# Want to be ready for Endo appt next week..



## CherryDrPepper (Jul 4, 2010)

Hi, I wasn't sure if I should put this in intro or general discussion.. I'm just trying to arm myself with as much knowledge as I can before my Endocrinologist appointment next week!

I believe that I'm suffering from some type of thyroid issue and have been for some time, but this is my first time working up the nerve to actually see an endocrinologist about it. My mom and other female members on both sides of the family have hypothyroidism.. and while I'd prefer not to be a copycat , I'd like an answer to why I feel like junk!

These are all my symptoms:

Fatigued ALL the time, no matter how much or how little I sleep. I have a very hard time falling asleep too, no matter how tired I feel.
I've gained 60lbs since March 09 and have managed to only lose 5 lbs of it despite diet changes, exercising, etc.
My hair is "shedding" a lot.. I can pull out strands of hair just by running my fingers through it.. I have to clean off my hairbrush every time I brush my hair because so much accumulates in the brush. This is new as of this year.. 
Very irritable/moody .. thank god my boyfriend is willing to put up with it, I snap at the poor guy for no reason..
I have painful and heavy periods, a doctor gave me muscle relaxers to help with the cramps, and they do.. but if I don't have them or don't take one.. bad news. My period comes anywhere from every 25-36 days, not sure if that is irregular or not.
Brain "fog" .. I forget what I want to say mid sentence FREQUENTLY (even while typing this) and it takes me a minute to remember or get back on track with my thought. I have a hard time focusing..but that might be because I feel like falling asleep all the time.
I get sinus and or ear infections all the time that sometimes last a month or more. 
Random dizzy spells.. an ear/nose/throat dr diagnosed me with vertigo after an ENG test

eesh..typing all them out makes me feel even worse. I also have celiac disease which I've read can sometimes go hand in hand with thyroid issues. I have had issues with low Vitamin D levels (my level was a 6 before taking 50,000IU 2x a week for 8 weeks about 3 months ago)

In October, I saw a regular doctor because of many of the above symptoms and asked to have my thyroid checked. She thought I had mono and ran the following tests:
(added range in parenthesis)
CMV IGM ANTIBODY: <0.90, No detectible antibody (<0.90 - )
TSH w/ FREE T4 REFLEX: 2.77 (0.4-5.0)
MONO HETEROPHILE: Neg 
WBC: 7.5 (4.0-11.0)
RBC: 4.95 (3.8-5.2)
Hemoglobin: 13.8 (11.7-15.7)
Hematocrit: 41.2 (35.0-47.0)
MCV: 83 (78-100)
MCH: 27.9 (26.5-33.0)
MCHC: 33.5 (31.5-36.5)
RDW: 13.1 (10.0-15.0)
Platelet Count: 325 (150-450)

After those results came back, she said my thyroid was fine and while I didn't have mono, I most likely had a mono type virus and would need to just let it run its course. That kind of made me not really enjoy doctors, and put me off to scheduling an endocrinologist appointment.. but I've kind of reached my breaking point now. I can't stand being exhausted all the time, not motivated to work or do homework or anything of that nature, I wake up and immediately want to go to sleep..then when I finally allow myself to sleep at night, I have a hard time falling asleep. I've been incredibly moody and irritable, especially the past 3 weeks.. it just makes me feel like a terrible person.

So... now that I've gotten all that out - I want to be prepared for my visit with the endocrinologist. What tests should I ask him to do? Should I wait and see what tests he decides to do? I worry he'll just do another TSH and won't test T4 or T3..which I believe I've read around also need to be tested.

I appreciate any advice that is offered!  Sorry if I ranted on too long, it kind of felt good to type everything out.


----------



## Lovlkn (Dec 20, 2009)

Hi Cherry Dr.Pepper,

Welcome to the board - I am sorry you are feeling so poorly.

"TSH w/ FREE T4 REFLEX: 2.77" I am not sure what this test is -

If you have lab ranges you should edit your post to reflect them as all lab's use different ranges.

TSH is a screening test for thyroid disorders so that should be a start point. Sometimes symptoms will appear before a lab test will reflect it - You could also ask for a Free T-4 test which may be more revealing.

You could ask for a TPO antibodies test which will tell if there is something happening or inflaming your thyroid.

Are you taking any Vit D as a follow up to the 50K IU you took? I have to take 2K IU daily to feel my best and notice if I don't take it for a few days -- mostly fatigued feeling and since you stated you have had Vit D issues supplementing daily is probably a good idea for you.

