# 40, newly pregnant and crazy Hypo!! Help!



## AngieG (Jul 5, 2010)

I really need some help here, or advice, or an ear, or a friend! I feel like I'm going nuts! :sad0049:

I am right about now, 6 weeks pregnant and unable to take anything for the constant anxiety/Panic I got several months ago when my OB (actually, Physician's Assistant) put me on Levothyroxine, then Synthroid. It was so horrible! 3 days into it I started having massive panic attacks - the worst were at night, I'd wake up out of a dead sleep because my body was having a panic attack.

* Originally the TSH with her (OB) was 10.3 (Last year at my regular Physician it was totally normal, but he gave me a provisional diagnosis of Fibromyalgia and I had a Vitamin D deficiency.)

* After 4-5 weeks on Synthroid I couldn't take it (side effects) anymore, had a restest. She says my levels were now normal, and can I go see a shrink please. (Gee thanks lady for your support! She didn't even speak to me herself, she had her nurse call me.)

* I dumped the Synthroid and stopped taking it. I was SO miserable and had gone to see the OB to get on birth control, not for this! 3 weeks into the stop, my regular physician retested me and said everything looks "normal" (4.2 or 4.4 TSH). So, by this time I believe the OB's lab had mixed up my blood results with someone else's.

*one day I messed up my thumb and had to go get an X-ray. They wanted to be certain I was/was not pregnant so I took a test, and to my utter surprise, it happened to be positive. So, back to my OB I go.

*They retest: TSH now 6.0. Got a different Dr this time too, and he urges to me get back on Synthroid for the pregnancy right away, otherwise it can lead to abnormalities in the fetus, mentally etc. ! I plead with him to give Armour a shot, for me. He writes a prescription for 30 and I take it the next night, after much deliberation.

* Got to see an Endocrinologist last week, nice guy, and he suspects Hasimoto's? Draws blood, haven't gotten the results back yet. But he said as long as I am feeling okay on Armour I should start doubling it after a week, (now 60). Today is day 3 of the doubling and I had late night anxiety again, just like with the Synthroid, though not as crazy in anxiety, but just as restless and worried/dark about life.

This can't go on! This and the pregnancy, it's just too much! I have a 5 year old too, and when my husband goes to work i am just full of dread and despair.

Do you think it's Hashimoto's? Do you think there is any danger the pregnancy has already been jeopardized?? I just want to feel better and make my life better. But I just keep feeling worse. I haven't been able to get rid of the panic attack and anxiety since starting the Synthroid, I'm worried it's really messed me up, or the other way around....I could really use some input here from anyone! I'm desperate.


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## chopper (Mar 4, 2007)

Ok, here's the deal...sure sounds like hasimotos and your levels are fluctuating. SO many women have trouble with symptoms when either pregnant or after witting smoking for some reason. Maybe due to all the other hormones going nuts.

You need to be monitored very closely with frequent blood tests. It is true you do not want to be hypo during pregnancy but you don't want to be hyper either.

Sound like your thyroid is sputtering out - starting and stopping on it's own. When you take meds and it starts back up you feel hyper.

Demand full thyroid panels when you get tested - free t3, free t4 and tsh minimally. Initially I would also add tpo antibodies, tg antibodies and tsi for a proper diagnosis.


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## Andros (Aug 26, 2009)

AngieG said:


> I really need some help here, or advice, or an ear, or a friend! I feel like I'm going nuts! :sad0049:
> 
> I am right about now, 6 weeks pregnant and unable to take anything for the constant anxiety/Panic I got several months ago when my OB (actually, Physician's Assistant) put me on Levothyroxine, then Synthroid. It was so horrible! 3 days into it I started having massive panic attacks - the worst were at night, I'd wake up out of a dead sleep because my body was having a panic attack.
> 
> ...


What a story. I am upset that you were Rx'd Synthroid or any other based on TSH alone. Any conscientous doc would have at the very least run FREE T3 and FREE T4. And what about antibodies? No tests for those?

I recommend these tests...

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/understanding/conditions/thyroid.html

Believe it or not, you could be hyperthyroid. When the antibodies are raging, they do skew the regular thyroid panel TSI will rule that in or out. You should have no TSI and if you do, you most likely should not be on thyroxine replacement.

Bear in mind, I am not a doctor; just giving you things to ask questions about.

Here is another good link for you to learn about thyroid testing.........
Understanding thyroid lab tests..... http://www.amarillomed.com/howto

You probably should also a least have an ultra-sound sonogram to look for nodules and other irregularities.

