What do these results mean? : Thyroid Disease Forum : Active Low-Carber Forums

#1 ^

Tue, Jul-03-12, 16:50

freckles

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Plan: Atkins Maintenance
Stats: 213/141/150 Female 5'4 1/2"

BF:
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Location: Dallas, TX

What do these results mean?

I'm pretty certain that these aren't all the tests I need done to get real answers. I have been looking for a doc who will know to do the right tests. Think I finally found one. In the meantime, my current hematologist had these tests done. Can I glean any information from them? Or do I just need to wait for the proper tests?

T3 uptake 37 high (22.0-35.0)
Thyroxine (T4) 5.7 (4.5 - 12.0)
Free thyroxine index, ng/dL 2.1 (1.4-3.8)
TSH, mIU/L 2.95 (no range given)

I had MANY more tests run, so if there are any others that would be helpful let me know and I will post them.

Thanks!

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#2 ^

Sun, Jul-08-12, 08:48

MoonDansyr MoonDansyr is offline

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Freckles, I will have to dig out my files and look at these numbers. I am here to tell you that your "TSH" is considered "in range" by 99.9% of doctors; sadly, that's what many of them go by and it doesn't tell the whole story. I will also tell you that I have symptoms when my TSH is at that number. Currently, mine is below a 1. My doctor allowed me to adjust my meds myself, finding the right dose that made all of my symptoms go away. Doctors like him are 1 in a million.

So, many doctors go mostly by the TSH, and won't do anything until you are DEFINITELY out of range. Then, they often will only prescribe Synthroid, which is synthetic T4. My problem is that I don't convert my T4 to T3, so I have to take T3. If I had a doctor that tried that with me, I'd be spinning my wheels and they would consider me a nut job because they'd tell my my TSH was in range, therefore it must all be in my head. Because I have a fantastic doc who knows his stuff, I take a combination of Cytomel (T3) and Armour (a natural thyroid medication made from pig thyroid which has all of the thyroid hormones in it).

All of the numbers have to be in the proper ratio, so just because they are all within range, it doesn't mean they are where they should be with each other.

I highly recommend going to About.com Thyroid Disease and looking up everything you can find by Mary Shomon. Thyroid disease is horribly taught in medical schools (even with endocrinologists). It shouldn't be that way, as there ARE doctors (few and far between) who do understand it. But I think pharmaceutical companies have a hand in causing the current problems.

Also, I found my first doctor (who retired his practice to return to education in hopes of spreading knowledge) through Top Doctors from deep within the about.com thyroid disease site. When my doctor retired, he put me in good hands with another doctor he trained, who combines a lot of natural medicine (and good diets) with his healing practice. My new doctor is now on the list. While I was nervous to switch, at first, I am beyond more than happy with this new doctor and am finding that I may even like him better, which I never thought possible.

Before my first doctor (who had a clue), I saw six doctors over four years that tried to diagnose me with everything from acid reflux to psychosomatic. I had nearly every textbook symptom, but because my TSH was consider "in range" (albeit 1/10 away from being out of range), it had to all be in my head.

I will look through my files and try to make sense of your numbers, but I'm not up on the exact ratios and you are missing quite a few numbers. Give me a couple days, as we're getting ready to go out to the in-laws today.

#3 ^

Thu, Jul-12-12, 08:41

MoonDansyr MoonDansyr is offline

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I'm sorry - I haven't dug my file out yet. We've been working non-stop on our basement. I will go do that now and see if I can make heads or tales of your numbers. I think without the Reverse T3 or Reverse T4, we won't really know, because those are supposed to be in a specific ratio. He wrote that ratio on one of my lab sheets - I will have to look for it, as I have several years worth of labs.

#4 ^

Thu, Jul-12-12, 10:05

Nancy LC

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Your T4 looks a tad less than optimal. TSH is a bit highish, which means your body might like more thyroid hormone.

Quote:

Thyroxine-Binding Globulation (T3-UPTAKE) - Increased levels are found in hyperthyroidism, severe liver disease, metastatic malignancy, and pulmonary insufficiency. Decreased levels are found in hypothyroidism, normal pregnancy, and hyperestrogenis status.

