# New Labs. Why do I still feel hyper?



## Nova8 (Oct 30, 2014)

Labs from Wednesday. I don't understand why my hospital's free reference ranges are so much different than many others' free ref ranges...? I know they use different sets of "healthy" people to determine normal ranges, but I don't understand why one hosp may consider my Free T3 result to be normal while my hospital considers it high. ? Either way tho I'm still having hyper symptoms. Ever since my last menstrual period about 3 weeks ago... but endo office staff tells me these numbers wouldn't give me symptoms still.

*Free T4: 1.51 (Ref: 0.76 - 1.46)*
*Free T3: 4.44 (Ref: 2.18 - 3.98) <--- I had to ask for this test. doc doesn't find it important (??)*
*Total T3: 161 (Ref: 76 - 181)*
*ESR: 16 (Ref: 1-28mm/h)* <-- I also requested this one to see if it would be elevated as in the case of Subacute Thyroiditis. Maybe it was when I was at the peak, but it's not right now, making me question if I have the painful/viral SAT or if I have the mysterious silent lymphocytic SAT.

Anyway if these are so normal as my doctor says, why do I still feel hyper?  My heart still races in the AM but not as bad as the peak of thyrotoxicosis I guess, tremors all day, anxiety, frequent BMs - formed but frequent. I pooped five freaking times today! Still on Atenolol 50mg/day.


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## Andros (Aug 26, 2009)

Low RAIU uptake and cancer
http://journals.lww.com/nuclearmed/Abstract/1987/05000/Thyrotoxicosis_Caused_by_Functioning_Metastatic.1.aspx
(Copy and paste into your browser)

Your labs are not normal; you are very hyper! Why do you not go ahead and have your thyroid out. I am curious. What do you expect to happen if you don't and what do you expect to happen if you do?

Maybe some of us can help w/the decision making process.

Low uptake could indicated some bad things in the thyroid gland; did you know that? Info above!

I got my life back when I had my thyroid ablated and have no regrets at all.

Sending hugs,

PS: I don't think your doctor knows how to interpret labs.


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## b1791 (Dec 3, 2014)

6 years ago I felt like you and my doctor kept telling me it was anxiety and prescribed Ativan and a beta blocker. 3 months later my symptoms stopped and went the complete opposite direction into hypo. It was only then that my doctor said "well, maybe you had silent thyroiditis". Anyways, I'm going through the exact same hyper symptoms now for the last 3 months and they don't know why. My labs look similar to yours TSH 0.13 (0.3 - 5.5) and FT4 23 (11 - 22) and I feel like crap so I know how you feel.


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## Nova8 (Oct 30, 2014)

Hey Andros,

I'm not having it removed because I don't have an autoimmune disease... I was diagnosed with Subacute Thyroiditis, something really rare (I can't find anyone to talk to who's had it!!) that can resolve itself or leave me permanently hypo. So I won't be needing to destroy or remove my thyroid; it's dying on its own. But there is an initial thyrotoxic phase for a few months and I'm coming out of that, my labs are showing that my Ts are going down. But I still feel awfully hyper.

Starting to wonder if I'm crazy-- it is very validating to hear that I could be feeling this way because my Free Ts are still in the high ranges, although, not really that high..... I guess that is why I was wondering, geez, my levels are improving but why do I still feel thyrotoxic? Tremors, heart racing, anxiety and all... so I guess, with labs like these, it is not surprising that I still feel this way?


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## Nova8 (Oct 30, 2014)

b1791 said:


> 6 years ago I felt like you and my doctor kept telling me it was anxiety and prescribed Ativan and a beta blocker. 3 months later my symptoms stopped and went the complete opposite direction into hypo. It was only then that my doctor said "well, maybe you had silent thyroiditis". Anyways, I'm going through the exact same hyper symptoms now for the last 3 months and they don't know why. My labs look similar to yours TSH 0.13 (0.3 - 5.5) and FT4 23 (11 - 22) and I feel like crap so I know how you feel.


What you need to diagnose Subacute Thyroiditis is labs indicating hyperthyroidism combined with a RAIU & scan test. If the RAIU is low, and your hormones are high, they diagnose Subacute Thyroiditis. Antibodies are either low or absent in this, too, which would further rule out the common causes of thyroid issues.

Subacute Thyroiditis can recur... but that is also rare. Have you had any other labs? any done when this happened to you 6 years ago? Also what did it feel like to go hypo? Hoping it was more tolerable than *this*


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## Lovlkn (Dec 20, 2009)

> *Free T4: 1.51 (Ref: 0.76 - 1.46)*
> *Free T3: 4.44 (Ref: 2.18 - 3.98) *


Being at top of out of range will make anyone feel hyper and anxious


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## Nova8 (Oct 30, 2014)

Lovlkn said:


> Being at top of out of range will make anyone feel hyper and anxious


Thank you for the reassurance. I feel like I'm losing it and the atenolol is losing effectiveness.