Here is info for the pregnant patient......
http://www.thyroidmanager.org/Chapter14/14-frame.htm


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## AngieG (Jul 5, 2010)

nasdaqphil said:


> Ok, here's the deal...sure sounds like hashimotos and your levels are fluctuating. SO many women have trouble with symptoms when either pregnant or after witting smoking for some reason. Maybe due to all the other hormones going nuts.


 I did find out that one needs more iodine during pregnancy. A regular adult it was around 150, pregnant ladies need 200.



nasdaqphil said:


> You need to be monitored very closely with frequent blood tests. It is true you do not want to be hypo during pregnancy but you don't want to be hyper either.


 I wonder if hyper hurts the pregnancy, too?



nasdaqphil said:


> Sound like your thyroid is sputtering out - starting and stopping on it's own. When you take meds and it starts back up you feel hyper.


I have wondered if it's something like that. Does that kind of thing happen when one becomes hypo? I guess it's not really an on/off switch.



nasdaqphil said:


> Demand full thyroid panels when you get tested - free t3, free t4 and tsh minimally. Initially I would also add tpo antibodies, tg antibodies and tsi for a proper diagnosis.


I called the Dr today to see how the tests turned out and what they were exactly, but he wasn't in. Monday, July the 5th.... I know I am scheduled for another blood test on the 13th, but so far I don't know what for. I will most certainly ask about the antibody types and what they mean!!


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## AngieG (Jul 5, 2010)

Andros said:


> What a story. I am upset that you were Rx'd Synthroid or any other based on TSH alone.


ME, TOO!



Andros said:


> Any conscientous doc would have at the very least run FREE T3 and FREE T4. And what about antibodies? No tests for those?


 Not with the OB at first. The 2nd OB did run T4, but not T3. The TSH was called "3rd generation."



Andros said:


> I recommend these tests...
> 
> 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.
> 
> ...


Thank you so much for all this useful information!!! Being perhaps hypterthyroid had never even occured to me, except that my symptoms mimic that, which is why I am having such a hard time on this medication.

I found this (below) on a website today, and I have all of them except the (excuse me) BM and menstrual symptoms. I get hot flashes that are followed by cold spells, or vice versa - my A/C bill is going to be enormous! Before all this started, I was more or less asymptomatic.

*Common symptoms and signs of hyperthyroidism*

Palpitations
Heat intolerance
Nervousness
Insomnia
Breathlessness
Increased bowel movements
Light or absent menstrual periods
Fatigue
Fast heart rate
Trembling hands
Weight loss
Muscle weakness
Warm moist skin
Hair loss
Staring gaze


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## Andros (Aug 26, 2009)

AngieG said:


> ME, TOO!
> 
> Not with the OB at first. The 2nd OB did run T4, but not T3. The TSH was called "3rd generation."
> 
> ...


Yep! Now do make sure you get FREE T3 and FREE T4. These are your "unbound" hormones available for cellular uptake. The "Totals" are bound and unbound as well as sometimes rT3 (reverse hormone.)

God bless and take care of that baby. I am keeping you and the little one in prayer.


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## Debbie from Milwaukee (Apr 18, 2010)

Here's something you could call the endo's office RE: your Armour meds: I have read that many people break the dosage up during the day because the T3 meds are quickly absorbed and used by the body. I would also ask the endo if you should maybe wait on doubling the dosage until you have hyperthyroidism ruled out (or confirmed).

Hashimoto's thyroditis is the most common cause of hypothyroidism. It is an autoimmune condition in which your own antibodies destroy the thyroid. The other major autoimmune condition is Grave's disease. Grave's antibodies cause the thyroid to overproduce thyroid hormone. I think is is more rare, but occasionally a person can have BOTH conditions. My 20 year old daughter was diagnosed and treated with radioactive iodine for her Grave's disease 3 years ago. Over the past few months she has been plagued with psychiatric symptoms, some of which have been kick started or complicated by her thyroid. We are waiting until she sees another doctor in the next few weeks to confirm if she also has Hashimoto's. The interaction between her thyroid and her monthly cycle really brings her very low, so I know that female hormones can really complicate matters with the thyroid.

I think you are doing a great job of monitoring these symptoms despite how you are feeling and taking care of your 5 year old! As long as you get the tests that Andros and Nasdaqphil suggest, a competent endo should be able to discern exactly what is going on with your thyroid. Also, the ultrasound that was suggested will be harmless to your baby. Since anxiety is such a problem for you right now, if I were you I would determine that this is a time to pamper yourself as much as possible. Do whatever things help you and your 5 year old relax and take it easy. Since you are a good researcher, concentrate more on the info. that gets you closer to correct diagnosis and treatment and less on scary things that MAY (or may not) happen. Also, get social support from friends, family, and online places like this forum. I wish you well!


