pls explain..hypothyroid how can you have..

Nurses General Nursing

Published

Hey guys,

Can you help me out with this. I know you can and thank you in advance for doing so... Today in lecture my prof spoke on hypothyroidism. She said in this condition you have decreased TSH secretion. (so far so good) She then went on to say that you would have increased levels of TSH with decreased T4 and normal T3. She lost me when she said you would first have decreased TSH secretion but I would actually have an increase of TSH on my labs??? WHAT? I don't follow. Can anyone shed some light and make this a little clearer than mud?:uhoh21:

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Oh! That's fantastic! Where did you find this information? I just found an article in the British Journal of Medicine from two years ago stating the new official range was .1 - 3 that I wanted to show my doctor because the lab ranges he uses list 4.6 as the high end of normal.
I'd really hate to sound like a sexist, but I must say this.

Find a female doctor to treat you for thyroid, whether she's a general/family practicioner or an endocrinoligist. My male doctor was 'less in tune' with my hormones and was overprescribing me with Tapazole. I subsequently gained weight at the rate of 15 pounds monthly until I looked like a beached whale. He saw nothing wrong with this and said I needed 'willpower' ans should have no problems losing weight.

I switched to a female family practice doctor who understood hormonal issues more proficiently. I lost all the weight and my thyroid levels remained WNL for three years in a row.

Up Vote Up Vote ×
I'd really hate to sound like a sexist, but I must say this.

Find a female doctor to treat you for thyroid, whether she's a general/family practicioner or an endocrinoligist. My male doctor was 'less in tune' with my hormones and was overprescribing me with Tapazole. I subsequently gained weight at the rate of 15 pounds monthly until I looked like a beached whale. He saw nothing wrong with this and said I needed 'willpower' ans should have no problems losing weight.

I switched to a female family practice doctor who understood hormonal issues more proficiently. I lost all the weight and my thyroid levels remained WNL for three years in a row.

Thank you for the advice. I appreciate it. I am really frustrated with him. I gained 20 in the blink of an eye and he didn't seem to think anything was wrong despite the fact that I hadn't stopped exercising and didn't change my eating habits. The weight gain defied logic! I just now started losing weight. It's only a few pounds, but it's something!

My throat was so swollen it hurt to talk sometimes. When I told him that, he said it was unrelated to my thyroid and then diagnosed me as having strep throat (without doing a culture on my throat). When that medication didn't work, he put me on prednisone for almost 4 months.

He refused to put me on any kind of thyroid medication until my antibodies tripled and he found out I had a goiter, and even then he didn't want to acknowledge I had any kind of thyroid problem. It took him 6 months before he admitted my thyroid was not functioning correctly.

Up Vote Up Vote ×

I feel like I need an endocrinologist. Someone who specializes in this stuff.

It is frustrating to be told you are fine.

Not that I'm looking to be sick but I'm exhausted.

steph

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I feel like I need an endocrinologist. Someone who specializes in this stuff.

It is frustrating to be told you are fine.

Not that I'm looking to be sick but I'm exhausted.

Go with your gut instinct. If you feel sluggish, have a slightly sluggish pulse, dry skin and hair, brittle nails, constipation, or at least three of the classic symptoms of hypothyroidism, there's a solid change your thyroid could be slowing down on you. I would see an endocrinologist ASAP before your heart undergoes permanent structural changes.
Up Vote Up Vote ×
I hated this lecture in school too . . .:crying2:

Different labs use different values which can also make it confusing. Because I'm looking at the lab values y'all are posting (TSH 120?) and I'm seeing something different on my labs.

steph

Yep, my TSH really was 120. And get this, the doctor didn't believe me when I said I thought I was hypothyroid, because I'd gained TOO MUCH weight. He claimed hypothyroid only ever results in a "moderate" weight gain. Every other person I've talked to who has hypothyroid gained a ton of weight and (sad to say) has had trouble taking it off, even with medication. Thank goodness I insisted on the test!

Up Vote Up Vote ×
I hated this lecture in school too . . .:crying2:

Different labs use different values which can also make it confusing. Because I'm looking at the lab values y'all are posting (TSH 120?) and I'm seeing something different on my labs.

My TSH was 3.82 in May of last year and is now 4.44

Ref.Range/Females is 0.50 to 6.00 uIU/ml

My F.T4 is 0.84

Ref. Range/Females is 0.75 - 1.54 ng/dl

So, the lab guy says I'm high normal . .. my doc says I'm normal. I'm tired, can't lose weight no matter how much I exercise, am losing hair in a short period of time.

Don't ya just love medicine??:)

steph

Steph...

PLEASE, go get an ultrasound of your thyroid and have an ENDO read it! NOT a radiologist, NOT your GP. But an ENDO!

