# Hashimoto anything else I can do?



## iroczinoz

Hello all! Been searching for a forum like this to get some advice on my situation.
Below is a snapshot of my blood results this year.

2011 results:
February -

Free T4 - 16.6 (10-19)
Free T3 - 5.1 (3.5 - 6.5)
TSH - 8.33 (0.5-4)
FSH - 2 (1-10)
LH - 2 (1-10)
TT - 13.9 (8.3-30.2)
SHBG - 29 (13-71)
FT - 304 (225-725)
Anti-Thyroid Peroxidase - 104 kIU/L (<60)
Anti-Thyroglobulin - 92 kIU/L (<60)

Doctor prescribed me 50mcg T4 daily.

2 months later
Free T4 - 20.4 (10-19)
Free T3 - 6.1 (3.5 - 6.5)
TSH - 3.37 (0.5-4)

Started feeling bad again a month later went back for another blood test
Free T4 - 21.9(10-19)
Free T3 - 5.0 (3.5 - 6.5)
TSH - 4.40 (0.5-4)

Doctor prescribed me 100mcg T4 daily.

T4 meds kind of worked at the start as I did feel an improvement. But after the initial 2-3 months I started feeling worse.

June 2011 - Now in Czech Republic (so maybe their ranges or scaling is different) as before I was in Australia. Suddenly Ft4 is in range still on 100mcg, surprising.
Free T4 - 14 (7-16)
TSH - 1.83 (0.34-5.6)
Anti TPO - 9.6 kU/l (0.0 - 9.0)
Anti Tg - 138 kIU/l (0-115)

Antibodies look like they are slightly elevated as compared to my 1st blood test but still present.

July 2011 - Saw Endo

Free T4 - 23.02 (9-25)
T3 - 1.53 (1.3 - 3.10) (NOT FREE T3)
TSH - 2.3 (0.27-4.2)
FSH - 16.6 (1.5- 12.4)
LH - 23.0 (1.7 - 8.6)
Testosterone - 10.74 (7.57 - 31.40)
DHEAS - 1.58 (4.3 - 12.2)
SHBG - 30.1 (15.4 - 63.8)
E2 - 107 ( 28-156)

Basically Endo says I can't do anything about it that Antibodies will continue to be made and slowly destroy my thyroid. I have read that you have to take high enough dosages to combat this and stop the attacking. Is this true? Or is there nothing you can do to revert Hashimoto's or stop the attack?

I have been feeling weak,fatigued and just lack of energy. That prompted me to see the doctor. Found out that I was Hypo and started medication. I also seem to have lower testosterone (but in range) for my age (34) which also could be part of my weakness and fatigued issues. I look back at my history of TSH readings and back in 2006 it was 2.34 then it has been going up gradually ever since.

For the month or so I have started taking combined T3+T4 to see if that helps the situation. But honestly I have not really seen the improvement I was hoping for. Interestingly though I had pretty good FT3 and FT4 numbers before starting medication. I looked into gluten intolerance since that can falsely flag Auto-Immune antibodies but my test came back negative for gluten intolerance.

Currently taking 90mcg T4 with 10mcg T3. Before this I was on 100mcg T4. I figure I might need to go a little higher with T3 maybe but my last tests run they did not measure Ft3 not sure why but the endo does not come across as that bright. I can't go to a local GP here since everything has to be done via an Endo for what ever stupid reason that is. Back home in Australia my local GP will usually run any test with reason that I ask for. I have to make do with what I have at the moment.

My biggest question is what should I be doing to stop hashimoto's if that is even possible? Can Auto-immune diseases be reversed?

I don't understand why I was hypo with good Ft3 and Ft4 numbers.

Any advice would be greatly appreciated.


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## bigfoot

iroczinoz said:


> My biggest question is what should I be doing to stop hashimoto's if that is even possible? Can Auto-immune diseases be reversed?


Cured? No. Put into remission? Yes.

Folks here and a couple of doctors I have talked to have mentioned an ideal TSH of between 1.0-2.0 (or lower, depending on the individual) in Hashimoto's patients.

You mentioned low testosterone -- that could be a big part of your tiredness and fatigue as well. If you can, I would pursue this avenue in conjunction with the thyroid issues. See if your doc can figure out why your testosterone is in the lower end of the range. For a male in their early 30's, your testosterone should be higher. (Ask me how I know; been struggling with this for over a year, too.) A key component is getting at the WHY part of the equation.

I am surprised your doc tested your E2. Estrogen can be a component of the testosterone issue as well. Too high and it will be siphoning off the testosterone that your body should be using, at least that's the theory. (Google "aromatase" and do a little reading.) Heck, my own docs don't know enough about this stuff and neither do I. You definitely want somebody experienced in male hormones before you start taking anything such as testosterone replacement therapy.

Your DHEA looks low in the recent labs you posted. Did your doc mention anything? This could be a sign of adrenal problems. One more rock to overturn and look under. See if he/she can run adrenal tests.

So between the thyroid, possible low testosterone, and possible adrenal issues, you certainly could have enough going on to give you the signs & symptoms you are experiencing.

Other miscellaneous random thoughts from a fellow newbie:
* Might want to avoid soy and iodine-containing products.
* Gluten-free foods can help reduce inflammation.
* Same goes for a fiber-rich, whole-grain diet (Oatmeal, whole grain breads/cereals, lots of veggies, fruits, etc. Just gotta watch labs, as the fiber can reduce the absorption of thyroid meds. May need med increase.).
* Excess stress or exercising really hard may trigger a flare-up.
* Stay well hydrated with lots of water. Avoid soda, coffee, and caffeine.
* A good daily multivitamin, some Selenium (200mcg), and quality fish oil (e.g., Carlson's liquid) may help as well with keeping things in balance.
* May wish to take thyroid meds at night (3-4 hours after eating) to increase effectiveness. Studies about how digestion slows at night when sleeping, thereby boosting thyroid med absorption.
* Be consistent in timing of when you take thyroid meds.
* Avoid taking calcium or eating calcium-rich foods within 3-4 hours of taking thyroid meds.


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## iroczinoz

Okay so if I understand this correctly to stop the attack is all about having the correct amount of thyroid meds? So if the attack is continuing I should be looking at increasing the amount I take?

I usually say in posts that people had poor Ft3 and Ft4 values that suffer issues with the thyroid. I guess in my situation things are a little different.

The Endo that I see has no idea. She only ran the tests because I asked for them and had to persuade her.

I train hard, eat heaps of oats so maybe not the best for my condition but I love training. I am looking into the testosterone,DHEA-S levels but the doctor is of no help. I will most likely go with the self treat route in the future.

I asked for E2 to see where I was at and now that I see it is higher up in the range I will try and lower it down with some arimidex and see if that helps my Testosteorne levels. I am supposed to get blood drawn at the end of the month to test my Thyroid levels so will adjust dose as required. I would really like to see myself around the 1 mark.

Endo mentioned my high LH and FSH levels are of concern but at the moment she is not going to do anything since my test levels are still in range. Stupid but I have given up with that Endo because she has no idea. She won't do anything with my low DHEA either. Basically brushed it off that everything is in my head and I am perfectly fine.

Been taking 1gram of magnesium, 100mg of zinc, 1 gram vitamin C, B vitamin complex.

I actually started taking my thyroid meds at night since I felt better during the day after. Doc said don't do it since it will interrupt my sleep. So I might revert back to night dosing.

thanks for the tips!


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## Andros

iroczinoz said:


> Hello all! Been searching for a forum like this to get some advice on my situation.
> Below is a snapshot of my blood results this year.
> 
> 2011 results:
> February -
> 
> Free T4 - 16.6 (10-19)
> Free T3 - 5.1 (3.5 - 6.5)
> TSH - 8.33 (0.5-4)
> FSH - 2 (1-10)
> LH - 2 (1-10)
> TT - 13.9 (8.3-30.2)
> SHBG - 29 (13-71)
> FT - 304 (225-725)
> Anti-Thyroid Peroxidase - 104 kIU/L (<60)
> Anti-Thyroglobulin - 92 kIU/L (<60)
> 
> Doctor prescribed me 50mcg T4 daily.
> 
> 2 months later
> Free T4 - 20.4 (10-19)
> Free T3 - 6.1 (3.5 - 6.5)
> TSH - 3.37 (0.5-4)
> 
> Started feeling bad again a month later went back for another blood test
> Free T4 - 21.9(10-19)
> Free T3 - 5.0 (3.5 - 6.5)
> TSH - 4.40 (0.5-4)
> 
> Doctor prescribed me 100mcg T4 daily.
> 
> T4 meds kind of worked at the start as I did feel an improvement. But after the initial 2-3 months I started feeling worse.
> 
> June 2011 - Now in Czech Republic (so maybe their ranges or scaling is different) as before I was in Australia. Suddenly Ft4 is in range still on 100mcg, surprising.
> Free T4 - 14 (7-16)
> TSH - 1.83 (0.34-5.6)
> Anti TPO - 9.6 kU/l (0.0 - 9.0)
> Anti Tg - 138 kIU/l (0-115)
> 
> Antibodies look like they are slightly elevated as compared to my 1st blood test but still present.
> 
> July 2011 - Saw Endo
> 
> Free T4 - 23.02 (9-25)
> T3 - 1.53 (1.3 - 3.10) (NOT FREE T3)
> TSH - 2.3 (0.27-4.2)
> FSH - 16.6 (1.5- 12.4)
> LH - 23.0 (1.7 - 8.6)
> Testosterone - 10.74 (7.57 - 31.40)
> DHEAS - 1.58 (4.3 - 12.2)
> SHBG - 30.1 (15.4 - 63.8)
> E2 - 107 ( 28-156)
> 
> Basically Endo says I can't do anything about it that Antibodies will continue to be made and slowly destroy my thyroid. I have read that you have to take high enough dosages to combat this and stop the attacking. Is this true? Or is there nothing you can do to revert Hashimoto's or stop the attack?
> 
> I have been feeling weak,fatigued and just lack of energy. That prompted me to see the doctor. Found out that I was Hypo and started medication. I also seem to have lower testosterone (but in range) for my age (34) which also could be part of my weakness and fatigued issues. I look back at my history of TSH readings and back in 2006 it was 2.34 then it has been going up gradually ever since.
> 
> For the month or so I have started taking combined T3+T4 to see if that helps the situation. But honestly I have not really seen the improvement I was hoping for. Interestingly though I had pretty good FT3 and FT4 numbers before starting medication. I looked into gluten intolerance since that can falsely flag Auto-Immune antibodies but my test came back negative for gluten intolerance.
> 
> Currently taking 90mcg T4 with 10mcg T3. Before this I was on 100mcg T4. I figure I might need to go a little higher with T3 maybe but my last tests run they did not measure Ft3 not sure why but the endo does not come across as that bright. I can't go to a local GP here since everything has to be done via an Endo for what ever stupid reason that is. Back home in Australia my local GP will usually run any test with reason that I ask for. I have to make do with what I have at the moment.
> 
> My biggest question is what should I be doing to stop hashimoto's if that is even possible? Can Auto-immune diseases be reversed?
> 
> I don't understand why I was hypo with good Ft3 and Ft4 numbers.
> 
> Any advice would be greatly appreciated.


Hi there and welcome. I personally do not see you as being hypo. I think you are hyper.

Symptoms can and do cross over.

There is one test that would settle that issue.

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

Also, I recommend either a sonogram or RAIU (radioactive uptake) as your Thyroglobulin and TPO are high which could indicate suspicious nodules. Cancer to be specific.

There are binding, blocking and stimulating antibodies and immunoglobulins which work to put the body to rights thus giving the appearance of lab results in normal range.


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## bigfoot

iroczinoz said:


> Okay so if I understand this correctly to stop the attack is all about having the correct amount of thyroid meds? So if the attack is continuing I should be looking at increasing the amount I take?


Yes, potentially. Probably should see if you can get that TSI test run, first.



iroczinoz said:


> I usually say in posts that people had poor Ft3 and Ft4 values that suffer issues with the thyroid. I guess in my situation things are a little different.


Possibly way different if hyper. There are medications for hyper and also radiation treatment and/or surgery. I don't really know much about this area.



iroczinoz said:


> The Endo that I see has no idea. She only ran the tests because I asked for them and had to persuade her.


Yeah, maybe it's time for a new doc.



iroczinoz said:


> I train hard, eat heaps of oats so maybe not the best for my condition but I love training. I am looking into the testosterone,DHEA-S levels but the doctor is of no help. I will most likely go with the self treat route in the future.


Just be careful with self-treating. IMHO, until the thyroid stuff is addressed and adrenal possibilities investigated, I'd go pretty slow on that.

