Continuation... Help with my friend's lab results, please.

[PPower]

My friend, who has never taken any thyroid meds before is having serious symptoms and just got her labwork results back since my last post. They are as follows:

TSH: 5.45 (it's gone up a bit)

FT4: 1.2 (.82 - 1.77)

Thyroid Peroxidase: <10 (0-34)

Her doc was going to test iron, D, B12 too but only tested B12 which was 999 (she's supplementing).

Her doc said, no, the Endocrinologist weighed in:

"Since she does not have +Ab there is no evidence of underlying autoimmune thyroid disease and her TSH is appropriate for her age. Fatigue is a quite non specific symptom and in the setting of normal thyroid hormone levels Levothyroxine should not be used. Should also be used with caution in the elderly because of potential for arrhythmias."

Really? Appropriate for her age?? (71 yo) Could this be true? She was also offended by being grouped in with "the elderly". (She is a very youthful 71 yo.) To me, it looks like she could use some help with meds. Any opinions would be greatly appreciated. Thanks!

[shaws]

They haven't done her Free T3 to see how much is in her system. Cursor down to read what Thyroiduk have to say about it.

thyroiduk.org.uk/tuk/testin...

You will be surprised by the following interpretation:-

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/about_...

On the left-hand side there is also other topics.

[PPower in reply to shaws]

The health care she has here in CA (Kaiser) doesn't believe it's necessary to test T3. I know that I wouldn't be able to pick myself up without it!

[shaws in reply to PPower]

They dont test Free T3 (not T3) in many countries I think. Personally I would add some T3 of my own. In actual fact I bought my own when the Endo wouldn't increase mine further and now take T3 only and am fine. Thankfully.

[shaws in reply to shaws]

I think in many countries they only do the TSH and T4. Nothing else.

[PPower in reply to shaws]

Yes, we have to be our own docs... Do you know anything about it being dangerous to start meds when 71 yo?

[shaws in reply to PPower]

If you are hypothyroid it would be more dangerous not to take them. Before the blood tests were introduced doctors were aware of clinical symptoms and we were given a trial of thyroid hormones (NDT) to see how we got on.

If we were frail, we would begin on low doses. This is an archived link from a doctor (now deceased) who lived in Florida and he has a wealth of info on his website. He was against the modern method of detection and treatment. Your friend's TSH is high. This is regarding T3 which the Endcrinologists try to frighten us with it being dangerous. In fact my palpitations and fast heart rate stopped when I took T3. I am on T3 only but I also know an NDT which suits me.

web.archive.org/web/2010103...

[PPower in reply to shaws]

Thanks, shaws!

[Jbbaker23 in reply to PPower]

My mum is 91 and on t3 twice daily, it has helped dramatically with her dementia

[PPower in reply to Jbbaker23]

Wow, jbbaker23. I am very happy for your mum. Thanks so much for sharing that with me!

[SAMBS]

PPower - I find what you have written very interesting ! I have been told by 1 doctor and 2 pharmacists (1 was yesterday, who have all said NOT to supplement with B12 if I have a thyroid problem)! However I do t know why!

I have other health conditions, which include underlying infections that have not been pinpointed - I ha enjust. Is a privTely paid for blood test ruled out TB - I am immune to that, but there is a possibility of it being latent perhaps, although the incomplete blood test says not.

I suggest your friends considers their own health over the years and potential connections with that to now. By the way I'm 68 and was only diagnosed In 2000 Age 53 as being Hypothyroid.

I've had several health things throughout my whole life that may or may not be connected with today's health issues. I think some are - it all comes down a question of knowing/deciding what's relevant and what isn't for the individual concerned!

[PPower in reply to SAMBS]

Thanks SAMBS. Yes, I think it's time for my friend to start looking for a new doctor and research and learn as much as she can.

Good luck with your health issues.

[Bluedragon in reply to SAMBS]

Why on earth would they say not to?! Sounds like nonsense to me. One would support the other surely.

[SAMBS in reply to Bluedragon]

Hi Bluedragon I've honestly no idea why they said it - but as I said all 3 are from the medical profession, and that's why I wrote it in my reply to ppower. Also some on this community write about having intravenous injections of it, so seems some docs must go with the idea, where others don't!

I'm Not medically trained or involved except as far as my own health goes!

