# Scared Mommy....very Hypo...what to expect



## eire6678 (Jan 8, 2010)

Hi Everyone -

I am so happy that I found this board. Here is my background...5 years ago I had my fist baby, horrible post partum, after doing my homework asked dr. for bloodwork of my thryoid. Turns out I ever very overactive, over time it corrected itself. Now after my 3rd baby I was sweating like crazy, heart palps, insomnia, weight loss, asked for blookdwork and my TSH was <.005 and my T3 was 600. Was on PTU and was feeliing hypo, stopped now 3 weeks later tested and my TSH is 74. Now they want to put my on synthroid. I had gained and lost 6 pound also in the last week. I really want to continiue my weight loss..what is to be expected when starting synthroid.

Thanks!
Brenna


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## Andros (Aug 26, 2009)

eire6678 said:


> Hi Everyone -
> 
> I am so happy that I found this board. Here is my background...5 years ago I had my fist baby, horrible post partum, after doing my homework asked dr. for bloodwork of my thryoid. Turns out I ever very overactive, over time it corrected itself. Now after my 3rd baby I was sweating like crazy, heart palps, insomnia, weight loss, asked for blookdwork and my TSH was <.005 and my T3 was 600. Was on PTU and was feeliing hypo, stopped now 3 weeks later tested and my TSH is 74. Now they want to put my on synthroid. I had gained and lost 6 pound also in the last week. I really want to continiue my weight loss..what is to be expected when starting synthroid.
> 
> ...


Hi, Brenna and welcome to the Board. How long were you on the PTU? How much were you taking? Did the doctor stop you cold turkey or did he/she wean you off of the PTU?

Hopefully, the Synthroid should bring down the TSH so that you feel better. And it should enable you to once again control your weight w/ a healthy diet.

Have you ever had any antibodies' tests or a radioactive uptake scan of the thyroid?


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## eire6678 (Jan 8, 2010)

Thank you for your reply...I weaned myself off very quickly...bad patient. I was on 300 mg. s Had ultrasound done of thyroid, but no radioactive scan. When I was hyper my anti-thyroglobulin aintibodies were 43, t4 was 12.7,T3was 205, TPO >600 T free 7.1. I have been doing weight watchers an managed to lose weight being so hypo. ANything else I should look out for?


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## Andros (Aug 26, 2009)

eire6678 said:


> Thank you for your reply...I weaned myself off very quickly...bad patient. I was on 300 mg. s Had ultrasound done of thyroid, but no radioactive scan. When I was hyper my anti-thyroglobulin aintibodies were 43, t4 was 12.7,T3was 205, TPO >600 T free 7.1. I have been doing weight watchers an managed to lose weight being so hypo. ANything else I should look out for?


I am concerned because hyperthyroid just simply does not go away and it could be that you were on too much PTU, thus making you hypothyroid.

So, it worries me that you will be starting on Synthoid now. For that reason, it would be wise to have labs every 4 weeks or so to stay on top of what is going on.

Since different labs use different ranges, it would be ever so helpful if you could include the ranges with the results.

What was the result of the ultra-sound when you had it?

When trying to find out what "really" is going on, it is better to run Free T4 and Free T3 with TSH. The "frees" are the unbound and active hormone available for cellular uptake. The "totals" (T4 and T3) are bound, unbound and even rT3 and rT4 (reverse.) You can see the enigma w/ the totals. You can't tell what portion is unbound. This is very very important for a correct diagnosis.


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## eire6678 (Jan 8, 2010)

After my first baby the hyperthyroid did go away, they called it Post Partum thyroidis. I guess that is different?? After a while I probably was being overmedicated...any idea how long that stays in your system? Does it have to be corrected w/ synthroid or after the PTU ""wears off" will I be hyper again. Initially I was told Graves, but maybe Hashi in my opinion. I was off for about 3 weeks when the 2nd round of labs were taken. Ultrasound did not show anything abnormal.

Here we go:

This is when I was hyper...waiting for fax of new labs showing hyp.

Free T4 3.18 Range .82-1.77
T4 12.7 Range 4.5-12
TPO >600 Range 0-34
Triiodothyronin Free Serum 7.1 Range 2-4.4

Thank you again for taking the time to help me.


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## Andros (Aug 26, 2009)

eire6678 said:


> After my first baby the hyperthyroid did go away, they called it Post Partum thyroidis. I guess that is different?? After a while I probably was being overmedicated...any idea how long that stays in your system? Does it have to be corrected w/ synthroid or after the PTU ""wears off" will I be hyper again. Initially I was told Graves, but maybe Hashi in my opinion. I was off for about 3 weeks when the 2nd round of labs were taken. Ultrasound did not show anything abnormal.
> 
> Here we go:
> 
> ...


I cannot thank you enough for the ranges; that paints a very clear picture. Wow; definitely hyper!

If you have Graves', the diagnostic criteria would be 3 out of these for clinical presentations. Exophthalmos, goiter, thyrotoxicosis, pre-tibial myxedema.

