Test Results - Hyper!?!!!

[JudyAnn]

I just got my test results back and it looks like I'm hyper again.

TSH .004 (.2 - 5.5) this is where it was before RAI!!!
FT4 2.0 (.8 - 1.7)
Total T3 127 (70 - 200)

My T3 seems normal to me, and the T4 has always been on the higher end of normal, but my TSH has been around .12 - .14. Now it's way back up there. A couple of weeks ago it was .04. My husband called me with the results (I'm at work right now) and I asked him 3 times if he was sure it wasn't 0.04, but he said it was 0.004!!! How can this be? How can the number change so much in just a couple of weeks? Anyway, the docs says to take half a dose on Mon, Wed & Fri. and get tested again in 8 weeks.

I thought I was doing soooo good on lc, I lost 8 lbs. in induction, I hope I don't start gaining weight back because of this!!! Why is it as soon as I decided to get real about diet and exercise something like this happens. :mad:

[wcollier]

Hi JudyAnn:

You'd be the best judge of your symptoms. Do you FEEL hyper?

It looks like you'd do well to perhaps reduce the T4 (I'm assuming you're on T4 alone) and add in either some synthetic T3 or Armour. Your T3 is lagging way behind your T4 levels, indicating some conversion problems. You want both the T3 and T4 levels to be in the upper range of normal, and your T3 is still below mid range.

[Nancy LC]

If I recall correctly, RAI can increase your thyroid production initially as the thyroid is dying it can do weird stuff. I remember there a risk of a thyroid toxic condition or "thyroid storm" after RAI. However eventually you'll get hypo. Your FT3 looks low though.

I've had high T4 and low T3 and its weird... you will feel hyper in some ways, hypo in others.

[JudyAnn]

It's been 3 years since I had RAI, and I've felt pretty good most of the time. I never even had my dose changed from the beginning, although it did take about a year before the hypo symptoms went away. I am just taking T4, Levathroid .112 mg. It does seem weird that my TSH and T4 levels are elevated, but the T3 is not. By the way the test was for total T3, not free T3

It's hard to say about the symptoms I have now. Some seem like hyper - my eyes are bothering me, grainy and dry feeling, my muscles seem weak, I've been working out for about 4 weeks and they still seem sore when I'm walking or riding my bike. And I am losing weight, I weighed today and I'm down another 2 lbs, that's 10 lbs in 3 weeks. However, I don't have the shakes like I did before, I have no trouble sleeping, I tend to feel cold, especially my hands and feet, my hair has been falling out more than usual (my endo said when this happened after RAI - much much worse than now - it was due to a change in hormone levels not so much a symptom of hyper or hypo), my BP is not elevated, it was 120/70 last time it was checked a couple weeks ago, and neither is my heartrate it's around 70 bpm.

I can see that the T3 levels are low compared to the others. Maybe that's why I have a combination of hyper and hypo symptoms. My GP has only requested a TSH test for about 8 weeks from now. I'm planning on calling her Monday and ask for the other tests to be done. I have Kaiser, an HMO, so you can only see the specialist if you are refered by your GP, I'd really like to deal with my endo.

[JudyAnn]

Something else I'm wonering about. I've had alergies so I've been using Abuterol, and Nasarel, which is a glucocorticosteroid. Do you think this could affect my thyroid levels? I noticed the directions said to notify your physician if you have thyroid disease.

[Nancy LC]

The grainy feeling in the eyes can be a hypo symptom, same with muscles being weak. Your heart rate doesn't sound hyper either. That's one of the first signs on me that I am. I don't think you're hyper. TSH is not really all that reliable. Go for your signs and symptoms, not the blood test.

Endo's don't treat thyroid well. They don't take the FT3/FT4 tests seriously, they usually just look at your TSH, pat you on the head, tell you your nuts and go away.

[JudyAnn]

Thanks Nancy and Wcollier, It's all so confusing. Maybe it's better if I stick with my GP. She's usually really good about working with me whereas the endo was more like "do this, take that, you're cured, have a nice life."

My eyes feel the same as they did when I was hyper, they get worse when I need to use them, like driving or working on the computer. Usually I build muscle very quickly, but now they just don't seem to be reacting like they should. It's hard to explain, it's more a lack of strength. When I was hyper I couldn't even pick up a gallon of milk and if I bent down I couldn't get back up, that's how it's starting to feel again. I've been trying to ignore it, blaming it on being out of shape lol. When I went hypo after RAI it was more like a lethargic feeling, it made me tired to use my muscles. I guess I'm just gonna wait and see what happens with my doc. Thanks again for your insights. I'm glad I come here, otherwise I'd just go with what the doc says and not question it.

[Sunshne24]

Judyann,
I have Kaiser too. You shouldn't have to get another referal to see your Endo. I've seen lots of specialists the last 2 years and after I've seen them once I'm able to make my own appointments if I need to go back. You would have to call your Endo's office directly, not the usual appt. line. Of course if you're happier with your GP you should probably stick to that. I have never seen a decent GP as long as I've been with Kaiser so if yours is knowlegeable about the thyroid then that is probably a rare find.

[JudyAnn]

I'm not so sure she's all that knowledgable, but that might be a good thing. Because then she wouldn't be stuck in her ways and may be more open to alternate views. I haven't seen the endo in 3 years. I tried calling his office, I had to leave a message, and he never got back to me, instead my GP's office called. I haven't even spoken to my GP, I get notes in the mail! That's why Monday I want to see if I can get her at least on the phone.

