# Newbie: Yikes! I think I have this! :(



## jerseyjim (Sep 3, 2012)

Hello All,
Newbie here. I have been suffering greatly. I'm like Jekyll & Hyde; one minute I'm fine & the next minute I'm extremely anxious. 
My endo says it's all in my head & referred me to a psychiatrist & psychologist. They say I'm depressed or anxious. I don't believe them! I'm on 150mg of zoloft & take klonopin on an as-needed, usually daily basis.
I've been a hash. thyroiditis patient for around 12 years. I have always suffered from bouts of anxiety, sleeplessness/insomnia/fatigue/etc. In fact, I suffer from just about EVERYONE of the symptoms noted here:
http://www.primehealthchannel.com/hashitoxicosis.html
Does hashitoxicosis really exist? How do you best treat it? Any excellent drs. in the northeast?
Thanks VERY much for any/all assistance. I actually had to quit my job (retired) because the anxiety & panic attacks became overwhelming. The only time I get true relief is when I'm laying in bed on the internet. 
I'm constantly apologizing to my lovely wife because of my problem.


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## jerseyjim (Sep 3, 2012)

Just added this to make sure I get instant replies; I missed this when i posted this.


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## jerseyjim (Sep 3, 2012)

Oh, for what it's worth, here are some recent labs:
-thyroid peroxidase - 69 H (range <35)
-thyroglobulin 1284 H (range<20)
I recently went to an alternative dr. who said my problem could be a lack of T3 uptake. He took me off T4 ( I was taking synthroid 175mg on day, 200mg the next & repeat) & put me on straight "biological-identical" T3 . 37.5mg.
After some time on this (mth. or 2) my labs came back as follows:
TSH 31.54 H (.4-4.5)
T4, free .3 L (.8-1.8)
T3, free 4.6H (2.3-4.2)
T3, reverse <3L (11-32)
I don't know what any of this means. I went back to my reg. endo. who had a fit. Now I'm back on alternating 175, 200mg synthroid. Due back to see my reg. endo in about 2 mths.
Any advice would be appreciated.


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## chopper (Mar 4, 2007)

Hey JerseyJim. Im the guy that actually wrote the article you referenced, before someone stole my image from my site: http://www.thyroidboards.com/hashitoxicosis.

Man, those are some WACKY labs. T3 is high and T4 is very low and TSH is high.

Have you ever had a TSI test?

My guess is this new doc is giving you too much T3 and that is causing the panic attacks. Your numbers are all out of whack. What were your labs like before you stopped Synthroid?

From the numbers I see here, LESS T3 and more Synthroid is the answer.

Why did the doctor switch you to all T3?


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## jerseyjim (Sep 3, 2012)

Hello Phil & All,

"Man, those are some WACKY labs. T3 is high and T4 is very low and TSH is high. Have you ever had a TSI test?"
***No.
"My guess is this new doc is giving you too much T3 and that is causing the panic attacks. Your numbers are all out of whack. What were your labs like before you stopped Synthroid?"
***In the "normal range" BUT I constantly suffered most of the symptoms in the article you wrote re: hashitoxicoma. So that's why I went to an "alternative" dr. who had me on straight T3, which threw my TSH & other numbers out of whack, so I went back to my endo, with my tail between my legs. 
"From the numbers I see here, LESS T3 and more Synthroid is the answer"
***Well, I'm back w/ my old endo taking, alternatively, 175mg & then 200mg synthroid, but, I'm 99.9% certain that I although I'll be brought back to "normal" ranges I will continue to suffer from what is called hashitoxicosis.
Why did the doctor switch you to all T3?
***Well, that's what this alternative dr. & his firm do. They believe some people can't process T4 into T3, so they order straight bio0idnetical T3.
Any suggestions??
TY very much!
Jim


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## chopper (Mar 4, 2007)

I feel for you man. 10 years ago, before my thyroid started dying off as it is now, I was having horrible panic attacks. I was useless. They became so bad I actually became agoraphobic for a little bit - I didn't want to go anywhere for fear of having one somewhere weird. They were totally debilitating.

