# Hashimoto-hypo-or secondary hypo no buddy knows..help?



## missydawn (Aug 19, 2011)

Hello everyone!

I am a bit confused as to what is going on so here are my lab results and a little information to go with them.

I went to get my blood test done after I had a week of extreme energy and anxiety. My TSH was 0.051. In April I went to check my blood again because something did not seem right. TSH 13.099 in April. Endocrinologist prescribed 100mcg of eltroxin. I got an ultra sound and the results were fine. She says I am hashimoto hypothyroid. So I stayed on 100mcg from late April to early July. During those months at first I felt ok then I started feeling extreme anxiety, panic attacks, rapid heart beat, shallow breathing with minimal exercise. It was not fun by June 17th I crashed and felt the complete opposite with extreme tiredness, depression and this lasted only a few days. After this she thought I was secondary hypothyroid and did a cortisol adrenal test. Adrenal was fine. I dropped down to 50mcg in July. July my TSH was 0.369 she upped my dose to 65mcg-she said I was still hypo. I was only on the 65mcg for 8 days until the next draw and it was TSH 0.940. I asked her why she says I am hypo when my TSH suggest that I am going towards hyper? She said oh no not hyper at all just looks that way I think you are secondary hypothyroid. So I had an MRI done and I am still waiting on the results. She wants to do another adrenal function test. I am confused. Before the month of February I was a pretty mellow individual, didn't have a lot of energy, I guess symptoms of hypo since I was a little girl but Thyroid test were always fine. Hypothyroidism runs in my family. Any help would be appreciative. Thank you so much.

Blessings,
Missydawn

-few months leading up to Feb and in the month of June from time to time when I would exercise which would normally be no more than 30 minutes I would get this surge of intense energy and then I would be able to work out for an hour 1/2 to two hours no problem. The feeling would go away a little after working out. Strange-and also a few times after eating if I waited too long to eat or if I had not had any food yet for a while I would either get a panic attack or anxiety always with rapid heart beat.

(2.50-3.90) (0.65-1.26) (0.340-5.600)

Feb 23 *freeT3 2.56 freeT4 0.53 TSH 0.051 *
_Week of extreme hyper, menses spotted_

April 22 *freeT3 2.58 freeT4 0.42 TSH 13.099 *
_Saw doctor she put me on 100mcg eltroxin
_
May 3 * freeT3 3.20 freeT4 0.77 TSH 10.006 *
_Started to notice hair beginning to shed and had changed texture_

May 26. *freeT3 2.61 freeT4 1.04 TSH 1.103*
_More hair shed _

June 7 * freeT3 2.56 freeT4 0.99 TSH 0.645 * 
_Started feeling anxiety, shortness of breath, no constipation _

July 5 * Thyroxine free 0.72 TSH 1.70 *
_Was on 50mcg one wk before test, less hair shed, heavy(normal menses)_

July 30 * freeT3 3.10 freeT4 0.96 TSH 0.369 *
_shed, energy, light menses(no ovulation)_

Aug. 20 *freeT3 2.55 freeT4 0.93 TSH 0.940 *
_Started taking 65mcg one week prior to this test. _

April 28
Anti TPO 119.59 0.00-5.61
Anti TG 17.32 0.00-4.11

Parathyroid Hormone 20.4 12.0-88.0

JULY 30
Parathyroid hormone 14.4 (12.0-88.0)

JULY 5TH 
Thyroxine free 0.72 ng/dl (.59-1.17)

AUG 5 (day three of menses)
FSH 4.91 E2 29 PROLACTIN 11.13


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## lainey (Aug 26, 2010)

If those are free T3 and T4 values, my first observation is that your free T3 is up there in the range. If your doctor was going to diagnose you with toxicosis, the key would be in the thyroid stimulating antibodies--were you tested for those? In that situation, the patient has both sets of antibodies, and their levels vary because of them. This often makes it difficult to medicate the patient with thyroid replacement, because they very quickly show hyper symptoms at low doses.

Secondary hypothyroidism? That would mean you have a pituitary problem. Have you been checked for that?