That's also why I suggested to pPower that the friend look at other health issues previous and/or ongoing also. My last B12 test was under range which is why I was going to supplement. I had only a couple of the huge list of potential indicators of hypothyroidism - as for the others, fatigue was never an issue for me. Laziness on occasion perhaps, but I think we all know, that too many other "symptoms" mentioned on this Community could be down to other health issues, no only the Thyroid!

That's why I'm p,eased to see that the adminis here concentrate almost purely on the thyroid and blood test results, although I also think it would and. Old be prudent to suggest that peop,e look into other health issues also.

Thyroid UK and Levothyroxine cannot solve all our health conditions or the reasons for them.

[greygoose in reply to SAMBS]

SAMBS, did you not ask why they said not to supplement with B12 if you have a thyroid problem? That's always my first question - just like a little kid! lol I like to see them squirm!

[SAMBS in reply to greygoose]

Yes me also GG. I think in my reply to PPower, I said I forgot to ask at the time on Saturday when in pharmacy. Too slow to thought process the information! A permanent problem for me since my brain haemorrhage.

If anyone watched the programme on UK TV last week about the Brain - they may remember it being said about perception and Information thought processing if there has been a brain injury. The presenter also spoke about brain cells and neurons - neuroreceptors and neurotransmitters. Unfortunately that is one of the problems I have because of my BI - the mind still works - it's just the rest that gets cocked up occasionally!

However B12 and other vitamin supplementing is one thing to bear in mind to ask my doctor 'why not'? when I have to go for next blood test prescription.

I've said on TUK before that he prescribes D3 monthly, and has said ok to the Arko supplement I bought. That has definitely helped me, I know for a fact because of improvement in eating and sleeping and feeling more energized by it. I've just finished 2nd month of taking it and into the last 10 days of stopping - so I will wait and watch to see what happens thereafter.

[greygoose in reply to SAMBS]

Yes, I saw that after I'd replied to you.

Lack of T3 doesn't do much for the brain, either! I forget all sorts of things when I'm hypo. I very well know that delayed reaction. You get outside the surgery or the pharmacy, and you think, damn! I should have asked so-and-so! lol Happens to us all, I'm afraid.

I'll be interested to hear what your doctor has to say!

[TheLadyOfShalott]

Her free T4 is 40% of the reference range. 50% and above is more optimal. A measurement of serum isn't a measurement of what is getting to the cells. She needs her free T3 tested. You can buy your own kits and get the phlebotomy done. Life Extension Foundation do full thyroid panels if you're in America. Her TSH is too high. Target TSH with levothyroxine treatment is 1 - 2, and 1.18 is thought to be ideal. However, TSH is a pituitary hormone anyway, and gauging the actual thyroid hormones is most important. Regarding "the right level for her age," well who wants the hormones of a 70 year old, whether one is 70 or not?! Youthful hormone levels keep us youthful. I would advise her to get a full thyroid panel and make a start on 25 mcg levothyroxine, adjusting dose depending on results of free T4 and free T3, and to monitor this herself.

[greygoose in reply to TheLadyOfShalott]

Who thinks a TSH of 1.18 is ideal? Not someone with hypothyroidism, I'll be bound!

[TheLadyOfShalott in reply to greygoose]

ncbi.nlm.nih.gov/pubmed/161...

True, some patients feel better with a lower or even higher TSH, 'optimal' is very individual. But the point is she doesn't feel well with a TSH of 5.45 but her GP won't prescribe based on that number. When I had the same problem, showing my GP that paper was the catalyst that got me the medication I needed, and despite TSH being a pituitary rather than thyroid hormone, most endocrinologists and patients agree 1 - 2 are good starting points to aim for and 1.18 is within that. Some patients can have a suppressed TSH but still be hypothyroid when looking at actual free T4 & T3 numbers, but only looking at TSH in that case would lead a doctor to believe the patient was actually hyper instead. Like I said, it's very individual and sometimes other medications can impede thyroid hormones etc.

[greygoose in reply to TheLadyOfShalott]

OK, just curious. It's terrible that the TSH is taken into consideration at all. But, stating that it has to be a certain number is going to leave a lot of people - me included, still ill.

But, good job I asked, because you didn't give that link in your original comment.

But, you're absolutely right, age should not be a consideration. That's what Anti-Aging médicine is all about, and why it's sometimes better to see an Anti-Aging doctor than an endo. (They admit themselves that the name is stupid! lol)