I am going to guess that you do have high TSI and TSI is what calls the shots in this. When TSI is really high, you get those jitters and anxiety.

TSI = Thyroid STIMULATING Immunoglobulins. Please demand this test next time and report back.

Have you ever had a thyroid sonogram/ultrasound? How about a biopsy? RAI uptake scan?

As I said in my article, IF it is a case of high TSI, the only way to get rid of it is to get the thyroid removed. Once removed it is controlled and you can regulate it from there. Or, you can go my route - wait 10 years, get divorced, miss out on a ton of life and pray your thyroid eventually burns itself out. Don't go that route - it sucks - really.

I would really like to have seen your "normal" labs before you went on the T3. Do you happen to have them around? Do you recall your TSH back then?

I say rip that sucker out of your neck and get it over with. It sounds like the little bastard is nothing but trouble and its not going to heal itself.


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## chopper (Mar 4, 2007)

Added - have you ever tried Armour Thyroid? It's pig thyroid basically and has the right amount of T4 and T3. A lot of people who have trouble with Synthroid do very well on Armour.


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## jerseyjim (Sep 3, 2012)

[quote name='nasdaqphil']I feel for you man. 10 years ago, before my thyroid started dying off as it is now, I was having horrible panic attacks. I was useless. They became so bad I actually became agoraphobic for a little bit - I didn't want to go anywhere for fear of having one somewhere weird. They were totally debilitating.
***I'm just about there. I'm always telling my wife I'd rather stay home & do nothing. I avoid my grown children because I'm afraid to have an attack in front of them (this has happended)

I am going to guess that you do have high TSI and TSI is what calls the shots in this. When TSI is really high, you get those jitters and anxiety.

TSI = Thyroid STIMULATING Immunoglobulins. Please demand this test next time and report back.

***Will do!
Have you ever had a thyroid sonogram/ultrasound? How about a biopsy? RAI uptake scan?
***I had an ultrasond. It showed a couple of small nodules. The dr. wasn't very concerned. The other tests - no.

As I said in my article, IF it is a case of high TSI, the only way to get rid of it is to get the thyroid removed. Once removed it is controlled and you can regulate it from there. Or, you can go my route - wait 10 years, get divorced, miss out on a ton of life and pray your thyroid eventually burns itself out. Don't go that route - it sucks - really.
***Have or anyone else on the board had their defective thyroid removed? Did the panic attacks & all the other symptoms go away? Is there a downside?

I would really like to have seen your "normal" labs before you went on the T3. Do you happen to have them around? Do you recall your TSH back then?
***My TSH fluctuated.That what drove my endo nuts. He would say that I said I felt good when my #'s weren't great & and that I felt bad when my #'s were good. Hence, the referral to a psychiatrist. 
That's the appeal of a diagnosis of hashitoxicosis. It seems you could have good #'s & still not feel good when your thyroid squirts extra T4.

I say rip that sucker out of your neck and get it over with. It sounds like the little bastard is nothing but trouble and its not going to heal itself.
***Ha! I would in a minute if I thought that would cure me. I'd need to know the downside first!


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## jerseyjim (Sep 3, 2012)

OK, I pulled out my labcrop lab slip for my next appmnt on Oct 8th. The endo has the following 2 tests checked:
-TSH
-T4, free
That's it. I'll check more myself. 
Here are the other tests available. Which ones should I check?
-thyroglobulin (w/Anti-Tg)
-thyroglobulin Ab (Anti-tg)
-thyroid stimulating immunogloblin
-T4
-T3, free
-T3, total
TPO antibodies
TSH receptor Ab
Thanks!
JIm
PS
Any other lab tests I should check?


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## chopper (Mar 4, 2007)

Ok, if you are able to check off whatever you want without any hassle, then shoot for these:

*T4 (Also called T4, Total or Total Thyroxine)
T4 Free (sometimes its called Thyroxine, Free)
T3 Free
T3 Total
Thyroid Stimulating Immunoglobulin (TSI)* **** You want this test for sure.
*Repeat TSH*

Other labs include:

*AM Cortisol or Serum cortisol* (this responds to panic attacks...part of adrenaline system)

*DHEAS* - (Dehydroepiandrosterone Sulfate) - Also tests your adrenal glands

*Testosterone, Free & Weakly bound* - Really low testosterone can also cause panic.

