others don't, constipation, dry skin, and fatigue. This all comes when my TSH is between about 2 and 4, well within the flawed lab ranges, and they get worse for me (and other symptoms develop) as the TSH climbs. --- Lois ___________________________________________ From: CBW Sent: September 16, 2000 Subject: At what TSH does your balance go "out"? For those who have been tracking their TSH numbers for a few years now, at what point on the TSH scale does your system balance start to go "out" of whack and you start manifesting hypo symptoms such as infections, water retention, constipation, GERD, esophagus spasm, sleeping long hours, etc etc. Mine is 1.8 or 2.0. Which symptoms do you notice first that tip you off something is amiss? At what point on the low end do you get hyper symptoms? I can go very low, off the scale, without hyper symptoms. Please post your experience. - CBW ___________________________________________ From: "Chet & Lola" Sent: September 16, 2000 Subject: kTSH I feel lousy, Fatigue again big time, depressed, nails breaking again, swelling and cranky! I called endo and he's sending me for blood test. I started on 25mg synthroid in March, went to 50 and then 75. I asked what my TSH was 2 months ago and he said it was fine and that it was 4 Well fine or not I feel awful and told him so. He said he might boost meds. Uh Duh! Sorry so Long and negative but thats how I feel at 4!! Lola ___________________________________________ From: CBW Sent: September 16, 2000 Subject: Re: High Cholesterol and Hypothyroidism >: > Am I correct in assuming that if hypothyroidism was >: > the root cause of my high cholesterol, treatment with >: > T4 will reduce the cholesterol level? That happened for me, cholesterol levels went high when I was getting hashi/hypo, then resolved when thyroid meds brought TSH into range, for me under 2.0. Always had low cholesterol before. - CBW ___________________________________________ From: "Stuart Harris" Sent: August 23, 2000 Subject: Re: One more time? A pinch of T3? I added T3 and it helped mentally, but physically I was still hitting the wall in the afternoon. My TSH was 2.6 and the doctor didn't want to increase my T4 but I bumped it up on my own from .1 to .112 and then to .125. (I refilled an old .025 mcg script) I haven't had blood work yet but it's been nearly four weeks and so far the afternoon slump has pretty much disappeared. Not sure what the doctor's going to say but at this point I don't really care - I feel better than I have in years. ___________________________________________ From: CBW Sent: August 22, 2000 Subject: Re: thyroid hormones during infections? wrote: >Does the body normally need more thyroid hormone during >infections such as bronchitis or sinusitis? >(My doctor has diagnosed Hashimotos, with mostly normal >TSH levels (1.8 to 2.8 - the latter during a bout of >bronchitis) Hypo or borderline hypo might have been why you got the infection to begin with. If my TSH gets above 2.0, I get all kinds of bizarre infections I do NOT get otherwise. - CBW ___________________________________________ From: "Marie (UK)" Sent: August 17, 2000 Subject: Re: New here, perhaps you can help? The TSH is not always a good indicator of your condition. My latest TSH was 0.1 (under normal range) but my doctor still agreed to a trial increase in thyroxine as I was still very symptomatic and my Free T4 and Free T3 blood tests were low down in the normal range. I currently take 200 mcg thyroxine (T4) and 10 mcg liothyronine sodium (T3), which seems to be a quite high dose - keeping my fingers crossed, but I am feeling a lot better now. Good luck, hope you feel better soon. Marie ___________________________________________ From: "Marion Thierry (NL)" Sent: August 4, 2000 Subject: Re: Plz. help with bloodresult I know that I'm getting hypo symptoms when TSH is about 2 or higher. When TSH was 0,08 a time ago I went hyper. When TSH is about 0,2 I feel good. ___________________________________________ From: "AH" Sent: August 1, 2000 Subject: Re: Differing TSH levels, whats the diff? everyone is different, and a person with a tsh of 19 can have more symptoms than a person with a tsh of 200 - which is why symptoms are more important than numbers in the end. we all deserve to be symptom free and must each find our own 'sweet