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## AngieG (Jul 5, 2010)

Well, after some more testing and more visits, it would appear I do not have Hashimoto's - I felt very convinced I did actually after a lot of reading up about it online, but apparently, nope. :/

The TSH is still high, tested at 6.2...
The T3 was normal
T4 was not tested this time around because the Endo said the levels will be high/higher due to pregnancy anyway and may result in a false positive they have no other way of circumventing. 
Tested for Antibodies: the AB test and TPO all within very normal ranges.

Here's what he did say, which is eh, ok, but still doesn't solve my reactionary problems to the meds...that some people are very sensitive to thyroid medications especially when they've felt totally asymptomatic over the years. He said it's possible that the symptoms I do have have come on so gradually that it feels regular and normal, and the body sort of metabolizes that way. In any case, things don't go up and down and all over the place. But since I am pregnant, I must stay on the thyroid medicine and now he recommends my trying Levoxyl, starting at 25mcg, then in 2 weeks at 50, another 2 week then 75mcg ideally. I am supposed to come see him again 3 to 4 weeks!

Needless to say, I'm kinda bummed,:sad0049: but at least I know that it's not Hashimoto's and that I must remain on meds, and I need to work on the Anxiety problems additionally. I almost wish it were Hashi's because I feel like I could have worked with that, and it would have given me some answers. 
(Small irony: I cancelled my therapist appointment to get this one today!)

SOOOooo, then I head straight over to the OB's office and actually got in to see him. He was happy to hear from me and wanted to know all about what the Endo had said. He can't give me anything for the anxiety/dread/side effect/psychiatric issues but did mention an herb I can take: St. John's Wort. 600-900mg a day is just fine (one pill) and should help aleviate symptoms a little. Can't take anything until the 3rd trimester, if that (and then it would just be an anti-depressant to stave off postpartum depression or something).

Anxiety therapy here I come! Yay.

Thanks everyone so much for your help and support. I wish there were something else I could do, seriously, but thank you so much for everything. ((((Hugs))))hugs3hugs6


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## chopper (Mar 4, 2007)

AngieG said:


> Tested for Antibodies: the AB test and TPO all within very normal ranges.


Normal is *ZERO*. Were your antibody tests normal or within the "normal range"? There's a big difference.

Did you have a TSI test run?

You are pregnant and experiencing bad anxiety. You need to be very proactive about this and insist on the proper tests. In the end it could just be anxiety but that's not very likely without a long history of it.

Any endo worth his license would try to get to the bottom of it.

Did anyone test your adrenals and Cortisol? ACTH test? Cortisol test? Prolactin?

I don't understand these doctors. Nothing ****es me off more than a doctor who just gives up because giving up is easier than trying to find a problem. I went for years, one doctor after another, trying to hand me Xanax for anxiety. Each one told me I was nuts basically UNTIL I found one special doctor who knew a lot about thyroid and was very expensive to test my TSI and found me to have Graves' and Hashi's. All those years were wasted with misdiagnosis because the docs were to lazy to pursue it.


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## Lovlkn (Dec 20, 2009)

AngieG,

How about posting some of those "normal" lab tests along with the ranges.

Normal in thyroid labs has a very big range. If my lab numbers can be way off for me but in "normal ranges". Are you catching my point?


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## arizonamom (Mar 10, 2010)

nasdaqphil said:


> Normal is *ZERO*. Were your antibody tests normal or within the "normal range"? There's a big difference.
> 
> Did you have a TSI test run?
> 
> ...


I totally agree about getting your Adrenals tested. Ask for all the above mentioned tests to be run. I, too, suffer from anxiety attacks. After much research, I've discovered that not only can out of whack thyroid hormones cause anxiety/panic issues, but so can out of whack estrogen hormones.

My adrenals were within the normal ranges (we all know what that word "normal" means) but after suffering for over three years with anxiety and other issues that seemingly came from out of left field, I finally found out that I was hypo. Even my own endo, who is no longer my endo, told me my levels were "normal". My TSH was at 3.7 and my free t3 and t4's were not right either. Oh sure, they were in the "normal" range, but after posting my info here and getting wonderful, sound advice, I realized that most of us function better at a TSH of 1.0 or lower.

I urge you to find a doctor, and it doesn't have to be an endo, that will listen to you and work with, and for, you! It could be an obgyn that understands thyroid issues or even an internest.

Sending possitive thoughts your way for a successful pregnancy and for the discovery of a doctor that "gets it"!:hugs:


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## AngieG (Jul 5, 2010)

Should I try and stick with the same Doctor, or try to find my Olympian? After I spoke this last time with my Endo, he wanted to see me in another 3-4 weeks. Is this normal? I would like to pursue the tests everyone here is mentioning, for sure, but I'm wondering if I am wasting my time with this doctor, or if I should try and push it and keep him for now. He seemed fine at first, but more rushed yesterday. 

