# What the !!!



## wrenlklein (Dec 16, 2009)

OK,
So newly dx with Hashi's. Been on 50 mcg of Synthroid since Dec 2. Have had no symptoms of hypothyroid (except infertility). More symptoms of hyperthyroid (if at all).

I lost my first pregnancy in January and that put my body into a weird place for quite some time. I also have suffered severe anxiety for most of the year, even panic attacks. (Sx of hyper, I know).

Dx with hypo from blood tests done for fertility testing. TSH 11.8. T4 1.84. TPO 79. No symptoms still.

So, last night, after being on Synthroid for nearly a month, I had horrible insomnia, waking up all the time, not able to really fall asleep and soooooo hot. More than hot. Even without covers on a cold Colorado night, I was hot. I wasn't sweating, but just hot, hot, hot. My heart was racing, my head hurt (and I rarely get headaches), my neck hurt, I was anxious again.

These all point to hyper, right? What the heck!!!!? Thanks....


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## Andros (Aug 26, 2009)

wrenlklein said:


> OK,
> So newly dx with Hashi's. Been on 50 mcg of Synthroid since Dec 2. Have had no symptoms of hypothyroid (except infertility). More symptoms of hyperthyroid (if at all).
> 
> I lost my first pregnancy in January and that put my body into a weird place for quite some time. I also have suffered severe anxiety for most of the year, even panic attacks. (Sx of hyper, I know).
> ...


Clearly your TSH is way up there and that would make one think hypo but not always so. I wish I had the ranges for the other stuff; different labs use different ranges.

The way to find out for sure where you are hypo or hyper is to have TSI (thyroid stimulating immunoglobulin) which if present in any amount no matter how small is responsible for hyperthyroid. Also, it would be good to get Free T3 and Free T4 with your TSH run at the same time. The "Frees" are the unbound portion of hormone which is available for cellular uptake. The totals consist of bound, unbound and rT3 and rT4 (reverse) so it is hard to tell where your frees might be and that is very important if you think you are hyper and you very well could be. There is also a lag time between clinical symptoms and the actual numbers. You could be feeling hyper yet the TSH could show hypo. That is why TSH alone is not enough, nor are the totals of much value. There are times when they are but this is not one of those times.

You might also have TBII (thyroid binding inhibitory immunoglobulins) which are usually present w/ TSI because they are antibodies to the autoantibodies. Whew!! What confusion, yes?


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