This test measures the amount of thyroxine-binding globulin (TBG) in the patient's serum. When TBG is increased, T3 uptake is decreased, and vice versa. T3 Uptake does not measure the level of T3 or T4 in serum. Increased T3 uptake (decreased TBG) in euthyroid patients is seen in chronic liver disease, protein-losing states, and with use of the following drugs: androgens, barbiturates, bishydroxycourmarin, chlorpropamide, corticosteroids, danazol, d-thyroxine, penicillin, phenylbutazone, valproic acid, and androgens. It is also seen in hyperthyroidism. Decreased T3 uptake (increased TBG) may occur due to the effects of exogenous estrogens (including oral contraceptives), pregnancy, acute hepatitis, and in genetically determined elevations of TBG. Drugs producing increased TBG include clofibrate, lithium, methimazole, phenothiazines, and propylthiouracil. Decreased T3 uptake may occur in hypothyroidism

#5 ^

Fri, Jul-13-12, 13:49

freckles

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Plan: Atkins Maintenance
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Quote:

Originally Posted by Nancy LC

Your T4 looks a tad less than optimal. TSH is a bit highish, which means your body might like more thyroid hormone.

I'm not even on any meds at this point. I am still in the process of finding a doc who will do the right tests.

Quote:

Thyroxine-Binding Globulation (T3-UPTAKE) - Increased levels are found in hyperthyroidism, severe liver disease, metastatic malignancy, and pulmonary insufficiency. Decreased levels are found in hypothyroidism, normal pregnancy, and hyperestrogenis status.

This test measures the amount of thyroxine-binding globulin (TBG) in the patient's serum. When TBG is increased, T3 uptake is decreased, and vice versa. T3 Uptake does not measure the level of T3 or T4 in serum. Increased T3 uptake (decreased TBG) in euthyroid patients is seen in chronic liver disease, protein-losing states, and with use of the following drugs: androgens, barbiturates, bishydroxycourmarin, chlorpropamide, corticosteroids, danazol, d-thyroxine, penicillin, phenylbutazone, valproic acid, and androgens. It is also seen in hyperthyroidism. Decreased T3 uptake (increased TBG) may occur due to the effects of exogenous estrogens (including oral contraceptives), pregnancy, acute hepatitis, and in genetically determined elevations of TBG. Drugs producing increased TBG include clofibrate, lithium, methimazole, phenothiazines, and propylthiouracil. Decreased T3 uptake may occur in hypothyroidism

This is what my research pointed to as well. I've heard a lot about hypothyroidism, but not much about hyperthyroidism.

#6 ^

Fri, Jul-13-12, 15:43

JEY100 JEY100 is online now

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Hi freckles,
I am completely a novice at thyroid tests and rather confused myself, but I too had high T3 Uptake (38, but then my lab range was 24-39). Most search results about this test indicated that it was basically useless and outdated. Plus when considering all usual symptoms of hyperthyroidism, I had none of them (alas, particularly not weight loss

), I choose not to worry about it. What I did do was slightly increase non-starchy vegetable carbs, and supplement with iodine and selenium (realized had basically no sources of iodine in my diet). Mild symptoms of hypothyroidism seem to have improved, so a symptom, rather than test approach worked.

#7 ^

Fri, Jul-13-12, 16:06

freckles

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Posts: 8,730

Plan: Atkins Maintenance
Stats: 213/141/150 Female 5'4 1/2"

BF:
Progress: 114%

Location: Dallas, TX

Quote:

Originally Posted by JEY100

), I choose not to worry about it. What I did do was slightly increase non-starchy vegetable carbs, and supplement with iodine and selenium (realized had basically no sources of iodine in my diet). Mild symptoms of hypothyroidism seem to have improved, so a symptom, rather than test approach worked.

Interesting that you posted this. I've been listening to The Real Foods Summit and the role of selenium and iodine on thyroid has been mentioned. I was going to do further research about it, actually, since I also don't get much of either in my diet.

#8 ^

Mon, Jul-16-12, 06:50

Neanderpam Neanderpam is offline

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Out of all the women who have hypothyroidism, 98% have Hashimoto's autoimmune type. Giving iodine in this instance can be harmful because of the antibody levels.

Selenium is known to lower the antibodies themselves (not proven).

Hashimoto's is where the antibodies (Freckles, do you have a TPO AB test there amongst the ones they did? How about a Free T4 and a Free T3 (looks like: FT4, FT3)?) attack the thyroid until it can no longer produce any hormone. TPO AB would tell you if you have Hashimoto's.

The only 'cure' for Hashimoto's is generally having the hormones the thyroid cannot produce be replaced.

Giving iodine and selenium to a Hashimoto's patient instead of replacing hormones would be like putting gas in a car with no engine.

