![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 26 to 50 of 58. Go back in thread:
Posted by Phillipa on April 8, 2005, at 17:35:00
In reply to Re: Anyone - For both Maxime and Spriggy » Maxime, posted by TamaraJ on April 8, 2005, at 15:54:50
Yup, all my problems started with an elevated TSH. I forget what the initial was but it wasn't that high. I had at first what appeared to be some sort of flu with a tightness in my chest that made it almost impossible to expand my chest to cough. I had to force myself to go through the pain to cough. This was accompanied by feeling so tired and lethargic I could not move. I lay on the couch for two days. Then came the anxiety. It put me in a state of panic. So the pdoc upped my xanax. I then went to an internist who checked my thyroid. He started me on .025mcg of synthroid, and said in about a week I'd feel better. I either would need more or less of the xanax. Well I was working as an RN and continued to work. I rember after about 6 days I was at work and all of a sudden it felt like my world opened up and I felt l00% better. I was able to cut down on the xanax little by little. About 2 months later I woke during the night with vertigo for the first time in my life. I had to go to the emergency room where they administered 2mg IM of ativan and sent me home with antivert. I didn't come out of it. I remained so tired but so nervous. The pdoc put me on lopressor 25mg to help lower my anxiety so he could put me on paxil. After 3 weeks he put me on l0mg of paxil with the lopressor. It took about 3 months for me to feel better. I returned to work. I was more than Great for about 2yrs. I stopped lopressor, and gradually weaned off the paxil. A lot of stress in my life and my anxiety again went off the charts. I was hospitalized. My TSH was 22. They tested me and I had Hashimotos Thyroiditis. They increased my synthroid to 0.l25mcg where I remain today. I felt better in a few days even though my anxiety increased so I had to take more ativan then. My TSH has gone from being around 8 which didn't bother my old pdoc down to the very lowest levels of normal now. He said he wanted to keep it low to ward off depression. In the time period above, I've been dx'd with lymes's disease[in remission], osteoporosis, and gone through menopause. So many changes to my endocrine system. So after this very wordy post, yes you can be both depressed and anxious at the same time, and yes I also lost a lot of wt, and yes I had sweats but they were the beginning of menopause. Fondly, Phillipa
Posted by KaraS on April 8, 2005, at 22:04:51
In reply to here is what I just found on TSH levels, posted by Spriggy on April 8, 2005, at 13:19:09
> Okay, DR. Bob, I don't know if this is against some rule to copy and paste or not so if it, delete me and forgive me. I repent ahead of time if I am committing some sin here.
>
>
> But this is what I just found:
>
> What is a “Normal” TSH Level?
>
> In the United States, most laboratories have as the normal TSH reference range from approximately 0.5 to 5.5. Yet, in early 2001, the American Association of Clinical Endocrinologists (AACE) made what constituted a fairly dramatic reversal of its previous doctrine, stating that a "Even though a TSH level between 3.0 and 5.0 uU/ml is in the normal range, it should be considered suspect since it may signal a case of evolving thyroid underactivity."
>
> A groundbreaking study published in the February 2002 issue of the Journal of Clinical Endocrinology and Metabolism examined levels of undiagnosed thyroid disease in different U.S. populations between 1988 and 1994. In addition to discovering that nearly five percent of Americans suffer from often undiagnosed thyroid disease, the Centers for Disease Control and Prevention (CDC) report on the National Health and Nutritional Survey (NHANES) found that among the disease-free population (those who did not have any presence of thyroid antibodies, or diagnosed thyroid disease), the mean TSH level was 1.5. This finding could bolster the assertions of some practitioners and many patients that the optimal TSH levels are between 1 and 2, and that levels above that may in fact represent an abnormality. It certainly points up the need to reconsider the basis for most U.S. labs measuring hypothyroidism as only at levels of approximately 5.0 and above.
>
Yes, those are more accurate numbers for judging thyroid health. I've also read that for those of us with depression, that a TSH of .5-1.0 may be best. TSHs over 3 probably indicate a hypothyroid condtion. Why some people with high TSHs present with HYPERthyroid symptoms is a mystery to most doctors. A friend of mine has the same problem and her doctor told her that her thyroid was working too hard to try to keep up thus accounting for the high TSH. I don't know if that really makes any sense or not. I just know that her TSH levels have recently been between 11-16 yet she's always hot, has lots of energy and has NO DEPRESSION. Another possible explanation I've seen for this may be due to pituitary problems.