*Serum Ferritin and TIBC* (Total Iron Binding Capacity) - This tests your iron stores and anemia and other problems. Many people with thyroid have iron troubles which lead to other problems.

Last, if your doc really doesn't mind, I would add a CMP (*Comprehensive Metabolic Panel*) if you havent had one in a while to check your cholesterol and a bunch of other things. I think it just says CMP on the lab sheet. Its a very routine series of tests most docs order once a year as part of a physical.

I would get all the tests done at the same time, while fasting and either before you take your meds or at least several hours after you take your meds. If taken all together, you get a good picture of how each is reacting to the other. My guess is your Cortisol will be high, Testosterone low, Cholesterol high, TSI high.

From here, you will get a really good overall outlook as to what's going on and how your thyroid is stressing out your adrenals.

The downside to ripping out your thyroid is potential complications from surgery as is normal with any surgery, damage to the vocal chords, damage to the parathyroid glands within the thyroid (they regulate calcium levels), with a good surgeon, most of the complications are usually avoided. You need a good surgeon though - someone who does a lot of these each year - quite a few per week is even better.

Additionally, with surgery, you will be on thyroid meds the rest of your life - which you are now anyway so that really shouldnt matter. You may gain a little weight at first but it should come off once your dose is stable.

Once its out, you are done. There is no more gland for the TSI to attack any more so the symptoms go away. There are TONS of members here who had the same thing and feel 100% better after. I am sure they will chime in. It's night and day according to most.

Regarding the shrink, been there, done that. These retarded endos should walk a day in our shoes. "Here's some Xanax...get hooked on that and come back when your normal" - *******s. You're most likely not nuts so don't worry. It really does sound like Hashitoxicosis. I would be very surprised if you didn't have high TSI. By the way, Xanax will help if you don't mind popping pills. Just dont get addicted to them. They can help you until you get this stuff regulated properly.


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## Andros (Aug 26, 2009)

jerseyjim said:


> Oh, for what it's worth, here are some recent labs:
> -thyroid peroxidase - 69 H (range <35)
> -thyroglobulin 1284 H (range<20)
> I recently went to an alternative dr. who said my problem could be a lack of T3 uptake. He took me off T4 ( I was taking synthroid 175mg on day, 200mg the next & repeat) & put me on straight "biological-identical" T3 . 37.5mg.
> ...


jerseyjim!!










It says Thyroglobulin 1284 and I am presuming that is Thyroglobulin Ab? If not, please let me know.

What does the test result mean?

Small amounts of thyroglobulin are normal in those with normal thyroid function. If thyroglobulin concentrations are initially elevated in a person with thyroid cancer, then it is likely that thyroglobulin can be used as a tumor marker. Thyroglobulin levels should be undetectable or very low after the surgical removal of the thyroid (thyroidectomy) and/or after subsequent radioactive iodine treatments. If levels are still detectable, there may be normal or cancerous thyroid tissue remaining in the person's body, indicating the need for additional treatment
http://labtestsonline.org/understanding/analytes/thyroglobulin/tab/test

It will be important to clarify which test this is. Thyroglobulin only or Thyroglobulin Ab. Actually, both are significant and warrant an ultra-sound and subsequent FNA if suspicious nodules are observed.

It is my humble opinion that you should insist on an ultra-sound. High TPO Ab and high Thyroglobulin Ab are "suggestive" of cancer. And this is perhaps why your numbers are so odd.

I have seen this "pattern" a lot. Please take my advice on this matter.

cancer TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html

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

Thyroglobulin Ab and cancer
http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf

Another Thyroglobulin and cancer
http://www.mdlinx.com/endocrinology...963/?news_id=811&newsdt=092010&subspec_id=419


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## chopper (Mar 4, 2007)

Andros is correct. I didn't mention it because I suggested surgery which would cut the cancer out if it was cancer or at least, they would do a full path report on the thyroid once its out to know for sure.