Has anyone tested your Ferritin levels? You periods are irregular and you may be ferritin deficient - that will also cause fatigue.

B-12 is another test they should do as that too can cause fatigue if low.

What is your diet like? I know if I eat alot of the wrong foods it can cause me to feel poorly - are you eating healthy?

Do you take a good multi vitamin?


----------



## Andros (Aug 26, 2009)

CherryDrPepper said:


> Hi, I wasn't sure if I should put this in intro or general discussion.. I'm just trying to arm myself with as much knowledge as I can before my Endocrinologist appointment next week!
> 
> I believe that I'm suffering from some type of thyroid issue and have been for some time, but this is my first time working up the nerve to actually see an endocrinologist about it. My mom and other female members on both sides of the family have hypothyroidism.. and while I'd prefer not to be a copycat , I'd like an answer to why I feel like junk!
> 
> ...


Hello and welcome. I like your forum name! Cutesy!

Anyway..............down to business. Why on earth could this doc not run any antibodies' tests indigenous to the thyroid. For Pete's sakes. All those tests and not a single one to give a clue re the thyroid.

And by the way, low Vitamin D and ferritin are quite common in those of us who have Thyroid Disase and they are considered secondary meaning this is a result of having a thyroid problem. (and the symptoms you listed, hoh boy)

Here are the tests that I suggest........

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

I think you do have something going on w/ the thyroid and I hope and pray the endo is a good one and gets to the bottom of all this for you!

Read through the folders and threads; lots of wonderful information here.


----------



## CherryDrPepper (Jul 4, 2010)

Lovlkn said:


> Hi Cherry Dr.Pepper,
> 
> Welcome to the board - I am sorry you are feeling so poorly.
> 
> ...


Sorry, it was late..I added the ranges in. I am taking Vitamin D supplements after having that test done. I never really noticed a difference while taking the large supplements or these. 
Never had Ferritin level checked or B-12.. I do take a multivitamin as recommended by my gyno.

I'd like to think I eat healthy for the most part.. I have celiac disease so I can't eat anything containing wheat, rye, or barley. I don't drink a lot of pop, have cut out excess sweets (been trying to lose those 60 lbs..) I love veggies and snack on them all day long.


----------



## CherryDrPepper (Jul 4, 2010)

Andros said:


> Hello and welcome. I like your forum name! Cutesy!
> 
> Anyway..............down to business. Why on earth could this doc not run any antibodies' tests indigenous to the thyroid. For Pete's sakes. All those tests and not a single one to give a clue re the thyroid.
> 
> ...


Thank you for the link.. I plan on spending time today reading through all of the folders and threads. I'm hoping I won't chicken out on handing the doctor a list of tests I'd like performed .. in the end it's my insurance paying for it anyway, why not test what I want. Worst case, I guess he says no and I go back to the endo search!


----------



## Andros (Aug 26, 2009)

CherryDrPepper said:


> Sorry, it was late..I added the ranges in. I am taking Vitamin D supplements after having that test done. I never really noticed a difference while taking the large supplements or these.
> Never had Ferritin level checked or B-12.. I do take a multivitamin as recommended by my gyno.
> 
> I'd like to think I eat healthy for the most part.. I have celiac disease so I can't eat anything containing wheat, rye, or barley. I don't drink a lot of pop, have cut out excess sweets (been trying to lose those 60 lbs..) I love veggies and snack on them all day long.


Thank you for adding the lab ranges. What a huge help.

That TSH is climbing up there. AACE recommends the range to be 0.3 - 3.0 and there is chatter that the top of the range should be even lower as per.................

http://www.lef.org/protocols/metabolic_health/thyroid_regulation_01.htm

My doctor keeps my TSH @ 0.03 and as long as the FT3 and FT4 are where they should be, I am good to go. We find keeping my TSH low like that keeps the antibodies quiet. Very quiet.

Good for you on your diet. Excellent! I have been gluten-free for many many years. Don't miss it at all and I sure don't miss the pain.


----------



## Lovlkn (Dec 20, 2009)

I mentioned I never head of the TSH w/ FREE T4 REFLEX was and think I understand that as a TSH test and a FT-4 *ONLY* if you are above or below TSH ranges.

You did not actually have a FT-4 test done because you are "in range" in TSH.



> TSH w/ FREE T4 REFLEX: 2.77 (0.4-5.0)


I think at minimum you need a FT-4 to confirm you are experiencing a thyroid issue.