I will post my test results as soon I get all those files together!


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## Debbie from Milwaukee (Apr 18, 2010)

I also noticed that you said that the T3 test came back, but what about free T3 and free T4? Do you think your O.B. would order those tests for you? I understand that the free T3 is the most important, because that is the only reliable test to show how much thyroid hormone is in your bloodstream. I have not idea is pregnancy can make that test inaccurate, but your O.B. would know. I think you will find that some people end up getting their internists or primary docs to do the thyroid tests that the endo docs SHOULD do but sometimes don't. Good luck on getting to the bottom of your symptoms!


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## AngieG (Jul 5, 2010)

Okay here is what I have so far on tests, and eh, it doesn't look like as much as I thought! There is even on incidence where my Primary physician ordered Free T3 and Free T4 and the lab just didn't do it (Spectrum Labs, Greensboro NC). My Endo even said they have a reputation around town for inconsistent thyroid results. Nice.

This is all I have for now. My OB has a copy of the earlier test they did waiting for me to pick up today, the one where TSH was supposedly 10+.

*October 27, 2008 - Dr. F.
10.27.2008*, Complained on sluggishness, fatigue, foggy brain. Found out eventually I had a Vitamin D deficiency and should be taking more Calcium. That cleared it up for me.

FastTSH : 3.74 uIU/mL (Range 0.35 - 5.50)

No test results for T3 or T4. It appears to have been requested yet not fulfilled by the lab (Spectrum Lab)

Cholesterol (LDL): 150.3mg/dL is borderline high at (130-159 is borderline high, 160 - 189 is high, and >190 is very high)

<<<missing controversial OGBYN test here>>>>

*April 30, 2010 - Dr. F.*
*04.30.2010*
Was on Synthroid now off since 1.5 weeks"
still taking Lorezepam occasionally for anxiety (prescribed by Mrs. Dr. S. )
TSH 4.43 (0.35 - 5.50)
Free T4 0.9 (0.6 - 1.6)
Free T3 3.2 (2.3 - 4.2)

Note on 05.03.2010, Dr F.: _"All normal including the full thyroid panel. No reason to explain fatigue. I suggest repeating a thyroid panel in 6 months."_

*June 24, 2010 - Green Valley OBGYN - Mr. Dr. S
06.24.2010*
TSH 6.028 (0.350 - 4.500)
FREE T4	0.92 
hCG 6775.4 (at the time a 5 week pregnancy, normal, but lower end)

*July 6th, 2010
07.06.2010 - LabCorp -** for Dr. C.*
Thryoid Antibodies:
TPO 5 IU /mL(0 - 34)
Antithyroglobulin Ab <20 IU/mL ( 0 - 40)

TSH 6.20 (0.450 - 4.500)

T3 (Triiodothyronine) 149 ng/dL (71 -180)


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## chopper (Mar 4, 2007)

Uggg.....those tests are almost useless as they stand.....

You need a comprehensive thyroid test done all at the same time. I would demand it:

TSH
Free T3
Free T4
Total T3
Total T4
Thyroid Peroxidase Antibodies (TPO Ab)
Thyroglobulin Antibodies (TG Ab)
Thyroid Stimulating Immunoglobulins (TSI)

...and since you are going to DEMAND the right tests  we are going to add a few:

ACTH
Serum Cortisol
Prolactin
Ferritin
Vitamin D
Magnesium

Now...that's a start.....

About the labs that you do have.....others may find something out of the ordinary as well - first, you have some TPO antibodies. I know its only 5 and below normal but they are there. My TPO are in the 2-thousands but if they are there, they're there. Your Free T3 in relation to your Free T4 is a bit out of whack. Your T3 is on the high side and your T4 is rather low. Your body appears to be over-converting T4 into T3. That is EXACTLY how I started my journey 8 years ago. In fact, my Frees were almost identical to yours except every now and then upon retest, my Free T3 would be OVER the range and since T3 is the "hyper feeling" chemical, that would explain the anxiety.

Im not a doctor but to me, it appears you have the beginnings of Hashi's or some type of T3 toxicosis perhaps. I would really like to see that TSI test.

Hopefully others will chime in as well.


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## AngieG (Jul 5, 2010)

nasdaqphil said:


> Uggg.....those tests are almost useless as they stand.....
> 
> You need a comprehensive thyroid test done all at the same time. I would demand it:
> 
> ...