Posted by KaraS on April 8, 2005, at 23:03:57
In reply to Re: Anyone - For both Maxime and Spriggy » Maxime, posted by TamaraJ on April 8, 2005, at 15:54:50
> This is just some info I had previously found on thyroiditis, which may be of interest to both of you.
>
> What I have read is that Thyroid Antibody Tests measure the number of immune system terminators created specifically to do battle against the thyroid. There are two types of these well-named antibodies, therefore, two tests are needed: antithyroglobulin and antimicrosomo. This is the test that helps identify whether you have thyroiditis, an allergy to your own thyroid. This autoimmune condition is becoming quite common. As I understand it, these two tests are the only way to diagnose thyroiditis (but then again, I am certainly not an expert or extremely knowledgeable about this stuff).
>
> In the same book there is a reference to a summary of thyroiditis symptoms, as developed by Stephen Langer, M.D. The list is as follows and is in decending order of frequency:
>
> "(1) profound fatigue; (2) memory loss; (3) depression; (4) nervousness; (5) allergies (6) heart-beat irregularity (7) muscle and joint pain (8) sleep disturbances (9) reduced sex drive (10) menstrual problems (11) suicidal tendencies (12) digestive disorders (13) headaches and ear pain (14) lump in the throat and (15) problems swallowing. Nervousness ranges from mild anxiety to full-blown panic attacks, of which some are true psychiatric emergencies. These are as puzzling to the patients as to their physicians, who, in desparation, recommend psychotherapy and powerful transquilizers."
>
> Spriggy - You may be interested in the following (which could explain the high TSH level, while experiencing symptoms of hyperthyroidism):
>
> Extracted information - clinical features of thyroiditis
>
> The main symptoms are a painful swelling of the thyroid gland and symptoms of hyperthyroidism. These symptoms include heat intolerance, nervousness, palpitations and weakness. The hyperthyroidism is due to the leaking of thyroid hormones from the damaged thyroid cells as a result of the viral infection. This is a temporary situation since once the virus infection has run its course, the thyroid cells recover their normal state. On examination, the patient has a very tender, swollen thyroid gland and mild signs of hyperthyroidism.
>
> Maxime and Spriggy - websites with info on thyroiditis
>
> http://www.emedicine.com/med/topic534.htm
>
> http://www.emedicine.com/MED/topic949.htm
>
> http://www.umm.edu/endocrin/hashim.htm
>
> http://www.nlm.nih.gov/medlineplus/ency/article/000371.htm#Symptoms
>
> http://www.thyroid.ca/Guides/HG05.html#2
>
> Tamara
Hi,
I just read your quote that explains why some people with high TSHs can present with hyperthyroid syptoms. That makes a lot of sense. I hadn't seen that theory before. Does the Langer book say how long a virus like this can take to run its course? If my friend has had this problem for over a year now, would her case also fit the viral theory?K
Posted by MidnightBlue on April 8, 2005, at 23:34:20
In reply to Re: Anyone - For both Maxime and Spriggy » Maxime, posted by TamaraJ on April 8, 2005, at 15:54:50
Darn!
That is interesting stuff I have almost EVERY SINGLE ONE of those symptoms. In fact two of my docs--GYN and GP-- repeatedly think I MUST have thyroid trouble, but the test (sorry I don't remember which one) always comes back fine. I thought they did a full panel, but I'm not sure.
MidnightBlue
Posted by KaraS on April 9, 2005, at 1:03:50
In reply to Re: Anyone - For both Maxime and Spriggy » TamaraJ, posted by MidnightBlue on April 8, 2005, at 23:34:20
> Darn!
>
> That is interesting stuff I have almost EVERY SINGLE ONE of those symptoms. In fact two of my docs--GYN and GP-- repeatedly think I MUST have thyroid trouble, but the test (sorry I don't remember which one) always comes back fine. I thought they did a full panel, but I'm not sure.
>
> MidnightBlue
Have you had the test for the antibodies?
My gp refused to believe I had any thyroid problems because my TSH was within the normal range. It was so frustrating for me because I had all of the symptoms of hypothyroidism and I knew I had that problem. Fortunately I insisted on seeing an endocrinologist (with the support of my psychiatrist). The endocrinologist felt my thyroid and knew instantly that I had Hashimoto's thyroiditis. Blood tests confirmed this. I was then put on thyroxin. (Unfortunately I never got the chance to say I told you so to my gp.)K
Posted by Spriggy on April 9, 2005, at 13:37:30
In reply to Re: Anyone - For both Maxime and Spriggy » MidnightBlue, posted by KaraS on April 9, 2005, at 1:03:50
But I wonder if your gp is going with some old "normal" numbers and not following the newer guidelines the endocronologist follow.
