# Thyroid out of whack again, are these problems related?



## hereigo (Mar 21, 2012)

I have been really miserable the past month. Feeling very down, constipated, frequent urination and having problems sleeping.

I went to the emergency room, they refused to test my tsh (was on 75 of lthyroxine plus 25 of t3. because my tsh was originally 6.14) They said my symptoms had nothing to do with my thyroid, did other blood work and urine cultures and everything came out fine. A week later my primary doctor sent me for lab work and my tsh was once again too high. I went from .50 to 7.11 within 4 months. She raised my medication from 75 to 88 4 days ago and I am still feeling awful. They did put me on anti biotic for the frequent urination even though the cultures came out with a normal level of bacteria. I am done with that and even though it is better sometimes it is still frequent. The constipation is also a little better.

My biggest problem now though is my inability to sleep even though I am very tired. I lay in bed for hours trying to sleep and just can't. Eventually I do fall asleep around 3-4am but only for about 3 hours and am just exhausted. I don't have good experiences with sleeping medications but am thinking I may need to use them again.

Does anyone else have these problems when they are hypo? My doctor says 7.11 although is high is not really that bad. All of my other lab work came back well so I am just at a loss and am worried I will never feel better. I am sorry if my post is rather long and if the grammar is kind of off I am just not feeling well.

I would appreciate any advice, thank's so much in advance.


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## Andros (Aug 26, 2009)

hereigo said:


> I have been really miserable the past month. Feeling very down, constipated, frequent urination and having problems sleeping.
> 
> I went to the emergency room, they refused to test my tsh (was on 75 of lthyroxine plus 25 of t3. because my tsh was originally 6.14) They said my symptoms had nothing to do with my thyroid, did other blood work and urine cultures and everything came out fine. A week later my primary doctor sent me for lab work and my tsh was once again too high. I went from .50 to 7.11 within 4 months. She raised my medication from 75 to 88 4 days ago and I am still feeling awful. They did put me on anti biotic for the frequent urination even though the cultures came out with a normal level of bacteria. I am done with that and even though it is better sometimes it is still frequent. The constipation is also a little better.
> 
> ...


Glad you got your e-mail confirmation.










So....................you are now on 88 mcg. of Levothyroxine and 25 mcg. of T3? Is it Cytomel? I am assuming mcg. for both as you did not state.

That is one hefty dose of Cytomel to have a TSH that high. Is your doctor not running the FREE T3 and FREE T4 as well?

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

http://www.drlam.com/articles/hypothyroidism.asp?page=2#diagnosis: standard laboratory test

Have you been checked for diabetes? Are you on any meds or supplements that could be interferring with your thyroid med regimen? Do you eat a lot of soy? Are you estrogen dominant? Are you taking Calcium, iron or L-Carnitine?

Hve you ever had any of the tests 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/

When did you get diagnosed as hypothyroid and how long have you been on the meds for it?

And finally (whew), have you ever had an ultra-sound of your thyroid?

Long posts are good.


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## hereigo (Mar 21, 2012)

Hello, Thank you so much for the quick reply.

Yes it is cytomel but generic versions of it. I was seeing a doctor previously whom I didn't really care for and he was the one who added put me on that one, he lowered my main and added cytomel. He didn't really believe in doing blood work and put me on pheternmine (sp?) for my weight which made me really sick and I had an adverse reaction. Just recently I switched from him and found out my tsh went up again. As far as I know my antibodies and free levels are good. I am getting a copy of the lab work on saturday so I can check for myself as well as look to see if they ran the tests you mentioned.

My a1c is good thankfully because I was worried about that with the frequent urination.

I did however recently start taking vitamins/supplements and I am not sure if they could interact with my thyroid meds. I am taking d3, b12, amino gest (like a protein I believe), flora, inisitol, and a good multi. The woman who put me on them (naturopath) told me to make sure they have no soy and they don't. I am still getting used to taking them... having a hard time remembering them all. I am slightly iron deficient and have been since I was a small child, iron pills never seemed to help and my doctor didn't think it would be a good idea to add them right now with the constipation problem.

As far as your question, I got diagnosed with hypothyroid about 1.5 years ago, it was about 6 and my doctor at the time said not to worry about it and I went to an endro anyway because I was having a lot of problems. I had two ultra sounds of my thyroid and both times they said it was enlarged. Even when my levels were okay it was still enlarged but they said that could be normal... I don't know though.

I am just so frustrated with everything I feel like it's never going to get straightened out, even when my levels were okay with the meds I still had some thyroid related problems.

Thank you again for your help.