I have called today to request the tests. I find half the battle to be his receptionist/nurse/assistant. She is very stuff and difficult to be around anyway, but when I asked for the tests right now she sounded very discouraging and said she would have him call me back. *rolls eyes*

I mean, heck you are TOTALLY RIGHT! This is my body, it's my concern and my responsibility. I think Doctors are wonderful, but in essence I am the client and they have a product. I don't have to shop at that store, right? Yeah!!! I wanted to get in the call in before noon though because he closes Friday at noon. 

There is one other lady here in Greensboro who sounds like she could be really useful but she doesn't take insurance at all! She doesn't believe in managed care - I like her rebel attitude - but sadly I doubt I could afford her that way. I might just give her a call though just to see...


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## AngieG (Jul 5, 2010)

Debbie from Milwaukee said:


> I also noticed that you said that the T3 test came back, but what about free T3 and free T4? Do you think your O.B. would order those tests for you? I understand that the free T3 is the most important, because that is the only reliable test to show how much thyroid hormone is in your bloodstream. I have not idea is pregnancy can make that test inaccurate, but your O.B. would know. I think you will find that some people end up getting their internists or primary docs to do the thyroid tests that the endo docs SHOULD do but sometimes don't. Good luck on getting to the bottom of your symptoms!


I think it may come to that! But I don't trust the lab my OB uses, they are known for inconsistent results concerning thyroid testing. The Endocrinologist said the T4 results would be skewed because of the pregnancy, but not the T3. Not sure how that works!


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## AngieG (Jul 5, 2010)

arizonamom said:


> I totally agree about getting your Adrenals tested. Ask for all the above mentioned tests to be run. I, too, suffer from anxiety attacks. After much research, I've discovered that not only can out of whack thyroid hormones cause anxiety/panic issues, but so can out of whack estrogen hormones.
> 
> My adrenals were within the normal ranges (we all know what that word "normal" means) but after suffering for over three years with anxiety and other issues that seemingly came from out of left field, I finally found out that I was hypo. Even my own endo, who is no longer my endo, told me my levels were "normal". My TSH was at 3.7 and my free t3 and t4's were not right either. Oh sure, they were in the "normal" range, but after posting my info here and getting wonderful, sound advice, I realized that most of us function better at a TSH of 1.0 or lower.
> 
> ...


Thank you so much for your helpful response, it made me feel a lot better - sorry I didn't respond sooner! I have a question: what tests do they run to test adrenals and the other female hormones? what are they called? I'd like to make sure I get some of those, especially the adrenals. Thanks!! I think I might go Doctor shopping this week!!


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## AngieG (Jul 5, 2010)

He didn't call back. I guess I'm not really surprised. Now it's the weekend. Hm.


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## Andros (Aug 26, 2009)

AngieG said:


> He didn't call back. I guess I'm not really surprised. Now it's the weekend. Hm.


I do agree w/our administrator Nasdaqphil, you know I suggested TSI also as you really could be hyperthyroid. The symptoms cross over all the time. It needs to be ruled in or out.

Hugs,


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## AngieG (Jul 5, 2010)

I believe it that it's a total possibility! I get on the medication and it just doesn't feel right to me, but thyroid issues don't seem to resolve so easy for lots of people. Seriously, I am thinking of calling my OB on Monday morning and asking him to authorize the tests for me. I can't believe how uncooperative my Endo's assistant was on the phone and the he didn't call. I have to wonder if she even gave him the message! I feel so ****ed off!


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## Andros (Aug 26, 2009)

AngieG said:


> I believe it that it's a total possibility! I get on the medication and it just doesn't feel right to me, but thyroid issues don't seem to resolve so easy for lots of people. Seriously, I am thinking of calling my OB on Monday morning and asking him to authorize the tests for me. I can't believe how uncooperative my Endo's assistant was on the phone and the he didn't call. I have to wonder if she even gave him the message! I feel so ****ed off!


My OB is the one that got me help. So...................I am all for it. Make an appt. with your OB. Let us know. There should be no reason why he/she would not order the labs you need for you.


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## kuka (Jul 12, 2010)

hi there, 
i can realy feel the pain your going through, as i have a child myself and am going thorugh most of the symptoms you are having.
there is one thing most people forgetting to mention, i have been told that infection makes these thyroid levels fluctuate, so try to have a blood test done for WBC just to make sure you don't have any infections.
also as for the anxiety and depression, try making yourself busy as much as you can with things you like, rather tahn taking medications as this may not be good for your beautiful baby..
in my case i find it even easier to sleep at night if i had spend a nice day during the morning. friend are great i am always here and welcome you as a friend if you would like me to be an ear for your emotions. i realy realy understand you.
i hope you get through all this and good luck.