From all I've read, regular gp's still think anything under a 5 is okay, but endo's don't think so anymore.
So it's possibly your gp is not up to date.
Posted by Phillipa on April 9, 2005, at 17:06:23
In reply to Midnightblue, posted by Spriggy on April 9, 2005, at 13:37:30
When the lab reports come back to your doctor they have a range of what is considered normal. If the ranges change the lab readjusts their scale to match the new criteria. That means that even you could look at your test results and see if you fall into the normal or abnormal range. The lab result will also red flag, so to speak, any abnormal result so that his nurse can immediately bring it to his attention. He definitely will know if what he is looking at is abnormal. Fondly, Phillipa
Posted by Maxime on April 9, 2005, at 19:12:07
In reply to Re: Midnightblue » Spriggy, posted by Phillipa on April 9, 2005, at 17:06:23
That's not entirely true. The lab I had mine done at had 5 as the top end of normal. Plus, even if 3 is NOW the new top end of normal, someone might feel hypothyroid at 2.5 and need to be at 0.3 in order to no longer feel hypothyroid.
Maxime
> When the lab reports come back to your doctor they have a range of what is considered normal. If the ranges change the lab readjusts their scale to match the new criteria. That means that even you could look at your test results and see if you fall into the normal or abnormal range. The lab result will also red flag, so to speak, any abnormal result so that his nurse can immediately bring it to his attention. He definitely will know if what he is looking at is abnormal. Fondly, Phillipa
Posted by Phillipa on April 9, 2005, at 20:15:37
In reply to Re: Midnightblue, posted by Maxime on April 9, 2005, at 19:12:07
I've had mine tested in January[when in hospital] by three different labs. All had slightly different ranges but all put me in the lower end of normal. I think if you still feel hypothyroid something else is going on. Like I had an MRI which showed a small tumor on the pituitary gland. Everyone, who read it said not to worry about it. So it was never addressed. It wasn't growing so they basically didn't care. I also had one done last summer that had showed it. I don't think even the endocrinologists can explain why some of us feel like we do, especially if they see a psych background. Now I've got to go clean up this leaking ick! Fondly, Phillipa
Posted by Spriggy on April 9, 2005, at 21:13:59
In reply to Re: Midnightblue » Maxime, posted by Phillipa on April 9, 2005, at 20:15:37
Well, I know my last results (although the nurse wouldn't tell me over the phone yesterday WHAT they were without talking to the doctor) were "abnormal" and thus that is why he sending me to the endocronologist. I Just want to KNOW what my own results are. Why can't I have my OWN INFORMATION without having to go make a stinking appointment with my gp first?
It annoys me to no length.. just like the heart monitor results- I still have no clue what they were. My doctor just sends me the results in the mail about 2 weeks after the tests are performed, even when they are abnormal. Makes me crazy!
Anyway, that's a whole other rant..
But I found it interesting over at psyched my husband has been reading how sometimes people are diagnosed with bipolar (becuase of the rapid cycling) and really they have an underlying thyroid problem that is going untreated.
I can't help but wonder if that's my case since all these brain drugs really aren't helping me.
And, up until December, I had never experienced anything like this in my life. I lived a normal, stable life. Then BAM! I had a traumatic experience with my dad, I got a bad infection (white count was very high), had a panic attack, got put on Lexapro- whacked out, and I have NOT been the same since. This has been almost 4 months now.
Can a person just suddenly become bipolar 2?
My dad is bipolar and my mom has hypothyroid so either way I go, I'm doomed. LOL
I have a great gene pool. *smirk*
Posted by Phillipa on April 9, 2005, at 21:36:22
In reply to interesting stuff, posted by Spriggy on April 9, 2005, at 21:13:59
It sounds so much like what happened to me. The infection, can't expand chest to breath, depression, and anxiety off the charts. Dx Hashimotos Thyroiditis. Fondly, Phillipa
Posted by MidnightBlue on April 9, 2005, at 22:21:33
In reply to Midnightblue, posted by Spriggy on April 9, 2005, at 13:37:30
I don't know. I think I have those results somewhere, but don't remember where. I hope to have my insurance card in the next couple of weeks and I'm sure they will be running another thyroid test.
