My Thyroid Test Results
 

My naturopath interpreted the results yesterday, but I wasn't convinced she's in the know on the latest insights about thyroid health.

Since hypothyroidism, some say, can lead to peripheral neuropathy, I wonder if anyone here would venture an opinion on the numbers?

(I've also heard the range doctors use for what is "normal" isn't necessarily valid.)

The results don't seem so extreme that they could cause PN (?), but perhaps could affect it?

Well--
 

--the TSH (thyroid stimulating hormone) is definitely high, indicating your body thinks it is not getting enough thyroid hormone, despite the levels listed, and that through the feedback loop the pituitary is signalling your thyroid to make more.

You're right about the controversy of "normal" ranges. About five years ago now, the American Academy of Endocrinology recommended that the "normal" range for TSH should be revised downward, from the old .5-5.5 range to .3-3.0 or so. The feeling was that there were subtle cases of hypothyroidism being missed in that 3-5.5 range; and that optimal ranges of TSH for many people (there is considerable variation in how people feel and what symptoms of hypothyroidism--fatigue, brittle hair, weight gain, etc., they feel at the upper end of the old range) were around 2 or lower. But many doctors, it seems, haven't "gotten the memo". (Mary Shomon talks about this at her About.com thyroid sites--she's a fountain of information about thyroid issues.)

Still, your TSH reading warrants further investigation, especially if you are symptomatic. Tests for autoimmune antibodies to thyroid tissue/hormone and an investigation by ultrasound to look for nodules would be warranted. Are you experiencing hypothyroid symptoms?

ILf this bloodwork was ordered by your primary doctor I would suggest getting an appt with an endocronolgist. They look at thyroid levels a little differently.

Body temp on arising, and carotene deposition in the skin
are both really strong symptoms.

Other symptoms are more vague.

Low thyroid also leads to elevated cholesterol levels.
If yours is normal, that suggests your thyroid is working still.

You have to call around, and ask THE QUESTION. "Does this doctor treat according to the new scale?"

In the end you can beg. I have been known to beg convincingly.
If you frame your request conservatively, and ask to try, low dose for a few months, there is no harm really. The body will adjust to any externally given hormone and even out. Staying below 100mcg is considered safe for your bones.

Thanks. I have Mary's book, but need to go back and finish reading it. She's done a tremendous amount of work and I like the way she writes.

As far as my symptoms, possibly due to hypo:

* core temperature consistently low (96s, sometimes 95s)

* fatigue

* decreased sweating

I still think it could be ATP-related. I'm not going to start any meds for it until I know. A lot of doctors seem to assume it's primary/secondary without seeing if it's tertiary.

I asked the doc, "Is it primary, secondary, or tertiary?" She didn't give me a straight answer.

My concern is that if I raise the core temperature with thyroid meds, it will increase my already high skin temperature, and that cause worse PN/more damaged nerves.

I'm planning to do more testing, incl. oxidative injury &/ mitochondrial damage.

How do we know that the thyroid functions exactly the same way every day?

Has anyone ever got two different sets of results in a short time span (say a week) for their thyroid?

It seems to me that a thyroid could behave differently depending on many different factors related to stress and what's going on in your life.

My body functions very differently after eight hours of sleep and a normal work day than it does after six hours and surprise stress. Would the bloodwork be the same for both days?

I'm interested in further testing, esp. since it's only $25/draw.

I've answered these comments in red.

The long term signs of elevated cholesterol and skin color changes do not change rapidly...and indicate to the doctor hypo states. Splitting fingernails, scaly dry skin, eyebrows that are only half visible anymore, loss of hair, enlarged tongue, are other signs that are longer term also.

One thing you might try:

an iodine supplement. I 'd do a natural kelp product, at double dose, for say 2 months or 3, and see if you feel better.

If you do not have enough iodine to make your hormone with, that could give confusing test results. You could try 2 a day.
I use this because I don't use iodized salt, and I had a goiter at one time.

