[Lara]

well, you weren't alone posting on Nov thread.
I hadn't noticed either

[bizi]

a sunny day today!
need to be focused and productive. the tomato salad came out great yesterday.
December and we are having fresh tomatoes!
The party was fun too much to drink oh well, no harm done(except to my brain cells)
bizi

[bizi]

I think I forgot to tell you that jeff is going to china over the break. He will be joining an orchestra and playing a solo piece with them on his classical guitar making it sound like a pippa. they will be gone 11 days. I will be visiting family and friends.
bizi

[Lara]

Dear bizi,
Wishing Jeff a wonderful trip to China. What he's doing sounds amazing. I only got to mainland China for a day and that was back in the 80s when I was in Hong Kong. Are you heading north for your holidays? Thinking of you.

[Dmom3005]

I had noticed, just thought you had things to say for November.

So posted and listened there.

Donna

[bizi]

I was a bit into a tizzy today.
my gp wanted me to go on 2 different meds after my lab results came in.
my chol was 240
but my hdl was 130 ldl was 114 so I was not concerned and told the nurse this.
then she wants to start me on synthroid for an elevated tsh high normal being 5 mine was 5.6. I don't have any symptoms.
So she is going to have me draw blood again in the morning for t3 and t4.
she was going to start me on 25mcg (a half dose) and have me retested in 2 months.
I told her I was bipolar to remind her and that I run hypomanic...this to her nurse so she spoke with my gp.They will call me the results on friday.
I have already said to myself that I would not start any new meds away from home...so if I have to start synthroid then it will be next year.
Not what I needed to get worked up about today.
bizi

[waves]

Originally Posted by bizi

I was a bit into a tizzy today.
my gp wanted me to go on 2 different meds after my lab results came in.
my chol was 240
but my hdl was 130 ldl was 114 so I was not concerned and told the nurse this.
then she wants to start me on synthroid for an elevated tsh high normal being 5 mine was 5.6. I don't have any symptoms.
So she is going to have me draw blood again in the morning for t3 and t4.
she was going to start me on 25mcg (a half dose) and have me retested in 2 months.
I told her I was bipolar to remind her and that I run hypomanic...this to her nurse so she spoke with my gp.They will call me the results on friday.
I have already said to myself that I would not start any new meds away from home...so if I have to start synthroid then it will be next year.
Not what I needed to get worked up about today.
bizi

Bizi, they really should just retest all three parameters (TSH, FT4, FT3) together in a couple months. A single lab draw (and a partial one at that) with one parameter slightly off and NO symptoms does not sound like grounds to start therapy!


Please ask her for a referral to an endocrinologist. Even a good internist could handle it but endocrinologist is exactly the "right" specialist.

FT4 (free T4) is usually tested because it is what the body can use. Even if T4 is normal, part of it can be bound by pathogens or other substances that essentially render it unusable. The free fraction might still be low. If repeat testing shows TSH is persistenly elevated AND Free T4 persistently low, then a hypothyroid condition is present. Also useful/common is a test for Hashimoto antibodies -- if positive, thyroid parameters must be rechecked periodically and eventually you'd need supplements.

You can also have a complete thyroid panel out of pocket for about $50 through an independent lab if they won't script it or insurance gives you a hassle. Not sure if that would cover Hashimotos.

I've had T4 low before but it was transient. I think I had TSH high once but also transient (and T4 was fine). I was given Synthroid (T4) and Cytomel (T3) when my values dropped due to Carbamazepine. My TSH was fine. My internist made a written note to the doctor who prescribed the thyroid meds, saying that she felt it was dangerous to supplement, because it risked eventually shutting off my thyroid. The endocrinologist I saw said there was no reason to supplement -- reference ranges are statistical, if a person is slightly off but symptom-free, the only recommendation was to retest.

The other side of the coin/my pdoc's perspective. Subtle symptoms can include mood-cycling. My pdoc felt supplementation could help my cycling. That approach is however controversial. No way to tell if it did help or not, either, as I was taking gobs of psych meds.

waves

[waves]

Excessive alcohol affects so much stuff, it's probably easier to list the things it does NOT affect.