Posted by MidnightBlue on April 9, 2005, at 22:34:52
In reply to Re: Midnightblue, posted by Maxime on April 9, 2005, at 19:12:07
OKAY, I found my thyroid test from May of 2003. It was T-4 free 1.2 and TSH 2.07 so if that is still valid, I've got no excuse thyroid-wise! I don't think I've had a test since.
Oh, one other little note, MANY years ago when I was about 10 I had radiation several times to a scar on my chin, and I do NOT think the machine properly shielded my thyroid.
Posted by Phillipa on April 9, 2005, at 23:29:12
In reply to Re: interesting stuff » Spriggy, posted by Phillipa on April 9, 2005, at 21:36:22
They probably didn't at that time. You very well could have the beginning of thyroid disease. My guess would be that it would be hypothyroidism. If the radiation is destroying it. Fondly, Phillipa
Posted by tealady on April 10, 2005, at 0:37:15
In reply to My latest TSH level, posted by KaraS on April 5, 2005, at 19:45:12
Kara what were your FT4 and FT3 (free levels?) Can you get them?
TSH is influenced by too many things.. pdrugs I'd expect to influence, how exactly I've no idea, but I've seen some posters on the thyroid forum who seem to know about some of them...lots of things feedback to TSH..cortisol lowers it, aspirin, alcohol, your sleep, would affect it etc..That how it's supposed to work
FT3 and Ft4 ain't perfect but at least they tell you the free levels in your blood...how the hormones work of course depends on the receptors and level of other things in your blood as well, sighStaying on a beginning dose too long is a mistake made by many.
Whether one can "get away" with it depends on how the feedback works to the pit, hypothalamus..and yes, in theory, the TSH should reflect this..in practise it doesn't seem to in many.For me 50mcg felt like it totally shut down my own thyroid production..I went way more hypo.
But I was too hypo to go and get a blood test at the time..or even work out what to do about it. So I stopped the meds and about a month later managed to crawl(literally) into an antiaging docs office..who has said she wisghes she had a photo of me then to do the before/after shots. I looked worse than the myxodema pics I've seen on the net.
You don't seem that bad :-))For some , adding a small amount of T4 or T3 can just augment their own thyroid with very little or no decrease in their own thyroid's output..lucky huh? ..apparently little feedback
In theory I think I'd expect the increased small dose (yes, 50mcg is a small dose) should reduce your own thyroid's output by the same amount after about 12 weeks or so...so the TSH should be similar to before starting if that is the case...never heard of this happening though
Usually most need a full replacement dose after a while..at least 100mcg t4..or 75 mcg T4 & 5mcg T4, minimum. Up to 200mcg T4 is pretty usual. A typical dose might be say 100mcg t4 and 7.5mcgT3. Just giving you a comparison here.
Your final dose should depend on your test results AND your symptoms, includings thiing like basal temperature, pulse, blood pressure etc.
It's probably best to aim for a TSH of around the 1.0 for starters and see how you feel from there. Test your TSH, Ft4, Ft3 first thing in the morning before meds for "best" results (highest TSH then)..oh and day 14 of cycle maybe too.(estrogen binds thyroid hormones).Zinc helps with thyroid hormone utilisation(which is how thyroid hormones work with receptors etc regardless of the levels)..small amounts like 8 - 15mcg a day,
as does selenium say 75mcg a day etc.Jan
Posted by Cecilia on April 10, 2005, at 3:20:48
In reply to Re: Midnightblue » Spriggy, posted by Phillipa on April 9, 2005, at 17:06:23
A lot of labs and doctors are still way behind the times in terms of thyroid. The American Academy of Clinical Endocrinologists changed normal for TSH to .3 to 3 a while ago but the lab at my HMO STILL lists up to 5.5 as normal and the GP`s go by that. Dealing with doctors is such a pain-you have to massage their precious egos so carefully to get what you need. Cecilia
Posted by ladyofthelamp on April 10, 2005, at 4:19:39
In reply to Re: TSH normals, posted by Cecilia on April 10, 2005, at 3:20:48
> A lot of labs and doctors are still way behind the times in terms of thyroid. The American Academy of Clinical Endocrinologists changed normal for TSH to .3 to 3 a while ago but the lab at my HMO STILL lists up to 5.5 as normal and the GP`s go by that. Dealing with doctors is such a pain-you have to massage their precious egos so carefully to get what you need. Cecilia
Dealing with docs is a pain,but i find that if you insist on something being done without resorting to outright rudeness they tend to respond.I said to my doctor that if they didn't do anything then i would have to get a second opinion,they seemed to try a bit harder then!.Put everything in writing aswell as you have more clout then.I went to see a female GP in my practice who was alot more helpful and had a fresh outlook on my problems and instead of saying i needed to change my psych drugs(which never work anyway)she tried every concievable test to find out what was wrong and said if they still came back normal she wouldn't give up.Maybe i have just been very lucky
My TSH jumped from 2.95 to 20.9 in 4 months so testing regularly has to be a good idea.In UK 4.25 is considered the cut off point.Sorry this is so long and maybe strays off the point but i feel better already after just 3 thyroxine(probably going manic for the first time in two years!!!!)
