# "Within Range"Labs



## Negative101 (May 23, 2011)

I've done a good amount of research on this, which includes talking to numerous doctors...

Before I start, let me say that personally, I believe symptoms should be given more weight than lab ranges. So if you feel like crap, don't let any doctor tell you it's normal or due to stress if you know it is not.

With that being said, a note about lab ranges. It has become apparent that the normal reference ranges for some people just aren't good enough anymore. You'll tend to read comments like "you're in the lower half of the range" or "you want your levels higher than X amount."

Everyone is different. Normal "ranges" were created for a reason. If you are within them, regardless of whether it's in the bottom or higher end, it's still NORMAL, and you'll likely have a difficult time being treated with that alone. It's true that some feel best in the upper ranges, but this doesn't mean that you will. Taking medication to put you in higher ranges can have adverse effects. Pay attention to how you feel and then worry about the numbers. I've seen too many posts where people are told they should be in the upper 1/3 of the range, and that's simply not true. YOU are unique. Your body is unique. Treat it that way. These are ranges for a reason, not absolute values.

God Bless


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## bigfoot (May 13, 2011)

Good points. Everyone is definitely their own case. I'm glad you found doctors to talk to that agree with you on symptoms carrying more weight. I wish that happened more often.

The last endocrinologist I saw flat-out said, "It's dangerous treating by symptoms." Obviously you don't want to treat _only_ by symptoms, but jeez, can't there be some middle ground?


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## Negative101 (May 23, 2011)

Im probably one of the rare cases... I dont have the symptoms, but I have the antibodies. My T3 and T4 are in the higher range (but not that we care about ranges, as per the 1st post)...

Initially, I went to my endo's and said "shouldnt we treat this?"... They all say the same thing... "why? you have no symptoms and your lab results are normal... if we treat you, you will become hyperthyroid and then we'll have a real issue to worry about. We've seen people with Hashi's who live their entire lives without the need for medication"

I believe too many of us have fallen victim to the internet forum "doctor"/Patients.... Listen to your real doctor and Endo's... They know what they're talking.


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## Andros (Aug 26, 2009)

Negative101 said:


> I've done a good amount of research on this, which includes talking to numerous doctors...
> 
> Before I start, let me say that personally, I believe symptoms should be given more weight than lab ranges. So if you feel like crap, don't let any doctor tell you it's normal or due to stress if you know it is not.
> 
> ...


Actually ranges are based on the mean average of cohorts of persons supposedly scientifically chosen to participate. Pooey on that.

Also, there are many antibodies and autoantibodies including immunoglobulins that the healthy person should have absolutely none of; zero, zilch, nadda.

That being the case the purpose of the range is to establish a "baseline" and to detect movement.

So, you are very on track w/your thinking. Thank you for this post.

Hopefully others will give it some thought.


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## bigfoot (May 13, 2011)

Negative101 said:


> Patients.... Listen to your real doctor and Endo's... They know what they're talking.


I respectively beg to differ on this point. They _don't_ always know what they're talking about. While you may be lucky in that you have no symptoms of a thyroid problem, others, including myself, are not so fortunate.

For example, I recently have seen a multitude of doctors, and this is after being diagnosed hypothyroid for over a year. This is what they said:

Doc. A) You just need to work out more and eat less. No point seeing an endocrinologist or doing any labs. You have mood problems.

Doc. B) You tested positive for Hashimoto's. Let's increase your dose of T4. Upon calling back complaining of side effects, they raised my T4 dose even more making me sick.

Doc. C) I'm not so sure you have a thyroid problem. I don't know why you have all these symptoms.

Doc. D) You likely have an autoimmune thyroid problem.


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## lavender (Jul 13, 2010)

It is important to have docs and endos, but they don't know everything.

For years, my PCP told me I didn't have a thyroid problem. Then I went into thyroid storm and she apologized for not connecting my symptoms to my thyroid tests until my condition became life threatening. For months my endo told me my symptoms had nothing to do with my thyroid, then I had it removed, and they magically went away. When I went hypothyroid, he told me those symptoms had nothing to do with my thyroid, that T3 was unnecessary. I found a new doctor who put me on Armour, and those symptoms disappeared.

Medical school does not cover every illness in enough detail for every doc to know everything. Some docs are better at treating certain conditions than others. I think the best outcomes occur when we listen to our own internal sense of knowing around doctors and their suggestions for our treatment. Patient forums can help us get a sense of what is working for others and to help fill in the gaps in what our docs are not able to tell us about our illness or treatment.


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## HeidiBR (Apr 4, 2010)

"I think the best outcomes occur when we listen to our own internal sense of knowing around doctors and their suggestions for our treatment."

I'm not sure I agree with this. After all, we haven't been trained as physicians. We for sure know our bodies and symptoms, but I certainly would not want to diagnosis myself. I totally agree with the need to listen to our internal voices re: what is going wrong with our bodies. I agree we need to educate ourselves and learn as much about our possible conditions. But - I still want a doctor to treat me based on his/her training and experience. Not mine. I do not want to diagnosis myself based on what I read on the internet, what my friends tell me, or books I read. Many thyroid symptoms are vague, not quantifiable, and not specific.