Theoretically the hard training could be triggering flare-ups of the thyroid antibodies, making you feel worse. And the oatmeal could be reducing absorption of thyroid meds due to high fiber, requiring you to take a little more medicine to keep up.



iroczinoz said:


> I asked for E2 to see where I was at and now that I see it is higher up in the range I will try and lower it down with some arimidex and see if that helps my Testosteorne levels. I am supposed to get blood drawn at the end of the month to test my Thyroid levels so will adjust dose as required. I would really like to see myself around the 1 mark.


It sounds like you know more about hormones than most docs out there. That is a good thing! I just don't think most docs receive any real significant training in male hormones. Which is a shame, as that is supposed to be part of an endo's speciality. I've had one doc test Estradiol (came back high) and none of the other docs think it even matters.



iroczinoz said:


> Endo mentioned my high LH and FSH levels are of concern but at the moment she is not going to do anything since my test levels are still in range. Stupid but I have given up with that Endo because she has no idea. She won't do anything with my low DHEA either. Basically brushed it off that everything is in my head and I am perfectly fine.
> 
> Been taking 1gram of magnesium, 100mg of zinc, 1 gram vitamin C, B vitamin complex.


Definitely not all in your head! But it sounds like you have a good handle on a lot of what is happening. Sorry to hear your doc isn't as knowledgeable.



iroczinoz said:


> I actually started taking my thyroid meds at night since I felt better during the day after. Doc said don't do it since it will interrupt my sleep. So I might revert back to night dosing.


The trick is being consistent, take them around the same time each night, and don't eat anything for a few hours beforehand. It isn't going to harm you, it just might affect your sleep, if you are one of those people. When you take your thyroid meds they peak about 3-4 hours later.


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## iroczinoz

Andros, Just curious what makes you think I am hyper and not Hypo? My TSH was measured at 8 before I started taking medication. On the previous other tests I had before hand leading up to that one. They were roughly all within a year and went like 5.00 to 6.50 to 8.33. The 6.5 to 8.3 occurred within 4 months.

TSI that is something new to me and I will look into this. Thanks for the heads up on that! I'll try and get this tested next time I get blood. So what you are saying is that if TSI is present I am Hyper? Hmm confusing, since my TSH is elevated, but reading some of your other posts other things have an influence on TSH.

Is there anything else I should test for to really be certain that I do have Hashi's or not. I would also hate to be taking medication if I really don't need it. I was feeling fatigued,weak etc, TSH came back at 8.33 doctor put me on Thyroxine said I was hypo and this will help. But right now on my 90mcg T4 and 10mcg T3, I get these real hot sweaty episodes and feel very hot. Then it goes away and comes back again later.

From what I can tell, it is more and more likely that I have primary Hypogonadism or the start of it.

It is astonishing how little these so called specialists (Endo's) really know, it is down right sad.

The only other thing that comes to mind if l went hypo by tsh because of my varicocele. Body trying to cool down because of varicocele. So i might be taking thyroid meds for all the wrong reasons and causing more harm than good. TSI looks like l need to get done. What a mess this might be. If l was hypo, l certainly never had problems with weight gain. lt has never been easy gaining weight for me. FNA to diagnose hashi's, l will ask about that too.


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## Andros

iroczinoz said:


> Andros, Just curious what makes you think I am hyper and not Hypo? My TSH was measured at 8 before I started taking medication. On the previous other tests I had before hand leading up to that one. They were roughly all within a year and went like 5.00 to 6.50 to 8.33. The 6.5 to 8.3 occurred within 4 months.
> 
> TSI that is something new to me and I will look into this. Thanks for the heads up on that! I'll try and get this tested next time I get blood. So what you are saying is that if TSI is present I am Hyper? Hmm confusing, since my TSH is elevated, but reading some of your other posts other things have an influence on TSH.
> 
> Is there anything else I should test for to really be certain that I do have Hashi's or not. I would also hate to be taking medication if I really don't need it. I was feeling fatigued,weak etc, TSH came back at 8.33 doctor put me on Thyroxine said I was hypo and this will help. But right now on my 90mcg T4 and 10mcg T3, I get these real hot sweaty episodes and feel very hot. Then it goes away and comes back again later.
> 
> From what I can tell, it is more and more likely that I have primary Hypogonadism or the start of it.
> 
> It is astonishing how little these so called specialists (Endo's) really know, it is down right sad.
> 
> The only other thing that comes to mind if l went hypo by tsh because of my varicocele. Body trying to cool down because of varicocele. So i might be taking thyroid meds for all the wrong reasons and causing more harm than good. TSI looks like l need to get done. What a mess this might be. If l was hypo, l certainly never had problems with weight gain. lt has never been easy gaining weight for me. FNA to diagnose hashi's, l will ask about that too.


You are fluctuating way to much re the Free T4, what few Free T3 I have seen and the TSH.

This is very very typical pattern on the journey to full-blown hyper. Sometimes your FREE T4 has almost been over the top. When you see that and at the same time you see TSH "in" range you have to wonder because usually the TSH would be way way down.

This happens because of antibodies. Their job is to fight each other i.e. antibodies versus autoantibodies and the same w/immunoglobulins. They bind and block receptor sites in an attempt to set the body to rights thus giving very strange lab results re the "numbers".

It is really hard to explain; not sure I am doing a good job of it.

Please let us know what progress you make w/ the medical establishment.


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## iroczinoz

Andros said:


> You are fluctuating way to much re the Free T4, what few Free T3 I have seen and the TSH.
> 
> This is very very typical pattern on the journey to full-blown hyper. Sometimes your FREE T4 has almost been over the top. When you see that and at the same time you see TSH "in" range you have to wonder because usually the TSH would be way way down.
> 
> This happens because of antibodies. Their job is to fight each other i.e. antibodies versus autoantibodies and the same w/immunoglobulins. They bind and block receptor sites in an attempt to set the body to rights thus giving very strange lab results re the "numbers".
> 
> It is really hard to explain; not sure I am doing a good job of it.
> 
> Please let us know what progress you make w/ the medical establishment.


Yes that was one of the things I never understood that my FT4 was above range on 2 consecutive readings. Before medication it was close to top of range. Once I started T4 meds at 50mcg it went over the top range, then it went further over the top range. Once I started taking 100mcg a day it surprisingly went back into range. I found this very odd.

I am really going to have a hard time convincing the Endo about running some more tests. I do my research bring in notes and she calls me crazy. She even said I should go see a psychiatrist because there is nothing wrong with me. The discussion turned a bit loud after that because she basically said I am a nutter and looking to far into it. I really should have replied well if you knew your job well enough I would not have to get educated.

I will push for the TSI test to confirm the situation. I hope they do that test here since when I asked for rT3 she said that test is not run here (Czech Republic). I might have to wait for Australia again if they don't run TSI here.

But you have really opened a can of worms and there might be something in it I think. Honestly I have not been feeling good on the T4 and T3. I am having blood drawn this month. Will wait and see what happens and then I might discontinue usage.

I should state that in 2009 I got chicken pox, if that plays any role.


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## Andros

iroczinoz said:


> Yes that was one of the things I never understood that my FT4 was above range on 2 consecutive readings. Before medication it was close to top of range. Once I started T4 meds at 50mcg it went over the top range, then it went further over the top range. Once I started taking 100mcg a day it surprisingly went back into range. I found this very odd.
> 
> I am really going to have a hard time convincing the Endo about running some more tests. I do my research bring in notes and she calls me crazy. She even said I should go see a psychiatrist because there is nothing wrong with me. The discussion turned a bit loud after that because she basically said I am a nutter and looking to far into it. I really should have replied well if you knew your job well enough I would not have to get educated.
> 
> I will push for the TSI test to confirm the situation. I hope they do that test here since when I asked for rT3 she said that test is not run here (Czech Republic). I might have to wait for Australia again if they don't run TSI here.
> 
> But you have really opened a can of worms and there might be something in it I think. Honestly I have not been feeling good on the T4 and T3. I am having blood drawn this month. Will wait and see what happens and then I might discontinue usage.
> 
> I should state that in 2009 I got chicken pox, if that plays any role.


This doctor talks down to you like this? Do you have a choice of doctors over there perchance?

She sounds like a sadist.

LHM (Lord have mercy) Chicken pox? Well.......................it would surely indicate that your immune system is in a weakened condition. Holy cats or should I say Holy chickens. This is no joke. When an adult gets them, they sure get awfully sick!

What you "can" tell her is that there is something wrong because you should not have either one of these.

Anti-Thyroid Peroxidase - 104 kIU/L (<60)
Anti-Thyroglobulin - 92 kIU/L (<60)

TPO Ab should be negative, 0
http://www.medlabs.com.jo/docs/Leaflet-17.pdf
(The normal thyroid has TPO but should not have antibodies to TPO)

Same is true with the Thyroglobulin (Small amounts of thyroglobulin are normal in those with normal thyroid function.) Meaning also that if there are large amounts, cancer should be ruled in or out.

But, you definitely should not have antibodies to thyroglobulin.
http://labtestsonline.org/understanding/analytes/thyroglobulin/tab/test


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## iroczinoz

Yeah they all say

Anti-Thyroid Peroxidase - 104 kIU/L (<60)
Anti-Thyroglobulin - 92 kIU/L (<60)

is because I have hashi's, end of story.

This female Endo knows limited stuff and once you start talking to her what you have read and researched she gets upset and very attacking.

Not sure If I will find someone else at the moment. I have found a pretty good urologist looking at my other issues. So I might ask her next time I see her (mid september) if she has any thyroid experience and maybe take it up with her.

Andros, if I understand you correctly if you were in my shoes you would:

1. Test TSI
2. RAIU test

If both those come back negative - stick to my current protocol and try and get TSH down to 1?

If TSI comes back positive would that indicate Hyper but me having HYPO TSH - I would need different medication??

Regarding antibodies is there anything you can do to stop them from being in the blood?

Sorry just getting a little confused with it all as I was under the impression having Anti-Thyroid Peroxidase,Anti-Thyroglobulin present was normal for people with Hashi's. But maybe you are implying I should rule out cancer when these antibodies are present?


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## Andros

iroczinoz said:


> Yeah they all say
> 
> Anti-Thyroid Peroxidase - 104 kIU/L (<60)
> Anti-Thyroglobulin - 92 kIU/L (<60)
> 
> is because I have hashi's, end of story.
> 
> This female Endo knows limited stuff and once you start talking to her what you have read and researched she gets upset and very attacking.
> 
> Not sure If I will find someone else at the moment. I have found a pretty good urologist looking at my other issues. So I might ask her next time I see her (mid september) if she has any thyroid experience and maybe take it up with her.
> 
> Andros, if I understand you correctly if you were in my shoes you would:
> 
> 1. Test TSI
> 2. RAIU test
> 
> If both those come back negative - stick to my current protocol and try and get TSH down to 1?
> 
> If TSI comes back positive would that indicate Hyper but me having HYPO TSH - I would need different medication??
> 
> Regarding antibodies is there anything you can do to stop them from being in the blood?
> 
> Sorry just getting a little confused with it all as I was under the impression having Anti-Thyroid Peroxidase,Anti-Thyroglobulin present was normal for people with Hashi's. But maybe you are implying I should rule out cancer when these antibodies are present?


The thing is, first and foremost; it is not normal to have Hashimoto's.

Also, the presence of TPO is "suggestive" of a myriad of things and while I am not a doctor, I do not consider that "definitive" of Hashi's.

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

TPO Ab
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

TPO Ab should be negative, 0
http://www.medlabs.com.jo/docs/Leaflet-17.pdf
(The normal thyroid has TPO but should not have antibodies to TPO)

Healthy folks have TPO and a small amount of Thyroglobulin. They should not have antibodies to either of these things and once again, it is "suggestive" of many things.

It is true that a lot of Hashimoto's patients do have high TPO so it is common. But once again, my personal opinion is that this is a misnomer as far as definitive diagnostic techniques are concerned.

FNA is considered to be definitive but only in "some" cases as there are Hurthle cells indigenous to Hashi's and there are Hurthle cells indigenous to thyroid cancer. Sometimes the "findings" are indeterminate.

http://onlinelibrary.wiley.com/doi/10.1002/cncr.21716/pdf

I would definitely follow through on numbers 1 and 2. It is very very important to make sure you don't have cancer and should it turn out that you do, that is important also because you can jump right on it. Treatment protocul for that is very very successful.

When you get TSI, make sure you get the print out. I don't want to hear negative. They say that all the time when it is within the range. You should have NO TSI and the range is only provided to determine a "baseline" and to detect any movement either up or down. As you are coming to learn, this is true of many antibodies and immunoglobulins.

And make sure you get a copy of the RAIU "comments" as well. Please and purty please?