If the doctor does not think it's your thyroid based on your TSH you can save yourself alot of headache and just order the tests yourself - TSH , FT-4 and FT-3 for $85 from www.healthcheckUSA.com

Then if those tests come back out of wack you can then ask for additional antibodies tests.


----------



## CherryDrPepper (Jul 4, 2010)

Thank you for all the advice.  my fingers are crossed!


----------



## CherryDrPepper (Jul 4, 2010)

Just wanted to update.. the doctor would only test TSH, Free T4 and Total T3 and these are the results.

TSH: 1.41 (0.3-5.0)
T4 FREE: 1 (0.7-1.8)
T3 TOTAL: 143 (80-200)

Should a TSH jump so much from 2.77 in October to 1.41 now? now I don't know what to think or do.


----------



## Andros (Aug 26, 2009)

CherryDrPepper said:


> Just wanted to update.. the doctor would only test TSH, Free T4 and Total T3 and these are the results.
> 
> TSH: 1.41 (0.3-5.0)
> T4 FREE: 1 (0.7-1.8)
> ...


Well, at least the doc ran that and that is progress. Your Free T4 is below mid-line (about 1.2) and that makes me want the FT3 even more to find out if you are converting FT4 to FT3 at a fast rate or are you a patient in need of T4 (thyroxine) replacement.

Antibodies' tests are necessary to narrow the field here.

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

And nag nag for the Free T3 (to be run on the same day and same time you get TSH, FREE T4.)


----------



## CherryDrPepper (Jul 4, 2010)

Andros said:


> Well, at least the doc ran that and that is progress. Your Free T4 is below mid-line (about 1.2) and that makes me want the FT3 even more to find out if you are converting FT4 to FT3 at a fast rate or are you a patient in need of T4 (thyroxine) replacement.
> 
> Antibodies' tests are necessary to narrow the field here.
> 
> ...


Thanks for not being all cherry "you're normal!" like the nurse on the phone was. hugs1

This might be a dumb question.. I looked into the HealthCheckUSA that a previous poster mentioned for paying to have tests done and it uses LabCorp near me.. so here is the dumb question: My primary care dr in my hometown wants to run all the tests suggested here, but I won't be able to get to my hometown until next month. Can we utilize LabCorp in this case? For example.. I go to LabCorp and they draw the blood and transfer the results to my primary care dr (I noticed the thyroid antibodies even on HCUSA requires a dr note) ? Sorry if that is a dumb question, I'm not sure how it all works.. trying to avoid paying completely out of pocket for the tests since I have an insurance-covered doctor that will run them all for me in a month.... but also want to try avoiding waiting a month.


----------



## CherryDrPepper (Jul 4, 2010)

Just wanted to update.. finally got antibodies tested but everything came back normal. I had other tests run as well and my doctor said I have metabolic syndrome. I'm on metformin now, and we'll see how that goes. I'm so shocked my thyroid stuff came back normal.

TSH: 1.05 (.40-4.50)
T4 Total: 7.0 (4.5-12.5mcg/dL)
T3 Total: 133 (76-181ng/dL)
Thyroglobulin Antibodies: <20 (<20 IU/mL)
Thyroid Peroxidase Antivbodies: 11 (<35 IU/mL)
FSH: 3.9

I appreciate all your help and advice, it made me push on and insist these other tests get run, and thankfully.. my old doctor, who is 400 miles away that I made the trip to see, agreed and ran them along with a bunch of other tests.


----------



## Andros (Aug 26, 2009)

CherryDrPepper said:


> Thanks for not being all cherry "you're normal!" like the nurse on the phone was. hugs1
> 
> This might be a dumb question.. I looked into the HealthCheckUSA that a previous poster mentioned for paying to have tests done and it uses LabCorp near me.. so here is the dumb question: My primary care dr in my hometown wants to run all the tests suggested here, but I won't be able to get to my hometown until next month. Can we utilize LabCorp in this case? For example.. I go to LabCorp and they draw the blood and transfer the results to my primary care dr (I noticed the thyroid antibodies even on HCUSA requires a dr note) ? Sorry if that is a dumb question, I'm not sure how it all works.. trying to avoid paying completely out of pocket for the tests since I have an insurance-covered doctor that will run them all for me in a month.... but also want to try avoiding waiting a month.


That is not a dumb question. Yes, you can do that! Of course.


----------