As far as your HDL. 240 is preposterously high. the upper reference range is about 80 and I've heard of people with 100. Are you sure you don't have the HDL/LDL switched around? -- edited to say I misread. I see that 240 is total, 130 is HDL... ok, high but not scary high. I will leave the rest in just FYI....

YOu know that they've found there's different kinds of HDL. Too much of that if it is compromised quality in fact be bad. I had found a better article at one point, but this is the best I can do right now:

http://www.cleveland.com/healthfit/i...be_bad_fo.html

"Hazen’s research shows that in people with heart disease, about 1 in 5 HDL particles in the artery wall -- where the particle’s function is to remove cholesterol-- is dysfunctional. People who have more of this dysfunctional HDL are at higher risk of heart disease, independent of traditional risk factors such as age, diabetes, smoking, and blood pressure. "

Is there any way your tests could have been thrown off? Is your HDL measured or calculated? What are your Triglycerides like?

Alcohol (especially chronic over-use) throws off blood lipids BIG TIME, are you aware of that? Along with gGT's and other things.

waves

[waves]

This might be more helpful:

Low HDL:

[...]
Alcohol raises HDL cholesterol but is not routinely recommended as a therapy because of its many other adverse effects.

Elevated High-Density Lipoprotein Levels

Elevated high-density lipoprotein (HDL) level is HDL cholesterol > 80 mg/dL (> 2.1 mmol/L).

[...]

Primary causes are single or multiple genetic mutations that result in overproduction or decreased clearance of HDL. Secondary causes of high HDL cholesterol include all of the following:

Chronic alcoholism without cirrhosis
Primary biliary cirrhosis
Hyperthyroidism
Drugs (eg, corticosteroids, insulin, phenytoin)

The unexpected finding of high HDL cholesterol in patients not taking lipid-lowering drugs should prompt a diagnostic evaluation for a secondary cause with measurements of AST, ALT, and thyroid-stimulating hormone; a negative evaluation suggests a possible primary cause.

http://www.merckmanuals.com/professi...l?qt=&sc=&alt=

[Mari]

Originally Posted by waves

Bizi, they really should just retest all three parameters (TSH, FT4, FT3) together in a couple months. A single lab draw (and a partial one at that) with one parameter slightly off and NO symptoms does not sound like grounds to start therapy!

Originally Posted by waves

Please ask her for a referral to an endocrinologist. Even a good internist could handle it but endocrinologist is exactly the "right" specialist.

FT4 (free T4) is usually tested because it is what the body can use. Even if T4 is normal, part of it can be bound by pathogens or other substances that essentially render it unusable. The free fraction might still be low. If repeat testing shows TSH is persistenly elevated AND Free T4 persistently low, then a hypothyroid condition is present. Also useful/common is a test for Hashimoto antibodies -- if positive, thyroid parameters must be rechecked periodically and eventually you'd need supplements.

You can also have a complete thyroid panel out of pocket for about $50 through an independent lab if they won't script it or insurance gives you a hassle. Not sure if that would cover Hashimotos.

I've had T4 low before but it was transient. I think I had TSH high once but also transient (and T4 was fine). I was given Synthroid (T4) and Cytomel (T3) when my values dropped due to Carbamazepine. My TSH was fine. My internist made a written note to the doctor who prescribed the thyroid meds, saying that she felt it was dangerous to supplement, because it risked eventually shutting off my thyroid. The endocrinologist I saw said there was no reason to supplement -- reference ranges are statistical, if a person is slightly off but symptom-free, the only recommendation was to retest.

The other side of the coin/my pdoc's perspective. Subtle symptoms can include mood-cycling. My pdoc felt supplementation could help my cycling. That approach is however controversial. No way to tell if it did help or not, either, as I was taking gobs of psych meds.

waves

'Right about the retesting. The single/ partial test yields very little actionable information.

M