You can get tests yourself online (TPO AB, FT4, FT3).

T3 Uptake is actually a test of binding T4 (another T4 test). I can make T4, but my body does not convert it into T3 (the energy part of the hormone) therefore I take natural dessicated thyroid (Armour). My doctor doesn't go by TSH he goes by FT4 and FT3 and how I feel.

#9 ^

Sat, Jul-21-12, 15:47

freckles

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Plan: Atkins Maintenance
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I'm sorry to hear about the selenium and iodine. I was hoping they would help me. Will need to do some more research, I guess. Are you saying that I should not be considering adding in cod liver oil, sea salt and fish to my diet? All of those things contain one or both. Would they end up being more harmful than helpful?

I have looked into the online test sites and honestly, we just can't afford to pay $200 to get them done. I am still searching for a doc in our insurance plan that will order them.

Thank you for your reply!

#10 ^

Sun, Jul-22-12, 06:29

JEY100 JEY100 is online now

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Freckles,
Here is a new post on thyroid from Hyperlipid, so as always, a bit technical, but also received some intelligent comments.
http://high-fat-nutrition.blogspot....el-is-very.html

One comment by William in particular spoke to me:

Quote:

My own endocrinologist, after years of exclusively treating hypothyroidism, has concluded that he has absolutely no idea what a particular patient's TSH, total T4, or freeT4 should be, apart from obviously pathological extremes.

He's very smart. He knows what he doesn't know. He thinks.

Different people clearly do better at quite different TSH and T4 levels, which is consistent with the very wide "normal" lab ranges. But there's no way to know which person should be at TSH 0.5 and which one at TSH 2.5.

Unless you ask them how they feel, that is. Radical!

Harder with the dogs and cats, I know—though our own hypothyroid greyhound tells us very clearly when her dose is suboptimal: spooky behavior, fur loss, and skin hyperpigmentation tell us, no matter what the labs say.

As for total T3, free T3, and reverse T3, my endo stopped even testing these years ago. He found them useless. They never added anything to asking patients how they feel (and monitoring TSH and T4 to avoid gross overdosing or underdosing). Interestingly, this is true even when values fall well outside "normal" ranges, which is why he feels no need to measure them at all.

I am very skeptical of any grand conclusions drawn simply because, say, a dietary change "lowered T3." How can anyone know that is a bad thing? Ron Rosedale believes lowered T3 on low carb diets is actually a sign of slower aging. That sounds pretty good.

Maybe because I lived in the UK and was always impressed that doctors' had "Consulting Rooms" where they actually listened to the patients' symptoms first before ordering blood tests, colors my view of all these thyroid tests and "normal ranges". If you are not feeling well, try adding some natural iodine from kelp or foods. If you feel better, great. If you don't or feel worse, then move on. I do feel better, but then I am eating more vegetables, up to about 70 carbs from 30, no longer in ketosis, and eat more nutrients of many kinds, including a kelp supplement.
Which change caused improvement?..I don't really care, I feel better.

The issue of iodine dose came up in comments here too: http://www.wheatbellyblog.com/2012/07/an-iodine-primer/

Dr Rosedale discussed thyroid function in his latest interview as well:
http://drrosedale.com/blog/2012/07/...-harvard-study/

Hope that you can figure it out soon and feel better,

#11 ^

Sun, Jul-22-12, 07:50

*bookish*

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Hi Freckles - once you find a good doctor (it took me 10 years to do so), you may also want to check out your D and B vitamin levels, plus estrogen and progesterone.

Dr Haskell (author of Hope for Hashimoto's - which I know you may not have...) writes:

∼ Avoid iodine & iodide in supplements. Douglas Labs makes a multivitamin, UltraGenic, which does not contain iodine. Read labels.
∼ Avoid foods high in iodine such as kelp, seaweed, shellfish and haddock. Other fish should be limited to 1-2 times per week. Fresh water fish are fine.
∼ Avoid iodized (iodide) salt.
∼ Sea salt can be used to taste.
∼ Avoid kelp in supplements. This ingredient is often found in thyroid supplements.

I was taking Iodine (Lugol's, you can get a higher dosage in Canada OTC) and my antibodies were up to 3500, the highest my Dr had ever seen. I've gotten then down to ~300 over the past year, which is still high, but a major improvement. Just a caveat for Iodine dosing - the thyroid is tricksy and you'll want to read read read before making any decisions.

