# BIG drop in TSH...cause?



## cduval04 (Mar 12, 2010)

Hello, I am a 26 y.o. Female been treated for hypo since 2009...have increased synthroid since then from 25, to 50 then to 75 and now am at 88
mcg. Thyroid level have never really been totally stable my tsh seems to go up and then down again along with FT4 levels, I have only had FT3 levels done once out of the dozens of thyroid labs that I have had, finally found a Dr. that would not refuse to do it!

The past week or so I had been feeling very anxious, not sleeping well, spooked at everything, eating like a horse, ALWAYS hot (wearing ice packs all the time) and my resting heart rate was frequently over 100 and my thyroid felt huge, then my mom said I sounded hoarse a few days. So I went and got my tsh tested and it was 0.44 out of range is anything below .40...it has never ever been anywhere below 1.1 my FT4 was 11.9 I think the range is to 12.4? Is this evidence of a nodule? Although my antibodies for hashis and graves have been tested a couple times and been normal, my doc told me one time my thyroid is "already crapping out" when I asked her if it was eventually going to totally crap out. Everything sorta points to autoimmune but I don't know why my antibodies have never come back elevated. Maybe I have to test them during a flare-up like this one? I also have been using this new salt I found called "sea shakes" (http://www.seashakes.com) which is made from seaweed looks like pepper but tastes like salt, is all natural and has about 1/6 the sodium as regular table salt. My whole life I have used kosher salt (I am not Jewish but my mom cooks a lot and prefers its coarseness so that is just what she buys) I know salt is the main iodine source in the American diet so I may have unintentionally set myself up for thyroid issues very early on. I also am in antibiotics for an ear infection just dxed a few days ago but I do not know how long I have had it. My basal temp hasn't been below 98.6 in over a week now and was 98.8 this morning (orally).

Was wondering to what degree the new salt or the ear infection may have affected my labs and whether I should request an ultrasound which despite my history has never been performed or even mentioned by my Endo, who is now on maternity leave until next month.

Thanks!!


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## joplin1975 (Jul 21, 2011)

Yes, you should have an ultrasound. Absolutely.

Also, lots of seaweed is not good for those with thyroid dysfunction. I'm not well-versed on the subject, but I'm sure someone who is will be around shortly.


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## Octavia (Aug 1, 2011)

Sea salt contains iodine. Iodine messes with thyroid function. Could be a connection.


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## Andros (Aug 26, 2009)

cduval04 said:


> Hello, I am a 26 y.o. Female been treated for hypo since 2009...have increased synthroid since then from 25, to 50 then to 75 and now am at 88
> mcg. Thyroid level have never really been totally stable my tsh seems to go up and then down again along with FT4 levels, I have only had FT3 levels done once out of the dozens of thyroid labs that I have had, finally found a Dr. that would not refuse to do it!
> 
> The past week or so I had been feeling very anxious, not sleeping well, spooked at everything, eating like a horse, ALWAYS hot (wearing ice packs all the time) and my resting heart rate was frequently over 100 and my thyroid felt huge, then my mom said I sounded hoarse a few days. So I went and got my tsh tested and it was 0.44 out of range is anything below .40...it has never ever been anywhere below 1.1 my FT4 was 11.9 I think the range is to 12.4? Is this evidence of a nodule? Although my antibodies for hashis and graves have been tested a couple times and been normal, my doc told me one time my thyroid is "already crapping out" when I asked her if it was eventually going to totally crap out. Everything sorta points to autoimmune but I don't know why my antibodies have never come back elevated. Maybe I have to test them during a flare-up like this one? I also have been using this new salt I found called "sea shakes" (http://www.seashakes.com) which is made from seaweed looks like pepper but tastes like salt, is all natural and has about 1/6 the sodium as regular table salt. My whole life I have used kosher salt (I am not Jewish but my mom cooks a lot and prefers its coarseness so that is just what she buys) I know salt is the main iodine source in the American diet so I may have unintentionally set myself up for thyroid issues very early on. I also am in antibiotics for an ear infection just dxed a few days ago but I do not know how long I have had it. My basal temp hasn't been below 98.6 in over a week now and was 98.8 this morning (orally).
> ...


