# TSH rapid rise



## gofigerr (Oct 5, 2009)

So I ended up in the ER last night with a heart rate of 197! I took a metoprolol and it really did slow it down.

Does anyone know if there is anything about a rapid heart rate that affects the TSH result?

Yesterday I had my TSH tested at 3pm, the result was 2.62 by the tested it in the ER again at 8pm that's 5 hours later and it was 7.33! But my t3, t4 are all in the normal range.

I'm not sure what's going on.


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## Andros (Aug 26, 2009)

gofigerr said:


> So I ended up in the ER last night with a heart rate of 197! I took a metoprolol and it really did slow it down.
> 
> Does anyone know if there is anything about a rapid heart rate that affects the TSH result?
> 
> ...


Holy cats! Has anyone checked your pituitary gland? That is a huge swing in a very short period of time. Of course, you know that.

http://www.hormone.org/Pituitary/overview.cfm

Also, do you eat a lot of soy?

What did the docs at the ER say? Did they suggest possible causes for this wild fluctuation?

What were the results and labs of the T4 and the T3. Did they not do the FREE T4 and FREE T3?

I am so sorry this happened to you. How are you feeling today?


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## gofigerr (Oct 5, 2009)

The ER docs didn't know about the earlier days results, I just found out about those today so I'm waiting for my doctor to respond. ER never does the t3 or t4, but these are the lab results from yesterday

T4,Total 6.5 ug/dL 4.7-13.3 *1
T3 Uptake 34.0 % 31-39 *2
Free Thyroxine Index 2.2 Index 1.44-5.42 *3
TSH 2.62

Nothing exciting here only excitement was the jump in 5 hours to the 7.33. I feel ok today, I'm taking the Metoprolol until they decide what's happening. My heartrate on the holter monitor i was wearing shows that while I was sleeping my rate at 5:43pm was 78 then in 1 minute at 5:44 it jumped to 197! That's what woke me up and sent me to the ER.

I've had the prolactin checked before and is always normal. I recently had a brain MRI looking for something else, I suppose it would have shown a pituitary tumor??


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## gofigerr (Oct 5, 2009)

Interesting link about the pituitary, my doctor was also testing my female hormones yeaterday due to ovarian failure and my FSH was 160! My LH was 75! both way off the charts.


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## Andros (Aug 26, 2009)

gofigerr said:


> The ER docs didn't know about the earlier days results, I just found out about those today so I'm waiting for my doctor to respond. ER never does the t3 or t4, but these are the lab results from yesterday
> 
> T4,Total 6.5 ug/dL 4.7-13.3 *1
> T3 Uptake 34.0 % 31-39 *2
> ...


Aaaaaaaaaaaaaaaaaaaaah; sounds like you had a big jump in cortisol. That does occur in the wee hours of the AM. Also, TSH peaks at about 2 AM. It is nocturnal.

Egads; your Total 4 is in the basement. I say this because the Total is bound and unbound hormone. FREE T4 would be the unbound hormone only which would be available for cellular uptake and conversion to FREE T3.

You see? You can't tell what is bound and unbound with the TOTAL.

Please read this about the Free Thyroxine Index and how to calculate.
http://www.npg.co.za/rcpa/free_th2.htm

Did you have this?

A specialized pituitary MRI is critical to an evaluation of a patient's condition. The pituitary gland is small and some tumors and growths and brain structures within and around it are even smaller.

A pituitary gland MRI is different than a regular MRI of the brain. It creates high resolution images that allow doctors to see the pituitary region better. It needs to be ordered specially by the doctor.A closed MRI is preferred over an open MRI because the resolution is better. Most commercial MRI scanners have a strength of 1.5 Tesla. Newer, 3.0 Tesla scanners create even better images.

http://www.cedars-sinai.edu/Patient...Center/Diagnostic-Imaging/Pituitary-MRIs.aspx


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## gofigerr (Oct 5, 2009)

The only thing is it was 5pm not am! I was taking a nap after work! So I'm not sure about the cortisol, also I broke my arm 5 weeks ago and had pins placed now I can't get an MRI. Would a CT of the pituitary pick anything up? Thanks for your info!


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## Andros (Aug 26, 2009)

gofigerr said:


> The only thing is it was 5pm not am! I was taking a nap after work! So I'm not sure about the cortisol, also I broke my arm 5 weeks ago and had pins placed now I can't get an MRI. Would a CT of the pituitary pick anything up? Thanks for your info!


Oh, man!! Sorry about your broken arm!! My Gosh, you have had some very serious challenges here lately!

I am going to say a prayer for you.

Yeah; well if you were napping.................sometimes with this endocrine stuff the body is getting mixed signals. It sound like a huge cortisol rush to me.

I don't know about a CT. You may have to consult w/ the experts on that one although the article was very specific about how hard it is to get good pictures of the pituitary so if I had to guess, I would say no, the CT wouldn't "get it!"








Good grief!


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## gofigerr (Oct 5, 2009)

My Doc says that TSH means nothing with Hashi's so why do they keep testing it! lol. He said high TPO antibodies mess with the TSH results. I'm so confused.


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## Andros (Aug 26, 2009)

gofigerr said:


> My Doc says that TSH means nothing with Hashi's so why do they keep testing it! lol. He said high TPO antibodies mess with the TSH results. I'm so confused.


Sadly, your doc may have it all backwards. I believe that high TSH triggers the antibodies to be more active.

What can mess with the results are blocking and binding antibodies to the TSH receptor site. Yes.

So maybe he is half right and I am half wrong. LOL!!

Anyway............................


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## eorhythm (Jan 3, 2011)

Eep, popped on the board to see what's up and saw this. I wish I had more to add, but I know that my thyroid affects my heart rate pretty strongly. Question is definitely what is causing such fluctuations. I hope you can get your pituitary _and_ adrenals checked out soon!

I know when I first started to really develop hypothyroidism, it came on very suddenly, but over the course of a week rather than a night. It abated almost as quickly, then slowly returned almost two years later. With the thyroid hormones so intimately linked with everything else controlling metabolism, it seems a probable trigger for palpitations.



Andros said:


> Sadly, your doc may have it all backwards. I believe that high TSH triggers the antibodies to be more active.
> 
> What can mess with the results are blocking and binding antibodies to the TSH receptor site. Yes.


Yeah, this is what my GP explained to me; she didn't want to test antibodies while my hormone levels were therapeutic and slightly above, only if they dropped again, or once they were totally stable on medication (hah, if that happens).


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