# New here and have questions



## jackpot13 (Jul 10, 2011)

Hello, I have a question about my thyroid. In september i woke up one morning in atrial fib. I went to the ER and it converted itself after a BM. Had blood work (TSH was 4.14) and cat scan to r/o blood clot in my lungs. Went to a cardiologist and found nothing wrong with my heart. Shortly after I started noticing a lump in my neck. Went to Dr. and was told I had a goiter. Ultrasound showed multi nodular goiter with no focal leasions. TSH was 2.12, free t4 0.87 did not get a t3. TPO 1115. Told I have Hashimotoes but was not put on anything. My Dr is afraid it will put me in atrial fib again. Just had labs done again (it's been 6 months). TSH 2.70, T4 0.86, T3 3.53, TPO 1286. My TSH and T3 are on the high end of normal and my T4 is on the low end. I thought T3 and T4 should be about the same. Should I be taking something? I feel kind of crappy most of the time. No energy, don't feel like doing anything, now my legs are getting achey. Oh ya and my goiter is making me nuts! It's not interfering with swallowing or breathing but I know it's there. Very easy to feel but not to noticable. Any input would be helpful. Thanks, Debby


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## northernlite (Oct 28, 2010)

I think you need a clearer picture of what your thryoid is doing. Can you get your latest blood work and post it on here with ranges? A FT3 would be a useful number to look at since you say your T3 is at the high end of the range. That does not make sense for Hashi's.

If you do have Hashi's-

Cardiac arrhythmia's can be tied to hyperthyroidism but they have many other causes. You need to find someone that is willing to treat your thyroid disease without fear of your heart. I am a Hashi's patient who takes a beta blocker to control my heart rhythm. In me, they are not connected although I would guess if I moved into the hyper range it would be one of the symptoms that I would have trouble with.

I have taken a beta blocker for 21 years and was diagnosed with Hashi's and started on thyroid medication last November. I seen no change in my heart conditions or heart medication since taking Levothyroxine.


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## jackpot13 (Jul 10, 2011)

Thanks for the reply. Here are my ranges.
TSH 2.70 (0.49-4.67)
FT4 0.86 (0.61-1.12)
T3 3.53 ( 2.5-3.9)
TPO 1286 (<10)
I know my TSH looks in the middle here but the American Endo Asso. says anything over a 3 is suspect for hypo. so that puts me pretty close to that. It was 10 months ago I had the atrial fib and nothing since but I do have heart palpatations sometimes. I go back to my Dr on the 20th to review these labs. Wanted as much info from others as I can get before I go. I'm new to this thyroid stuff and kind of worried. Thanks


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## Andros (Aug 26, 2009)

jackpot13 said:


> Hello, I have a question about my thyroid. In september i woke up one morning in atrial fib. I went to the ER and it converted itself after a BM. Had blood work (TSH was 4.14) and cat scan to r/o blood clot in my lungs. Went to a cardiologist and found nothing wrong with my heart. Shortly after I started noticing a lump in my neck. Went to Dr. and was told I had a goiter. Ultrasound showed multi nodular goiter with no focal leasions. TSH was 2.12, free t4 0.87 did not get a t3. TPO 1115. Told I have Hashimotoes but was not put on anything. My Dr is afraid it will put me in atrial fib again. Just had labs done again (it's been 6 months). TSH 2.70, T4 0.86, T3 3.53, TPO 1286. My TSH and T3 are on the high end of normal and my T4 is on the low end. I thought T3 and T4 should be about the same. Should I be taking something? I feel kind of crappy most of the time. No energy, don't feel like doing anything, now my legs are getting achey. Oh ya and my goiter is making me nuts! It's not interfering with swallowing or breathing but I know it's there. Very easy to feel but not to noticable. Any input would be helpful. Thanks, Debby


Hey there, Deb! Welcome.

Could you please re-type you most recent lab results w/the ranges. Different labs use different ranges.

I will say this much, leaving a patient untreated is just as dangerous to the heart. It "really" is.

TPO is "suggestive" of many things and it is by no means specific to a diagnosis w/o further testing.

Please read.

TPO
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

Being on thyroxine replacement will help to shrink the nodules also.


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## Andros (Aug 26, 2009)

jackpot13 said:


> Thanks for the reply. Here are my ranges.
> TSH 2.70 (0.49-4.67)
> FT4 0.86 (0.61-1.12)
> T3 3.53 ( 2.5-3.9)
> ...


Thank you for re-posting the labs.

Free T4 is right at the mid-range of the range given by your lab. This may not be a good thing as the Total 3 is high. However, the Total 3 is bound, unbound and rT3 hormone whereas the FREE T4 is unbound hormone only.

So, it's anybody's guess here. Sad that your doc did not run the FREE T3 as well.

