Asking for some help to put this all together - please. Lab results included

[CFitzRN]

Hi,

My 23 year old son has been hypothyroid for about 5 years now. He was taking 75 mics and then 88 mics of Synthroid. He has been severely symptomatic despite, and his TSH has always been higher with each test. He's been studying Engineering at University and has graduated (by the skin of his teeth due to all the health problems) with 2 degrees. To say he suffered through would be putting it very mildly. He had fibromyalgia symptoms, extreme fatigue, severe bouts of IBS, terrible brain fog which he says made it nearly impossible to study and stay focused, insomnia... I could go on. Finally, after graduation, he moved home while finding a job. He was gaining weight, getting more and more miserable and I finally took him to an Endocrinologist, who frankly acted a bit like an arrogant d*ck, but agreed to do some more in-depth testing. These were the results. Although I've read and researched until my eyes are crossed, I could really use some help interpreting these and advice on the best way to follow up. I know he's positive for Hashimoto's, but there are clearly some other things happening. Thank you if you have gotten this far, and thank you in advance for your help. (also, the Endo has been terrifically unhelpful in advising us)

Labs:

TSH - 9.23 uIU/ml (HIGH) - norm 0.36-2.84 uIU/ml

Thyroxine (T4) – 6.2 ug/dl - norm 4.5 – 12.0

T3 uptake – 32 - norm 24 – 39

Free t3 lll - 3.4 pg/ml - norm 2.0 – 4.4 pg/ml

Free t4 ll - 1.08 ng/dl - norm 0.93 – 1.7 ng/dl

Thyroglobulin Antibody - 12.5 IU/ml(HIGH) - norm 0.0 – 0.9 IU/ml

Thyroid Peroxidase (TPO) ab – 6 IU/ml - norm 0-34 IU/ml

Vitamin D, 25-Hydroxy - 19.42 ng/ml(LOW) - norm 30.0 – 100.0 ng/ml

Testosterone, total LC/MS – 251.6 ng/dL(LOW) - norm 348.0 – 1197.0 ng/dL

Prolactin – 25.9 ng/ml(HIGH) - norm 4.0 – 15.2

Ferritin, Serum – 69 ng/ml - norm 30 – 400 ng/ml

t-Transglutaminase IgA (for Celiac) - < 2U/ml - norm 0 -3 U/ml (negative)

Hemoglobin A1c – 5.2 - norm 4.8 – 5.6

Vitamin B-12 – 529 pg/ml - norm 211 – 946 pg/ml

Triglycerides – 178 mg/dl(HIGH) - norm 0 – 149

LDL Cholesterol – 101 mg/dl(HIGH) - norm 0 - 99

He had a thyroid ultrasound and it was apparently normal.

[shaws Administrator]

Hypothyroid for five years and his latest TSH result is nearly 10. I don't know how he has managed to get through his exams never mind coping with all of the unpleasant symptoms which come along when seriously hypothyroid.

If I were him, I'd add liothryonine T3 to his T4. Synthroid is a synthetic T4 which converts to T3 in the body. T4 is inactive and has to convert to T3. T3 is the only active hormone required in all of our receptor cells and the brain contains the most. Raising hormone intake has to be done gradually until all symptoms are resolved and he feels normal health again. Others will respond about the other blood test results.

Big Pharma has made wonderful attempts to ensure that Synthroid/levothyroxine is the top of the list for doctors when people are first diagnosed. Many do fine and many do not and remain unwell with continuing clinical symptoms and some very disabling.

Your son needs gradual increases until his TSH is 1 or lower. We need a Free T4 and Free T3 to be towards the upper part of the range.

A higher cholesterol level is due to hypothyroidism (undiagnosed and/or undertreated). Doctors might prescribe statins but not advisable as with the proper hormones it will reduced.

There is also a product called Natural Thyroid Hormones made from pigs or cows thyroid glands. In use since 1892 which big pharma has made false statements, believed by the endocrinology departments worldwide so that only levo is given. NDT contains all of the hormones a healthy thyroid gland would produce, i.e. T4, T3, T2, T1 and calcitonin (the latter 4 in small amounts of course).

The doctor who wrote the following would never prescribe Synthroid or any T4 for his patients, so much so that he resigned his licence so that he could give his patients the best that he could.

thyroidscience.com/Criticis...