spot'. mine is 1.7-2.0 - I am so happy when I am there. Alyson -------------------------------------------------------------------------------- Denise wrote: > Are the higher numbers *really* different as far as symptoms go? > > I have just been diagnosed, and I was told my TSH was 14.8, but I have > been having all the same symptoms that people mention on this NG. My > hair started going thin over a year & a half ago. I have been having > the lack of energy, confusion/fog, throat thickness/soreness, and a > multitude of other symptoms that I now realize that are connected to > Hypo. > > But yet I see people mention having levels in the 50's 100's and even > higher. Are those people's symptoms worse? or is there much > difference? > does anyone know what the difference is? > > Why is the normal TSH scale around .5 to 5.5 when people can have a > 100 or even more TSH. > > Denise & Brian ___________________________________________ From: "Elainep" Sent: July 13, 2000 Subject: Re: Chromium Picolinate Mild is such a relative and worthless term. When my TSH is 5.25 I don't feel like I have "mild" anything - I can't function. Are taking Synthroid now? If not, I think that is a huge mistake. It can take a long time before you really notice a difference, however the longer you let it go, the harder it is to regulate the dose. -- Elaine remove spamfree to e-mail me ___________________________________________ From: "LuvARabbit" Sent: June 16, 2000 Subject: Re: "Consequences of the TSH" I've had fibro for close 20 years and have only been treated for Hashi's for the last year. Even when I first found out I had it, from my old dr., he didn't want to treat me because my tsh was 3.3 and he totally ignored my symtoms and told me to see a shrink. Funny, with a new doc and armour thyroid, I'm doing so much better, though not completely cured (at least at this point). ___________________________________________ From: "Nick" Sent: March 25, 2000 Subject: Re: Are symptoms possible? On Wed, 22 Mar 2000 21:27:48 GMT, wrote: >Is it possible to have some hypothyroid symptoms (depression, anxiety, >muscle aches, nervousness, palpatations, insomnia) with TSH levels that >are only slightly elevated (5.5 to 8.5)? Yes My wife was permanently cold and sleeping 15 hours a day with a TSH of 4. She now lives a normal life thanks to Armour and a private doctor that believes that body temperature is relevant. Her temperature was around 35.5 to 36 when it should have been 37. Nick ___________________________________________ From: "Sonya" Sent: March 15, 2000 Subject: Re: Hashi's My TSH got up to 22 last March after an increase of Synthroid it came down to 2.8 but I still had many symptoms. They were extreme fatigue, muscle aches and pains, brain fog, and heavy periods. In January of this year I was put on Cytomel in addition to my Synthroid I take 25 of Cytomel and 150 of Synthroid most of my symptoms are gone now and my TSH is in the 1.0 range now I have recently found out that alot of the muscle problems I am having are due to Fibromyalgia. I was very lucky to have a Dr. that treated my symptoms and not my labs this is the first time in 13 years that my TSH has ever been below 2. I really wish more Dr.'s would listen to there patients and understand what it's like to still have so many symptoms. ___________________________________________ From: "VPierce17" Sent: March 5, 2000 Subject: Re: TSH levels survey I'm really new to this (just diagnosed last week for sure!). My TSH on the first test in late Jan was 7.76 and 2 wks later was 9.79. The doc told me that I have Hashimoto's Thyroidism (my antibody level is 55.5 if that means anything to anyone?). I've had a feeling that I would eventually become hypo, since my mother, grandmother and great-grandmother have all had this.... I started feeling lousy just before Christmas. The first doc told me it was stress, but did bloodwork as well, which showed the elevated TSH. Anyway, I'm 35 F and my symptoms have included: feeling cold all the time constantly tired (I used to sleep only 5-6 hrs per night, now it's 8-9 to be able to function!) Tightness of chest and lower neck pressure at bottom of right rib cage (don't know yet if this is thyroid-related or IBS-related) depression (doesn't help that my hubby is away at the moment!) dry skin breaking