Posted by KaraS on April 10, 2005, at 18:22:13
In reply to Re: My latest TSH level » KaraS, posted by tealady on April 9, 2005, at 5:54:52
Hi Jan,
> Kara what were your FT4 and FT3 (free levels?) Can you get them?
I doubt they even did those tests. This was a free clinic so you get the minimum. A couple of years ago I had a full panel done by a holistically oriented physician and all levels were normal. Nothing much has changed for me in terms of symptoms so I have a feeling all of my other thyroid tests would be normal. As soon as I have insurance, I will get more thorough testing though.
> TSH is influenced by too many things.. pdrugs I'd expect to influence, how exactly I've no idea, but I've seen some posters on the thyroid forum who seem to know about some of them...lots of things feedback to TSH..cortisol lowers it, aspirin, alcohol, your sleep, would affect it etc..That how it's supposed to work
Also, someone else posted to me that ADs can decrease free T3. I think you really do need to get more systemic testing to get the full picture of what's going on. I don't know why they only do thyroid testing in a vacuum.
> FT3 and Ft4 ain't perfect but at least they tell you the free levels in your blood...how the hormones work of course depends on the receptors and level of other things in your blood as well, sigh
>
> Staying on a beginning dose too long is a mistake made by many.
> Whether one can "get away" with it depends on how the feedback works to the pit, hypothalamus..and yes, in theory, the TSH should reflect this..in practise it doesn't seem to in many.
>
> For me 50mcg felt like it totally shut down my own thyroid production..I went way more hypo.
> But I was too hypo to go and get a blood test at the time..or even work out what to do about it. So I stopped the meds and about a month later managed to crawl(literally) into an antiaging docs office..who has said she wisghes she had a photo of me then to do the before/after shots. I looked worse than the myxodema pics I've seen on the net.Wow, that does sound really bad. I've never been that hypo.
> You don't seem that bad :-))
>
> For some , adding a small amount of T4 or T3 can just augment their own thyroid with very little or no decrease in their own thyroid's output..lucky huh? ..apparently little feedback
>
> In theory I think I'd expect the increased small dose (yes, 50mcg is a small dose) should reduce your own thyroid's output by the same amount after about 12 weeks or so...so the TSH should be similar to before starting if that is the case...never heard of this happening though
>
> Usually most need a full replacement dose after a while..at least 100mcg t4..or 75 mcg T4 & 5mcg T4, minimum. Up to 200mcg T4 is pretty usual. A typical dose might be say 100mcg t4 and 7.5mcgT3. Just giving you a comparison here.
> Your final dose should depend on your test results AND your symptoms, includings thiing like basal temperature, pulse, blood pressure etc.
> It's probably best to aim for a TSH of around the 1.0 for starters and see how you feel from there. Test your TSH, Ft4, Ft3 first thing in the morning before meds for "best" results (highest TSH then)..oh and day 14 of cycle maybe too.(estrogen binds thyroid hormones).
>Yes, I think that aiming for a TSH of 1.0 makes sense. I have taken the same dosage of thyroid hormone for over 6 years now. I've always continued to have hypo symptoms even when I took the Armour. I wish I could use the home tests that you send out to the labs. Unfortunately, in California you have to have a doctor's prescription to use these home tests. Most other states here allow it. I would have to use basal temperature, pulse and energy/mood level and anxiety levels as my only guides. I could purchase a blood pressure monitor as well.
The test I just had done was completed before I took my thyroid med that day.
> Zinc helps with thyroid hormone utilisation(which is how thyroid hormones work with receptors etc regardless of the levels)..small amounts like 8 - 15mcg a day,
> as does selenium say 75mcg a day etc.I'm covered in the zinc and selenium departments.