This is an excerpt from the following link:

Safely Getting Well

with Thyroid Hormone

ONE OF THE WORST DISASTERS in the history of medicine is the

endocrinology specialty’s modern guidelines for diagnosing and

treating patients whose bodies are under-regulated by thyroid

hormone. These guidelines and the beliefs they’re based on have

caused a worldwide public health crisis. It involves the chronic illness

of scores of millions of people and the premature deaths of

incalculable numbers more. Each year, billions of dollars are spent

for drugs intended to control patients’ chronic symptoms; the drugs

are largely ineffective and often induce adverse effects in the

patients. Researchers who fail to recognize that the cause of the

patients’ symptoms is under-regulation by thyroid hormone do

studies looking for other causes. Since they are blinded to the real

culprit, their fruitless efforts squander billions of research dollars.

We learned of this public health disaster through our study of

fibromyalgia patients. Our research taught us the main underlying

cause of most of the patients’ fibromyalgia symptoms: under-regulation

of their bodies by thyroid hormone. After learning this, we

developed metabolic rehab, a treatment method that helps patients

recover normal metabolism. The treatment involves the use of thyroid

hormone, but in ways that differ from the method the endocrinology

specialty has imposed on most doctors and patients.

Most patients who undergo conventional thyroid hormone therapy

remain ill. In stark contrast, some 85% of patients who undergo

metabolic rehab fully and lastingly recover. In this chapter, we

explain how patients use thyroid hormone in metabolic rehab.

nebula.wsimg.com/e0c9c9ed95...

[CFitzRN in reply to shaws]

It is a miracle he got through. He would text me in near breakdown mode (and he is not like that at all) saying he just didn't think he could do it anymore. It was so hard for me to truly understand, but I heard the desperation in his messages. I just want the kid to be able to live a normal life and not feel like he's at death's door every day. Thank you for your help, I will look into the links.

[shaws Administrator in reply to CFitzRN]

He can get well with the right thyroid hormone replacements for him. He has to be commended for such a struggle without really knowing what was happening to his health with all the terrible symptoms. His doctor has been very neglectful. In other countries people are given medication when it is just over 3 not on hormones with a TSH which is still 10.

[Clutter]

Welcome to the forum, CFitzRN.

Your son is very under medicated on 75mcg to have TSH >9 and will need a couple of dose increases. Increases are usually in 25mcg increments every 6-8 weeks.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

Thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

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

VitD is optimal around 40-50ng/ml. I would supplement 5,000iu D3 daily for 3 months and retest late May. He should take vitD 4 hours away from Levothyroxine.

Ferritin is a bit low. Halfway through range is optimal. Your son could supplement iron with 1,000mcg vitamin C to aid absorption and minimise constipation and retest in 4-6 months. Iron should also be taken 4 hours away from Levothyroxine.

Cholesterol will probably fall once your son is optimally medicated on Levothyroxine with TSH around 1.0.

Check out labtestsonline.org to see what low testosterone and high prolactin indicate.

[CFitzRN in reply to Clutter]

Thank you for the links and information. This is such a deeply complex condition - I could spend hours on the internet reading about it and still barely scratch the surface (and I have!). I appreciate your help!

[startagaingirl]

Hi - he is way undermedicated, but I think he should stick with the synthroid for now until he knows if he actually converts well. Dose can vibe raised by 25mcg at a time, then re-test after 6-8 weeks and keep raising until Tsh is around 1, ft3 and ft4 are near the top of the ranges and see if he feels well.

His ferritin, whilst ok ish, could do with being a bit higher. Iron tablets with 1000 vit c each or eating liver will raise that. Optimum is mid-range.

B12 again isn't bad but is less than optimal (1000 ish) for hypothyroid. Sublingual methyl cobalamin lozenges 1000 would solve that in a few months. With this it is important to take a mixed b- vits to balance them out.

I don't see a result for folate, that also needs to be high in range.

Vit d is much too low, optimum 60+, so needs addressed with vit d3 supplement plus vit k2-mk7 and magnesium.

There is something going on with his prolactin, but I can't help you there.

A strict gluten free diet and selenium supplement should help reduce the impact of the Hashis.

Cholesterol should normalise once thyroid is optimum as should his cortiso and possibly testosterone as these are linked to tired adrenals from supporting his thyroid.

Good luck to him

Gillian xxl

[CFitzRN in reply to startagaingirl]

Thanks so much for the supplement information! That's one thing I wasn't 100% sure on.

[CFitzRN]

Taking it all in - thank you so much for your replies thus far.