Thyroid Panel Interpretation

TSH is within "normal" ranges, old clinical standards were 0.8-5.. i was diagnosed at 5.6x, and I felt like crap- had given up all training (triathlete at 15-20h/wk), was sleeping 12h night + napping.. took me awhile to convince my Dr to increase it, they started way to gradually IMO, and now I try to keep my TSH under 2. Most people with hypothyroidism feel best when its around 1.. I've seen some guidelines that say treat when TSH is over 2, but it totally depends on the Dr, old ones generally are crappy at treating this, and refuse to prescribe medication, younger ones are better as what they're teaching in canada is treat symptomatically because TSH has such a wide range. I would suggest starting on a low dose of synthroid, (0.05 mgs/day) and see if they feel better. email me if you have any q's..

I disagree.

Normal ranges are dependent upon the lab. This person has had two normal TSH levels and has a Free T4 and a free T3 level which are normal. There has been much debate about TSH levels in the 4 to 5 range not being normal. These are NORMAL ranges. The thyroid gets blamed for a lot of things that it shouldn't be blamed for. This patient's symptoms are very non specific and can be atrributed to alot of conditions not just the thyroid. When you have THREE tests all in the NORMAL range then the results are normal. By the way...I am in my 40's.

My opinion? Look into another possible cause for the symptoms...

Thanks all so far for the answers. It seems there is a divide with regard to the thyroid and I can understand why. It sounds like people with similar results have had good results with thyroid meds. Keep in mind this is not somebody overweight trying to lose weight and blame the thyroid, but rather somebody who feels like crap with many symptmos (I forgot to mention low resting temperature also, as well as some perceptions of temp extremes, like feeling hot for a while, then cold, etc. Most of the time feeling hot is after eating)

Does anybody think it is worth testing for antibodies or doing a stim test? If not, what other tests would anybody recommend?

just another concurring opinion...

these are normal test results. there is nothing else to do in regard to thyroid function workup. i would not add more thyroid-related studies because you are bound to get one that will be falsely positive and that may lead you down a path of more tests and more interventions that introduce more problems than you started with.

you could try a low dose thyroid medication like a previous poster recommended. it may help.

but what i worry about is that there may be something else (nonthyroid) going on that could be serious. you need to look into other causes for the symptoms; this ranges from depression to cancer. discuss this with your doctor.

Thanks. She has had a complete workup for indigestion/gastroparesis. This included two gastric emptying studies, abdominal ultrasound, and gastrointestinal endoscopy. The gastric emptying studies showed marked gastroparesis, but there has not been anything pointing to why. I realize it is sometimes idiopathic, but we were hoping to find some other answers. That itself does not explain many of the other symptoms she has had for nearly three years now. The symptoms consistent with hypothyroid seem to be progressive.

celiac?

No signs of it, related to diet. She did have a gliadin antibody test (and one other antibody, I believe), and they were negative. It does not seem to be one food in particular, and we have tried elimination diets to no avail.

perhaps she should see a neurologist. gastroparesis is caused by a neurologic dysfunction. sometimes that is a side effect of diabetes. other causes may be other neurologic disorders like myasthenia gravis, multiple sclerosis and a host of others but to be honest i don't know enough about these things to give you advice on them.

good luck.

Cushings syndrome?

Or maybe she's just getting old.

Shaggy wrote:

you could try a low dose thyroid medication like a previous poster recommended. it may help.

it really doesn't look like thyroid based on the labs and i wouldn't go this route. once you are on these meds, lowering the dose makes you feel worse at first until your body adapts to it so if it turns out you stop taking them altogether, i suspect you would crash. hard to explain unless you have been there.

Each person feels best at a slightly different TSH level. I know some people who start to feel awful at anything above 2.0 and feel best around 1.5 or lower.

Each person is an experiment of one. Try getting the TSH down under 2.0 and see if it makes any difference.

Hey,

Modern, western medicine is best at dealing with "really" bad problems, cancer, heart disease, broken bones, etc. For these day to day type problems alternative medicine can be much more effective. Alternative medicine + diet is good at making a person's day to day life better. These non-diagnosable symptoms/non-conditions are too subtle for western medicine. So to improve her endocrine system you should read "adrenal fatigue" by Wilson(http://www.amazon.com/Adrenal-Fatigue-Century-Stress-Syndrome/dp/1890572152/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1224130804&sr=8-1), Thyroid Power by mr and mrs shames (http://www.amazon.com/Thyroid-Power-Steps-Total-Health/dp/0060082224/ref=sr_1_1?ie=UTF8&s=books&qid=1224130854&sr=1-1) and think about What Your Doctor May Not Tell You About Hypothyroidism: A Simple Plan for Extraordinary Results by Ken Blanchard (http://www.amazon.com/What-Your-Doctor-About-Hypothyroidism/dp/0446690619/ref=sr_1_1?ie=UTF8&s=books&qid=1224130894&sr=1-1).

These will give you good practical advice. I am in a very similar place and going through the same symptoms. Western medicine has not been helpful, so I am looking elsewhere for answers. Good Luck

Is she on birth control aka "the pill"?

my observational experience - cold practically all of the time - wearing a sweater / long sleeves when everyone else is comfortable or warm; coughing a lot, getting "choked" on food frequently; low, no energy - going from high energy to being unmotivated; waking temps consistently 96 or less for ~7-10 days in a row; heat intollerance; a shift toward depression or blue mood; inability to fall asleep easily or at all, without a sleep aid or alcolchol; weight gain despite exercise; hands and feet cold to the touch; change from being confident to being nervous/anxious.

regarding "the pill" if she was previously only one type then changed to another - recently. (1 - 3 months)

sorry, it is getting late and i have been up too long.

... if she was previously on one type of birth control, then recently switched to another type, within the last 1 - 3 months.

I'd also look elsewhere other than thyroid. Believe me, I know how tricky it is because the symptoms can be so subtle. But based on the lab results, it's really worth looking into other causes and solutions. You really don't want to start down the hormone replacement road if you don't have to. Or miss another disease because you were convinced it was thyroid.

If it is thyroid disease, her numbers will get worse over time, and then she'll know. Consider this test a benchmark. If she spends the next year, looking into other causes or ways to treat the symptoms and then gets her TSH tested again and it's 3.9, even though that's not super high, it's still a sign that her thyroid is failing and them maybe then it will be worth looking into hormone replacement.

I wish her good luck.