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## lainey

iroczinoz said:


> Yeah they all say
> 
> Anti-Thyroid Peroxidase - 104 kIU/L (<60)
> Anti-Thyroglobulin - 92 kIU/L (<60)
> 
> is because I have hashi's, end of story.
> 
> This female Endo knows limited stuff and once you start talking to her what you have read and researched she gets upset and very attacking.
> 
> Not sure If I will find someone else at the moment. I have found a pretty good urologist looking at my other issues. So I might ask her next time I see her (mid september) if she has any thyroid experience and maybe take it up with her.
> 
> Andros, if I understand you correctly if you were in my shoes you would:
> 
> 1. Test TSI
> 2. RAIU test
> 
> If both those come back negative - stick to my current protocol and try and get TSH down to 1?
> 
> If TSI comes back positive would that indicate Hyper but me having HYPO TSH - I would need different medication??
> 
> Regarding antibodies is there anything you can do to stop them from being in the blood?
> 
> Sorry just getting a little confused with it all as I was under the impression having Anti-Thyroid Peroxidase,Anti-Thyroglobulin present was normal for people with Hashi's. But maybe you are implying I should rule out cancer when these antibodies are present?


Are you male or female? For some reason, I can't tell from your posting, it's makes the evaluation of your low testosterone/dhea different. However, the estrogen hormones bind thyroid hormone in the blood, making less available, while the progestin hormones do the opposite. An imbalance of these can lead to an imbalance in thyroid hormones. Low testosterone in males is a separate condition and needs to be adequately treated for them to feel the full affect of thyroid treatment simply because the symptoms are so very similar for each. Estrogen dominance in women has a similar effect, and needs to be corrected for the same reason.

A good percentage of the normal healthy population can have low titers of thyroid antibodies of several types. Your antibodies are not so far off the charts to make a doctor excited--though they usually don't cause doctors much concern anyway.

You could have your thyroid removed, and still have antibodies in the blood. 
You can't really get rid of them, you can't treat them. You can only replace the thyroid hormone after the thyroid has slowed it's functioning--which is where you are presently.

You CANNOT determine the likelihood of thyroid cancer from a blood test. This is determined via ultrasound or other imaging--ie, nodules are found to be present in the thyroid. For RAIU, you need to be off all T4 medications for about 5 weeks, and T3 only medications for 10 days beforehand. A sonogram would be your better first choice if you have not yet had one.


----------



## iroczinoz

All good information!! I will try and get the suggested tests. When I see the urologist at the end of next month I'll ask her. The endo I have seen is hopeless and has no interest in helping me with my other issues.

Just to clarify I am male.

On a side note my wife had TSH measured. Her doctor did not want to run Ft3,Ft4 because it is another know it all GP and stubborn as they get. So she only tested TSH it came back at 2.8 (.5-5.6) So it is getting up there.

Wife feels cold a lot of the time while others are not, and a lot of time she is tired. So it could be symptoms of Hypo. But unfortunately no Ft4,Ft3 values to go off.

I was thinking of giving her some T4 meds (50mcg) to try out for say 4-6 weeks to see if it makes any difference to her. It would definitely lower her TSH down. But should we try and get Ft4 and Ft3 measurements 1st before trying T4 meds? Or should we try T4 meds and see how she feels??

Also she asked me to ask if there are any issues with taking T4 meds while trying to become pregnant or during pregnancy? To me it would seem like it would have no effect but I thought I would ask anyway. From what I have read being Hypo would make it more difficult to become pregnant if anything.


----------



## Andros

iroczinoz said:


> All good information!! I will try and get the suggested tests. When I see the urologist at the end of next month I'll ask her. The endo I have seen is hopeless and has no interest in helping me with my other issues.
> 
> Just to clarify I am male.
> 
> On a side note my wife had TSH measured. Her doctor did not want to run Ft3,Ft4 because it is another know it all GP and stubborn as they get. So she only tested TSH it came back at 2.8 (.5-5.6) So it is getting up there.
> 
> Wife feels cold a lot of the time while others are not, and a lot of time she is tired. So it could be symptoms of Hypo. But unfortunately no Ft4,Ft3 values to go off.
> 
> I was thinking of giving her some T4 meds (50mcg) to try out for say 4-6 weeks to see if it makes any difference to her. It would definitely lower her TSH down. But should we try and get Ft4 and Ft3 measurements 1st before trying T4 meds? Or should we try T4 meds and see how she feels??
> 
> Also she asked me to ask if there are any issues with taking T4 meds while trying to become pregnant or during pregnancy? To me it would seem like it would have no effect but I thought I would ask anyway. From what I have read being Hypo would make it more difficult to become pregnant if anything.


Thank you for telling your gender. There are times when it is very important. Worth noting is that most men w/thyroid disease do need their testosterone checked as it most likely is low.

And...............

men more likely to have cancer than women
http://www.umm.edu/endocrin/thytum.htm

It is my humble opinion that you "both" need a good doc who is amenable and has the desire to see his/her patients well. It really is not that hard.

If the wife takes thyroxine that is not Rx'd for her, there could be problems. Not to mention that if you do find a good doc, the med will skew her tests.


----------



## iroczinoz

still no new news on my end waiting to see my urologist at the end of the month. Will see if she can help me with my thyroid issues as my last endo was useless.

I did want to ask a question though. My endo did a blood test to check if I am gluten intolerant. It came back negative, but I want to confirm if a blood test is possible to check for gluten intolerance? Some sites say you cannot check via blood test.

So I am curious to know what is true and what the most reliable method is to check for gluten intolerance.


----------



## Andros

iroczinoz said:


> still no new news on my end waiting to see my urologist at the end of the month. Will see if she can help me with my thyroid issues as my last endo was useless.
> 
> I did want to ask a question though. My endo did a blood test to check if I am gluten intolerant. It came back negative, but I want to confirm if a blood test is possible to check for gluten intolerance? Some sites say you cannot check via blood test.
> 
> So I am curious to know what is true and what the most reliable method is to check for gluten intolerance.


I believe that gluten intolerance and celiac disease are words that are used interchangeably. Most likely she did an IgG or IgA or something like that for celiac.

Gluten Sensitivity is another story. Many of us are and the only way to find out is to go totally gluten-free for about 30 days. As far as I know,that is the only test for that. In other words, it's an allergy to gluten.


----------



## hochelaga

iroczinoz said:


> I did want to ask a question though. My endo did a blood test to check if I am gluten intolerant. It came back negative, but I want to confirm if a blood test is possible to check for gluten intolerance? Some sites say you cannot check via blood test.
> 
> So I am curious to know what is true and what the most reliable method is to check for gluten intolerance.


Most doc's who understand Hashi's recommend a gluten-free diet.


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## bigfoot

Yes -- had a doc recommend gluten free to me re: Hashi's.


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## iroczinoz

Gluten free diet is going to be a disaster for me. I eat a lot of oats. If I was to go gluten free it would be a major pita for me since I rely on loads of oats in the morning, into bodybuilding etc...


----------



## Andros

iroczinoz said:


> Gluten free diet is going to be a disaster for me. I eat a lot of oats. If I was to go gluten free it would be a major pita for me since I rely on loads of oats in the morning, into bodybuilding etc...


I also eat a lot of rolled oats. Just no wheat gluten. That is what puts me in a tither. Most can tolerate oats. My husband cannot.

Must have my rolled oats w/molasses on it. 
And we use a lot of Maize and regular corn meal yellow and white. Lots of rice too. Plenty of potatoes in the diet as well. It's not the potato but what you put on it as you no doubt well know.


----------



## iroczinoz

Andros said:


> I also eat a lot of rolled oats. Just no wheat gluten. That is what puts me in a tither. Most can tolerate oats. My husband cannot.
> 
> Must have my rolled oats w/molasses on it.
> And we use a lot of Maize and regular corn meal yellow and white. Lots of rice too. Plenty of potatoes in the diet as well. It's not the potato but what you put on it as you no doubt well know.


Well that is some good news that oats are generally okay. The only other thing I eat would be bread that has gluten. This probably could get eliminated without that much of an issue. I will have to keep this in mind.


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## northernlite

I am 11 years a celiac and I eat oats. Oats are fine for most on a GF diet.


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## iroczinoz

I saw a kidney specialist today after she did a few blood tests for me. Kidney's are fine nothing wrong. This was just another thing I had to get checked out after the Uro sent me there.

Luckily enough the Kidney specialist also ran TSH and Ft4 test. Which was good since I had no idea what my values were since changing to 90mcg T4 and 10mcg T3 for the last 3 or so months.

She did not test Ft3 which I took into account anyway since she was not really looking to diagnose my thyroid etc...

Values

TSH - 0.54 mU/l (0.17-4.05)
Ft4 - 21.5 pmol/l (11.5-23)

I think I will keep the dose the same for now as I don't feel any sides. I will still try and get the TSI test at some stage in the next couple of months. Doctors here are really reluctant to do tests that you ask for... I'll pay out of pocket if I have to, but they are just ignorant.

Are these good values to be at or have I gone too low? Without feeling any real sides, I think I am pretty good to keep it as it is right?


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## bigfoot

Wow, I would say those numbers look pretty darned good to my untrained eye. If you aren't having any signs or symptoms and you feel good, why rock the boat? Perhaps you have hit the euthyroid state.

hugs3


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## Andros

iroczinoz said:


> I saw a kidney specialist today after she did a few blood tests for me. Kidney's are fine nothing wrong. This was just another thing I had to get checked out after the Uro sent me there.
> 
> Luckily enough the Kidney specialist also ran TSH and Ft4 test. Which was good since I had no idea what my values were since changing to 90mcg T4 and 10mcg T3 for the last 3 or so months.
> 
> She did not test Ft3 which I took into account anyway since she was not really looking to diagnose my thyroid etc...
> 
> Values
> 
> TSH - 0.54 mU/l (0.17-4.05)
> Ft4 - 21.5 pmol/l (11.5-23)
> 
> I think I will keep the dose the same for now as I don't feel any sides. I will still try and get the TSI test at some stage in the next couple of months. Doctors here are really reluctant to do tests that you ask for... I'll pay out of pocket if I have to, but they are just ignorant.
> 
> Are these good values to be at or have I gone too low? Without feeling any real sides, I think I am pretty good to keep it as it is right?


Those labs look good althought I am surprised that the FT4 is so high considering the fact that you are taking T3. Usually when taking T3, the FT4 is a bit lower than ordinary and that is expected.

You are feeling good; right?


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## iroczinoz

Andros said:


> Those labs look good althought I am surprised that the FT4 is so high considering the fact that you are taking T3. Usually when taking T3, the FT4 is a bit lower than ordinary and that is expected.
> 
> You are feeling good; right?


I have always had pretty high Ft4 to begin with. As far as feeling good I would have to say no, but in all fairness this has probably nothing to do with my thyroid.

The reason I am seeing the Urologist is because of my weakness and fatigue. The way it stands everything is pointing towards my very sub-par testosterone levels. I am exhausting every avenue at the moment and TRT might be an option I might have to look at.

Currently taking DHEA @ 100mg as I was under the normal range by 400%. Seeing if this will improve my testosterone values as DHEA is the precursor to testosterone.. But at the moment it seems like it is not really helping.

I talk with the Urologist on Thursday we will see what we come up with.

As for my thyroid, I think the numbers are very good, cortisol came back okay as well so my adrenals are up to the task.


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## iroczinoz

Saw the uro the other day, I went in with a list of tests I wanted done to check up on things. For the last 6 weeks I have been on dhea 100mg daily to see if this will raise my testosterone levels and replensih my dhea-s levels.

Uro said I have to go see an Endo for Ft3 and ft4 and tsi tests. So that sucks, not going back to the previous endo as she was hopeless. Trying to find another Endo now because something is not right.

I really need to check my ft3 and ft4 levels since they have not been when they should have been.

I went on a diet for 3 weeks since I have had high cholesterol. I eat clean so I disregarded all the nonsense advice doctors were saying eat less fat blah blah.... I don't eat any fat, but what I did do was eliminate all carbs from diet except for oats in the morning. So no bread,potatoes sugars etc....

Cholesterol dropped from 6.5 to 4.99 in just 3 weeks and all because of carb elimination. They wanted to put me on statins haha I kindly declined. Read heaps about cholesterol and it is all a myth we have been told.. But the statin industry is worth billions so you get the picture.

But the main point I want to make is that I am finding it hard to put on weight now. If what Andros is true and I am in fact hyper and taking meds for hypo what a disaster that would be. I am fatigued, sweat heaps, lost a bit of my appetite and feeling weaker.

Tomorrow I get my other test results from the Uro and hope to see an endo next week to test tsi also.


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## iroczinoz

I saw the Endo yesterday again the sadist one to see if she calmed down from my last visit. Unfortunately not she again became hysterical at some of my suggestions and started yelling and being very unprofessional. Obviously her knowledge is poor at best and this was her way to vent her anger.

Simply put she had no idea what TSI. Slammed the paper work for blood tests and told me to show her where TSI is. It does not exist, well sorry to burst your bubble but I never knew that this country is so behind to the rest of the mature world.