This is the one I use.
http://www.puritan.com/kelp-571/sea-kelp-000623

There is a group of people who use very HIGH iodine and I am unsure whether this is safe. So I don't endorse it.

http://www.lef.org/Vitamins-Suppleme...FUcCQAodCUgAKA
You could ask your new naturapath for comments.
Iodine is supposed to be conserved in the body by the kidneys, but it is conceivable that that process can fail for some reason, and thus the person loses the iodine.

Here is an eMedicine article on Iodine:
http://emedicine.medscape.com/article/122714-overview

I've got some organic kelp powder, but didn't know the right dose. I'm going to get my kidneys tested, because I want to make sure I can take high Mg doses that don't cause problems. Good to know it'd also help with kelp.

Recommended Reading:

When Should Thyroid Patients Get A Second Opinion? Interview by Mary Shomon

Unreliable thyroid testing
 

http://www.drlowe.com/QandA/askdrlowe/dxthyrd.htm

So this is great. First we have the supremely intelligent doctors using a thyroid test for several years (or decades?) with a reliable range of tests result for what it "normal."

Then we get the doctors conceding they made a huge mistake on what is the real healthy range. "Normal" is revised dramatically.

And now at least one doctor is saying the conventional testing and/or its interpretation is bogus.

Who wants to be a doctor? :rolleyes:

That is just one doctor's opinion. If you lined up 100 doctors and asked a medical question, you'd be amazed at the answers!

I'd say...the orange pigmentation in the skin is biggie ..it was for me. Also the cholesterol. The problem is that the thyroid affects everything...and in some people one or two things more than others. There is also an edema that comes with hypo, and a significant brain fog. The tongue can swell in the mouth as well.

Feeling tired and weight gain, are less convincing to doctors because they hear these complaints all day long from just about everyone.

We do know that lab ranges are just statistical averages. My lab ranges were iffy... so I got a scan finally and that showed major problems. If it hadn't I'd still be hypo I bet! As it was the endo made me wait another 6months, to get treated, in case the scan was revealing a temporary abnormal condition. I was not happy about THAT either. But I finally got my treatment.
And my internist comments: "I always thought you were hypo, but could not justify treatment based solely on your blood work". How's that for infuriating?

No doubt. Reading the private email exchange between two doctors discussing hypo treatments was very interesting. Saying there are so many who are winging it was disconcerting - and something the general public should know. Then they can read widely before they pick one method.

It boggles the mind how such things as T3 and Mg which are in every cell get so little research and expertise. You'd think this would be the starting point and top priority.

I have been lucky enough not to have weight gain issues, but the PN and lack of sweat is bad enough.

Low core temperatures, lack of sweat, adrenal/energy problems, and PN are key indicators for me even if I reject the blood work results as unreliable.

I feel more comfortable trying a thyroid protocol of some kind now that my BP is normal and CoQ10 levels are about normal (and I'm taking 300 mg/day). My heart is in better shape to handle the potential side effects of thyroid including higher blood pressure and heart palpitations.

My current plan is to try the circadian thyroid protocol, hoping that if I fix my thyroid, the adrenals will take care of themselves.

My ND wants me to do the saliva test. I understand that test is popular, but it seems redundant. Obviously anyone whose sleep is disrupted every day is going to be tired and that will affect their cortisol levels.

By the way, I called my doctor's office this afternoon to check on the results, including a second set of thyroid tests. I believe I was told the new test results show I'm in the normal range (the new normal). And this second test was only several weeks after the first one which said I was twice as high as it should be. It seems to indicate my suspicion to rely solely on one test was valid, but I'll wait till I have the print out to make sure.

It just seems really risky to subject your body to potential heart problems based on only one blood sample!

P.S. Since my doc had ordered a pelvic/abdominal ultrasound, I was sneaky and added a check mark to the box below in the form for, you guessed it, thyroid! (Partly because of the low lighting the technician last week didn't take a closer look.) Those results should be available to me this week.

Got the second lab results...

sTSH went up from 5.86 to 8.17.
T4 Free was 15 and is still 15.
Free T3 was 5.3 and now 5.1.

The ultrasound found two small nodules they believe are cysts. These, I have read, act like the thyroid gland.