Thanks for all of your input, Jan. Hope you're doing well.
Kara
Posted by KaraS on April 10, 2005, at 18:24:18
In reply to Re: TSH normals, posted by Cecilia on April 10, 2005, at 3:20:48
> A lot of labs and doctors are still way behind the times in terms of thyroid. The American Academy of Clinical Endocrinologists changed normal for TSH to .3 to 3 a while ago but the lab at my HMO STILL lists up to 5.5 as normal and the GP`s go by that. Dealing with doctors is such a pain-you have to massage their precious egos so carefully to get what you need. Cecilia
Ain't it the truth! Most of them are in the dark ages when it comes to thyroid treatment.k
Posted by KaraS on April 10, 2005, at 18:30:25
In reply to Re: TSH normals, posted by ladyofthelamp on April 10, 2005, at 4:19:39
> > A lot of labs and doctors are still way behind the times in terms of thyroid. The American Academy of Clinical Endocrinologists changed normal for TSH to .3 to 3 a while ago but the lab at my HMO STILL lists up to 5.5 as normal and the GP`s go by that. Dealing with doctors is such a pain-you have to massage their precious egos so carefully to get what you need. Cecilia
>
> Dealing with docs is a pain,but i find that if you insist on something being done without resorting to outright rudeness they tend to respond.I said to my doctor that if they didn't do anything then i would have to get a second opinion,they seemed to try a bit harder then!.Put everything in writing aswell as you have more clout then.I went to see a female GP in my practice who was alot more helpful and had a fresh outlook on my problems and instead of saying i needed to change my psych drugs(which never work anyway)she tried every concievable test to find out what was wrong and said if they still came back normal she wouldn't give up.Maybe i have just been very lucky
> My TSH jumped from 2.95 to 20.9 in 4 months so testing regularly has to be a good idea.In UK 4.25 is considered the cut off point.Sorry this is so long and maybe strays off the point but i feel better already after just 3 thyroxine(probably going manic for the first time in two years!!!!)
I would think that threatening to get a second opinion could work either way. They might get defensive and say "Fine, get your second opinion." I'm glad it worked for you though. What do you mean by getting it in writing? What would you write and would you insist it be added to your chart?You really had a huge TSH jump in a short period of time. I can imagine you would feel a lot better with some thyroid hormone in your system.
K
Posted by Phillipa on April 10, 2005, at 18:39:03
In reply to Re: TSH normals » ladyofthelamp, posted by KaraS on April 10, 2005, at 18:30:25
That's what happened to me with the Hashimotos. One week it was within normal ranges and the next week it was 22. Fondly, Phillipa
Posted by ladyofthelamp on April 11, 2005, at 3:43:34
In reply to Re: TSH normals » ladyofthelamp, posted by KaraS on April 10, 2005, at 18:30:25
> > > A lot of labs and doctors are still way behind the times in terms of thyroid. The American Academy of Clinical Endocrinologists changed normal for TSH to .3 to 3 a while ago but the lab at my HMO STILL lists up to 5.5 as normal and the GP`s go by that. Dealing with doctors is such a pain-you have to massage their precious egos so carefully to get what you need. Cecilia
> >
> > Dealing with docs is a pain,but i find that if you insist on something being done without resorting to outright rudeness they tend to respond.I said to my doctor that if they didn't do anything then i would have to get a second opinion,they seemed to try a bit harder then!.Put everything in writing aswell as you have more clout then.I went to see a female GP in my practice who was alot more helpful and had a fresh outlook on my problems and instead of saying i needed to change my psych drugs(which never work anyway)she tried every concievable test to find out what was wrong and said if they still came back normal she wouldn't give up.Maybe i have just been very lucky
> > My TSH jumped from 2.95 to 20.9 in 4 months so testing regularly has to be a good idea.In UK 4.25 is considered the cut off point.Sorry this is so long and maybe strays off the point but i feel better already after just 3 thyroxine(probably going manic for the first time in two years!!!!)
>
>
> I would think that threatening to get a second opinion could work either way. They might get defensive and say "Fine, get your second opinion." I'm glad it worked for you though. What do you mean by getting it in writing? What would you write and would you insist it be added to your chart?
>
> You really had a huge TSH jump in a short period of time. I can imagine you would feel a lot better with some thyroid hormone in your system.