It makes no difference in the treatment if you are "Hashimoto's" or not. You have the thyroid antibodies, so you probably do have an autoimmune thyroid disorder. If it were thyroiditis, it would likely resolve on it's own and you would find yourself needing little to no medication (although you are on a very low dose).

Are you seeing a GP or an endo?

Have you had a thyroid ultrasound or uptake scan? What were the results?


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## Andros (Aug 26, 2009)

missydawn said:


> Hello everyone!
> My doctor has said that I was hashimoto toxicosis, then I was not I was just hashimoto hypothyroid and now she believes I have secondary hypothyroidism. Another doctor I was able to only see once out of country told me I had a bout of thyroiditis and that I probably have mild hypothyroidism. Here are my lab results. I hope someone can help me figure out this madness  Thank you I have researched and researched and cannot make sense of it.
> 
> Blessings,
> ...


Welcome to the board!










A few questions first.

The ranges are in sequence at the top there? (T3, T4 and TSH?)

And those are Total 3 and Total 4; not FREE T3 and FREE T4?

Just double checking.

And yes, you do have antibodies indigenous to the thyroid.

The one that is troubling to me is the Thyroglobulin Ab. You should have a small amount of Thyroglobulin under normal circumstances but the healthy person should not have Thyroglobulin Ab.

For that reason, I recommend at the very least a sonogram because the high titer of Thyroglobulin Ab could be suggestive of cancer and it needs to be ruled out or in as the case may be.

Has your doctor commented on that?

cancer TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract

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

It also is my humble opinion that you could be hyperthyroid; hence all the fluctuation re the TSH going back to Feb..

It would be interesting if your doc would run this lab test........

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Glad you have become part of the community. You will find plenty of help here, I am sure. If nothing else, we are supportive.


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## missydawn (Aug 19, 2011)

Hello again 

Thank you for such quick replies. To answer your question it is Free T3 and Free T4, not Total 3 and 4. I had an ultrasound done to my thyroid already. It came back fine. I just had an MRI done last night to rule out pituitary tumor. My doctor seems to think I am not hyperthyroid but hypothyroid. A part of me thinks I should just get off the medication and see how I do. I am usually a very mellow person not hyper at all. I did not feel hyper until the month of February for one week and that subsided. Then when she gave me 100mcg of eltroxin thats when I became very hyper feeling. I am seeing an endocrinologist. Thank you again for your quick response.


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## Andros (Aug 26, 2009)

missydawn said:


> Hello again
> 
> Thank you for such quick replies. To answer your question it is Free T3 and Free T4, not Total 3 and 4. I had an ultrasound done to my thyroid already. It came back fine. I just had an MRI done last night to rule out pituitary tumor. My doctor seems to think I am not hyperthyroid but hypothyroid. A part of me thinks I should just get off the medication and see how I do. I am usually a very mellow person not hyper at all. I did not feel hyper until the month of February for one week and that subsided. Then when she gave me 100mcg of eltroxin thats when I became very hyper feeling. I am seeing an endocrinologist. Thank you again for your quick response.


I am soooooooooooooooo glad to hear this about the sonogram! I take it that absolutely no irregularities were noted?

MRI ruled out the pituitary tumor, I hope?

Thank you for clarifying about the FREES. It makes a huge difference on interpretation.

In February, everything most certainly was in the basement.

Your doctor appears to be on top of this. You are lucky to have found such a good one.

Estrogen dominance and adrenal fatigue would be considerations as well.

http://www.drrind.com/therapies/thyroid-scale-matrix


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## missydawn (Aug 19, 2011)

Andros,

Thank you. I will see my doctor today and ask her about the TSI test. Also I should get my MRI results back as well. Hope you have a great day.

Missydawn


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## missydawn (Aug 19, 2011)

[quote name='lainey']

Thank you. I had an ultra sound and she said that everything was fine. I have an endocrinologist. I did test positive so I do have hashimoto. She says I do not have toxicosis. I am wondering why with 100mcg that was too much for me and being on medication my levels never really rise but fluctuate on the lower scale. Before medication I was a mellow person somewhat on the low energy side my entire life it seems. Thank you again. Hope you have a great day.