So I'm reading various hypo books and researching protocols.

Sounds like you need some hormone treatment.

The cysts can be tested with either ultrasound and/or
a radio uptake scan (which is what I had).

Cysts may be cold or hot. A scan will show that. Hot nodules take up the radioactive isotope and concentrate it. Cold areas show no uptake.

I think you're right.

I'm stuck, though, trying to choose between these four options:

1) Synthyroid (T4 only);

2) Armour/Erfa (T4 & T3 @ 80%:20%);

3) a compound (e.g., 95% T4 & 5% T3); or,

4) Cytomel (T3 only).

I'm leaning towards the compound that mirrors natural thyroid hormone production (95% T4:5% T3), but don't know if my T4-T3 conversion is poor, or if my
bloodwork indicates a better way to start.

My other concern is that heavy metals or something else (e.g., liver, where 60% of T3/T4 is converted?) could interfere with any new protocol, slowing/preventing progress.

Meanwhile I'm getting baselines on my core temp, pulse rate, and blood pressure before I start any protocol.

Any thoughts? You had said you first started on Synthyroid? Would you have done so back then if you knew everything you know today?

I would start with T4 only. Give it a shot for several months.

If it doesn't work, consider the T3 added to it. Discuss this with the doctor, and make sure you can get the combo if the T4 doesn't work. For the vast majority the T4 will do the job.

You may still need T3, but see how it goes, to be sure. Too much T3 will rob your bones, for one thing, and overstimulate the heart for another.

I have been taking thyroid hormones for over 25 years since I had RAI treatment. I used to take just Synthroid for a while, but then reduced that and added Armour which really help me a lot. My Free T3 levels were just to low. Recently I switched from Synthroid to Tirosint which doesn't have all of the fillers that Synthroid had and is better absorbed. If you are going to start with a T4 I would recommend Tirosint and see how you respond. You can then add T3 or a T3/T4 like Armour if your FreeT3 levels don't respond.

Most people do best when their Free T4 and Free T3 levels are in the upper end of the range around 60-70%. This has been true for me.

It is a long and slow process to get your levels balanced and you have to be patient. If on T4 it can take 6-8 weeks for your body to stabilize each time you make a dosage change and you want to take small steps.

Good luck.

Thanks. I forgot to mention my iron is high, which is interesting, because usually people with thyroid issues have low iron.

I'm reading several books on thyroid issues and one doctor lists different issues that can affect thyroid absorption/conversion. Guess what one is?

Chronic inflammation!

So now I'm thinking if I don't figure out the cause of the chronic inflammation, any thyroid supplementation is going to have limited effect.

I still don't know if the inflammation is the cause or effect of the thyroid dysfunction. The thyroid affects every cell in the body? The thyroid (with the hypothalamus and pituitary) is involved with temperature regulation, right? If so, it would likely be trying to sort out the heat of the inflammation.

High cortisol also is one of the listed things that lowers thyroid function, and of course the chronic inflammation causes stress.

Low selenium can also be a problem, but my Spectracell results showed it was normal.

Janie B (StopTheThyroidMadness) interestingly suggests that too much iron in the thyroid could cause hypo. I don't know where my excess iron is exactly. But I did notice I felt slightly better after my last blood draw (five vials). Apparently occasional bloodletting is a valid way to lower iron. I might just use that as an opportunity to get new, specific, focused blood tests done each time.

Gamma Dynacare, which is the closest lab for me, has a few extra thyroid tests that I didn't get last time, including Reverse T3.

If your iron (Total blood iron) is high I'd get a tranferritin done, and see if you have Hemochromatosis. This is genetic and
can be fatal as iron builds up in organs, and can lead to liver failure.

Don't take any multivits with iron either!

I'm revising my earlier opinion after further reading, including:

"peripheral circulation to the extremities (especially the skin, hands, and feet) may decline by 40% or more as a result of hypothyroidism."--Dr. Mark Starr, Hypothyroidism Type 2, p. 138

Dr. Ken Blanchard, endocrinologist and doctor for 40 years, in his book, What Your Doctor May Not Tell You About Hypothyroidism, summarizes his protocol after treating of thousands of hypo patients:

Today I have a compounding pharmacist weigh out natural thyroid extract and put it into time-release capsules. I always prescribe synthetic T4 to balance the ratio in order to achieve 98 percent T4 and 2 percent T3.