My doc kept telling me I was fine (two periods in a year, gaining weight and that's never been a problem before, my hair falling out, little old lady ankles, my thyroid was messing with my voice and I was starting to sound like Mr. T, etc.) but my TSH was high normal.

The Endo Assoc. has come up with new normals. Six is TOO HIGH! Four is now high normal. You are beyond that. With your TSH going up what do you have to lose by getting an ultra sound of your thyroid? They can tell by the texture if other things are going on. I was on Levoxyl and even at 300mcg qd my TSH was still creeping up. I'm on Cytomel now and feel like a new person.

Up Vote Up Vote ×
Oh! That's fantastic! Where did you find this information? I just found an article in the British Journal of Medicine from two years ago stating the new official range was .1 - 3 that I wanted to show my doctor because the lab ranges he uses list 4.6 as the high end of normal.

Oh my goodness, I don't even remember anymore. I did mega research on it when nobody would believe me that something was wrong. I did some research, took it to my doc, and he said that yes, something was wrong but it wasn't thyroid.

Went to an endo and she verified everything I had researched. Cytomel is my best friend now.

There is actually a great web site for non medical professionals and let me tell you, these people have ALL the most up to date info on thyroid. They can point you to every bloody study there is. The regulars there know their stuff, I have to admit I am very impressed. Some of the newbies pass on bad info but someone else comes along and corrects them. If you go to About.com and find their thyroid forum, you are there. They also have the patient's version of Top Docs/Endo. That's how I found my Endo and I love her.

There is old school and new school. :) You need to find a new school endo. Do your research and check your sources. But About.com's website is great. If you can't find it, let me know and I'll find it and give you the link. Don't let the fact that it is run by non-medical professionals fool you, these folks are full of studies and links so you can see for yourself.

Up Vote Up Vote ×
I'd really hate to sound like a sexist, but I must say this.

Find a female doctor to treat you for thyroid, whether she's a general/family practicioner or an endocrinoligist. My male doctor was 'less in tune' with my hormones and was overprescribing me with Tapazole. I subsequently gained weight at the rate of 15 pounds monthly until I looked like a beached whale. He saw nothing wrong with this and said I needed 'willpower' ans should have no problems losing weight.

I switched to a female family practice doctor who understood hormonal issues more proficiently. I lost all the weight and my thyroid levels remained WNL for three years in a row.

Yeah, I was going to say the same thing but was afraid someone would jump down my throat. Find a female endo.

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Steph...

PLEASE, go get an ultrasound of your thyroid and have an ENDO read it! NOT a radiologist, NOT your GP. But an ENDO!

My doc kept telling me I was fine (two periods in a year, gaining weight and that's never been a problem before, my hair falling out, little old lady ankles, my thyroid was messing with my voice and I was starting to sound like Mr. T, etc.) but my TSH was high normal.

I agree with Bipley on this issue. Doctors are wonderful people, so don't get me wrong. However, the average thyroid patient knows much more about thyroid ailments than the average general/family practice physician. I suggest you find any endocrinologist and get the help you possibly need. They look at the 'whole picture' instead of simply dismissing you as 'okay' even with high-normal lab values.
Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Yeah, I was going to say the same thing but was afraid someone would jump down my throat. Find a female endo.
And if you absolutely cannot get to a female endocrinologist, the next best thing would be a younger, new-school male endo who has only been out of residency for a couple of years or less. If you can't track down an endo, then female general practice doctors or female nurse practitioners are great for thyroid treatment.
Up Vote Up Vote ×
And if you absolutely cannot get to a female endocrinologist, the next best thing would be a younger, new-school male endo who has only been out of residency for a couple of years or less. If you can't track down an endo, then female general practice doctors or female nurse practitioners are great for thyroid treatment.

Agreed. One difference between an endo and GP is when the GP feels your thyroid he'll dig his thumbs in and tell you to swallow once. My Endo had me sit in a chair, she stood behind me, handed me a glass of water and told me this would take awhile. She wasn't kidding. Then she did the ultra sound herself and showed me what she was seeing as she did the test.

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Agreed. One difference between an endo and GP is when the GP feels your thyroid he'll dig his thumbs in and tell you to swallow once. My Endo had me sit in a chair, she stood behind me, handed me a glass of water and told me this would take awhile. She wasn't kidding. Then she did the ultra sound herself and showed me what she was seeing as she did the test.
My endo also hands me a cup of water, and as I swallow a sip, she stands behind me and palpates lightly. She then tells me her estimation of the size and texture of my thyroid. Prior to receiving radio-iodine, she said my thyroid was soft and weighing roughly 30 mg, which was normal. Ten weeks after the radio-iodine treatment, she palpated and determined that my gland was rigid and had shrunk somewhat.

How funny, because all of the GPs who palpated my thyroid in the recent past declared that it was "grossly enlarged". :rolleyes:

Up Vote Up Vote ×
+ Add a Comment