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## AngieG (Jul 5, 2010)

Well, the endo still hasn't called back today and probably won't so, grabbing this bull by the horns (and thank you to everyone for your encouragement, I couldn't do it without you!!) I called my OB's office and am having the nurse call me back to try and get the comprehensive testing done as soon as possible Although my Ob is out till Thursday, I do have an early appt with him that day, so it would great to work that out already.

I will be 8 weeks on Tuesday and am scared to death irreparable harm has been done. I really need to read up, does anyone have any recommendations on where I can start? I would like to learn about how all these hormones and tests go along with each other.

Tearful and sad ~
AngieG


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## Andros (Aug 26, 2009)

AngieG said:


> Well, the endo still hasn't called back today and probably won't so, grabbing this bull by the horns (and thank you to everyone for your encouragement, I couldn't do it without you!!) I called my OB's office and am having the nurse call me back to try and get the comprehensive testing done as soon as possible Although my Ob is out till Thursday, I do have an early appt with him that day, so it would great to work that out already.
> 
> I will be 8 weeks on Tuesday and am scared to death irreparable harm has been done. I really need to read up, does anyone have any recommendations on where I can start? I would like to learn about how all these hormones and tests go along with each other.
> 
> ...


This is peer reviewed by many doctors...............

http://www.thyroidmanager.org/Chapter14/14-frame.htm

I am praying for you and the baby. Keep us posted on when you will see your ob/gyn and all about the tests.


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## AngieG (Jul 5, 2010)

Andros! What a great link, thank you!!


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## AngieG (Jul 5, 2010)

kuka said:


> hi there,
> i can realy feel the pain your going through, as i have a child myself and am going thorugh most of the symptoms you are having.
> there is one thing most people forgetting to mention, i have been told that infection makes these thyroid levels fluctuate, so try to have a blood test done for WBC just to make sure you don't have any infections.
> also as for the anxiety and depression, try making yourself busy as much as you can with things you like, rather tahn taking medications as this may not be good for your beautiful baby..
> ...


Thank you Kuka, I appreciate it! I think getting accurate diagnoses is the right way to go before I know whether I'm hypo-, hyper- or some other state of thyroid - lol! It's hard being alone out here all the time, but this website has already helped so much with numerous questions. hugs4


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## AngieG (Jul 5, 2010)

SO MAD I COULD SCREAM!!!! :sad0049: The nurse called back from my OB's office and though my Doc isn't there till Thursday, the other Doctor (Dr. W) there told her "he would not approve it because he believes I didn't need it." And that if my Dr. S wants to approve it Thursday morning that's another story. What a jerk!!! %$#@&^*!!!

I explained to the nurse that if TSI were present along with some other symptoms it might prove that I am Hyperthyroid and not Hypo. She says the tests indicate that I am hypo, so I'm hypo. And I said, I have several tests that indicate both normal and hypo ranges, with or without medication. I "agreed" that Dr. W was not an endocrinologist and does not specialize in this area, but having the presence of TSI would rule this out and who wouldn't want that? After all, I'm pregnant and the difference between HYPO and HYPER is huge, and especially so in these circumstances and when it comes to the treatment of these differing condidtions.

JHC! What does a person have to do to get some jerkoff to just sign YES on the forms already? Frick!


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## chopper (Mar 4, 2007)

You need to keep going and going until you find the right doctor then. It's your health. You have to just keep going and going.

I will not suggest you fill out the lab slip yourself the next time and add the correct tests that you need because that would not be right and I certainly have never done something like that a thousand different times. :evilgrin0010:


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## AngieG (Jul 5, 2010)

Haha! No kidding!  But alas, I could never do something like that, because as a previous special effects artist I have a special code of honor to uphold. I used to copy my mother's signature in high school to cut school, but soon learned that with great power comes great responsibility...in a Robin Hood sort of way. 

I have a question about the results of this test below, And I was hoping maybe you can help me answer a question or two I have about them:

Thryoid Antibodies:
*TPO* 5 IU /mL (0 - 34)
*Antithyroglobulin Ab* <20 IU/mL ( 0 - 40)

The TPO does say that there are some antibodies there, like Andros said, and that has got me thinking. And the second score, it has a score that says "less than 20." Does that mean zero, or actually something, but less than 20? Because it could indicate that there are antibodies here, too, right? And antibodies can be present in both Hashimoto's AND Graves?? Though in differing amounts?

Also, even if I can get my very sweet, nice Dr. S to run the tests I need (TSI, Cortisol, etc), what then? Do I try and figure it out with him, or...an internist? Another endo? I'm not sure which way to go soon, with or without the tests being approved/declined Thursday. Also, we are supposed to be going out of state soon to visit family and frankly the timing stinks, but there are 2 important family birthdays we'd feel bad about missing. Besides, I'd love to get out of Greensboro (preferably in a permanent fashion)!


