# Do my labs verify my belief I'm hypo?



## tiki505 (Jan 11, 2011)

Hello everyone, I'm a 48 year old female who has been dealing with a diagnosis of celiac for the last year. I have all the symptoms of hypothyroid except the high cholesterol (mine is around 148). When I lived abroad I was treated for with levothyroxin (125mcg) for about 8-10 yrs. My doctor, once I moved to the U.S. felt it was unnecessary and took me off. I've did o.k for several years, but about 2 years ago I started to develop the same type of symptoms, fatigue, slow steady weight gain (lost my lifetime weight watcher standing :sad0049: ) heavy periods, joint pain, anemia, hair loss, depression (no surprise there) and the list goes on. My labs are as follows:
TSH 3.6 (Range 0.4-4.5)
T4 4.9 (Range 4.5-12.0)
T3 Uptake 32 (Range 24-39)
Free Thyroxine Index 1.6 (Range 1.2-4.9)

I know that from what I have read I would benefit from having thyroid antibodies testing done, but I have had to fight to get these test.
Thanks in advance for any guidance.


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## lavender (Jul 13, 2010)

While in range your levels are dreadfully low. Will your doc put you on thyroid replacement?


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## Andros (Aug 26, 2009)

tiki505 said:


> Hello everyone, I'm a 48 year old female who has been dealing with a diagnosis of celiac for the last year. I have all the symptoms of hypothyroid except the high cholesterol (mine is around 148). When I lived abroad I was treated for with levothyroxin (125mcg) for about 8-10 yrs. My doctor, once I moved to the U.S. felt it was unnecessary and took me off. I've did o.k for several years, but about 2 years ago I started to develop the same type of symptoms, fatigue, slow steady weight gain (lost my lifetime weight watcher standing :sad0049: ) heavy periods, joint pain, anemia, hair loss, depression (no surprise there) and the list goes on. My labs are as follows:
> TSH 3.6 (Range 0.4-4.5)
> T4 4.9 (Range 4.5-12.0)
> T3 Uptake 32 (Range 24-39)
> ...


Oh, what a shame!!! As a general rule, once on thyroxine replacement, always on it. This is a horrible thing for me to hear.

Thank you for the ranges. They are appreciated. The truth is AACE recommends the range of 0.3 to 3.0 for TSH and MOST of us feel best when TSH is down around 1 or less. Your Total 4 is awfully low also which indicates a need for replacement. The T4 is bound and unbound hormone so when it is low, we know something wrong. FREE T4 is the unbound hormone available for cellular uptake. So next time around, insist on FREE T4 and FREE T3 tests. FT3 is your "active" hormone so it is very important to have the FT3 test as well.

I do advise antibodies' test as well.

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/unders...s/thyroid.html

In my humble opinion, you are hypothyroid and you do need thyroxine replacement.

Are you on a totally gluten-free diet for celiac?

Welcome to the board!


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## tiki505 (Jan 11, 2011)

Thank you Lavender and Andros for your replies. Yes I have been totally gluten free for around a year now. I no longer have the migraines and dizziness several times a week that I was suffering from. My doctor doesn't believe I am hypo but I have begged to at least let me have a low dose to see if it help. My heart rate is really out of whack. I was sent to a cardiologist after wearing a monitor for 48 hrs and had just a little over 3,000 skips, pauses, and other "incidents" along with a super low pulse 47 at one point. The cardiologist did not advise treatment at this point because if I become active (treadmill, walking briskly, etc) my heart rate evens out and becomes regular so there is no structural damage to the heart although I am on aspirin to help prevent clots. I think my reg dr. may be afraid that the thyroid meds will add to my irregular heart beat--I'm not a doctor but I think the thyroid is what is causing the irregular beat although I haven't found a lot on the internet to support my theory. I will push for the additional tests, I knew about the antibody test but was unfamiliar with the rest.


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## Andros (Aug 26, 2009)

tiki505 said:


> Thank you Lavender and Andros for your replies. Yes I have been totally gluten free for around a year now. I no longer have the migraines and dizziness several times a week that I was suffering from. My doctor doesn't believe I am hypo but I have begged to at least let me have a low dose to see if it help. My heart rate is really out of whack. I was sent to a cardiologist after wearing a monitor for 48 hrs and had just a little over 3,000 skips, pauses, and other "incidents" along with a super low pulse 47 at one point. The cardiologist did not advise treatment at this point because if I become active (treadmill, walking briskly, etc) my heart rate evens out and becomes regular so there is no structural damage to the heart although I am on aspirin to help prevent clots. I think my reg dr. may be afraid that the thyroid meds will add to my irregular heart beat--I'm not a doctor but I think the thyroid is what is causing the irregular beat although I haven't found a lot on the internet to support my theory. I will push for the additional tests, I knew about the antibody test but was unfamiliar with the rest.


There can be nothing worse for your heart than to deprive it of the necessary hormones T4 and T3 (thyroxine replacement.)

Glad you are gluten-free. I have been for a many many years. It is awesome to feel so much better. The longer you are gluten free, the better you will feel and this sometimes takes many years.