Clearly something is wrong and it seems to point to thyroid but as you no doubt by now have read the link to TPO, you know that more in-depth testing is required.

I suggest these......................(the ones you did not have)

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

And I would like to comment that "most" of us feel best w/TSH @ 1.0 or less w/the FREES above the mid-range of the range given by your lab.


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## northernlite (Oct 28, 2010)

TSH of 2.7 is way too high for me. I would be quite symptomatic so do not fear that we will judge all is well because it is in the normal range. My sweet spot where I feel good is with a TSH below 1.0 just as Andros mentioned, it is for many of us.

It is going to be a challange but you need to find out if the heart issues are linked to the thyroid. Lots of things can trigger an arrhythmia, I can get mine rolling with too much caffeine! One episode in 10 months is not a major issue in my opinion.

FT3 and TSI would give a better picture of what your thyroid is doing.


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## jackpot13 (Jul 10, 2011)

Thanks for all the responses! I guess my concern is if I take levothyroxine to lower my TSH wont that raise my T4 and T3? My T3 is already at the high end of normal. Will that throw me into hyperthyroid? This is so confusing!!


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## Andros (Aug 26, 2009)

jackpot13 said:


> Thanks for all the responses! I guess my concern is if I take levothyroxine to lower my TSH wont that raise my T4 and T3? My T3 is already at the high end of normal. Will that throw me into hyperthyroid? This is so confusing!!


If your FREE T3 is at the high end, that would be a concern. That is why I wish for you to get that test.

understanding thyroid labs
http://www.amarillomed.com/howto/#Thyroid

http://pro2services.com/Lectures/Spring/Thyroid/ThyTests.htm

Free T3 etc. 
http://www.thyroid-info.com/articles/freet3woliner.htm


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## Sanapia (Jul 10, 2011)

The first symptom of Hashi's that I could not ignore was heart palpitations. I would swing between hyper and hypo. My bouts of hyperthyroidism caused heart issues. Your thyroid quarterbacks your entire endocrine system and *can* cause a plethora of medical issues directly or by domino effect.

I've recently had a total thyroidectomy. In addition to synthroid I take a beta blocker to calm my heart.


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## jackpot13 (Jul 10, 2011)

OK going to the Dr tomorrow and still not sure if I should ask to be treated. I do feel I need to be treated because my TPO went up alittle from the last time and I think my goiter is getting bigger. (see labs in previous post). I am afraid to take anything because I am a big pillophobe! Hate taking anything! Always very afraid of what it will make me feel like with side effects.I forgot to mention that I am Diabetic and take Metformin 500 mg every day at supper. My diabetes is very well maintained and my A1C has been 5.5 for the past 3 years so thats good. I am also on Zoloft 25mg. I started that last Sept. after I went into atrial fib. I had myself in such a tizzy I couldn't function. Im going to start tappering of that starting this Fri. Wish me luck! I did find out that Zoloft can raise your TSH and lower your T4. I asked a pharmasist and she said it was true. Also I found out that Levothyroxine and Synthroid can raise your blood sugars. Anyone have this problem? I was thinking I would wait 3 months and have labs drawn again and see where my TSH and T4 are. What to do What to do! lol Any advice would be greatly welcome.


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## Andros (Aug 26, 2009)

jackpot13 said:


> OK going to the Dr tomorrow and still not sure if I should ask to be treated. I do feel I need to be treated because my TPO went up alittle from the last time and I think my goiter is getting bigger. (see labs in previous post). I am afraid to take anything because I am a big pillophobe! Hate taking anything! Always very afraid of what it will make me feel like with side effects.I forgot to mention that I am Diabetic and take Metformin 500 mg every day at supper. My diabetes is very well maintained and my A1C has been 5.5 for the past 3 years so thats good. I am also on Zoloft 25mg. I started that last Sept. after I went into atrial fib. I had myself in such a tizzy I couldn't function. Im going to start tappering of that starting this Fri. Wish me luck! I did find out that Zoloft can raise your TSH and lower your T4. I asked a pharmasist and she said it was true. Also I found out that Levothyroxine and Synthroid can raise your blood sugars. Anyone have this problem? I was thinking I would wait 3 months and have labs drawn again and see where my TSH and T4 are. What to do What to do! lol Any advice would be greatly welcome.


We all wish you the very best of all possible outcomes today and please do share w/us all about it when you can.


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## jackpot13 (Jul 10, 2011)

OK well heres the story. I was mistaken when I said I didnt have a free t3. It was the t3 i didnt have. My free t3 was 3.53 (2.50-3.90) Im going to taper off the Zoloft then have a bunch of thyroid labs done one month after I get off the zoloft. So What does a free t3 show? Thanks!


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