Do follow up on the iron. The easiest way to reduce it is to give blood. Iron will get stored in your endocrine system as well as the pituitary gland, heart and liver. Long term iron overload is dangerous. Getting rid of the iron can go a long way to reducing inflammation and improving your overall health. Bacteria thrives in an iron rich environment.

Last November 2011 (a month after the start of my PN symptoms), I had a TSH test and the result was 9.230. Prior to this, I have always been on Synthroid, .75 mcg (since my total thyroidectomy in 2007). I had a TSH test last May 2010, it was a little low, but it normalized after one month without adjusting my dosage.

Since November 2011, my dosage has been adjusted every month but it has been low. The latest was 0.100 taken last end of March. I am now at .75 mcg for 6 days and half of .75 mcg for 1 day. My result for my thyroid antibodies is negative. My next test is due end of April.

I am wondering if this has a bearing in my pain, or is it only hypothyroidsm that can cause PN? Is there anything that my doctor and me are missing in managing my thyroid? By the way, the T4 is normal.

Thank you for your inputs.

I believe my hypo preceded my PN. As far as I can guess, hypo can affect every cell in the body; therefore it would be surprising if it didn't affect nerves. Nerves need T3, so a short- or long-term lack of T3 is going to cause problems.

What were your T3 levels like, if you don't mind me asking, when your TSH was over 9?

I suspect I've been hypo for a long time - long before I got tested - and it gradually became a bigger problem.

Stress can cause problems for the adrenals; when that happens, the thyroid issues can start; if they continue, you can get PN.

My research lately has led me to several doctors' books where they say you need to fix your adrenal function before hypo treatment. Even Armour's warning says adrenal insufficiency is a contraindication for taking the popular supplement.

My new plan is to take Lugol's 2% solution for one week to one month. This Iodine detox can take care of significant problems that are constant chronic stressors; e.g., heavy metals and parasites. Dr. Mark Starr advocates using it and claims great success with his hypo patients. I've also read lots of positive reviews online from users.

Today I bought ten more medical books, mostly about thyroid health and iodine. (I also got one or two on salt; I'm switching to a new table salt and cooking salt that will cause less stress.)

"Iodine: Why You Need It, Why You Can't Live Without It"

"Overcoming Thyroid Disorders"

"Salt: Your Way to Health"

"The Guide to a Gluten-Free Diet"

"Pharmocracy: How Corrupt Deals and Misguided Medical Regulations Are Bankrupting America--and What to Do About It"

"Your Body's Many Cries for Water: You're Not Sick; You're Thirsty: Don't Treat Thirst with Medications"

"The Body Electric"

"Thyroid Power: Ten Steps to Total Health"

"The Thyroid Crisis and the Seaweed Remedy"

"Healing Is Voltage"

"Neuropathy and Myopathy in Treated Thyroid Disease"

"Could It Be B12?: An Epidemic of Misdiagnoses"

"The Coconut Oil Miracle"

"The Women's Guide to Thyroid Health: Comprehensive Solutions for All Your Thyroid Symptoms"

P.S. It seems hypo tends to reduce circulation to the skin which could prevent nerves from getting what they need.

T3 has never been tested.

People with their thyroid removed will not be making T3 which will not be entering the serum for transport to other places in the body.

They will be converting T4 stored in the tissues to T3 instead, and this will not show up appreciably if at all.

Is T3 the same as Triidothyronine? If so, this was tested last May when I was referred to an endocrinologist (but never by my primary care physician). The result was 3.2 with a reference interval of 2.0 - 4.4.

Yes T3 is triiodo... But with no gland, I wouldn't think it would be transported around much. Unless of course if you have that ectopic tissue possibly? We discussed that before.
I'll do a search on this.