nails (they used to bend all the time, not break off) hair falling out low body temp difficulty concentrating and/or following thru on thoughts/actions tired, gritty eyes irregular, crampy periods irritability and mood swings There, now you all know how I've been falling apart at the seams!! __________________________________________ From: "ElaineP" Sent: March 5, 2000 Subject: Re: TSH levels survey (long response) I was diagnosed in 1990 about 6 years after I started having symptoms. My first TSH level was 27. Through the next three years my TSH ranged from .59 to 71 up and down and my dose increased from 50 mcg to 175 mcg. I stayed at 175 mcg for four years. I don't have the lab results from those years, but I was seeing a doctor who tested only yearly, and I suspect that my TSH levels were not under 2. When my TSH was high, my symptoms were extreme fatigue, muscle aches, feeling cold all the time, hair falling out, depression. If I sat for more than 5 minutes I had difficulty moving when I stood up. I had trouble walking. There was a strange delay in my leg muscles, as if I would take a step and the muscle would contract too late. (It's so hard to describe this) I needed to sleep all the time. In 1998 my Synthroid was raised to 200 mcg and over the next two years my TSH bounced around a lot, I had hyper episodes and from 2/99 to now I've had several decreases in Levoxyl (changed to Levoxyl 3/99). In 11/99 I started on 100 mcg Levoxyl and my doctor added 5 mcg Cytomel twice a day. I can't find my last TSH (12/99) but I think it was .6 or so. I have not felt this good in 16 years. Before the Cytomel, my TSH was close to 2 and I did feel much better, but still not "normal". Since the Cytomel, I remember what "normal" feels like. I like it! During all those years I had periods where I felt better, but I never felt normal. The most significant example for this topic is in 1995 I was still feeling awful. Dry skin, cold all the time, needed to sleep during the day, depressed. I think I stopped working around that time. My doctor told me that my thyroid was under control and that it must be "something else". I didn't know much about the tests at the time so I didn't ask about the levels. My mother was worried so she offered to pay for an endocrinologist in NY who treated my grandmother from way back when. After a physical exam he said "you can't keep raising your Synthroid every time you don't feel well" He asked if I ever felt "down". When I told him yes, he said that my symptoms were a result of depression and that he would recommend antidepressants. I cried in the office and was so upset I couldn't even discuss it with him. (I refused to believe that depression was primary and didn't follow through with antidepressants) I did get a copy of the results. After being involved on this NG, I looked back at all the lab results that I had copies of. My TSH at the time of that visit was 3.6. If I only knew then what I know now! My daughter's recent saga is in another thread under the subject "My daughter and the bad doctor" and in a response to another thread "Thyroid and treatment resistant depression" -- Elaine ___________________________________________ From: "JennyAnyDotts" Sent: March 5, 2000 Subject: Re: TSH levels survey One month ago I was diagnosed hypothyroid with a TSH of 13.8. It takes me forever to do simple things like balance a checkbook, make a shopping list, and 4 hours to do shopping at one Wal-mart supercenter IF I have to take 9 yo and 3 yo boys with me. - Dry hair - Dry skin - Grainy eyes, inability to wear my contacts for four years now - Peeling nails - Confusion/brain fog - lack of ability to force concentration on needed tasks - almost debilitating fatigue - (feel the need to nap on weekends) - joint pain - headaches - have lost only 5 lbs in two months on my doctor's medically augmented (diethylproprion) and supervised low-calorie (first) and lower fat (less than 50 gms) diet. Most others lose at least 10 lbs first month. - depression (crying almost every day, sometimes for hours - I just came off Zoloft for this - so far, so good) - been feeling down and 'not right' with these symptoms ever since the middle of my pregnance with soon-to-be 4 yo (April 2). - hoarse voice Have only taken Synthroid one month - not sure how to read dosage - .05?