Otherwise, you would just be in hyper state. Have you ever had FNA (fine needle aspiration) to diagnose Hashimoto's? Some say if TPO is high that that in and of it's self is a diagnostic tool. I do not agree w/ that. High TPO can mean a lot of things.....................including cancer, Lupus, RA and the list goes on.

If I can help, I will be overjoyed; it is my pleasure.


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## eire6678 (Jan 8, 2010)

You are amazing ...thank you for your wonderful explinations. No, never had FNA but will bring it up at next appointment. Is that to diagnose Hashi only?

Question about PTU...does that raise TSH? Now that I have been off of it for 3 weeks and my TSH is 74 does that mean w/ out it, it will come down again, or will I need synthroid to bring it down? Does that make sense?

Also, although I am clearly hypo now, I still have a racing heart and insomnia...I didn't think those thing were assocaited w/ hypp. The fact that I was able to lose 5 pounds doing Weight watchers while so hypo is surprising. Any thoughts?

Thanks again!


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## Andros (Aug 26, 2009)

eire6678 said:


> You are amazing ...thank you for your wonderful explinations. No, never had FNA but will bring it up at next appointment. Is that to diagnose Hashi only?
> 
> Question about PTU...does that raise TSH? Now that I have been off of it for 3 weeks and my TSH is 74 does that mean w/ out it, it will come down again, or will I need synthroid to bring it down? Does that make sense?
> 
> ...


There are many reasons for an FNA. One would be to rule out cancer and the other would be for firm up the diagnosis for Hashimoto's. There are "certain" Hurthle cells that are indigenous to Hashimoto's and if they are present, then viola.............the patient has Hashimoto's. As far as I know,that is the only definitive critera for diagnosing Hashimoto's.

Yes, the purpose behind taking the PTU was to raise the TSH (to normal levels) and to lower the FREE T4 and FREE T3 to normal levels where supposedly you are to feel well. It never worked for me.:anim_03:

There is a reason for that because meanwhile the antibodies and autoantibodies keep on attacking the thyroid gland. And that keeps one feeling badly even if the thyroid panel is in range. With me so far?:anim_63:

That is why in my very humble opinion, removing the gland is such a sensible option. When dog training, we are able to effect a lot of positive training by simply removing the problem. Dog likes the waste basket? Well, duh! Put the wastebasket where the dog can't get it. So simple.

Without the PTU, it should come down and also the Synthroid should bring it down.

When exactly did you quit the PTU? It has a very fast half life. Actually hours.

Your current symptoms point out why haveing the FREE T3 and FREE T4 labs would have been ever so helpful. It they are still high, you can still be symptomatic from hyper. There sometimes is a lag time between the TSH and the FREES. I have seen that many a time.

In other words, your system is still dumping thyroxine.


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## eire6678 (Jan 8, 2010)

In that case ( even though I really don't want it) I will bring up the FNA to my Dr.

I have been off of the PTU for a little over 3 weeks...3 weeks when labs were taken. I never asked for the frees but can't wait to see them on monday when I call!

It sounds like I could could have hashi and not graves like my Dr. first suspected.

Why is it that these things happen right after child birth? After my 1st I went hyper, it resolved itself, end of story until I just had my 3rd. Almost immediately I went hyper.


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## Andros (Aug 26, 2009)

eire6678 said:


> In that case ( even though I really don't want it) I will bring up the FNA to my Dr.
> 
> I have been off of the PTU for a little over 3 weeks...3 weeks when labs were taken. I never asked for the frees but can't wait to see them on monday when I call!
> 
> ...


First and foremost, the propensity for autoimmune disease is genetic. It is just lying there waiting to happen.

Things that trigger that propensity are any kind of trauma or stressor. Child birth is considered traumatic. No easy feat there; I am sure you will agree with that!

Here is info on TPO so you can brush up before you talk to the doc......

Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto's thyroiditis and Graves' disease.

So, while the TPO is often found in thyroid patients, their presence could suggest that something else of an autoimmune nature is going on.

Here is the link so you can read the whole thing........
http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/test.html


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## eire6678 (Jan 8, 2010)

Okay so here are my labs...the things that were flagged:

t4, Free (direct) .45 Range.82-1.77
TSH 74.875 Range .45-4.5
Antithyroglubulin Ab 355 Range 0-40

Thank you Andros!


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## Andros (Aug 26, 2009)

eire6678 said:


> Okay so here are my labs...the things that were flagged:
> 
> t4, Free (direct) .45 Range.82-1.77
> TSH 74.875 Range .45-4.5
> ...


You know what? I don't believe I have ever seen a FREE T4 that low. How in world are you able to function?

Well; I hate to be a nag here but cancer does need to be ruled out.

Fifteen to twenty percent of people with thyroid cancer develop thyroglobulin antibodies (also called thyroglobulin autoantibodies).