Here is a paper on this:
http://www.ncbi.nlm.nih.gov/pubmed/18285588

I guess it was something "assumed" until discovered otherwise.

I have always had a thyroid function test at least once a year prior to May 2010, when I had a high TSH, but as mentioned earlier, in June 2010, my TSH became normal (without adjusting my dosage .75mcg). The next test came last November 2011, when my TSH was 9.230 (a month after my PN symptoms). I dont know how long does it take to be hypo to affect the nerves. In my case, I do not think that I have been hypo for a long time.

SInce my TSH has been low for 5 months now, does hyperthyroidism affect the nerves the way a hypo does? Is decreasing the Synthroid the ideal strategy in my case? The endocrinologist, unfortunately, was not so interested to look at the summary I made for my TSH results and the adjustments made for my medicine.

Thank you.

When you mention about stress causing problems to the adrenal, do you mean the stress of daily living or something else e.g. metals, etc. (i think you are referring to the latter, but just wanted to make sure:winky:).

Whew, that's a bunch of books!!!! I am sure you can find information that you will benefit....

Thank you.

I don't think anyone really knows all the answers about thyroid issues.

I had a patient once who had her thyroid removed and was so hypo all the time, she became so constipated, she was in agony.

TSH is made by the pituitary in response to some trigger in the tissues that signals a need for more hormone. The hypothalamus is involved too to signal the pituitary.

High TSH means the body's tissues are signaling for more hormone. It will go up irregardless of whether you have a gland to respond to it or not. It is similar to women having very high FSH (follicle stimulating hormone after menopause). In this case the ovaries cannot respond, either, so the pituitary ramps up the FSH.

In the case of treating hypothyroidism, doctors use the TSH values to gauge if your body needs more T4.

Common signs of hypo and a need for more T4, are cold intolerance, orange palms and soles of feet, hair falling out, and edema (fluid retention). Over time hypo people deposit tissue in the skin which can compress the carpal ligament and tarsal ligments. This is the basis for the PN.

In my opinion and the opinion of many others including my Dr. too many rely on the TSH reading only and it is not a good indicator. It is better to get the Free T3 and Free T4 readings and use those as the primary indicator of thyroid function. Most people do better with their Free T3 and Free T4 is in the 60% to 70% of range, but everyone is different.

One problem with the TSH reading is that if you are taking a natural thryoid hormone such as Armour it will suppress your TSH readings. This is normal and if it doesn't suppress the TSH reading then something else might be wrong.

I have always felt cold. But, with the PN symptoms, I think I feel more cold than I used to. I don't have orange palms and soles of feet. My hair has been falling for years now (its good that I still have thick hair). I dont have have edema.

So its the tissue deposits in the skin that cause the PN for hypo. I have been wondering about this. Now that you told me this, its probably not the hypo that is triggering my disease. The pain in my feet is in my soles. When I stand, its like there are electric shots jolting in my ankles; its like I am standing with no skin in my soles. My feet would seem to feel soooooo tired. My prickly skin is all over my body, but mostly legs/thighs and arms and ramdomly in my back.

Does hyper affect the nerves too?

Thank you.

To treat my hypo and nodules I ordered JCrow Lugol's (2%); Nascent Iodine; and Iodoral (12.5 mg).

They should all arrive within a week. I'm still not sure which one I'll choose to start.

My ND thinks internal use of Lugol's is crazy because she says it's toxic. It is toxic in high doses. I've read the warnings from serious mistakes made by medical professionals using wrong doses. But many conscientious adults have used very low doses with great success. Lugol's itself isn't a new idea; it's been around since about 1825. (The FDA doesn't ban it; solutions with 2% are legal.)

Iodoral is supposedly the supplement version of Ludol's (same components). It is more expensive but requires less fussing and likely is easier to get the exact amount of iodine each day. That could help for hormonal balance.

Nascent Iodine gets some good reviews online but it's a bit too young for me to fully commit to it as my first treatment choice, even though it has been said it's milder and possibly better for more sensitive people as well as kids.

