Quote:
Originally Posted by waves
Hi again Butterfly  
Regarding the thyroid issue...
Do you have a history of hypothyroidism with or without treatment, or is this the first time you've noticed your values changing?
You did indicate your TSH has shot up so, there could indeed be a problem, however that value is just barely on the high end, and if your T4 is within range still (what is T4 value?), not medicating is technially justified.
Has TSH increased progressively over time, or are you comparing a single current test with a much older one? There can be temporary variances too. This spring, my TSH had gone up to 7.xx. My pdoc called it "compensated hypothyroidism" because my T4 was normal. 2 months later a retest showed normal TSH again.
There is another thing I should mention... i've been through this. Some pdocs have actually adopted the use of thyroid hormones in cases they consider "subclinical hypothyroidism" and have reported success with mood regulation. This is neither standard practice, nor is it safe for all patients. If it is done, close monitoring is essential. If the TSH downregulates so far as to restore the original TSH/T4 values for a patient, those T4 values are most likely that individual's norms, in which case, medicating into "official range" is dangerous: in the long run, endogenous T4 production can be shut off - not always reversible. (i had a situation once with a pdoc giving me T3+T4 and my internist blowing gaskets at him in writing, on his lab copies. the meds did not keep my t4 up for long, the overall effect was that my TSH just got lower and lower...). Remember the official ranges are based on stats. individuals may have norms slightly outside of those ranges.
Getting the pdoc's perspective to the internist sets the stage for a more open approach on her part, i think. If she too wants to wait you could ask whether, in light of the psychiatric needs, it might be possible to do a "trial period" with medication. Monitoring will show whether it is actually needed or inappropriate as I described above. However, if she is firm about not medicating, do realize she is simply taking a conservative approach to protect your thyroid from potential iatrogenic damage. In compsci or car repair, we'd say "if it ain't broke don't fix it."
One thing you could do is request a lab screening for Hashimoto's antibodies. If you test positive, they will give hormone therapy.
I wish you the best. I hope your aunt's internist listens and is openminded. Most of all I hope you click with her. That really helps. 
oh boy it's past my "bedtime" (HA!) again
~ waves ~ |
Waves, I so appreciate your input on this matter as my mind is swirling. Yesterday in the mail I got another piece to this puzzle.
OK, in 2009 my TSH was 1.24.
pdoc ordered bloodwork which was drawn on 11/26/12. CBC, Hepatic Fuction Panel, BUN, Creatinine, Valproic Acid, Lithium, all normal. Only thing out of norms is that TSH is 4.96.
pdoc tells me to see endo, his schedule had a cancellation, and I was seen 3 days later. They drew blood on that day 11/29/2012.
Then remember I got the phone call Monday that Dr. BXXXXXX is not going to do any treatment at this time. Let's schedule an appt in 6 months.
Well yesterday in the mail I got a copy of the bloodwork that that endo's office did. It shows my TSH as 1.86.
Is this possible? That my thyroid went from 4.96 to 1.86 in 3 days? I mean how does that happen? I have double & triple checked and I'm looking at both lab copies right now and this is what they say. Mr. Butterfly looked at them with me last night and we're certain this is what they say.
If it is helpful the endo's bloodwork results also has T4 1.14, T3 166, Thyroid Peroxidase (TPO) Ab 7 which are all in the normal ranges.
So I guess I take it all back about endo being a jerk. If nurse on the phone would have just explained that my TSH was 1.86 I would have understood him not treating me with thyroid hormone, b/c that's under 3. I just don't understand such a high fluctuation in 3 days.
I am still glad that I have the appt set up with the internist. Maybe she can retest and tell me what it is. My appt is Jan 2nd. Although if there is this much variation day to day then what is the point of even getting TSH tested?
I'm soooooo confused.
Oh I forgot to say waves, my dad had a benign tumor on his thyroid and as a result had his thyroid removed. 2 of his sisters have thyroid trouble but my mom is unclear as to what kind, they still have theirs.