I think the challenge lies with finding a doctor who listens. And it is incumbent on us as patients to be able to communicate and explain well what we feel like not just a "I'm so tired, I can't lose weight, etc..." I have thought about it from the doctor's perspective; what if a woman presents with normal thyroid levels with a bevy of symptoms that are explained vaguely. And this woman is already convinced she has a thyroid condition based on her reading, and activity in an online forum. What if she doesn't have a thyroid problem? The doctor is already damned because he/she has to be the bearer of news the patient doesn't want to hear. If she does have a thyroid issue and based on info the patient learned in an online forum she demands Synthroid/Cytomel/Armour/Whatever as if she knows the best road to treatment.

Don't get me wrong - I listen to my body every minute. But I do not self-diagnose. I know I am not educated or experienced in that realm. That is why I interviewed endos until I found one who made sense to me. I liked his philosophy, he knows what he is doing - and then I let him treat me. It works well; he treats me, and I as a librarian suggest books for him to read  We both know our respective professions and we have mutual respect.


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## Elegant_Phoenix (Feb 26, 2011)

Negative101 said:


> Patients.... Listen to your real doctor and Endo's... They know what they're talking.


I have to respectfully disagree as well.

My 1st endo was a POS. Told me to take a vacation and that I had reflux and depression. I know I don't have reflux and I am not depressed.

My labs are "normal". However, my TSH is low as are my T3 and T4. So not only am I making T3 and T4, my body is not telling me to make it.

I felt AWFUL. Completely non functional. I am now on a low dose of synthetic T4 and I feel better than ever. The endo would not treat me based on labs, but my NP who also has Hashi's gave me the low dose based on symptoms. I am NOT hyper because of it. My T3 and T4 have raised a tiny bit. But that tiny bit has me feeling more like myself. 100%? No. But better to the point that I can get back into the gym and start to live again. I don't dread spending time with my kids - I'm initiating things to do.

My 1st endo said that I don't need to change my diet. Really? Really doc? I'm eating clean and gluten free and following a more alternative path along with my medication. Evey week I see improvements. My vitamin D is going up, my iron and ferritin are going up and physically I look healthier. My hair is growing back in, my cheeks are rosy, my nails are strong and I'm slowly losing a bit of the weight.

My naturopath's wife has Hashi's for the past 20 years. They have been down the road and know that there is not a magic pill or formula that works for everyone. Each case is different. We go with what makes me feel better and leave those things that do not.

So the docs and endos? Don't trust them. I trust people - both in the medical community and not - with real life experience with the disease and the ones who are open-minded to patients taking an active role in their own health.


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## HeidiBR (Apr 4, 2010)

"So the docs and endos? Don't trust them."

Wow. I trust mine. As a partnership we have made me well.


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## Elegant_Phoenix (Feb 26, 2011)

HeidiBR said:


> "So the docs and endos? Don't trust them."
> 
> Wow. I trust mine. As a partnership we have made me well.


Out of context, but yes, a broad brush. The next sentence says that the people I do trust in the medical community have had personal experience with Hashi's. I did a lot of searching for the ones I do have. And the partnership I have with them have made me better. That is what my entire post was above. Or did I not make that clear?

Perhaps that sentence should be that I don't feel that all of them have their patient's best interest at heart and care more about the bottom line than our health. So to that end - I don't trust them until they show me that they are able to listen and take me seriously and not blow me off like some sort of head case.

Not all docs and endos are worth the paper thier diplomas are printed on. The opinion of one doc is not the end all be all, especially if you get blown off and you are made to feel like you are nuts for trying to get well at all.

I think we are trying to say the same thing, but in different ways.


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## Elegant_Phoenix (Feb 26, 2011)

To add - I'm a firm believer in trusting my own gut. I will never put all of my eggs into the basket of a physician - especially one who dismisses me.

If I had put my faith into the doctors that I have seen over the past four years, I would be very very sick today. I reached my breaking point this past March and got super aggressive and that led me to the right place.

I trusted my gut and did what I needed to do to find the right people to treat me. Specifically me and not according to some cookie cutter mold that they read a chapter about in med school. Am I jaded? I would say yes. I lost out on 4 years of my life because I was told over and over again that nothing was wrong - never mind I had a goiter and I was gaining weight like crazy. I finally switched medical groups and found the right folks, but I still am leery - and rightfully so.

There needs to be a balance between an educated physician with a piece of paper (many of which should not have it, in my opinion) and real life experience. It took me over four years to find the right mix for me. Over those four years, I just got sicker and sicker and sicker after being told by various docs and endos that nothing was wrong and that I must be depressed and that I needed to lay off the cake and ice cream. Never mind I was a triathlete and never ate the junk. They had a picture of me painted in their brains before I even opened my mouth to speak -and it was wrong, and I suffered for it.