>
> KHi again.I didn't threaten to get a second opinion as i don't think that would be very productive!:-).I just kept telling them how bad i felt and because all 3 of my immediate family are hypothyroid,i told them that i couldn't rest until i had been tested properly.I think writing letters with your concerns about results and your symptoms over time is a good idea as Doctors have a habit of homing in on one symptom to the exclusion of others(in my case thirst).They can always say you didn't tell them something important when you did all along.I think writing letters is very therapeutic(even if you don't send them).As i am sure everyone is aware,hypothyroid problems can make you forgetful and slow your mental processes down,so when i saw my Endo i kept forgetting to tell him things and was dismissed as being fine,as i had good colour in my cheeks!!!!!!!!!!!.You will have to excuse any angry overtones in my messages please as it is not how i mean to sound,but i am a little bit cross at the moment with the medical world in general.Really i am easy going and only stood up to the Doctors because i was so desperate that i had planned my suicide!Best wishes to everyone.
Posted by tealady on April 11, 2005, at 5:28:54
In reply to Re: My latest TSH level Spriggy and Maxime, posted by ladyofthelamp on April 8, 2005, at 13:15:15
> When i was tested and the results were 2.95 my endo told me i definitley wasn't hypothyroid.At the time my main symptom was tiredness and extreme thirst plus bone pains.All 3 of my immediate family are hypothyroid so as you can imagine i was still thinking that the problem was with my thyroid.I was to be tsted for DI but being the NHS a bed has not yet been available so as i was getting more and more ill e.g low body temp(96.2)weird throat feelings,cough,fatigue,headaches,bone pains,heavy periods etc,i decided to get my GP to do more tests and surprise surprise i am hypo!
> I took my first thyroxine tablet today but i still have to have other investigations re the thirst.I am relieved to have a partial answer to my symptoms after years on Effexor,prozac etc.I have a mental health history(no formal diagnosis as such)and am sick of doctors thinking it was all in my mind.Oh by the way i am 36 and feeling about 80.I will write a bit more later so thanks for your messages and interest.Hi There,
With your TSH up over 20 at least maybe your hypothamaus and pituitary are working..thinking positive here!yes I've heard of jumps like, often enough for it to be "normal"
Did you change anything else med wise at all in that time?
I have hashimoto's atibodies too..and I also have that extreme thirst (and no ADH on 2 blood tests so far(one random , one after fasting and water fasting overnite), but also haven't got into a hospital as yet for a DI test. I tried adding estrogen/progesterone and my body seemed to retain more water and I wasn't so dehydrated or desperately thirsty so I postponed the hospital. It took 6 months to see the endo and I was fiddling in the meantime. Please let me know how you go re the thirst especially!.Your TSH going so high is a good sign as far as ADH goes anyway as the ADH is made in the hypothalamus and pitutary..like TSH
Also TSH varies over the 24 hr cycle(a few points apparently , although mine doesn't seem to that much). Its best to test early in the morning before meds and on your highest estrogen day (about day 14 or a few days after)..as this should "theoretically" give you one of your highest TSH readings (which docs think are good as far as providing treatment goes anyway)
good luck with everything
Jan
Posted by ladyofthelamp on April 11, 2005, at 14:07:57
In reply to Re: My latest TSH level Spriggy and Maxime » ladyofthelamp, posted by tealady on April 11, 2005, at 5:28:54
> > When i was tested and the results were 2.95 my endo told me i definitley wasn't hypothyroid.At the time my main symptom was tiredness and extreme thirst plus bone pains.All 3 of my immediate family are hypothyroid so as you can imagine i was still thinking that the problem was with my thyroid.I was to be tsted for DI but being the NHS a bed has not yet been available so as i was getting more and more ill e.g low body temp(96.2)weird throat feelings,cough,fatigue,headaches,bone pains,heavy periods etc,i decided to get my GP to do more tests and surprise surprise i am hypo!
> > I took my first thyroxine tablet today but i still have to have other investigations re the thirst.I am relieved to have a partial answer to my symptoms after years on Effexor,prozac etc.I have a mental health history(no formal diagnosis as such)and am sick of doctors thinking it was all in my mind.Oh by the way i am 36 and feeling about 80.I will write a bit more later so thanks for your messages and interest.
>
> Hi There,
> With your TSH up over 20 at least maybe your hypothamaus and pituitary are working..thinking positive here!
>
> yes I've heard of jumps like, often enough for it to be "normal"
>
>
> Did you change anything else med wise at all in that time?