I had to explain to her what TSI is and told her that it could suggest HYPER. She replied strictly TSH and Ft4 will tell her that. I said how can that be since those meausrements will only tell you that at 2pm on Thursday I was HYPO etc etc.. Those TSH and FT4 values only show you a snap shot at that given time. I want to rule out HYPER she said nonsense that I am crazy.... Again no FT3 test guess that is not important either, rT3 is also BS according to her. We have a winner here.

I said that ANTIBODIES suggest Hashi's but it is not 100% certain, it could be 95% of the time. She said rubbish I have Hashi's and that was the end of it. She wanted to hear no more from me.

I also talked to her about my LH and FSH values and lowish testosterone... I wanted to do a trial run of HCG to see if the boys are capable of producing more testosterone since my LH and FSH are just above the low limit. She said NO BLOODY way will she give me HCG that I am not a candidate. I said look at my LH and FSH values they are clearly on the low end why not try and at least we can rule out if I am primary or not. She said no, forget it that I am crazy and what not. Very unprofessional!! Obviously she has no clue but to attack me like this is absurd. God she has an ego for some reason.

She went on to say that my boys are not producing, men in there 80's might have higher testosterone than me in my 30's. I asked her if this is right then and okay with her? She said that I am aging, it is bad luck and to deal with it. Basically I am unlucky, so she acknowledges I have an issue but will deny me any help!!

I asked her this question, when female patients come and see you who have gone through menopause do you tell them the same thing you told me. That it is normal with age and that it is bad luck. To that she replied no I supplement hormones. I asked why the double standard? You just told me something totally different.

She said I am too difficult to deal with and that she never wants to see me again. She wrote on my medical statement will not see me again and to find another doctor. Haha, I have no issue with that, I just find it hilarious that this is an Endocrinologist who should be the person to see with issues like mine, yet when things get a little difficult she basically tells me to find someone else. Bloody unreal I say!! I have no issue not seeing her, I really just went in there to give her 1 more chance get my meds for the next 6 months and that is it. I guess she only know's how to deal with TSH numbers!

The way she acted is pathetic. Honestly I have no idea how she is even able to work as a doctor, she has extremely limited knowledge. I guess she is used to people nodding her every command. But the few like myself who actually have some knowledge before going in, she kicks out.

As for FNA did not even make it that far, I was in there for too long she said my 20mins was up 20mins ago and never come back.


----------



## Andros

iroczinoz said:


> I saw the Endo yesterday again the sadist one to see if she calmed down from my last visit. Unfortunately not she again became hysterical at some of my suggestions and started yelling and being very unprofessional. Obviously her knowledge is poor at best and this was her way to vent her anger.
> 
> Simply put she had no idea what TSI. Slammed the paper work for blood tests and told me to show her where TSI is. It does not exist, well sorry to burst your bubble but I never knew that this country is so behind to the rest of the mature world.
> 
> I had to explain to her what TSI is and told her that it could suggest HYPER. She replied strictly TSH and Ft4 will tell her that. I said how can that be since those meausrements will only tell you that at 2pm on Thursday I was HYPO etc etc.. Those TSH and FT4 values only show you a snap shot at that given time. I want to rule out HYPER she said nonsense that I am crazy.... Again no FT3 test guess that is not important either, rT3 is also BS according to her. We have a winner here.
> 
> I said that ANTIBODIES suggest Hashi's but it is not 100% certain, it could be 95% of the time. She said rubbish I have Hashi's and that was the end of it. She wanted to hear no more from me.
> 
> I also talked to her about my LH and FSH values and lowish testosterone... I wanted to do a trial run of HCG to see if the boys are capable of producing more testosterone since my LH and FSH are just above the low limit. She said NO BLOODY way will she give me HCG that I am not a candidate. I said look at my LH and FSH values they are clearly on the low end why not try and at least we can rule out if I am primary or not. She said no, forget it that I am crazy and what not. Very unprofessional!! Obviously she has no clue but to attack me like this is absurd. God she has an ego for some reason.
> 
> She went on to say that my boys are not producing, men in there 80's might have higher testosterone than me in my 30's. I asked her if this is right then and okay with her? She said that I am aging, it is bad luck and to deal with it. Basically I am unlucky, so she acknowledges I have an issue but will deny me any help!!
> 
> I asked her this question, when female patients come and see you who have gone through menopause do you tell them the same thing you told me. That it is normal with age and that it is bad luck. To that she replied no I supplement hormones. I asked why the double standard? You just told me something totally different.
> 
> She said I am too difficult to deal with and that she never wants to see me again. She wrote on my medical statement will not see me again and to find another doctor. Haha, I have no issue with that, I just find it hilarious that this is an Endocrinologist who should be the person to see with issues like mine, yet when things get a little difficult she basically tells me to find someone else. Bloody unreal I say!! I have no issue not seeing her, I really just went in there to give her 1 more chance get my meds for the next 6 months and that is it. I guess she only know's how to deal with TSH numbers!
> 
> The way she acted is pathetic. Honestly I have no idea how she is even able to work as a doctor, she has extremely limited knowledge. I guess she is used to people nodding her every command. But the few like myself who actually have some knowledge before going in, she kicks out.
> 
> As for FNA did not even make it that far, I was in there for too long she said my 20mins was up 20mins ago and never come back.


OMG! I wish you could have taped the conversation on your cell phone or something. This is a very dangerous sociopathic woman and has no business being a doctor.

Are you going to write up a report on her? I hope you do.

Anyway; what now? Have you found another doc? You don't really need an endo. What you need is a doctor who has an open mind, is willing to learn about TSI and such and has the desire to help you, the patient to get well.

A GP, Internal med, Naturopath, DO............etc..


----------



## iroczinoz

Andros said:


> OMG! I wish you could have taped the conversation on your cell phone or something. This is a very dangerous sociopathic woman and has no business being a doctor.
> 
> Are you going to write up a report on her? I hope you do.
> 
> Anyway; what now? Have you found another doc? You don't really need an endo. What you need is a doctor who has an open mind, is willing to learn about TSI and such and has the desire to help you, the patient to get well.
> 
> A GP, Internal med, Naturopath, DO............etc..


I will be flying back to Australia for 3 months next month, so I will not have any more time to deal with doctors here. Once I arrive back here in Czech next year I might try and find another Endo.

I agree that an open minded GP would be best, but the thing is in Czech it does not work that way. The local GP's will not even talk to you about hormone issues and just refer you to Endo's. So it is a loop you are in.

To make matters worse I found out about a really good Endo (or so they say) but they will not take me because I don't live in the area they take patients from. Doctors separate their available patients by the location where you live. So I cannot get to see him. It is all a joke here really and I don't think I can make any ground. I will speak with my URO on Friday if she can take matters into her own hand and lets forget about Endo's. She at least knew what TSI is! But is a little apprehensive because this is not her field and I should see an Endo she said.

The way I see it, it might be best just to self medicate, source my drugs from underground labs and do it that way. But I am a little hesitant going this way since you never have the guarantee what you get is pharmaceutical grade stuff.

In Australia I might get the TSI and RT3 tests that I have been unable to get here. I won't have time to see doctors too much over there since I am going there for work. So I can only hope I have luck when I get back here, or that my URO takes matters into her own hand (best outcome)

As far as a complaint, you know I am thinking about it. I actually forgot to record the conversation bit of a shame. I did ask her though if she did remove her remarks from my previous report that I need to see a shrink. She said yes I did but I still think it anyway. I said good otherwise I would have seen the doctors commission about you. She said no you would not, I said trust me 100% yes I would!

She finds it very strange that I am looking into my own health.


----------



## Andros

iroczinoz said:


> I will be flying back to Australia for 3 months next month, so I will not have any more time to deal with doctors here. Once I arrive back here in Czech next year I might try and find another Endo.
> 
> I agree that an open minded GP would be best, but the thing is in Czech it does not work that way. The local GP's will not even talk to you about hormone issues and just refer you to Endo's. So it is a loop you are in.
> 
> To make matters worse I found out about a really good Endo (or so they say) but they will not take me because I don't live in the area they take patients from. Doctors separate their available patients by the location where you live. So I cannot get to see him. It is all a joke here really and I don't think I can make any ground. I will speak with my URO on Friday if she can take matters into her own hand and lets forget about Endo's. She at least knew what TSI is! But is a little apprehensive because this is not her field and I should see an Endo she said.
> 
> The way I see it, it might be best just to self medicate, source my drugs from underground labs and do it that way. But I am a little hesitant going this way since you never have the guarantee what you get is pharmaceutical grade stuff.
> 
> In Australia I might get the TSI and RT3 tests that I have been unable to get here. I won't have time to see doctors too much over there since I am going there for work. So I can only hope I have luck when I get back here, or that my URO takes matters into her own hand (best outcome)
> 
> As far as a complaint, you know I am thinking about it. I actually forgot to record the conversation bit of a shame. I did ask her though if she did remove her remarks from my previous report that I need to see a shrink. She said yes I did but I still think it anyway. I said good otherwise I would have seen the doctors commission about you. She said no you would not, I said trust me 100% yes I would!
> 
> She finds it very strange that I am looking into my own health.


Your dialogue w/this doc is just too too scary!

Just keep this in your mind; the main concern w/hyper (TSI) is that if proper medical intervention does not ensue, it can and does damage organs; specifically the heart.

So, it is my special wish and hope for you that you find the proper medical care that you require.

And, I cannot see her "removing" anything she has already written in your report. This woman is hateful and vengeful. How horrible to have such a sick soul.


----------



## iroczinoz

thanks for the tip Andros. I will really make sure I get that TSI test done in Australia.

I took her word for it that she did remove it. But as you say, she has some serious hate so very well she could have left it there and just say she removed it.

I might go in and see the nurses in a couple of weeks and ask for a print out of my reports. That way I can see if she did in fact remove it or not. If not, a complaint will be made from my side to the commission. Also her online review will also get a nice addition.

Thanks for your support to date!


----------



## Andros

iroczinoz said:


> thanks for the tip Andros. I will really make sure I get that TSI test done in Australia.
> 
> I took her word for it that she did remove it. But as you say, she has some serious hate so very well she could have left it there and just say she removed it.
> 
> I might go in and see the nurses in a couple of weeks and ask for a print out of my reports. That way I can see if she did in fact remove it or not. If not, a complaint will be made from my side to the commission. Also her online review will also get a nice addition.
> 
> Thanks for your support to date!


You are welcome; I just hope this board has been helpful to you!


----------



## iroczinoz

Got my lab results in the mail along with a report stating everything is normal.

Blood draw on these labs was around 2pm.

TSH - 4.00 (0.27 - 4.2) !!!! WHAT THE HELL
FT4 - 18.50 (9.0 - 25.0)
T3 - 1.87 (1.3 - 3.1)

I was shocked to see TSH so high after it being 0.5 (morning draw and I did take my meds about 90mins before blood draw) the last time and around 1.5 in previous tests. I am on 90mcg T4 and 10mcg T3. I just take all medication in the morning. Which makes me wonder if I should be taking T3 multiple times a day instead of just once in the morning.

But I really want to get TSI tested to make sure nothing funky is going on. Could my body be fighting HYPER and showing HYPO on blood tests?

Of course the Endo did not do FT3. To her this test is useless as she says.

FT4 has gone down when it has always been at the very top of the range or above it. Now it has had a significant drop. Any ideas why this is happening?

So it looks like I might need to adjust the dosages maybe take more T3 throughout the day. I could take 80mcg T4 and 20mcg T3 since the pills are 40mcg t4 and 10mcg t3. One in the morning and one around 4pm.

Not sure what is going on any ideas?


----------



## Andros

iroczinoz said:


> Got my lab results in the mail along with a report stating everything is normal.
> 
> Blood draw on these labs was around 2pm.
> 
> TSH - 4.00 (0.27 - 4.2) !!!! WHAT THE HELL
> FT4 - 18.50 (9.0 - 25.0)
> T3 - 1.87 (1.3 - 3.1)
> 
> I was shocked to see TSH so high after it being 0.5 (morning draw and I did take my meds about 90mins before blood draw) the last time and around 1.5 in previous tests. I am on 90mcg T4 and 10mcg T3. I just take all medication in the morning. Which makes me wonder if I should be taking T3 multiple times a day instead of just once in the morning.
> 
> But I really want to get TSI tested to make sure nothing funky is going on. Could my body be fighting HYPER and showing HYPO on blood tests?
> 
> Of course the Endo did not do FT3. To her this test is useless as she says.
> 
> FT4 has gone down when it has always been at the very top of the range or above it. Now it has had a significant drop. Any ideas why this is happening?
> 
> So it looks like I might need to adjust the dosages maybe take more T3 throughout the day. I could take 80mcg T4 and 20mcg T3 since the pills are 40mcg t4 and 10mcg t3. One in the morning and one around 4pm.
> 
> Not sure what is going on any ideas?