Sure would like to see your most recent lab results w/the ranges.

Hope you have had some or all of those listed below?

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

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/

I also agree w/others that you should definitely insist on an ultra-sound!


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## cduval04 (Mar 12, 2010)

Hi and thanks...I know awhile back I had a couple TPO tests one thyroglobulin test and one ANA test...which I believe were all normal...I have never had (or heard of until now) TSI antibodies tested. I will post my last few labs ASAP and def. request/demand? and ultrasound. My Endo is sort of not on the proactive side, but has pretty much said she will do anything she can to help...as this is the 2nd Endo I've had that is now pretty much stumped. I guess I just wait until it progresses to a worse step till they find something....unfortunately I am freakishly in tune to my body....like the "I can tell I have a cavity months b4 it is visible to my dentist"...kind of in tune...


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## Andros (Aug 26, 2009)

cduval04 said:


> Hi and thanks...I know awhile back I had a couple TPO tests one thyroglobulin test and one ANA test...which I believe were all normal...I have never had (or heard of until now) TSI antibodies tested. I will post my last few labs ASAP and def. request/demand? and ultrasound. My Endo is sort of not on the proactive side, but has pretty much said she will do anything she can to help...as this is the 2nd Endo I've had that is now pretty much stumped. I guess I just wait until it progresses to a worse step till they find something....unfortunately I am freakishly in tune to my body....like the "I can tell I have a cavity months b4 it is visible to my dentist"...kind of in tune...


It would be interesting to see the results of those tests w/ the ranges as you should not have any TPO Ab or ANA. Period.


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## cduval04 (Mar 12, 2010)

hey everybody....I finally got the chance to post my labs...the reason it took me so long was b/c I made a spreadsheet of all my thyroid tests because there was getting to be too many and it was hard to keep track of them in paper form all tucked away in a file cabinet, especially when I needed to pull one out quick for reference. The top is the oldest, going down to the most recent at the bottom, there were probably a couple more that were tucked away somewhere else that I didn't type in. Note my ONLY FT3 test is the very bottom row, just done over a week ago. I have had 3 TPO tests, and 1 thyroglobulin which they don't give a number for, they just say I have "less" than a particular number, so I don't know whether that means I have zero, or a little bit? I have not had TSI...and correct me if I am wrong, but the one FT3 I did have done (last week), isn't that a tad low considering my TSH is also low, shouldn't it be a little higher? Couldn't this also indicate troubles with my body converting T4 to T3? I have never had a Reverse T3 test done either, so I wouldn't know, just a speculation.

The only reason I ask is because since 2005 I have had (what has been debated) as a 7mm pit. tumor. The reason I say debated is because it was dxed as a tumor by one endo, then by 2 other hospitals who did MRI's it has been described as a "hypodensity" and an "asymmetry" with the right side measuring bigger than the left.

This became more complicated in 2006, when I had a medtronic neurostimulator implanted in my deep brain (deep brain stimulation surgery) for a debilitating case of Tourette Syndrome which I was diagnosed with in 1992, and can no longer have an pituitary dedicated MRI. 
When I do have an MRI, the machine has to be specially calibrated and when it is, they still cannot obtain the close up, detailed images of my pituitary like they would normally be able to do because I risk damage to the device (or worse, my brain) from the magnets in the MRI machine. (btw the surgery has completely saved my quality of life, my Tourette's is now 90-95% gone, and I would do it again in a heartbeat, but just typical of the way things has always been for me, I have never been able to "have my cake and eat it too" so to speak, a loss almost always has to accompany a gain.