I find the idea of a mineral supplement or iodine tablet fixing my hypo after only a short period of time (weeks or months) much more appealing than a lifetime of synthetic or dessicated thyroid consumption. Less time and money, for one!

As a starting point the experiment seems reasonable because of the relatively low cost and low risks.

The main contraindication is thyroid antibodies. My bloodwork showed there aren't any.

Side effects from Iodoral seem to be uncommon from what I've read, esp. when starting on low doses.

I don't intend to bother with an iodine deficiency test. I'm going to use iodine to see if it raises my core temperature from an average of 96.8 and if it increases my skin's ability to sweat/moisten enough and quickly enough to cool down the way it used to for me and still does for most people.

I also have a baseline for my resting heart rate (72-76BPM). I have to monitor it daily to watch for a jump of 10 or more (which would indicate dosage is too high).

Iodine Supplement for Thyroid Nodules is Controversial
 

Before anyone copies my personal medical plan, consider this statement by Jorge D. Flechas, M.D:

Source: http://cypress.he.net/~bigmacnc/drflechas/iodine.htm

After doing some more reading today, it seems iodine supplementation can restore the thyroid gland in some cases, and it's more likely when the hypo is mild and/or the person has high toxicity. In general, though, it seems one can expect iodine to lower the need/dose for thyroid supplements, as opposed to bringing complete restoration.

The problem arises when a patient is already on thyroid supplementation (Armour/ERFA/other) at a dose that gives hormonal balance, and then adds iodine. It has the same or similar effect of increasing the dosage of the supplement. When patients have been dosing at or near their maximum level, i.e., very close to HYPERthyroidism, the extra iodine pushes them beyond that point of stability, into hyperthyroidism.

So it seems to me it's better to start with iodine than Armour, instead of Armour followed by iodine (or both at the same time). And monitor the same things on iodine as you would with the supplements (i.e., core temperature, heart rate, etc.).

Thyroid hormones inhibit Iodine absorption
 

I found something today that is interesting and troubling.

I listened to a long radio interview of iodine expert Dr. Jorge Flechas. He says thyroid hormones affect iodine absorption.

So the millions of people who are taking thyroid meds from Synthroid (top 10 prescribed drugs in America) to presumably Armour are at the same time depleting their iodine and causing an iodine deficiency.

This can lead to all sorts of problems, including cancer, because it shuts off the body's natural (iodine) defense system.

http://iodine4health.com/overviews/a...udiovisual.htm

He himself used to be on Synthroid, but weaned himself off it, switching to iodine. He does the same thing with his patients.

It sounds like millions of people are going to hell in a handbasket.

Dr. David Brownstein says about 90% of Americans are iodine deficient. (Not surprising - who ever even tests for it?!) I think I read somewhere else that about half the US population is 50% deficient.

P.S. I started on 12.5 mg of Iodoral and gradually increased it. After two weeks I'm at 50 mg. I'll probably stay at this level for another week or longer, and then go for 100 mg. No major detox reactions so far. Core temp, BP, and HR all remain about the same. Plan to get another ultrasound to check the nodules in a month or two.

You know when T4 is converted to T3, an iodine molecule is cleaved off naturally. T4 therefore supplies some iodine, which is mostly recycled.

I'll look this up later this week. We are having a family emergency this week, and I am not online here as much as I usually am.

I'll try to search this "theory" for validity, soon.

There is "something" that strikes me as unreasonable about the new wave of high dose iodine therapy.

This article explains why:
http://thyroid.about.com/od/newscont...muchiodine.htm

Our bodies do not absorb iodine when it is at sufficient levels.
When you read that thyroid supplements are withheld before certain treatments or tests, it is because the purpose is to create a negative balance so the radioactive iodine will be absorbed well.(as per that link) This does not mean levothyroxine is BAD in any way. It is composed of iodine molecules...that is how it works.

If you do not take a multivitamin with 150mcg in it, and you don't use salt at the table, and you eat processed foods mostly, then using 150mcg per day is a good idea. Vegetarians who do not eat seafood, or meat also are at risk. But I remain on the fence for recommending any more than that daily, because the evidence is still lacking about safety issues.