Antibodies and immunoglobulins are causing this w/the numbers and what a shame she won't run the FREE T3. The T3 is useless for as you know it is comprised of bound, unbound and rT3 (reverse) hormone. So, how do we tell what is what here re the unbound portion.

Not only do I suspect you have TSI but your probably have TBII as well which is the opposing immunoglobulin (binding/blocking.)

TBII (Thyrotrophin Binding Inhibiting Immunoglobulin)
http://www.ncbi.nlm.nih.gov/pubmed/1969138

I am not into doctor bashing but that lady really is a dolt.


----------



## iroczinoz

Andros said:


> Antibodies and immunoglobulins are causing this w/the numbers and what a shame she won't run the FREE T3. The T3 is useless for as you know it is comprised of bound, unbound and rT3 (reverse) hormone. So, how do we tell what is what here re the unbound portion.
> 
> Not only do I suspect you have TSI but your probably have TBII as well which is the opposing immunoglobulin (binding/blocking.)
> 
> TBII (Thyrotrophin Binding Inhibiting Immunoglobulin)
> http://www.ncbi.nlm.nih.gov/pubmed/1969138
> 
> I am not into doctor bashing but that lady really is a dolt.


Thanks for the ideas Andros! In 1 month I'll be back in Australia so I hope to get these tests done once and for all!

I am going to try and get into another Endo before then here in Czech. I might get lucky and get a good doctor, but I doubt it.

If not, I am pretty confident back in Australia I will be able to get the missing tests done and post up the results.

So if in fact I have higher levels of TSI and also TBII I am taking the wrong medication for my condition. I hope this is not the case, but it very well may turn out to be the case. Not going to jump to conclusions just yet but in the next month I hope to find out.


----------



## bigfoot

iroczinoz said:


> So if in fact I have higher levels of TSI and also TBII I am taking the wrong medication for my condition. I hope this is not the case, but it very well may turn out to be the case. Not going to jump to conclusions just yet but in the next month I hope to find out.


Hope you find out as well! As I am also learning, finding a doc who understands all of this stuff is very difficult. They are so hung up on the TSH it isn't even funny.


----------



## Andros

bigfoot said:


> Hope you find out as well! As I am also learning, finding a doc who understands all of this stuff is very difficult. They are so hung up on the TSH it isn't even funny.


And Synthroid. Don't forget to add that one in. Aaaaaaaaaaaaaaaargh!


----------



## bigfoot

Yeah, the wonder drug. If it's so wonderful, why do so many people feel awful? LOL


----------



## Andros

bigfoot said:


> Yeah, the wonder drug. If it's so wonderful, why do so many people feel awful? LOL


You got it. Sad, but true!


----------



## iroczinoz

Thought I would post an update since I just got my blood work back.

FSH - 5 (1-10)
LH was not checked but I imagine it would be a similar value as FSH
Total Testosterone - 20.6 (8.3-30.2)
SHBG - 33 (13-71)
Calculated Free Testosterone - 445 (225-725)

Nuclei (hep-2000 Cells) Negative

Glucose non fasting 4.5 (fasting 4.0-6.0) Random (4.0-7.8)

Ferritin - 200 (20-300)
Iron - 2.6 (2.2-3.7)
Transferrin Sat 22 (13-47)

Prolactin - 74 mIU/L (45-375)
Serum Rheumatoid Factor - 5 kIU/L (<14)

TSH - 6.41 (.5-4.0)
Ft3 - 5.8 (3.5-6.5)
Ft4 - 18 (10-19)

Anti-Thyroid Peroxidase - 115 (<60)
Anti-Thyroglobulin - 123 (<60)

Vitamin B12 - 393 (150-700)
R.C.Folate - 920 (>630)

4 months ago my TSH was 0.5 now it is 6.4 and climbing. My ft3 and ft4 numbers look good so I don't understand it.

I hope to get an ultrasound on my thyroid done this Saturday if I can get in. 
I am also going to get a MRI scan on my pituitary gland and a scan of my hypothalamus. Something is going on and I am feeling pretty bad at the moment.

I took Tamoxifen for 2 weeks at 10mg daily to see what kind of a response my testosterone levels would get. 100% increase in both free testosterone and total testosterone. This was good news since this really kind of rules out primary hypogonadism for me, and maybe an issue with my Pituitary.

I also managed to finally get a referral for a blood test to check TSI and Rt3! Finally after such a long time I will know the values!

Will post results once I get them.

My usually doctor will be back in a week. This doctor that I saw said I need to increase my dosage. He was surprised I am taking both T3 and T4, he said T4 should only be needed. But I really did not get into it with him since I only went in to get my results.

Kind of stumped what to do. Do I really need more medication? Why such a dramatic increase in TSH in such a short period of time. 0.5 - 6.4 in 4 months?

Unless Rt3 is off the charts which would explain it, or TSI might be a culprit. Sure will be good to know the values.


----------



## Andros

iroczinoz said:


> Thought I would post an update since I just got my blood work back.
> 
> FSH - 5 (1-10)
> LH was not checked but I imagine it would be a similar value as FSH
> Total Testosterone - 20.6 (8.3-30.2)
> SHBG - 33 (13-71)
> Calculated Free Testosterone - 445 (225-725)
> 
> Nuclei (hep-2000 Cells) Negative
> 
> Glucose non fasting 4.5 (fasting 4.0-6.0) Random (4.0-7.8)
> 
> Ferritin - 200 (20-300)
> Iron - 2.6 (2.2-3.7)
> Transferrin Sat 22 (13-47)
> 
> Prolactin - 74 mIU/L (45-375)
> Serum Rheumatoid Factor - 5 kIU/L (<14)
> 
> TSH - 6.41 (.5-4.0)
> Ft3 - 5.8 (3.5-6.5)
> Ft4 - 18 (10-19)
> 
> Anti-Thyroid Peroxidase - 115 (<60)
> Anti-Thyroglobulin - 123 (<60)
> 
> Vitamin B12 - 393 (150-700)
> R.C.Folate - 920 (>630)
> 
> 4 months ago my TSH was 0.5 now it is 6.4 and climbing. My ft3 and ft4 numbers look good so I don't understand it.
> 
> I hope to get an ultrasound on my thyroid done this Saturday if I can get in.
> I am also going to get a MRI scan on my pituitary gland and a scan of my hypothalamus. Something is going on and I am feeling pretty bad at the moment.
> 
> I took Tamoxifen for 2 weeks at 10mg daily to see what kind of a response my testosterone levels would get. 100% increase in both free testosterone and total testosterone. This was good news since this really kind of rules out primary hypogonadism for me, and maybe an issue with my Pituitary.
> 
> I also managed to finally get a referral for a blood test to check TSI and Rt3! Finally after such a long time I will know the values!
> 
> Will post results once I get them.
> 
> My usually doctor will be back in a week. This doctor that I saw said I need to increase my dosage. He was surprised I am taking both T3 and T4, he said T4 should only be needed. But I really did not get into it with him since I only went in to get my results.
> 
> Kind of stumped what to do. Do I really need more medication? Why such a dramatic increase in TSH in such a short period of time. 0.5 - 6.4 in 4 months?
> 
> Unless Rt3 is off the charts which would explain it, or TSI might be a culprit. Sure will be good to know the values.


What thyroxine replacement are you on and how much? Your thyroid lab results are "suggestive" of something being afoot. Antibodies or immunoglobulins or both. And cancer should be ruled out.

Have you had an ultra-sound or RAIU?

Also, non-fasting glucose is low. Has your doctor commented on that?


----------



## daisydaisy

my tsh was 2.27 and in one month it was 7.34 I crashed hard. they upped my meds and am waiting to get tested next week. I am in bed and feel bad. One doctor said that when hash hits like that you don't know how bad the thyroid stops working due to it. I must get tested every month. Hash can happen anytime. I have hash antibodies and hypoglycemia but all other tests are fine. I do not have graves or any other autoimmune disease. Recently diagnosed with fibromyalgia.


----------



## iroczinoz

Currently on 90mcg T4 + 10mcg T3 daily.
I take all my meds in the morning.
Will be getting ultrasound this week I hope.

Curious to see rt3 and TSI results.

If this is hashi's that is causing my issue I am unsure how I can control this and keep my levels stable. If I up my dosage and Hashi's subsides I will be hyper I think.

This seems like a situation where you can never dial in the medication and be set.

I guess the only way you can have 100% control is if I get the thyroid removed.

Should I be moving to T3 meds only for better control?

Will post update once I get my results.


----------



## Andros

iroczinoz said:


> Currently on 90mcg T4 + 10mcg T3 daily.
> I take all my meds in the morning.
> Will be getting ultrasound this week I hope.
> 
> Curious to see rt3 and TSI results.
> 
> If this is hashi's that is causing my issue I am unsure how I can control this and keep my levels stable. If I up my dosage and Hashi's subsides I will be hyper I think.
> 
> This seems like a situation where you can never dial in the medication and be set.
> 
> I guess the only way you can have 100% control is if I get the thyroid removed.
> 
> Should I be moving to T3 meds only for better control?
> 
> Will post update once I get my results.


Will be anxious to see the results of rT3 and TSI. I take it you have not had ultra-sound or RAIU? And that your non-fasting glucose being low in the range? No comment from your doctor?


----------



## iroczinoz

Andros said:


> Will be anxious to see the results of rT3 and TSI. I take it you have not had ultra-sound or RAIU? And that your non-fasting glucose being low in the range? No comment from your doctor?


Ultrasound I plan to get on Saturday. If there is going to be any concern then a RAIU will be done doctor said.

I did not speak with my normal doctor just another one that was in. My doctor comes back next week and he is little more switched on so will see what he says about the glucose test.

I should mention that I only had oats in the morning and after every meal I have apple cider. So maybe the glucose test was low for this reason?

Yes I am also anxious to see rt3 and tsi, finally I will get to see the values.

The thing I don't understand though is good levels of ft3 and ft4, but high tsh.

If I did not have adequete levels of ft3 ft4 then I could understand the high tsh.

Could it really be a problem with the pituitary gland by chance?

I will hopefuly know soon enough. But over the last few weeks my body composition has changed dramatically. Lost my visible abs, still eating clean however a little more bread though.


----------



## Andros

iroczinoz said:


> Ultrasound I plan to get on Saturday. If there is going to be any concern then a RAIU will be done doctor said.
> 
> I did not speak with my normal doctor just another one that was in. My doctor comes back next week and he is little more switched on so will see what he says about the glucose test.
> 
> I should mention that I only had oats in the morning and after every meal I have apple cider. So maybe the glucose test was low for this reason?
> 
> Yes I am also anxious to see rt3 and tsi, finally I will get to see the values.
> 
> The thing I don't understand though is good levels of ft3 and ft4, but high tsh.
> 
> If I did not have adequete levels of ft3 ft4 then I could understand the high tsh.
> 
> Could it really be a problem with the pituitary gland by chance?
> 
> I will hopefuly know soon enough. But over the last few weeks my body composition has changed dramatically. Lost my visible abs, still eating clean however a little more bread though.


It is possible that you have antibodies and immunoglobulins rolling around. There are binding, blocking and stimulating antibodies and immunoglobulins that are opposing.

That could account for the strange labs. That or cancer.

This should explain:

Substances not found in normal serum
http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm

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/


----------



## Andros

Andros said:


> It is possible that you have antibodies and immunoglobulins rolling around. There are binding, blocking and stimulating antibodies and immunoglobulins that are opposing.
> 
> That could account for the strange labs. That or cancer.
> 
> This should explain:
> 
> Substances not found in normal serum
> http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm
> 
> 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/


That breakfast while a very good one for a person who does not have diabetes is very high on the glycemic index which normally would drive glucose up. So, do query your doctor.
http://www.medicinenet.com/hypoglycemia/article.htm


----------



## iroczinoz

Andros said:


> It is possible that you have antibodies and immunoglobulins rolling around.  There are binding, blocking and stimulating antibodies and immunoglobulins that are opposing.
> 
> That could account for the strange labs. That or cancer.
> 
> This should explain:
> 
> Substances not found in normal serum
> http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm
> 
> 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/


Kind of scaring me a little with the cancer. I hope not, booked in on saturday.


----------



## Andros

iroczinoz said:


> Kind of scaring me a little with the cancer. I hope not, booked in on saturday.


Sure don't mean to scare you but it would be good to save a life if needed!

This way we will know and not have to wonder. And most importantly, I hope cancer is ruled out.

Glad you have an appt. for Saturday. Let us know please.


----------



## iroczinoz

Andros said:


> Sure don't mean to scare you but it would be good to save a life if needed!
> 
> This way we will know and not have to wonder. And most importantly, I hope cancer is ruled out.
> 
> Glad you have an appt. for Saturday. Let us know please.