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## Andros (Aug 26, 2009)

hereigo said:


> Hello, Thank you so much for the quick reply.
> 
> Yes it is cytomel but generic versions of it. I was seeing a doctor previously whom I didn't really care for and he was the one who added put me on that one, he lowered my main and added cytomel. He didn't really believe in doing blood work and put me on pheternmine (sp?) for my weight which made me really sick and I had an adverse reaction. Just recently I switched from him and found out my tsh went up again. As far as I know my antibodies and free levels are good. I am getting a copy of the lab work on saturday so I can check for myself as well as look to see if they ran the tests you mentioned.
> 
> ...


It may be a good idea to have an actual glucose test. Not sure about that A1c stuff in regards to being a diagnostic tool.

With enlarged thyroid; any nodules or other irregularities noted?

Hope you use cast iron cook ware? That is a wonderful source of iron as are many many dark green veggies, beets, raisins etc..

Will be looking forward to some lab results with the ranges.


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## hereigo (Mar 21, 2012)

Hello Again,

I got a copy of my results today so I am going to type them in.

TSH- 7.11 and the range is .40-4.5 which is weird because my doctor told me it should be less than 2.5
T4 Free- 1.0 and the range is .8-1.8
T4 Total- 7.8 and the range is 4.5-12.0
T3 Uptake- 27 and the range is 22-35
T4 Free Calculated- 2.1 and the range is 1.4-4.2
T3 Total- 143 and the range is 76-181 
T3 Free- 2.9 and the range is 2.3- 4.2

My cortisol say's it is high it says it's 23 and the range is 4-22 so I guess it's not really that high.

I don't think my labs ranges are updated to the new ranges yet but I am not really sure.

Thanks again

I don't think


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## Andros (Aug 26, 2009)

hereigo said:


> Hello Again,
> 
> I got a copy of my results today so I am going to type them in.
> 
> ...


That's a pretty high TSH and w/ the FREE T3 being that low; I would wager something is up.

Your doc is right about it being less than 2.5. Sounds like your doc is up to date on things.

So, were do you stand as far as treatment goes. When do you next see your doc for labs?


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## hereigo (Mar 21, 2012)

Well she raised me from 75mcg to 88mcg and is keeping my cytomel the same at 25mcg. I started the new dose a few days ago and am still feeling really tired but I did manage to actually sleep the past 2 nights for the first time in a while. I go for blood work the second week of April.

I just hope we get to the right dose eventually because I am just so tired and achy.

Do you have any idea why my thyroid may be enlarged even when my levels were normal? They said there was nothing on it just that it was enlarged and the doctors said that's okay. I just think it's weird and haven't talked to my new doctor about it yet.


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## Andros (Aug 26, 2009)

hereigo said:


> Well she raised me from 75mcg to 88mcg and is keeping my cytomel the same at 25mcg. I started the new dose a few days ago and am still feeling really tired but I did manage to actually sleep the past 2 nights for the first time in a while. I go for blood work the second week of April.
> 
> I just hope we get to the right dose eventually because I am just so tired and achy.
> 
> Do you have any idea why my thyroid may be enlarged even when my levels were normal? They said there was nothing on it just that it was enlarged and the doctors said that's okay. I just think it's weird and haven't talked to my new doctor about it yet.


I do know that a thyroid should not be enlarged. That is a given so I hope your new doc has some better input.

You may wish to get your ferritin checked also. Most of us with TD do have low ferritin.

Ferritin http://www.thewayup.com/newsletters/081504.htm
(should be 50 to 100; the closer to 100, the better)


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## hereigo (Mar 21, 2012)

Thank's for the quick replys I am going to check out the link.

Btw, I am only on 5mcg on the cytomel... my previous doctor always said 25mcg when we talked but I just looked at the bottle and it says 5mcg... hoping it's not a mistake or something.


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## Faithfully (May 22, 2012)

Hi hereigo
I have the exact symptoms and more that you described and my levels are normal and my doctors don't seem to think its my thyroid either. Its pure hell


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## Andros (Aug 26, 2009)

Faithfully said:


> Hi hereigo
> I have the exact symptoms and more that you described and my levels are normal and my doctors don't seem to think its my thyroid either. Its pure hell


You do have a thyroid situation. And by the way, 5 mcg. is the usual starting dose of Cytomel.

Have you had labs recently. If so, you know the drill; post results and ranges here!

Have you had any antibodies' tests? If not, you should as this would get to the bottom of things.

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/

Have you had an ultra-sound of the thyroid? This is also important!

http://www.tpa-uk.org.uk/standard_tests_for_thyroid_disease1.php


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