Missydawn


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## missydawn (Aug 19, 2011)

MRI results came out fine. If you have secondary hypothyroidism will your other hormones be affected? Can a person have a bout of thyroiditis and also have secondary thyroidism? Thank you

Missydawn


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## lainey (Aug 26, 2010)

Because the pituitary is the "master gland" issues there can cause other hormone issues, yes. If the doctor thinks this is the source, there are a lot of blood tests that can be run to measure the hormone levels to see. Usually the first thing they look for is a tumor--which would show up on the MRI.

Thyroiditis tends to be transient. A virus or stress can cause it--the thyroid becomes inflamed and fails to produce thyroid hormone or produces too much. An uptake scan plus your bloodwork would confirm this. Usually the treatment for that is watch and wait, so I am guessing your doctor doesn't think this is simply a bout of thyroiditis, but rather mild hypothyroidism, as evidenced by the antibodies in your lab work.


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## missydawn (Aug 19, 2011)

lainey said:


> Because the pituitary is the "master gland" issues there can cause other hormone issues, yes. If the doctor thinks this is the source, there are a lot of blood tests that can be run to measure the hormone levels to see. Usually the first thing they look for is a tumor--which would show up on the MRI.
> 
> Thyroiditis tends to be transient. A virus or stress can cause it--the thyroid becomes inflamed and fails to produce thyroid hormone or produces too much. An uptake scan plus your bloodwork would confirm this. Usually the treatment for that is watch and wait, so I am guessing your doctor doesn't think this is simply a bout of thyroiditis, but rather mild hypothyroidism, as evidenced by the antibodies in your lab work.


Lainey, this has me troubled because my other hormones seem to be fine, such as FSH, and Prolactin. The MRI showed no signs of a tumor nor damage to the pituitary gland. For about three months leading up to Feb. I went through a lot of stress, more than I have ever gone through. Feb. is when I got really hyper and then the next two months I just felt more tired. She then put me on the 100mcg of Eltroxin. That was too much pushed me into feeling really speedy. A few more tests and now she says I am secondary hypo.??? She said because I had three concussions when I was in my teens that this has caused the secondary hypo probably.?? So now I am on 65mcg. She wants me to up it soon. She says not to look at my TSH but rather the FreeT3 and FreeT4 and she says that those are low despite medication. With secondary hypo -my optimum level should be lower than what they are now???? She also says that because I take my medicine before a blood draw that my levels are probably lower.

I dont know what to do??? My hair is still shedding not as bad thank God! But now I am getting a lot of grey coming in -crazy.

My question is what if I really do not need to be on medication at this time and I am taking medication-what would ones blood levels look like? My husband and I are going to get a second opinion soon, she does not like questions so...Thank you for all of your help.

Blessings 
missydawn


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## Andros (Aug 26, 2009)

missydawn said:


> Lainey, this has me troubled because my other hormones seem to be fine, such as FSH, and Prolactin. The MRI showed no signs of a tumor nor damage to the pituitary gland. For about three months leading up to Feb. I went through a lot of stress, more than I have ever gone through. Feb. is when I got really hyper and then the next two months I just felt more tired. She then put me on the 100mcg of Eltroxin. That was too much pushed me into feeling really speedy. A few more tests and now she says I am secondary hypo.??? She said because I had three concussions when I was in my teens that this has caused the secondary hypo probably.?? So now I am on 65mcg. She wants me to up it soon. She says not to look at my TSH but rather the FreeT3 and FreeT4 and she says that those are low despite medication. With secondary hypo -my optimum level should be lower than what they are now???? She also says that because I take my medicine before a blood draw that my levels are probably lower.
> 
> I dont know what to do??? My hair is still shedding not as bad thank God! But now I am getting a lot of grey coming in -crazy.
> 
> ...


I am not sure I buy that. To my knowledge, when you have such high titers of antibodies, this is an autoimmune issue, most likely familial.

It is true however that whiplash or any blow to the thyroid can and does damage the thyroid.

Trauma usually is the culprit that triggers the antibodies that have been genetically predisposed and lying dormant.

Just a reminder; this above is opinion only. I am not a doctor.


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