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## arizonamom (Mar 10, 2010)

AngieG said:


> Thank you so much for your helpful response, it made me feel a lot better - sorry I didn't respond sooner! I have a question: what tests do they run to test adrenals and the other female hormones? what are they called? I'd like to make sure I get some of those, especially the adrenals. Thanks!! I think I might go Doctor shopping this week!!


I'm sorry I just read your reply. Crazy around here - hubby has pneumonia and I started to feel kinda crappy too. I found this link for you. It contains lots of info on adrenal testing. It's the one I read before having my adrenals tested.

http://www.thyroid-info.com/articles/shamesadrenal.htm

As for the female hormones, it's a simple blood test but since you are preggers, your estrogen levels will be off kilter anyway. See if you can get your adrenals tested and discuss the estrogen thing with your doctor.

I hope your hunt for a new doctor, one that will listen to what you have to say, goes well. :hugs:


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## chopper (Mar 4, 2007)

The most rudimentary adrenal tests you want are ACTH and Cortisol to begin with. If either shows a problem you then may be asked for a 24-hour catecholamine pee test. That tests epinephrine, dopamine, and norepinephrine over a 24 hour period.

TPO antibodies are most common in hashimotos. In bad cases the number is pretty high. My last TPO came back >2700! and my TG was like 900 or so.

Those antibodies can fluctuate greatly as disease progresses. It may be a fluke but it is likely you will retest in the near future and your TPO is higher somewhere down the road. Why did your body build any antibodies that are made to attack your thyroid gland? Does the quantity stop there or is it likely the same signal that created the few you have continues to create antibodies?

You probably need to see an endo whose main practice is not just diabetes.

Regarding your TG antibodies, I'm not sure if that means zero or a very small number but it probably means the number, if any, was too small to reach a valid conclusion so your ok there for now.


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## AngieG (Jul 5, 2010)

Well, I nagged my Ob yestesrday and he agreed to do the TSI test (not as much as I'd hoped, but still a win) and I should be getting the results back today, latest tomorrow! Yay!!


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## Andros (Aug 26, 2009)

AngieG said:


> Haha! No kidding!  But alas, I could never do something like that, because as a previous special effects artist I have a special code of honor to uphold. I used to copy my mother's signature in high school to cut school, but soon learned that with great power comes great responsibility...in a Robin Hood sort of way.
> 
> I have a question about the results of this test below, And I was hoping maybe you can help me answer a question or two I have about them:
> 
> ...


Yes to the thyroglobulin ab. This means you have a smattering (a detectable amount) and it also suggests activity.

That is correct; some antibodies indigenous to the thyroid can be present in both cases. There are more definitive tests as you get into it such as FNA (fine needle aspiration, sonograms, radioactive uptake scans) and so on.

For example: High titers of TPO are "suggestive" of Hashimoto's but they are also suggestive of a lot of other things. At that point, doctor should wish to be more definitive and order more in-depth tests such as FNA whereupon if certain Hurthle cells that are indigenous Hashimoto's are present at pathology, then that becomes a definitive diagnosis.


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## chopper (Mar 4, 2007)

Did you get the TSI results back yet? Outcome?


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## AngieG (Jul 5, 2010)

Nope, no call back. Gotta wait till Monders. :/


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## AngieG (Jul 5, 2010)

UPDATE: 
Well, carpfish! The nurse called and I won't be getting my TSI result in until July 23rd. Granted it's only 4 more days, but it's 4 more days!!! Uggghhhh. I am even happier now that I pushed for it when I did. The good news is the pregnancy looks normal on the ultrasound so far, so no blighted ovum - yay! No vacancy!  But I am still quite concerned about how this is all affecting the fetus.

WHAT I'M DOING NOW:
The endo had suggested I go up on the Levoxyl after 2 weeks.....25 to 50, then 50 to 75 after another two weeks. But these pills look like 2 arrowheads that butt up against one another, so the new plan with the OB is to go even more gradually, but getting the dose higher sooner. So I have 25mcg, I split a second one and take it too, making it 37.50. After a week of that, I will be taking the 2nd half of the 2nd pill and bringing up to 50 by the endo's proposed date.

So far, so good...

I mean, I feel like I should stay on what he prescribed until I know otherwise. Any plan is better than no plan, I think. It's not just my health, either. If it were up to me, I really wouldn't be on anything and I'd start from scratch. But there are 2 people in this sleeping bag! 