Okay had the ultrasound today, don't have written results as the images have to be looked at by a doctor. But from what the lady who did the scan she said she can't see anything out of the ordinary. She said my thyroid looks pretty good a lot better than hers. But she has been dealing with this for 7 years.

So that is some relief if that is anything to go by.

Went to get blood draw also. The lady was surprised to see Rt3 and TSI. She even asked maybe this is supposed to be TSH. I said no no TSI so she drew up a vial as for any thyroid tests. She brought out her folder and looked at all the tests available and TSI and Rt3 was not there. But I hope the lab does do them.. I also noticed they only had T3 in the folder but do Ft3 all the time. So I hope to get these numbers.

Once I get them will post up!


----------



## Andros

iroczinoz said:


> Okay had the ultrasound today, don't have written results as the images have to be looked at by a doctor. But from what the lady who did the scan she said she can't see anything out of the ordinary. She said my thyroid looks pretty good a lot better than hers. But she has been dealing with this for 7 years.
> 
> So that is some relief if that is anything to go by.
> 
> Went to get blood draw also. The lady was surprised to see Rt3 and TSI. She even asked maybe this is supposed to be TSH. I said no no TSI so she drew up a vial as for any thyroid tests. She brought out her folder and looked at all the tests available and TSI and Rt3 was not there. But I hope the lab does do them.. I also noticed they only had T3 in the folder but do Ft3 all the time. So I hope to get these numbers.
> 
> Once I get them will post up!


Good deal; hope to see the numbers and ranges soon!

How are you feeling otherwise?

By the way, do you or did you have an Iroc Z28? When I was a young lass, I had a 1982 IROC Z28, fuel injected 5.0 liter. Just wondered.


----------



## iroczinoz

Andros said:


> Good deal; hope to see the numbers and ranges soon!
> 
> How are you feeling otherwise?
> 
> By the way, do you or did you have an Iroc Z28? When I was a young lass, I had a 1982 IROC Z28, fuel injected 5.0 liter. Just wondered.


I don't feel that great, mainly fatigue and tiredness. I can't even finish watching a movie most of the time after work as I fall asleep. Hot flushes..

Yes spot on about the car. I had a black 86 IROCZ that was my pride and joy, most of the time it was just parked in the garage. Ended up selling it 2 years ago. Awesome cars, love the look of them. Hence my username irocz in oz (australia)


----------



## Andros

iroczinoz said:


> I don't feel that great, mainly fatigue and tiredness. I can't even finish watching a movie most of the time after work as I fall asleep. Hot flushes..
> 
> Yes spot on about the car. I had a black 86 IROCZ that was my pride and joy, most of the time it was just parked in the garage. Ended up selling it 2 years ago. Awesome cars, love the look of them. Hence my username irocz in oz (australia)


Loved that car; a lot!! It was awesome.

Looking forward to seeing those labs when they come in.


----------



## peacesells560

iroczinoz said:


> Yes spot on about the car. I had a black 86 IROCZ that was my pride and joy, most of the time it was just parked in the garage. Ended up selling it 2 years ago. Awesome cars, love the look of them. Hence my username irocz in oz (australia)


My uncle had an IROC 1LE {factory race car} back in the day. Unfortunately, he sold it long before I learned how to drive.


----------



## Andros

peacesells560 said:


> My uncle had an IROC 1LE {factory race car} back in the day. Unfortunately, he sold it long before I learned how to drive.


*SWEET* What year was it, do you recall?


----------



## peacesells560

Andros said:


> *SWEET* What year was it, do you recall?


I don't remember, but based on the numbers that were made it, it was probably an 89, since that was the year that had the highest production number {111}. It was red with a 305 and a stick. I think he sold it when I was three or four, so my memory is pretty fuzzy.


----------



## iroczinoz

Rang the doctor today to see if my results have come in. Receptionist said yes they have come through, I said I had the blood test just last Saturday TSI and RT3. She said yep.

Made a booking to see the doctor. Waited about 90mins as he is always running behind. Went in doctor said those tests have not come through ( good job receptionist)....

Anyway we discussed my issue and will also have a pituitary MRI to see if anything funky is present.

He recommended to up my dosage.

So I said either I can take 140mcg T4 and 20mcg T3 he said yes that should be fine.

On the way back home I also thought about just taking 3 pills of my T4+T3 mix. Which would make it 120mcg T4 and 30mcg T3.

Either way I will split my dosage throughout the day. If I go with option 2 I might even try and take 3 pills at different times morning,midday,afternoon.

What do you think I should go with?

He said to monitor how I feel. Once I get the MRI I will go back and see him and grab the RT3 and TSI blood test results.

But for now he says up the dosage.


----------



## Andros

iroczinoz said:


> Rang the doctor today to see if my results have come in. Receptionist said yes they have come through, I said I had the blood test just last Saturday TSI and RT3. She said yep.
> 
> Made a booking to see the doctor. Waited about 90mins as he is always running behind. Went in doctor said those tests have not come through ( good job receptionist)....
> 
> Anyway we discussed my issue and will also have a pituitary MRI to see if anything funky is present.
> 
> He recommended to up my dosage.
> 
> So I said either I can take 140mcg T4 and 20mcg T3 he said yes that should be fine.
> 
> On the way back home I also thought about just taking 3 pills of my T4+T3 mix. Which would make it 120mcg T4 and 30mcg T3.
> 
> Either way I will split my dosage throughout the day. If I go with option 2 I might even try and take 3 pills at different times morning,midday,afternoon.
> 
> What do you think I should go with?
> 
> He said to monitor how I feel. Once I get the MRI I will go back and see him and grab the RT3 and TSI blood test results.
> 
> But for now he says up the dosage.


Hmmmmmmmmmmmm; I would prefer to reserve judgement and decision-making until we find out about TSI (be sure to get the number result, negative is not a satisfactory answer) and the results of the ultra-scan.


----------



## iroczinoz

Ultrasound came back fine. Asked about the glucose and he said that for it to be of any worry it would have to be 3 or lower.


----------



## iroczinoz

Well this is a joke.

Went to get my TSI and RT3 results.. And the only thing the LAB done was TSH. So obviously they have no idea what TSI or RT3 is. The doctor is going to call them to ask what the hell is going on. They probably just don't do these tests. Will call myself and ask and will also call another Pathology and see if they do these tests. Otherwise I will never know what these values are. How else would they confirm graves disease if not by TSI? They can't just go by TSH since people could have pituitary problems etc...

Anyway

TSH came back at 2.06

Which is odd since at that time I did not take any extra medication. 2 weeks prior to this test TSH was 6.4. So 2 weeks later I was down to 2.06 while on the same medication.

I have started taking an extra 40mcg T4 and 10mcg T3 the last couple of days. So if the trend continues downward I am going to be going below .5 I think. Not to mention I have been feeling pretty bad lately and today was an absolute disaster, just so tired and weak.

Need to get my MRI on the pituitary to rule out anything there.

Ultrasound results:

The right lobe measures 3.7 x 1.4 x 1.4 cm, the left lobe being 3.9 x 1.3 x 1.3 cm.

The AP thickness of the isthmus is 1.7mm

The size and appearance of the thyroid gland are normal.

No evidence of goitre, solid nodule, or cystic change is detected.

That is what the report said.

If I can't get RT3 and TSI done where do I go from here?


----------



## Andros

iroczinoz said:


> Well this is a joke.
> 
> Went to get my TSI and RT3 results.. And the only thing the LAB done was TSH. So obviously they have no idea what TSI or RT3 is. The doctor is going to call them to ask what the hell is going on. They probably just don't do these tests. Will call myself and ask and will also call another Pathology and see if they do these tests. Otherwise I will never know what these values are. How else would they confirm graves disease if not by TSI? They can't just go by TSH since people could have pituitary problems etc...
> 
> Anyway
> 
> TSH came back at 2.06
> 
> Which is odd since at that time I did not take any extra medication. 2 weeks prior to this test TSH was 6.4. So 2 weeks later I was down to 2.06 while on the same medication.
> 
> I have started taking an extra 40mcg T4 and 10mcg T3 the last couple of days. So if the trend continues downward I am going to be going below .5 I think. Not to mention I have been feeling pretty bad lately and today was an absolute disaster, just so tired and weak.
> 
> Need to get my MRI on the pituitary to rule out anything there.
> 
> Ultrasound results:
> 
> The right lobe measures 3.7 x 1.4 x 1.4 cm, the left lobe being 3.9 x 1.3 x 1.3 cm.
> 
> The AP thickness of the isthmus is 1.7mm
> 
> The size and appearance of the thyroid gland are normal.
> 
> No evidence of goitre, solid nodule, or cystic change is detected.
> 
> That is what the report said.
> 
> If I can't get RT3 and TSI done where do I go from here?


You will never believe this but that is what I thought. Either your doc did not mark it and dissed you or the lab screwed up. I believe the former.

Your thinking is correct about the TSH re it's diagnostic parameters.

Good report on the ultra-sound. Now we can relax about that one!


----------



## iroczinoz

Andros said:


> You will never believe this but that is what I thought. Either your doc did not mark it and dissed you or the lab screwed up. I believe the former.
> 
> Your thinking is correct about the TSH re it's diagnostic parameters.
> 
> Good report on the ultra-sound. Now we can relax about that one!


Called the lab today to ask what the hell is going on.

RT3 they have to send out to a different lab and they are 3 months behind. So she said I will have to wait some time.

TSI - they have not heard of that one so they need to speak to a scientist as there was not one on duty when I rang up.

Will be interesting to see what they say tomorrow.


----------



## Andros

iroczinoz said:


> Called the lab today to ask what the hell is going on.
> 
> RT3 they have to send out to a different lab and they are 3 months behind. So she said I will have to wait some time.
> 
> TSI - they have not heard of that one so they need to speak to a scientist as there was not one on duty when I rang up.
> 
> Will be interesting to see what they say tomorrow.


Indeed it will. Did you furnish the links for TSI to them?


----------



## iroczinoz

Andros said:


> Indeed it will. Did you furnish the links for TSI to them?


Never got a call back from the pathology about tsi. Will chase it up tomorrow.

MRI booked for saturday to check pituitary.

One question though I want to ask is if I decide to go for t3 meds only how does that compare to t4?

Is t3 like 3 times more powerful? So for example if I take 130mcg of t4 and 20mcg t3. for only t3 should I be taking about 60mcg t3 daily? Divided doses I assume 2 doses or better 3? Either 4 or 6 hrs apart?

I figured that t3 dosage is equivalent to 3x more potent than t4, about right or not?


----------



## Andros

iroczinoz said:


> Never got a call back from the pathology about tsi. Will chase it up tomorrow.
> 
> MRI booked for saturday to check pituitary.
> 
> One question though I want to ask is if I decide to go for t3 meds only how does that compare to t4?
> 
> Is t3 like 3 times more powerful? So for example if I take 130mcg of t4 and 20mcg t3. for only t3 should I be taking about 60mcg t3 daily? Divided doses I assume 2 doses or better 3? Either 4 or 6 hrs apart?
> 
> I figured that t3 dosage is equivalent to 3x more potent than t4, about right or not?


No..................good grief! Very few people would require 60 mcg. of T3 per day. Figure about half of that if you are operating at your maximum capacity i.e. normal life style which might or might not include sports, the gym, running etc..

And you don't start at the top. You start at the bottom on like say about 5 mcg..


----------



## iroczinoz

hmm.. I basically just upped my dosage based on docs recommendation when he saw tsh at 6.4.

was on 90mcg t4 and 10mcg t3.

he said go to 130mcg t4 and 20mcg t3.

so that was basically an extra pill.

But even before I started taking this higher dosage my tsh went down to 2.0. But he did not see this change in tsh. But I just sticked with the higher dosage.

So basically I might be taking too much. Any major concerns with taking a too high dosage. Because I asked him if taking this much is okay and he said considering my size it is perfectly okay.


----------



## Andros

iroczinoz said:


> hmm.. I basically just upped my dosage based on docs recommendation when he saw tsh at 6.4.
> 
> was on 90mcg t4 and 10mcg t3.
> 
> he said go to 130mcg t4 and 20mcg t3.
> 
> so that was basically an extra pill.
> 
> But even before I started taking this higher dosage my tsh went down to 2.0. But he did not see this change in tsh. But I just sticked with the higher dosage.
> 
> So basically I might be taking too much. Any major concerns with taking a too high dosage. Because I asked him if taking this much is okay and he said considering my size it is perfectly okay.


Wow!

What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. 
Overdose symptoms may include headache, sweating, diarrhea, irregular menstrual periods, confusion, weakness, swelling in your hands or feet, fast heart rate, chest pain, feeling short of breath, fainting, or feeling nervous, restless, or irritable.