And even to go one step further - If I had listened to the doctors nealry 6 years ago, my son would have died. I trusted my gut and my own research that the doctors were unwilling to do and pushed and pushed for more testing for him. Lo and behold... I was right when the docs said I was wrong. I recieved a prompt apology and they were big enough to use him as a learning experience to better help other children in the future.

I hope that clarifies my statements.


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## lavender (Jul 13, 2010)

I am not suggesting self-diagnosis or self-treatment, just trusting our own internal senses when something is wrong and a doc tells us something that's way off base, finding a balance between our own knowledge and medical science.

Doctors are not always right. Perhaps I know this more acutely than others because I seem to always be the medical mystery, the one who does not respond typically to anything. I have had more than one doctor look at me and scratch their head as if they had no idea what was going on or how to treat me. Doctors who try to fight with me and tell me they know better usually end me up in a whole heap of trouble. Then I have to live with the consequences while the doc continues with their day. I have had docs recommend treatment without ever reading my chart, making assumptions before even speaking to me. And I have to be proactive to make sure I am not getting something I have already had an allergic reaction to.

I knew something was wrong in my body months before my Graves disease became lethal. I was having heart palpitations and anxiety and bouts of rage. My doctor blew it all off, but I knew something was not right. Something told me to insist on a thyroid test, to be re-screened on something that was off several years prior that my doc refused to monitor. And wouldn't you know, I was starting to go hyper again? But since the doc told me it was no big deal, I believed her, until I was laying in a hospital bed being evaluated for a heart attack at 33.

So, yeah I trust myself. I trust a working partnership with a doc who is willing to listen to my instincts about what is going on and to do tests and make suggestions from there. I don't trust a doc who blows me off because their education is far more superior to what I know is going on in my body. I would never suggest self-treatment or treating without labs, even though I know people do it. There is a balance between the two.


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## Negative101 (May 23, 2011)

I think its important to note the opening memo of this thread... which is:



Negative101 said:


> Before I start, let me say that personally, I believe symptoms should be given more weight than lab ranges. So if you feel like crap, don't let any doctor tell you it's normal or due to stress if you know it is not.


So if you have symptoms, find the cause.
My situation is a bit different. I have the antibodies, but no symptoms... some docs would put me on meds, others wouldnt even think of it because im still "normal."

Medication isnt for everyone, but it is so much to some. Only you, with the knowledge youve obtained from research and your doctors can make the decision as to where you stand.
I find that many people on various health forums have lost trust in their doctors, and that theyre too cookie cutter. Unfortunately, many are trained that way, because MOST people fit into the cookie cutter situation. Its when a rare individual comes up that we get the difficult situations we so often see with Thyroids. The ranges are changing, we dont know whats normal, some have symptoms and normal ranges, and others vice versa.... all we really can depend on is our symptoms.


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## castledreams (Jun 13, 2011)

Well said Phoenix! Not all docs are created equally. I have been down that road with the ones that called me crazy and said that I was just stressed out. The most recent doctor I was seeing prescribed anti depressants and anti anxiety meds that only worsened my problems. She wanted to send me to a psychiatrist because I refused to take the medication. I had to tell her to check my throat and lo and behold she felt the knot on my thyroid. She ordered an ultrasound which she said was normal. Well that doesn't explain why my thyroid is swelled up or the fact that I can't swallow or breath very well and I sleep all day. According to my recent doctor my TSH was in a "normal range" and just totally dismissed the goiter in my neck as the measurements were in a normal range as well. Really? I have a hard time believing that a thyroid that was totally unnoticeable and now is noticeable to the general public being normal. I have set back for the last 9 years and let the doctors tell me what to do about it and so far I have managed to go from 180lbs up to 300lbs and this is on a 1500 calorie, low fat, low carb diet that I have been on for the last 2 years. Haven't lost a single pound. I am to the point I can barely walk I am so overweight. I have heart disease, high blood pressure and severe arthritis to go along with the possible thyroid cancer now. :confused0068:

After that last round with her I got a referral to an endocrinologist. I am glad that I did because they faxed her my ultrasound of my thyroid. I was totally floored when she read the SAME results that my doctor obviously had gotten from the radiologist. My endo stated that "thyroid was ABNORMALLY ENLARGED on both right and left lobes"
That's amazing how two different doctors can read the same thing and it sound sooooo different. I for one don't trust a doctor that won't listen to me. Not any more. They are only as good as their experiences. :aim33:


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## lavender (Jul 13, 2010)

Castle, I am sorry to hear you got the run around from your doc. It sounds good that you have an endo who cares now. You have every right to be angry that your body has already suffered so much from this, and now you have an uphill battle to health like I have had all because a doc ignored your symptoms.

I think what Negative said is right, that it's important to listen to symptoms. A doc who doesn't listen to a patient's report that something is not right is a dangerous doc. I have had these docs and ended up in a lot of trouble. I think I am learning that I don't need the best doc as long as she is willing to listen to me when I say something's not right and keep working to find what is right for my body.

Nothing is "normal" in my body. Why should I expect "normal" lab ranges to be "normal" for me?


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