Andros knows her stuff. She's probably saved many lives with her advice on these boards. It is not all that unusual to not even suspect cancer, have the thyroid cut out only to find the path report comes back cancer and the patient didn't even know it. It does happen.


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## jerseyjim (Sep 3, 2012)

I went back & looked at my results again. They are from 11/11. My dr. never said a word about them! This is what they say:
-thyroid peroxidase Ab (TPO) 69 H(<35)
-AB thyroglobulon (ATA)1284 H (<20)
Do I have thyroid cancer?!!


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## chopper (Mar 4, 2007)

Don't freak out. First, none of us here are doctors. Next, thyroid cancer is usually slow growing and tends to stick to the area its in and has a very high cure rate.

The only way to know you have cancer for certain is with a positive FNA (Fine Needle Aspiration - a biopsy). Even with a biopsy, a huge percent of the time they are inconclusive. If they stick you and pull out cancer cells, its cancer. If they stick you can do not pull out cancer, it doesnt mean you do not have cancer, it just means the needle didn't hit any cancer.

Ultimately, if and when they take out your gland, they dissect it and will know with 100% certainty if you had cancer or not.

You are just suspect for cancer given your labs but so are millions of others who do not have cancer. It is just something to keep in mind when discussing with your doctor. Don't worry.


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## jerseyjim (Sep 3, 2012)

I'm faxing my endo the test results now & asking him to comment.
Thanks very much for bringing this info to my attention! 
I'm VERY DISAPPOINTED the dr. said/did nothing regarding the test #'s..


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## chopper (Mar 4, 2007)

A lot of endos really don't know thyroid as well as they should. Diabetes is much more common so they tend to specialize in either diabetes or reproduction problems for couples that cannot have babies. Thyroid gets pushed to the side.


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## jerseyjim (Sep 3, 2012)

Fax has been sent. We'll see what he says.
Thanks for all your help!


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## Andros (Aug 26, 2009)

jerseyjim said:


> I went back & looked at my results again. They are from 11/11. My dr. never said a word about them! This is what they say:
> -thyroid peroxidase Ab (TPO) 69 H(<35)
> -AB thyroglobulon (ATA)1284 H (<20)
> Do I have thyroid cancer?!!


It needs to be ruled in or out. One big clue is that your thyroxine replacement is not working and your lab numbers look strange. The other clue of course is as I stated re the high numbers for TPO and Thyroglobulin.

So, do you know if that is Thyroglobulin or Thyroglobulin Ab?

Also, men are more prone..............

men more likely to have cancer than women
http://www.umm.edu/endocrin/thytum.htm

Please call your doctor and have him/her set you up for an ultra-sound.


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## jerseyjim (Sep 3, 2012)

The lab report says, "AB thyroglobulon".


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## chopper (Mar 4, 2007)

AB stands for AntiBody on labs. So it is Thyroglobulin antibodies.


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## Andros (Aug 26, 2009)

jerseyjim said:


> I'm faxing my endo the test results now & asking him to comment.
> Thanks very much for bringing this info to my attention!
> I'm VERY DISAPPOINTED the dr. said/did nothing regarding the test #'s..


I hear ya'! Not a responsible thing to do by any stretch of the imagination.


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## bigfoot (May 13, 2011)

You sound like the poster child for a lot of this stuff. So glad you are here talking with the super-knowledable folks and getting aware of things! I generally think that the anxiety, mood swings, depression, and what-not are easy for doctors to label and then they miss the big picture. Those things are usually the signs and symptoms of something far larger that needs to be addressed (thyroid, adrenals, hormones, etc.). Plus, how can any doctor just write off the myriad of physical things that are occurring to so many people? The hair falling out, dry skin, vision problems, joint pain, muscle weakness, GI problems, libido, nausea, dizziness, etc. just to name a few. The mind is pretty powerful, but last I checked it didn't cause rashes and stiff joints, LOL.

Keep on chugging along and being a good advocate for yourself. Just being here and learning new stuff puts you so much farther ahead. It's not always easy, but nothing worth it usually is. Let us know how things go...

:anim_32:


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