Getting back to the thyroid. I am not sure I would battle it out w/ the current doctor you have. You might consider finding another who is more willing to help you out of this jam and who is thinking outside the box.

To keep you in this state is unconscionable in my humble opinion.


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## lavender (Jul 13, 2010)

tiki505 said:


> Thank you Lavender and Andros for your replies. Yes I have been totally gluten free for around a year now. I no longer have the migraines and dizziness several times a week that I was suffering from. My doctor doesn't believe I am hypo but I have begged to at least let me have a low dose to see if it help. My heart rate is really out of whack. I was sent to a cardiologist after wearing a monitor for 48 hrs and had just a little over 3,000 skips, pauses, and other "incidents" along with a super low pulse 47 at one point. The cardiologist did not advise treatment at this point because if I become active (treadmill, walking briskly, etc) my heart rate evens out and becomes regular so there is no structural damage to the heart although I am on aspirin to help prevent clots. I think my reg dr. may be afraid that the thyroid meds will add to my irregular heart beat--I'm not a doctor but I think the thyroid is what is causing the irregular beat although I haven't found a lot on the internet to support my theory. I will push for the additional tests, I knew about the antibody test but was unfamiliar with the rest.


Glad your doc is starting you on meds. My heart does weird stuff when I am high or low.


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## tiki505 (Jan 11, 2011)

I am starting 12.5 mcg of levothyroxin (1/2 tablet) and then after 2 weeks start taking a full tablet. On average how long will it take to get to an acceptable dose considering my numbers? I remember when I took it years ago, it took quite a while to get to a dose that I felt good at (125mcg). My doctors then based my dosage then on more how I felt rather than lab results. I don't think my doctor here will be as open to that method. Is it worth pushing for an endocrinologist or is it pretty hit and miss with them as well?


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## Andros (Aug 26, 2009)

tiki505 said:


> I am starting 12.5 mcg of levothyroxin (1/2 tablet) and then after 2 weeks start taking a full tablet. On average how long will it take to get to an acceptable dose considering my numbers? I remember when I took it years ago, it took quite a while to get to a dose that I felt good at (125mcg). My doctors then based my dosage then on more how I felt rather than lab results. I don't think my doctor here will be as open to that method. Is it worth pushing for an endocrinologist or is it pretty hit and miss with them as well?


As long as this doc is willing to titrate your Levothyroxine upward every 8 weeks (based on labs and clinical evaluation) until you are euthryoid (feeling great), I would stick w/him or her.

No sense doctor hopping if you are getting the job done.


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## lavender (Jul 13, 2010)

Unfortunately, there is no quick fix for thyroid. It could take a while to get back up to 125, but hopefully you will start feeling better with every increase!


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## tiki505 (Jan 11, 2011)

As I mentioned earlier I was to move up to 25mcg for several weeks then retest, well I just got my result (notice no -s) on there. Sadly my doctor only ran a TSH and it has dropped for 3.6 to 2.9 (Range 0.4-4.5) Her view is there is no reason to increase the levothyroxin again as I'm still in range and I had to beg for her to even give me a prescription for a low dose. My joint pain has lessened significantly, although the fatigue, always being cold, and heart palpitations are still a problem. My weight, or should I say inability to lose weight is still a problem. I joined Dr. Oz's 11 week challenge, it graphs how much your anticipated weight loss will be based on calories and activities (although states very clearly there are many other factors that come into play) but each week I just stay the same even though realistically there should be at least a small loss. My question is-what do I do now? I can bring extra levothyroxin the next time I travel abroad and increase on my own-I can try to find another dr. who will test. It is so frustrating! I'm tempted to try and find a private lab to get the test you guys have recommended but I'm not sure she understands thyroid issues well enough to be able to read any results from the more advanced labs. Any suggestions of what I should do? Thank you all in advance.


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## Andros (Aug 26, 2009)

tiki505 said:


> Hello everyone, I'm a 48 year old female who has been dealing with a diagnosis of celiac for the last year. I have all the symptoms of hypothyroid except the high cholesterol (mine is around 148). When I lived abroad I was treated for with levothyroxin (125mcg) for about 8-10 yrs. My doctor, once I moved to the U.S. felt it was unnecessary and took me off. I've did o.k for several years, but about 2 years ago I started to develop the same type of symptoms, fatigue, slow steady weight gain (lost my lifetime weight watcher standing :sad0049: ) heavy periods, joint pain, anemia, hair loss, depression (no surprise there) and the list goes on. My labs are as follows:
> TSH 3.6 (Range 0.4-4.5)
> T4 4.9 (Range 4.5-12.0)
> T3 Uptake 32 (Range 24-39)
> ...


Yes; you would benefit from antibodies' tests. That said, "Once on thyroxine replacement, always on thyroxine replacement." General rule of thumb with few exceptions.

Your T4 is bottomed out. Why that is worthy of note is because that is bound and unbound hormone. The FREES would be better tests for that measures the unbound hormone available for cellular uptake. If the T4 (total) is that low, something "is" wrong. Not to mention AACE recommends the TSH range to be 0.3 to 3.0.

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

Welcome to the board.


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