What should I avoid while taking Cytomel (liothyronine)?
Do not change brands or change to a generic product without first asking your doctor. Different brands of liothyronine may not work the same. If you get a prescription refill and your new pills look different, talk with your pharmacist or doctor. 
If you also take cholestyramine (Prevalite, Questran) or colestipol (Colestid), avoid taking these medications within 4 hours before or after you take liothyronine.

Cytomel (liothyronine) side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. 
Less serious side effects may include temporary hair loss (especially in children

Read more at http://www.drugs.com/mtm/cytomel.html#scSubwbMwCcF4xMR.99

Try to stay in touch w/your body. You are the only one that will know if something is wrong.

It is also beyond me why your doc raised your T4. When you take T3, T4 is naturally suppressed. You only need a little T4.

Keep us in the loop here. We live to serve!


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## iroczinoz

Andros said:


> Wow!
> 
> What happens if I overdose?
> Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
> Overdose symptoms may include headache, sweating, diarrhea, irregular menstrual periods, confusion, weakness, swelling in your hands or feet, fast heart rate, chest pain, feeling short of breath, fainting, or feeling nervous, restless, or irritable.
> 
> What should I avoid while taking Cytomel (liothyronine)?
> Do not change brands or change to a generic product without first asking your doctor. Different brands of liothyronine may not work the same. If you get a prescription refill and your new pills look different, talk with your pharmacist or doctor.
> If you also take cholestyramine (Prevalite, Questran) or colestipol (Colestid), avoid taking these medications within 4 hours before or after you take liothyronine.
> 
> Cytomel (liothyronine) side effects
> Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
> Less serious side effects may include temporary hair loss (especially in children
> 
> Read more at http://www.drugs.com/mtm/cytomel.html#scSubwbMwCcF4xMR.99
> 
> Try to stay in touch w/your body. You are the only one that will know if something is wrong.
> 
> It is also beyond me why your doc raised your T4. When you take T3, T4 is naturally suppressed. You only need a little T4.
> 
> Keep us in the loop here. We live to serve!


Something is definitely up as I have been feeling very bad for the last 1.5 months. To be honest I feel absolutely terrible but nothing to stop me from doing my normal activities. Just the usual like flu symptoms; blocked nose, sensitive throat (dry), feeling hotter than usual , sweating more and just down right fatigued.

I asked the doctor about T3 only meds and he said that they don't use them here just T4 as they generally work the best. I know that this is not true. But if this is the way to go I will demand T3 and ask for a script and get a compounding pharmacy to supply these.

I am sure they must exist here in Australia.


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## iroczinoz

Called the lab rt3 will be done in a week. TSI apparently they call thyroid stimulating antibodies, so that is the confusion for TSI. But I am not 100% sure these are the exact same things. The lady on the line said tsi equals this. So that will also be done within a week.

MRI came back all good.
Ultra sound on upper abdomen all good also.

Me feeling like crap I guess will never change. I have pretty much exhausted all my avenues, doctors just say you have hashi's going to have to deal with it. This combined with lower testosterone levels probably duplicate my symptoms.

I will wait for rt3 and tsi results. If rt3 is high I will probably try and switch to T3 only and see how that goes. I have got nothing to lose can't feel any worse than I am currently.

This really sucks but I have no more avenues to look into.


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## Andros

iroczinoz said:


> Called the lab rt3 will be done in a week. TSI apparently they call thyroid stimulating antibodies, so that is the confusion for TSI. But I am not 100% sure these are the exact same things. The lady on the line said tsi equals this. So that will also be done within a week.
> 
> MRI came back all good.
> Ultra sound on upper abdomen all good also.
> 
> Me feeling like crap I guess will never change. I have pretty much exhausted all my avenues, doctors just say you have hashi's going to have to deal with it. This combined with lower testosterone levels probably duplicate my symptoms.
> 
> I will wait for rt3 and tsi results. If rt3 is high I will probably try and switch to T3 only and see how that goes. I have got nothing to lose can't feel any worse than I am currently.
> 
> This really sucks but I have no more avenues to look into.


TSI is Thyroid Stimulating Immunoglobulin. Alternate name: Trab (TSH receptor antibody)

http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Have you ever had a Ferritin test?
http://www.thewayup.com/newsletters/081504.htm

Really really glad the MRI came back good!!!


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## iroczinoz

Yeah I can't believe it one of the biggest pathology labs in Australia and they don't know what TSI is. I'll let them do the test and call them after. Spoke with a different lab and they know what TSI is so go figure.

Ferritin 200 ug/L (20-300)
iron 14 umol/L (10-30)
transferrin 2.6 g/L (2.2-3.7)
transferrin saturation 22% (13-47)


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## Andros

iroczinoz said:


> Yeah I can't believe it one of the biggest pathology labs in Australia and they don't know what TSI is. I'll let them do the test and call them after. Spoke with a different lab and they know what TSI is so go figure.
> 
> Ferritin 200 ug/L (20-300)
> iron 14 umol/L (10-30)
> transferrin 2.6 g/L (2.2-3.7)
> transferrin saturation 22% (13-47)


Excellent on the Ferritin! Thanx!


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## iroczinoz

I found this so maybe they are the same thing.

Thyroid-Stimulating Immunoglobulins (TSI) / TSH Stimulating Antibodies (TSAb)

TSH receptor antibodies (TRAb) are seen in most patients with a history of, or who currently have, Graves' disease. Testing is usually done for a specific type of stimulating TRAb that goes by several different names, including: 
Thyroid-Stimulating Immunoglobulins (TSI) 
TSH stimulating antibodies (TSAb)

Thyroid-stimulating immunoglobulins (TSI) can be detected in the majority - some estimates say as many as 75 to 90 percent - of Graves' disease patients. The higher the levels, the more active the Graves' disease is thought to be. (The absence of these antibodies does not, however, rule out Graves' disease.) Less commonly, some people with Hashimoto's disease also have these antibodies, and this can cause periodic short term episodes of hyperthyroidism.

When monitoring TSI, elevated levels may help predict relapse of Graves' disease, and lowered TSI levels may indicate that Graves' disease treatment is working.

also from last year before starting thyroid meds my values looked like this

ferritin 162
iron 24
transferrin 2.4
transferrin saturation 40%

so iron had gone considerably down but ferritin looks good.


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## Andros

iroczinoz said:


> I found this so maybe they are the same thing.
> 
> Thyroid-Stimulating Immunoglobulins (TSI) / TSH Stimulating Antibodies (TSAb)
> 
> TSH receptor antibodies (TRAb) are seen in most patients with a history of, or who currently have, Graves' disease. Testing is usually done for a specific type of stimulating TRAb that goes by several different names, including:
> Thyroid-Stimulating Immunoglobulins (TSI)
> TSH stimulating antibodies (TSAb)
> 
> Thyroid-stimulating immunoglobulins (TSI) can be detected in the majority - some estimates say as many as 75 to 90 percent - of Graves' disease patients. The higher the levels, the more active the Graves' disease is thought to be. (The absence of these antibodies does not, however, rule out Graves' disease.) Less commonly, some people with Hashimoto's disease also have these antibodies, and this can cause periodic short term episodes of hyperthyroidism.
> 
> When monitoring TSI, elevated levels may help predict relapse of Graves' disease, and lowered TSI levels may indicate that Graves' disease treatment is working.
> 
> also from last year before starting thyroid meds my values looked like this
> 
> ferritin 162
> iron 24
> transferrin 2.4
> transferrin saturation 40%
> 
> so iron had gone considerably down but ferritin looks good.


And that is what you want. Ferritin is the protein that stores iron for cellular uptake. You can have high iron but low ferritin. It's inverse.


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## iroczinoz

Yeah ferritin is good.

Got my TSH receptor antibodies result

now this should be the same as TSI from what I have been told and read.

result < 1.0 IU/L

reference
negative < 1.0 IU/L
indeterminate 1.0 - 1.5 IU/L
positive > 1.5 IU/L

So according to this I am negative. The only problem is I do not have an exact reading but rather a range.

Not sure if this is how TSI is normally ranged?

Still waiting on rt3

I am dropping my extra dose to half as it made me feel pretty bad.

Other than RT3 I don't know what else to really do.


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## Andros

iroczinoz said:


> Yeah ferritin is good.
> 
> Got my TSH receptor antibodies result
> 
> now this should be the same as TSI from what I have been told and read.
> 
> result < 1.0 IU/L
> 
> reference
> negative < 1.0 IU/L
> indeterminate 1.0 - 1.5 IU/L
> positive > 1.5 IU/L
> 
> So according to this I am negative. The only problem is I do not have an exact reading but rather a range.
> 
> Not sure if this is how TSI is normally ranged?
> 
> Still waiting on rt3
> 
> I am dropping my extra dose to half as it made me feel pretty bad.
> 
> Other than RT3 I don't know what else to really do.


This is Trab. Here is info. Not the same as TSI.

http://www.ncbi.nlm.nih.gov/pubmed/1633635

http://online.liebertpub.com/doi/abs/10.1089/105072504323030951?journalCode=thy

You do have some Trab. You should not have any.

A third antibody commonly measured is TRAB i.e. Thyroid Receptor Activating Antibody, which is raised in some forms of thyrotoxicosis and is the cause of the disease. Obviously if TRAB remains elevated then the disease process is still active.

You probably have TSI and TBII as well.

http://www.medscape.com/viewarticle/578909

http://www.ncbi.nlm.nih.gov/pubmed/1969138

Hope you feel like reading. LOL!


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## iroczinoz

Andros said:


> This is Trab. Here is info. Not the same as TSI.
> 
> http://www.ncbi.nlm.nih.gov/pubmed/1633635
> 
> http://online.liebertpub.com/doi/abs/10.1089/105072504323030951?journalCode=thy
> 
> You do have some Trab. You should not have any.
> 
> A third antibody commonly measured is TRAB i.e. Thyroid Receptor Activating Antibody, which is raised in some forms of thyrotoxicosis and is the cause of the disease. Obviously if TRAB remains elevated then the disease process is still active.
> 
> You probably have TSI and TBII as well.
> 
> http://www.medscape.com/viewarticle/578909
> 
> http://www.ncbi.nlm.nih.gov/pubmed/1969138
> 
> Hope you feel like reading. LOL!


Thanks for the info. I rang the lab again to see if rt3 was done and told them trab is not the same as tsi.

They checked again and said it most definitely is. So I give up with them, will maybe try a different lab where the do TSI but have to see if my Doctor can send a referral to them.

Otherwise I don't know. The less than 1 result does not state if it was 0 or .2 so hard to know how much of it was there.

I plan on trying T3 only what do you think?

Lets say for arguments sake I do have TSI what would treatment be like?

If rt3 is high that is a clear message to go on T3 meds only correct?

Sorry for the questions I am desperate to fix myself. I am having loose stools which would point to over medication. But I am on the same dose currently as for the last 6 months.


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## Andros

iroczinoz said:


> Thanks for the info. I rang the lab again to see if rt3 was done and told them trab is not the same as tsi.
> 
> They checked again and said it most definitely is. So I give up with them, will maybe try a different lab where the do TSI but have to see if my Doctor can send a referral to them.
> 
> Otherwise I don't know. The less than 1 result does not state if it was 0 or .2 so hard to know how much of it was there.
> 
> I plan on trying T3 only what do you think?
> 
> Lets say for arguments sake I do have TSI what would treatment be like?
> 
> If rt3 is high that is a clear message to go on T3 meds only correct?
> 
> Sorry for the questions I am desperate to fix myself. I am having loose stools which would point to over medication. But I am on the same dose currently as for the last 6 months.


Please, don't be sorry. I was desperate at one time myself and have many others who post here. We all "know" what you are going through

Let us wait to see the rT3 results. And do be aware of the fact that if you are hyperthyroid and you body is pumping out excess amounts of thyroxine, it will convert to T3 and because of the overflow it will in turn become rT3.

This stuff is very very tricky!

explodeThe lab is correct. I wish they would not have so many different names. Anyway, my error. For which I apologize.

Alternative Names: TSH receptor antibody; Thyroid stimulating immunoglobulin
http://www.nlm.nih.gov/medlineplus/ency/article/003685.htm

Doing more research. Never a happy camper when there is more than one name for the same thing. There has to be a reason and there is.

Thyroid Stimulating Hormone (TSH) Receptor Antibodies

Thyroid Stimulating Hormone (TSH) Receptor Antibodies. The family of autoantibodies known as TSH Receptor Antibodies is comprised of two members. Firstly, Thyroid Stimulating Immunoglobulins (TSI) which is characteristic of Graves disease, and is detected using an invitro bioassay. Secondly, Thyrotropin Binding Inhibitory Immunoglobulins (TBII) which compete, with thyrotropin, for binding to the receptor without necessarily leading to its stimulation. TBII is measured simply using a radioreceptor assay (Henning Trak Assay). TSI, however is detected using human TSH transfected host cells where bioactivity is measured. A detailed description of the TSI bioassay, as well as a comparison of the two methods, is provided in the following abstract. This abstract was presented at the 1998 Meeting of The American Thyroid Association in Portland Oregon.