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## Lovlkn (Dec 20, 2009)

Is that all you are taking?


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## Andros (Aug 26, 2009)

http://www.thyroidmanager.org/chapter/acute-and-subacute-and-riedels-thyroiditis/

Subacute is not chronic; it is acute lasting only a few weeks up to a month. What antibodies' tests have you had done to show that you do not have antibodies indigenous to thyroid disease?

If those are your labs in your signature; you do have autoimmune. Those antibodies would not be present if you did not. Bottom line here.

Have you had a biopsy of any thyroid nodules? Do you know if nodules are present? Are you 100% sure you do not have cancer?

I truly am concerned.

Hugs,


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## Nova8 (Oct 30, 2014)

Andros said:


> http://www.thyroidmanager.org/chapter/acute-and-subacute-and-riedels-thyroiditis/
> 
> Subacute is not chronic; it is acute lasting only a few weeks up to a month. What antibodies' tests have you had done to show that you do not have antibodies indigenous to thyroid disease?
> 
> ...


Hey Andros, yes I am sure I do not have cancer. They did an ultrasound and an RAIU. U/s is good, no nodules; RAIU was very low at 1%. Combined with my high thyroid hormone labs, they diagnosed me with Dequervain's Subacute Thyroiditis.

From the link you provided above: "This condition, most likely of viral origin, lasts for a week to a few months, with a tendency to recur. The eponym was selected because of its uncertain cause."

So my disease is running its usual course. My numbers have been oming down on their own over the last few months, but I still feel thyrotoxic, and I was just wondering at what point of the reference range might I get some relief? I will likely go a bit hypo for 6-9 months after this thyrotoxic phase is over...

Yeah, only onAtenolol for my thyroid...


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## Lovlkn (Dec 20, 2009)

> *Labs 11.12.14 Meds: Atenolol 50mg PTU 100mg x3/day *
> 
> Thyroid Stimulating Immunoglobulin Antibodies (TSI): 32 (Ref: <140)


Taken from your signature

Having TSI , I would want more than Atenolol having labs still above ranges.

Why did they stop your PTU?


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## Nova8 (Oct 30, 2014)

Lovlkn said:


> Taken from your signature
> 
> Having TSI , I would want more than Atenolol having labs still above ranges.
> 
> Why did they stop your PTU?


Because of the low RAIU. :sad0049: Said that high labs combined with low RAIU means Subacute Thyroditis, which will resolve on its own without ATDs. I guess, my labs are reflecting that, but man, I still feel hyper just about everyday. What I DIDN'T like to hear them say was that my labs were so close to being in range that I should go seek head meds if I'm still having anxiety. GRRRR. I needed you guys to reassure methat I could still feel hyper even tho my ranges are coming down. I feel like it's not a mental problem if my labs are still showing above range. I hope.


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## Octavia (Aug 1, 2011)

Nova8 said:


> What I DIDN'T like to hear them say was that my labs were so close to being in range that I should go seek head meds if I'm still having anxiety. GRRRR. I needed you guys to reassure me that I could still feel hyper even tho my ranges are coming down. I feel like it's not a mental problem if my labs are still showing above range. I hope.


I disagree with the doctor and completely agree with you on this.

With TSH, someone can be pretty high out of range and still feel pretty normal. Not so with Free T3 and Free T4. If someone is even slightly high out of range on Free T3 or Free T4, they'll feel it--often physically and mentally. When I'm AT the top of the range for Free T4 (not even over the range), I feel hyper. You are well out of range, and you're going to feel it.

I don't know much at all about subacute thyroiditis, but I'm a bit surprised your doctor would "let" you continue to feel this way by not being an ATDs. Based on your research, how quickly is this expected to resolve on its own?


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## jenny v (May 6, 2012)

I would definitely ask for an increase in your Atenolol. Your frees are out of range which equals hyper symptoms (even if they don't believe it), including a higher heart rate and anxiety.


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## Lovlkn (Dec 20, 2009)

> What I DIDN'T like to hear them say was that my labs were so close to being in range that I should go seek head meds if I'm still having anxiety. GRRRR. I needed you guys to reassure me that I could still feel hyper even tho my ranges are coming down. I feel like it's not a mental problem if my labs are still showing above range. I hope.


As long as you are at the top of range like you are and having moving thyroid hormones you will feel a bit keyed up. Keep that in mind if you are already a type A personality.

My mind raced like crazy when I was hyper and when I was brought to hypo in a matter of 3 months I had to seek therapy because of some serious intensity in thoughts.

Once I crawled out of hypo my ability to think more sanely returned. I never took antidepressants.


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