> I have hashimoto's atibodies too..and I also have that extreme thirst (and no ADH on 2 blood tests so far(one random , one after fasting and water fasting overnite), but also haven't got into a hospital as yet for a DI test. I tried adding estrogen/progesterone and my body seemed to retain more water and I wasn't so dehydrated or desperately thirsty so I postponed the hospital. It took 6 months to see the endo and I was fiddling in the meantime. Please let me know how you go re the thirst especially!.
>
> Your TSH going so high is a good sign as far as ADH goes anyway as the ADH is made in the hypothalamus and pitutary..like TSH
>
> Also TSH varies over the 24 hr cycle(a few points apparently , although mine doesn't seem to that much). Its best to test early in the morning before meds and on your highest estrogen day (about day 14 or a few days after)..as this should "theoretically" give you one of your highest TSH readings (which docs think are good as far as providing treatment goes anyway)
>
> good luck with everything
> Jan
>Hi,it is good to hear of someone else with thirst(although not so good for you:-))plus thyroid problems as i haven't seen the two mentioned together.I stopped taking Effexor last year and the test of TSH was at 2.95 then.I had taken it for 4 years.I knew my problems were more physical but my first G.p didn't agree.My second test of 20.9 was after 5 months completely drug free.I had my test on the 9th day of my cycle so it could have potentially been higher still!!
I too would be interested to hear how you get on in the water dep test.I wonder who will get an appointment first?!!.I haven't been tested for Adh by blood test or urine or whatever else they do.I don't quite understand the workings of the hypothalmus or pituitary yet but i am on the case.I wish you all the luck in the world...Amanda
> Oh by the way i tested negative for thyroid antibodies
Posted by KaraS on April 11, 2005, at 22:45:47
In reply to Re: TSH normals, posted by ladyofthelamp on April 11, 2005, at 3:43:34
> > > > A lot of labs and doctors are still way behind the times in terms of thyroid. The American Academy of Clinical Endocrinologists changed normal for TSH to .3 to 3 a while ago but the lab at my HMO STILL lists up to 5.5 as normal and the GP`s go by that. Dealing with doctors is such a pain-you have to massage their precious egos so carefully to get what you need. Cecilia
> > >
> > > Dealing with docs is a pain,but i find that if you insist on something being done without resorting to outright rudeness they tend to respond.I said to my doctor that if they didn't do anything then i would have to get a second opinion,they seemed to try a bit harder then!.Put everything in writing aswell as you have more clout then.I went to see a female GP in my practice who was alot more helpful and had a fresh outlook on my problems and instead of saying i needed to change my psych drugs(which never work anyway)she tried every concievable test to find out what was wrong and said if they still came back normal she wouldn't give up.Maybe i have just been very lucky
> > > My TSH jumped from 2.95 to 20.9 in 4 months so testing regularly has to be a good idea.In UK 4.25 is considered the cut off point.Sorry this is so long and maybe strays off the point but i feel better already after just 3 thyroxine(probably going manic for the first time in two years!!!!)
> >
> >
> > I would think that threatening to get a second opinion could work either way. They might get defensive and say "Fine, get your second opinion." I'm glad it worked for you though. What do you mean by getting it in writing? What would you write and would you insist it be added to your chart?
> >
> > You really had a huge TSH jump in a short period of time. I can imagine you would feel a lot better with some thyroid hormone in your system.
> >
> > K
>
> Hi again.I didn't threaten to get a second opinion as i don't think that would be very productive!:-).I just kept telling them how bad i felt and because all 3 of my immediate family are hypothyroid,i told them that i couldn't rest until i had been tested properly.I think writing letters with your concerns about results and your symptoms over time is a good idea as Doctors have a habit of homing in on one symptom to the exclusion of others(in my case thirst).They can always say you didn't tell them something important when you did all along.I think writing letters is very therapeutic(even if you don't send them).As i am sure everyone is aware,hypothyroid problems can make you forgetful and slow your mental processes down,so when i saw my Endo i kept forgetting to tell him things and was dismissed as being fine,as i had good colour in my cheeks!!!!!!!!!!!.You will have to excuse any angry overtones in my messages please as it is not how i mean to sound,but i am a little bit cross at the moment with the medical world in general.Really i am easy going and only stood up to the Doctors because i was so desperate that i had planned my suicide!Best wishes to everyone.
I understand completely. What you did makes a lot of sense (aside from being therapeutic for you).Take care,
Kara
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