A NOTE FROM A BOOK: 
One interesting thing I read in my book, _The Thyroid Solution_ (2007 ed.), in a segment about Levothyroxine and the dangers of this generic mixture, was that...if a patient has a history or depression, post partum depression or anxiety disorders, that bringing them straight onto a full dose (like I had with the 75 of Synthroid) will bring that patient within 4-6 days into a panicky, horribly depressive state of turmoil, sweating, even delusions. This is exactly what happened to me. :sick0012:

HINDSIGHT: 
That P.A. at the OB's office also had told me to see a shrink, but in reality I should have very slowly and gradually dosed up - if I am truly hypo - instead of grandslamming it, and all could have been avoided if she were just even a little bit better educated and had simply asked the right question. :ashamed0001:


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## Andros (Aug 26, 2009)

AngieG said:


> UPDATE:
> Well, carpfish! The nurse called and I won't be getting my TSI result in until July 23rd. Granted it's only 4 more days, but it's 4 more days!!! Uggghhhh. I am even happier now that I pushed for it when I did. The good news is the pregnancy looks normal on the ultrasound so far, so no blighted ovum - yay! No vacancy!  But I am still quite concerned about how this is all affecting the fetus.
> 
> WHAT I'M DOING NOW:
> ...


My school of thought will always be to start the patient on the lowest possible dose and titrate upward slowly but surely. It works every time.

"Less is always better"


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## AngieG (Jul 5, 2010)

Um okay.
So I called the Ob's office today and found out the results of my TSI blood test. She first said, "everything's fine hon'!" and I asked for actual number, and then she said it was 0.7.

SO. There and not really there. I have no idea what this means. :confused0024:


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## Andros (Aug 26, 2009)

AngieG said:


> Um okay.
> So I called the Ob's office today and found out the results of my TSI blood test. She first said, "everything's fine hon'!" and I asked for actual number, and then she said it was 0.7.
> 
> SO. There and not really there. I have no idea what this means. :confused0024:


It means it is loitering. You are not supposed to have any as you know. I just hope she read you the right lab over the phone. Something tells me that does not sound quite right.


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## chopper (Mar 4, 2007)

Well, there ya go....TSI's in da house!!!

That .7, or 70 depending on how ya read it is not a teeny tiny number. Mine is 179 typically or 1.79.

I've been as low as 50 or 60 or .5 or .6 - it fluctuates with flare ups. The higher the number, the more hell you deal with.

I'll guarantee you that if you have the little boogers running around in your system that's not the last you've heard of them. TSI has just become a major phrase in your personal dictionary.


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## AngieG (Jul 5, 2010)

Andros said:


> It means it is loitering. You are not supposed to have any as you know. I just hope she read you the right lab over the phone. Something tells me that does not sound quite right.


I admit, it's a _weird score_. I have an appointment with a Dr who seems a lot more specialized, and has a strong nutritional focus as well, for August 5th. When I get back into town I'll go ahead and ring the regular endo, but...I don't think he is going to respond well to my testing for TSI, and therefore may poo-poo the results. He may surprise me though, so I'll give him that chance.

0.7. Huh. Andros, do you know where I can read up specifically on this kind of test? Thanks!!!


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## Andros (Aug 26, 2009)

AngieG said:


> I admit, it's a _weird score_. I have an appointment with a Dr who seems a lot more specialized, and has a strong nutritional focus as well, for August 5th. When I get back into town I'll go ahead and ring the regular endo, but...I don't think he is going to respond well to my testing for TSI, and therefore may poo-poo the results. He may surprise me though, so I'll give him that chance.
> 
> 0.7. Huh. Andros, do you know where I can read up specifically on this kind of test? Thanks!!!


http://www.hopkinsmedicine.org/endocrine/graves/TopicAnswer.asp?QuestionID=22

http://graves.medshelf.org/Lab_Tests

http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

http://www.gluetext.com/content/t/Thyroid/Thyroid_stimulating_immunoglobulin.html

Just for starters and may I remind you that the healthy person should have absolutely no TSI.


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## McKenna (Jun 23, 2010)

Hi Angie,

I just wanted to say that I'm right there with you, having gotten my TSI level back and it was 103. The ran another one, but I don't have those results yet.

Unfortunately, my endo does not see anything wrong with it. He said it was under the 125 top of the range. Ugg! Even with my symptoms being mostly hyper all the time. I think he goes my my TSH, which was high, and wants me to continue taking my Armour. I scheduled a TT for Sept. and I'm praying this puts an end to this nonsense.

From what nasdaqphil wrote above, I wonder if my level was up above 103 when I had a hyper flare a few weeks ago, but by the time I got the blood drawn a week or so later, it went down to 103. Can anyone answer, is that how it works?

I hope your new doc works out well for you!


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