Where in NorCal do you live, which Kaiser to you go to. My GP is Karen Brown in Petaluma, and my endo is Kevin Kobalter in San Rafeal. When I did see him he just seemed so cut and dry about my options, and not concerned at all about my symptoms.

[Sunshne24]

Thats good that your GP is open-minded. I saw quite a few who were not willing to listen and would spend about 5 minutes with me. Even though my doc doesnt seem to know a whole lot about whats going on with me he does listen. He's the best I've found in that he seems to care about my symptoms and doesnt totally blow me off like the others. I've kind of had to be my own doctor and do alot of research but he will order tests if I ask him and he's open-minded.
I moved to Manteca from San Jose...I used to go to Santa Clara Kaiser but now I'm kind of all over the place. My Endo is in Sacramento, other specialists I've seen are in Stockton and my GP is here in Manteca...which is only a small clinic.
I've seen 3 Endo's, Craig Smith in Sac., Dr. Jauques in Stockton and Dr. Sadur in Pleasanton. They are all very similar and treat lab results rather than symptoms. Dr. Smith is willing to prescribe Armour and T4/T3 combo though..IMO he's the best of the 3. The doc in Pleasanton is nice but not open-minded...he thinks Armour should be discontinued.

[JudyAnn]

That's the hard thing about Kaiser, you are limited to their doctors. At least Dr. Bloom ordered the T3 when I asked, even if it was a Total T3 and not the FT3 that I really wanted. I think it was a miscommunication. Hopefully if I am able to talk to her personally she will see my point of view.

[JudyAnn]

I just found out something interesting. I've had alergies so I've been using Nasarel and Qvar. Well, it turns out these are both corticosteroids, not glucocorticosteroids and, according to Kaiser's website about THS, "can interfere with your test and the accuracy of the results." I am definately talking to the doc before I do anything to my dose. Corticosteroids don't affect T4 or T3, both of which are in the normal range according to Kaiser's website. That may be why my TSH number is so out of whack.

I makes me so mad that I had to do my own research. Shouldn't the doctors have known about this? She's the same doctor who prescribed these meds, when the results came out funky she should have looked at my chart to see if there was any medication that might interfere with the results. Isn't this what I'm paying these people to do?!?!?

[Nancy LC]

Doctors don't spend a lot of time thinking about the combinations of medicines you take. Your pharmacist is supposed to. However, if you don't use the same pharmacy all the time, or they're just not good, they won't catch it either.

All in all, I think doctors are pretty bad at coming up to date on new changes in medicine. And I think we give them too much credit for knowing everything about medicine. I think if we want the best treatment its going to be up to us to figure out what it is and then find the right doctor.

BTW: You can always go outside the network for treatment if you really want to. You just have to pay for it yourself. Sometimes it truly is worth it. But just make sure you get a good doctor, because you don't want to pay a small fortune for another lame-ass doctor.

I think maybe the best sort of GP you can get is one that will listen to you and go along with what you want them to do. :D

[JudyAnn]

Thanks Nancy, Yeah I know the doctors can't possibly know all the meds that all their patients are taking. But one thing is when I called to ask for the T3 test I was asked about any meds I was taking. But then again I can't expect the doctor to know every drug interaction. I could have talked to the pharmacist, but because I had taked these meds before I just initialed the slip. Anyway, hopefully tomorrow I'll be able to talk to her and she will listen!

BTW, I really like you FAQ section, lots of help there.

[Natrushka]

I just got my test results back and it looks like I'm hyper again.

TSH .004 (.2 - 5.5) this is where it was before RAI!!!
FT4 2.0 (.8 - 1.7)
Total T3 127 (70 - 200)

How can this be? How can the number change so much in just a couple of weeks? Anyway, the docs says to take half a dose on Mon, Wed & Fri. and get tested again in 8 weeks.

I thought I was doing soooo good on lc, I lost 8 lbs. in induction, I hope I don't start gaining weight back because of this!!! Why is it as soon as I decided to get real about diet and exercise something like this happens. :mad:


LCing will cause two thing to happen to your thyroid hormones; it will raise your FT4 and it will lower your TSH. Just like it did for you. After a few days it will then lower your FT3. It's your body's way of slowing down metabolism in the face of what it perceives as starvation.

I would bet your numbers would go back to something more normal if you raised your carbs and got out of ketosis.

[JudyAnn]

Extreme Low Carb and Thyroid:

Very low consumption of carbs can negatively impact thyroid function. If you are severely restricting carbohydrates, your liver has to work overtime converting protein and glycogen into glucose, the liver is also where ketones are converted. This extra work means that the conversion of T4 into T3 is compromised.

Dieting (low carb dieting included) also reduces TSH, but NOT by increasing your thyroid hormones. TSH drops because your body is trying to slow metabolism. When TSH drops, T4 production by the thyroid gland slows down in response. T4 to T3 conversion, also compromised, further lowers your metabolism, and causes it to be harder to build muscle tissue. T3 is VITAL for protein synthesis such as building muscle tissue. If you can't build muscle tissue, it is harder to increase your metabolism.


You can also see how a lowered TSH would make life more difficult when you are trying to get that initial diagnosis.

Wow, I've never heard of this. Thanks, Natrushka! I have a whole list of things to talk to my doc about, I'm adding this in. I have a phone appt. w/her next week.

So should I keep my meds the same and up my carbs?? What is a good number to raise them to? One thing though, my 1st thyroid test was done by my gyno because I had gained a lot of weight in the last year. She only had TSH done though :rolleyes: and it was .014, already low before I reduced my carbs. I'm so confused right now...I think I'm suffering from too much info in too short a period of time.