Please read the whole page here and they do use thyroglobulin and thyroglobulin Ab through out so one has to read carefully. There are pages so click the little next arrow bottom right to turn page.

http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

TSH does not seem to be budging, does it?

Has your doctor commented at all?


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## eire6678 (Jan 8, 2010)

Thank you for the link..if I am reading it correctly it my be a good thing that my antibodies went down. Initially my anitbodies were >600, now they are at 350. First round of labs TSH was <.001, 2nd round 74. The link stated that a person being treated for Graves will have lowering antibodies if respoding to treatment...so maybe I was just overmedicated.

Really, the lowest free T4?? I have 3 kids under the age of 5...I thought this was normal?


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## Andros (Aug 26, 2009)

eire6678 said:


> Thank you for the link..if I am reading it correctly it my be a good thing that my antibodies went down. Initially my anitbodies were >600, now they are at 350. First round of labs TSH was <.001, 2nd round 74. The link stated that a person being treated for Graves will have lowering antibodies if respoding to treatment...so maybe I was just overmedicated.
> 
> Really, the lowest free T4?? I have 3 kids under the age of 5...I thought this was normal?


Well; cleary you are hypothyroid. When TSH rises, the FREES go down. That part is normal but the more the FREES go down, the less energy you have. Free T4 converts to Free T3 and your Free T3 is your active hormone (your energy souce.) So, I would say you are extremely tired. Are you?

Yep; that is a good thing they are going down but still should be looked into. They can wax and wane as antibodies are so wont to do.

Glad you read the link. You are my kind of person.


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## eire6678 (Jan 8, 2010)

Yes I feel hypo. Very tired, I almost feel drunk all of the time, I can't maintain eye contact w/out feeling my eyes drift away, just so not in the moment, but at the same time irritable.

Now I am curious as to why they didnt test my free T3?

I will most definitely have to bring all of your excellent points up at the dr.s


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## Andros (Aug 26, 2009)

eire6678 said:


> Yes I feel hypo. Very tired, I almost feel drunk all of the time, I can't maintain eye contact w/out feeling my eyes drift away, just so not in the moment, but at the same time irritable.
> 
> Now I am curious as to why they didnt test my free T3?
> 
> I will most definitely have to bring all of your excellent points up at the dr.s


I was dismayed that they did not run the FREE T3; very dismayed. It would have been extremely interesting to see that. For example, it could have been high indicating that you are converting at top speed, hence still hyper regardless of where the TSH is at.

Had it been really low, that would be a cause for concern as well.

You may find this interesting.....
http://www.drrind.com/therapies/thyroid-scale#intro2


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## eire6678 (Jan 8, 2010)

sorry to be such a stalker, but it was on there. Apparently listed as Triiodcthyonine Free 2.5 Range 2-4


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## Andros (Aug 26, 2009)

eire6678 said:


> sorry to be such a stalker, but it was on there. Apparently listed as Triiodcthyonine Free 2.5 Range 2-4


No problem; it's a pleasure. Below mid-range; it should be @ 3 or more but within the range. Yikes.

I don't know how you are functioning right now; truly!


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## eire6678 (Jan 8, 2010)

Hi..back again. I was supposed to have an appointment w/ my endo tomorrow but had to cancel b/c my daughter is sick. I did get my new labs...much better!

TSH 4.29 Range .45-4.5
T4 7.4 Range 4.5-12
T3 105 Range 83-100

I am sure you will have to go through the history...but now I am on 100mg of synthroid..so I guess it is working.

They did not test frees, or antibodies..not sure why I wish they had...I might ask for more bloodwork before I go back.

Thanks!
Brenna


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## Andros (Aug 26, 2009)

eire6678 said:


> Hi..back again. I was supposed to have an appointment w/ my endo tomorrow but had to cancel b/c my daughter is sick. I did get my new labs...much better!
> 
> TSH 4.29 Range .45-4.5
> T4 7.4 Range 4.5-12
> ...


Well, indeed...............the tsh has come down. I would like to comment though that with your history of previous "hyperthyroid", they should be doing the "frees" and they should give you the antibodies' tests suggested.

While Total 3 is rather outdated and is comprised of bound, unbound and rT3 (reverse) hormone, because it is over the top, that worries me.

A radioactive uptake scan would also be smart.

More importantly, how do you feel.


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## eire6678 (Jan 8, 2010)

Thank God I really do feel better! No longer woozy, and I can stay up until 10pm...a huge difference. I still have the brittle nails and constipation...maybe that will clear up. Calling right now to get a slip for bloodwork.

Thanks!
Brenna


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## Andros (Aug 26, 2009)

eire6678 said:


> Thank God I really do feel better! No longer woozy, and I can stay up until 10pm...a huge difference. I still have the brittle nails and constipation...maybe that will clear up. Calling right now to get a slip for bloodwork.
> 
> Thanks!
> Brenna


Brenna; I am so so happy to hear that you feel so much better!! The nails take about 6 months to grow out and hopefully the intestinal motility will improve as well.

Share your labs when you get them, okay?


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