So basically the "study" of this pituitary "thing" that I have has been halted for the last 6 years. Anyways, assuming this is not a pituitary issue, and is autoimmune......do these labs resemble that of someone who has a confirmed diagnosis of hashis or graves?? I have not been feeling "normal" for years and things don't seem to be getting better and doctors are just not of much help, seeing as I am on endo number 4 and PCP number 3....I am so sick of being sick, but I am even more sick of coming out of appointments in tears because they think I'm crazy and I'm so done switching doctors, I've tried being pushy in the beginning and now I've tried emotionally detaching myself as much as I can and sitting back, playing dumb (most docs don't particularly like it if it looks like you're trying to do their job for them) and letting them do what they want, and that has not worked either.....and I know this sounds awful...but I am just at the point where I just want my thyroid to poop out completely so they can just take it out and put me on a steady dose of synthroid and be done (even though I know things wouldn't be that simple). Also if I felt one way all the time (like or constantly tired and sleepy and low BP or constantly jumpy w/ high BP and unable to sleep, that would almost be better than this cyclical hell I've been living in for years now).

Anyways, here is my lab record. any suggestions, tips, anecdotes, advice or moral support would be strongly appreciated. Thanks you guys are great.


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## jenny v (May 6, 2012)

Welcome!

There will be others along who are much better at reading your labs than I am, but your TSH numbers seem to bounce around a lot (and I know from experience how even the slightest change can make you feel just awful!) and right now it looks like you are hyper.

I know the feeling of all of the differing symptoms, it's exhausting. And I know the frustration with doctors who do nothing to help because your labs look "normal". You situation sounds very similar to mine except that I have antibodies popping up across the board. Hang in there!
:hugs:


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## Andros (Aug 26, 2009)

cduval04 said:


> Hi and thanks...I know awhile back I had a couple TPO tests one thyroglobulin test and one ANA test...which I believe were all normal...I have never had (or heard of until now) TSI antibodies tested. I will post my last few labs ASAP and def. request/demand? and ultrasound. My Endo is sort of not on the proactive side, but has pretty much said she will do anything she can to help...as this is the 2nd Endo I've had that is now pretty much stumped. I guess I just wait until it progresses to a worse step till they find something....unfortunately I am freakishly in tune to my body....like the "I can tell I have a cavity months b4 it is visible to my dentist"...kind of in tune...


Thanks for posting your labs. Replying here because the matrix stretched out the screen.

You do have evidence of TPO and Thyroglobulin Ab although they are both <. This is not negative. It means they are below the suggested range. Indicative of something being afoot.

Your TSH sure is fluctuating a lot and the one FT3 you had was very low which when TSH (.44) was low also that would "suggest" antibodies to the receptor site skewing the numbers.

Please get the TSI and an ultra-sound.

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

Incidentally, Tourette-like symptoms can be and are caused in some cases by hypo or hyperthyroid.


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## cduval04 (Mar 12, 2010)

Thank you. I will def. requests a TSI and an ultrasound at my appointment with my endo on 7/16. I don't understand when multiple endos have said word for word my thyroid levels "are stable". DO THEY EVEN READ MY CHARTS?? Geez coventional docs make me so mad...I try not to think about it for too long or I get myself all in a stew. Whatever is going on is probably progessive, albeit SLOOOWWW.....so one day {hopefully} something significant will show up, and hopefully not something terminal or disabling.

My life motto, athough very cliche is "never give up" despite it's simplicity it has always had a meaning in my life and has helped me get through periods like this. I wear it in various places on my body to remind me not to. Thanks everyone, you too, encourage me not to give up. Now I'm going to try to get to sleep before 3 tonight...baby steps


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## Andros (Aug 26, 2009)

cduval04 said:


> Thank you. I will def. requests a TSI and an ultrasound at my appointment with my endo on 7/16. I don't understand when multiple endos have said word for word my thyroid levels "are stable". DO THEY EVEN READ MY CHARTS?? Geez coventional docs make me so mad...I try not to think about it for too long or I get myself all in a stew. Whatever is going on is probably progessive, albeit SLOOOWWW.....so one day {hopefully} something significant will show up, and hopefully not something terminal or disabling.
> 
> My life motto, athough very cliche is "never give up" despite it's simplicity it has always had a meaning in my life and has helped me get through periods like this. I wear it in various places on my body to remind me not to. Thanks everyone, you too, encourage me not to give up. Now I'm going to try to get to sleep before 3 tonight...baby steps


Give up? What in the world is that? ROLF!! I am definitely not guilty, nor are you!

Keep on keeping on. There will be a breakthrough.


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