So......................you see? I knew they were different and they also require different assay methods.

Here is the whole abstract.

http://www.palms.com.au/Education/Endocrin/TSH/TSHtalk.shtml

Suffice it to say that if you have Trab (Thyrotrophin receptor antibodies), you probably have TSI and TBII. If you have TBII, you probably have the other 2 and so on. They are a "family" coming under the heading of TSH (Thyroid Stimulating Hormone) Receptor Antibodies.


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## Andros

iroczinoz said:


> Thanks for the info. I rang the lab again to see if rt3 was done and told them trab is not the same as tsi.
> 
> They checked again and said it most definitely is. So I give up with them, will maybe try a different lab where the do TSI but have to see if my Doctor can send a referral to them.
> 
> Otherwise I don't know. The less than 1 result does not state if it was 0 or .2 so hard to know how much of it was there.
> 
> I plan on trying T3 only what do you think?
> 
> Lets say for arguments sake I do have TSI what would treatment be like?
> 
> If rt3 is high that is a clear message to go on T3 meds only correct?
> 
> Sorry for the questions I am desperate to fix myself. I am having loose stools which would point to over medication. But I am on the same dose currently as for the last 6 months.


Very good info on Trab/TSI

http://www.clinicalcorrelations.org/?p=2523


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## iroczinoz

rt3 result is in

613 pmol/l. (140-1200)

considering my Ft3 was 5.8 pmol/l

I calculated the ratio

5.8 x 1000 = 5800 / 613

ft3/rt3 ratio = 9.46

So the recommended ratio is 20+ so I am very much under.

Would any of you recommend me push for T3 only medication?

Or dessicated Thyroid? With having more T3 than T4 in each tablet?


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## lainey

It is not uncommon for the patient to produce more reverse T3 when there is excess exogenous T3 medication present. It is your body's way of preventing you a from having too much, by converting some of it to an inert form.

I peeked at your thread and wonder if anyone has ever really addressed your testosterone. Is it still on the lower side? In men, to get good symptom relief, that issue has to be addressed. Most feel better when the values are higher in the range.


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## iroczinoz

lainey said:


> It is not uncommon for the patient to produce more reverse T3 when there is excess exogenous T3 medication present. It is your body's way of preventing you a from having too much, by converting some of it to an inert form.
> 
> I peeked at your thread and wonder if anyone has ever really addressed your testosterone. Is it still on the lower side? In men, to get good symptom relief, that issue has to be addressed. Most feel better when the values are higher in the range.


Currently on clomid 12.5mg a day. I was given a months supply at 50mg. But after reading a lower dose is just as effective so trying that. I had good results on tamoxifen test levels doubled in 2 weeks while on 10mg daily.

Starting to wonder if I should be on medication at all. My ft3 and ft4 levels were very good. I do have positive antibodies so I guess that is another thing to take into consideration and maybe meds are needed.

Even though my pituitary came up fine on the MRI, it could be acting up. Maybe all my symptoms where due to lowish testosterone.

Hopefully I find a solution soon.


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## Andros

iroczinoz said:


> rt3 result is in
> 
> 613 pmol/l. (140-1200)
> 
> considering my Ft3 was 5.8 pmol/l
> 
> I calculated the ratio
> 
> 5.8 x 1000 = 5800 / 613
> 
> ft3/rt3 ratio = 9.46
> 
> So the recommended ratio is 20+ so I am very much under.
> 
> Would any of you recommend me push for T3 only medication?
> 
> Or dessicated Thyroid? With having more T3 than T4 in each tablet?


The body does need some T4 for peripheral deoiodination. There are other hormones at play re the thyroid. T1, T2, T1a, T0a and more.

http://en.wikipedia.org/wiki/Thyroid_hormone

For that reason, I do feel one would fare better on dessicated porcine thyroid rather than T3 only.


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## lainey

> Starting to wonder if I should be on medication at all. My ft3 and ft4 levels were very good. I do have positive antibodies so I guess that is another thing to take into consideration and maybe meds are needed.


Having antibodies does not guarantee progression to overt hypothyroidism. The meds are not for the antibodies, they don't control them, they don't prevent the progression of the disease based on what I have read at the moment.

The medication is supposed to help and for a very high percentage, it does.

If it is not.....


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## Andros

iroczinoz said:


> Currently on clomid 12.5mg a day. I was given a months supply at 50mg. But after reading a lower dose is just as effective so trying that. I had good results on tamoxifen test levels doubled in 2 weeks while on 10mg daily.
> 
> Starting to wonder if I should be on medication at all. My ft3 and ft4 levels were very good. I do have positive antibodies so I guess that is another thing to take into consideration and maybe meds are needed.
> 
> Even though my pituitary came up fine on the MRI, it could be acting up. Maybe all my symptoms where due to lowish testosterone.
> 
> Hopefully I find a solution soon.


More on thyroid hormones.

http://www.tpa-uk.org.uk/thyroid_hormones1.php


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## iroczinoz

lainey said:


> Having antibodies does not guarantee progression to overt hypothyroidism. The meds are not for the antibodies, they don't control them, they don't prevent the progression of the disease based on what I have read at the moment.
> 
> The medication is supposed to help and for a very high percentage, it does.
> 
> If it is not.....


So any suggestions where I go from here?

Should raising my ft3/rt3 ratio be a priority? Staying on the same medication will not help with this so I guess I need a change. T3 only has been talked about that it can correct the ratio. But if I miss out on the t1,t2 am I doing myself disservice maybe.

Seems like the opinion here is to go to dessicated thyroid. But whether this will help with my ratio I don't know.

All I know something needs to change because what I am doing currently is just not working.

Andro's read the links so maybe dessicated is the way to go.

Thanks to everyone for helping me your input is valuable.


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## lainey

Keep in mind that desiccated has a higher T3/T4 ratio than is found in the body. If the problem is too much rT3 due to too much exogenous T3, it might not be the answer.
As long as your thyroid isn't completely non functioning, missing or completely suppressed-- it probably still works in a limited capacity--and it still does produce thyroid hormones--tiny amounts of the tertiary hormones, so it's not like you are devoid of them.

A lot of men with low T struggle to get the values to stay higher in the range. I would focus first on making sure that gets into a good place and stays there. You have a variety of options, so it may take some trial and error to figure out what produces consistent results. In addition, increasing the progesterones tends to alter the thyroid labs slightly--increases the frees and consequently lowers the TSH a bit.


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## iroczinoz

lainey said:


> Keep in mind that desiccated has a higher T3/T4 ratio than is found in the body. If the problem is too much rT3 due to too much exogenous T3, it might not be the answer.
> As long as your thyroid isn't completely non functioning, missing or completely suppressed-- it probably still works in a limited capacity--and it still does produce thyroid hormones--tiny amounts of the tertiary hormones, so it's not like you are devoid of them.
> 
> A lot of men with low T struggle to get the values to stay higher in the range. I would focus first on making sure that gets into a good place and stays there. You have a variety of options, so it may take some trial and error to figure out what produces consistent results. In addition, increasing the progesterones tends to alter the thyroid labs slightly--increases the frees and consequently lowers the TSH a bit.


My testosterone is around 10nmol but on tamoxifen it went to 20nmol only after 2 weeks. It definitely dropped off after that as I felt it especially strength wise.

My boys are able to produce but the pituitary is just lazy with the LH and FSH for some reason. So either I can fix that somehow or try out TRT and inject exogenous Testosterone. The problem is I am in range so hard for me to get my point across to doctors.

I will try new meds as I have nothing to lose as my current protocol is just not working as it should be.

When Hashi's flares up I can notice the body composition change. I go from having visible abs to none in a matter of weeks. It could be water retention though.

If I cant get my pituitary to keep firing LH requests and I cant get testosterone from doctor for a trial, I will most likely just source some veterinary grade testosterone and do it myself for a trial run. If I start to feel fantastic I know what the problem is.

This is dragging on for too long. I will try both dessicated and T3 only if I can get it.


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## lainey

There are actually several men here in the forum with the testosterone issue and it is the same for several--low in the range but not deficient. Many docs don't think to test it and like with thyroid, attentive docs realize that men have hormone issues also.

Try posting it as it's own question and see if you can get some advice from them about it.....


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## iroczinoz

lainey said:


> There are actually several men here in the forum with the testosterone issue and it is the same for several--low in the range but not deficient. Many docs don't think to test it and like with thyroid, attentive docs realize that men have hormone issues also.
> 
> Try posting it as it's own question and see if you can get some advice from them about it.....


I will do that thanks for the tip. One thing I have noticed over the last couple of days maybe even a week now is shortness of breath. In the gym I get this weird feeling like I am running out of air, chest also feels a little funny on the heart side. But it is probably most likely not enough air.

Is it true that looking at TSH values is useless when you have Hashi's?

Which brings me to my next question if I were to stop medication since I have good ft3 and ft4 values naturally, am I doing myself disservice and letting Hash's run a bigger muck on me?

I could very well be over medicated and just causing even worse issues for me being on Thyroid meds than not taking anything?

If I was to stop medication am I really going to feel worse since I would have good ft3 ft4 levels anyway?

Maybe I should just stop the medication and look at getting T levels higher and see how I feel?

In the last year I have been on Thyroid meds the antibodies have not gone down. Ft3 Ft4 levels are a little higher but not much. The only thing that changes is TSH but if TSH is just being secreted because of the antibodies it is a false reading?

But having said that by taking medication TSH does go down. So I guess I am confused what the body wants since it has what it needs without medication.

I crash at 3pm, I fall asleep during a movie say at 8pm. No motivation to do anything except I push myself to go to the gym.

I am sick of it and honestly pretty close to giving up. The clomid is probably too low dose as not feeling any different. But then again all this can be skewed because of my thyroid/meds.


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## iroczinoz

Well just a short update.

latest blood results -

ft4 13.6 (10-19)
ft3 6.4 (3.5-6.5)
tsh 1.6 (0.5-4.0)

I am on 100mcg t4 + 25mcg t3

Endo only checked tsh in Czech so I am in Australia now and got my full tests done. I was slightly suspicious of over range ft3 as I am going to the toilet frequently.

Looks in range though so probably of no concern. It is also getting better though so maybe body adjusting to the higher dose.

Looks like I have had some good results with my lowish testosterone. My 2month trial of clomid looks like it has paid off.

Latest testosterone came back at 21nmol so a huge increase. I treated my very high e2 as a result of the clomid use with my own self treatment with letrozole just 1/4 tablet e3d and it done the trick.

E2 has been steady at 69pmol so that is optimal and could also be the reason why testosterone went up.

Considering I was at 600pmol at its highest the letro has done the trick in controlling e2 and clomid may have restarted my HPTA.


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## Andros

iroczinoz said:


> Well just a short update.
> 
> latest blood results -
> 
> ft4 13.6 (10-19)
> ft3 6.4 (3.5-6.5)
> tsh 1.6 (0.5-4.0)
> 
> I am on 100mcg t4 + 25mcg t3
> 
> Endo only checked tsh in Czech so I am in Australia now and got my full tests done. I was slightly suspicious of over range ft3 as I am going to the toilet frequently.
> 
> Looks in range though so probably of no concern. It is also getting better though so maybe body adjusting to the higher dose.
> 
> Looks like I have had some good results with my lowish testosterone. My 2month trial of clomid looks like it has paid off.
> 
> Latest testosterone came back at 21nmol so a huge increase. I treated my very high e2 as a result of the clomid use with my own self treatment with letrozole just 1/4 tablet e3d and it done the trick.
> 
> E2 has been steady at 69pmol so that is optimal and could also be the reason why testosterone went up.
> 
> Considering I was at 600pmol at its highest the letro has done the trick in controlling e2 and clomid may have restarted my HPTA.


TSH will probably go down more. My suggestion is to keep busy and burn that T3 up and this information might be helpful depending on when you take your labs.

Liothyronine (T3)
is almost totally absorbed, 95 percent in 4 hours.
http://www.frx.com/pi/armourthyroid_pi.pdf

Sounds to me like you are on track and I sure hope you feel like it!


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## iroczinoz

I'll take a read Andros thanks. I had bloods takem 8am and did not take my medication before blood draw.

I usually take 60mcg t4 + 15mcg t3 first thing in the morning. Then at 3pm take 40mcg t4 and 10mcg t3.

So my blood draw at 8am was about 17hrs after my last dose.

I work manual labour for 10hrs and then hit the gym 4x per week for some heavy lifting. So I am active should be burning up the t3.


----------