Good luck!
(ps if you still eat gluten now would be a great time to stop

)

#12 ^

Sun, Jul-22-12, 17:41

freckles

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Plan: Atkins Maintenance
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Quote:

Originally Posted by JEY100

Thanks for the links. I'm still reading through them. Found mention of this in one of the comments on Wheat Belly:

Iodine and Hashimoto’s Thyroiditis

There are two parts and the comments are just as interesting as the articles. Very scientific, so I kind of just skimmed enough to get the gist.

I'm leaning toward trying iodine w/selenium after reading about SO many good experiences. I've got to do something while I'm trying to find a doctor!

#13 ^

Sun, Jul-22-12, 17:56

JEY100 JEY100 is online now

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Be sure to read ItstheWoo's comments. She described my issues to a T.
I had been doing very low carb for a year, and was close to goal weight, had some classic hypo symptoms yet my TSH was 1. By my symptoms the tests made no sense, but my fat was "atrophying" ...love that word. She had a few others to describe low thyroid after fat "deflation" as a good thing. Her comments on this post have been the best description of the process I've read so far...now I can be proud of my low thyroid function as a sign of success with fat cells hanging around empty...though just a tad more emptying would be nice too

She also explains the difference between people who have primary thyroid disease and those of us who have low thyroid because of our weight loss.One reason, in my case, the supplementation should not cause a problem.

Thanks for the Jaminet article. It was his series on zero-carb and thyroid that convinced me to raise my carb level and try supplementing. I'll be in line for their new book; they have a very healthy approach to diet.

Last edited by JEY100 : Mon, Jul-23-12 at 02:58.

#14 ^

Mon, Jul-30-12, 15:19

Scarlet

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Hey Freckles

I recall you had a TSH of 5 or 6 a few months ago, no?

#15 ^

Mon, Jul-30-12, 16:34

freckles

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Quote:

Originally Posted by Scarlet

Hey Freckles

I recall you had a TSH of 5 or 6 a few months ago, no?

No. It's always been "normal."

Here's the update that I posted in my j today:

Quote:

Originally Posted by freckles

Thanks everyone. I am looking for a new doc. I meant to ask the doc I saw today if she knew of anyone she could refer me too, but I had so much information to take in and let settle that I forgot.

The doc I saw today was very kind and took her time with me. Within 30 minutes of arriving at the office she had diagnosed me. It all seemed to happen so fast, though. I have a billion questions still.

I do have Hashimoto's and I was so thankful to get the diagnosis that I cried.

She sat with me and asked me a lot of questions, then she did the ultrasound. She said that I have two issues, the Hashimoto's and a very large nodule. If I'm remembering correctly, the lumpiness that showed up on the scan is indicative of Hashimoto's and that is what is causing my fatigue, hair loss, etc. However, I also have a very large nodule on the right side and that is what has been causing my throat/neck to feel sore, causing me to cough, and my voice to be gravely.

She showed me a plastic model of a thyroid, then showed me ultrasound of her healthy thyroid, then showed me ultrasound of mine. Yeah. The differences were quite obvious.

Then we sat back down and she began telling me what my options were. She said that she would like to take a biopsy of the nodule to rule out cancer and that I would not have to be off my blood thinners for that. If it was cancerous we would need to remove my thyroid, which would require bridging with the Lovenox shots (still haven't called insurance back to check on coverage for that!). She explained the procedure and the limited risks, etc. She said that her recommendation is removal whether it is cancerous or not because the nodule would continue to interfere with my throat/speech.

I was reeling with all the information and was kicking myself for not making dh come to the visit (because last time I did it was nothing, of course

). I have no memory, so felt quite overwhelmed. I told her I would need to talk it over with my husband. She suggested that in that case we start with doing the biopsy, as the results could very well make the decision for me.

She did the biopsy right then and there.

I was concerned about having a needle stuck in my neck while being on blood thinners. Even though the bleeding stopped fairly quickly on the surface of my skin, I hope it did inside as well. It wasn't as painful as I imagined it would be. More uncomfortable, and it seemed to last F.O.R.E.V.E.R. So they will call Thursday with the results.

The good news is that if it is cancerous removal will take care of it. I guess it doesn't spread or anything. No other treatment other than some kind of anti-cancer pill. Can't remember what she called it.

She did not prescribe any medication, saying that the protocol is different depending on whether I opt for removal.

So I have some more research and thinking to do.

I'm quite stunned, but I am happy to have a diagnosis and the beginnings of a plan.