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Re: Endocrinology consult Tabitha

Posted by Larry Hoover on January 2, 2006, at 15:04:22

In reply to Re: Endocrinology consult Larry Hoover, posted by Tabitha on January 1, 2006, at 22:41:20

> So Lar, are you saying my TSH reading would not vary as much during the day as the free T3? If that's the case I'll make the effort to get the first lab numbers also. I asked for them to be sent to me, they didn't send them, and I didn't follow up.

I think there is still meaning in that value, whatever it is. I do not believe that TSH changes rapidly in response to e.g. an oral dose of T3. TSH is T3 sensitive, but I don't believe it is rapid.

> Also I thought at some point I'd read that TSH is not meaningful when you're on T3, but I can't find that reference anymore.

Over time, your body does respond to those surges in *free* T3 caused by oral dosing. The TSH value loses meaning in the sense of being accurate feedback, but, it still has meaning. Your TSH will likely be "out of range", but it shouldn't be zero.

> Interesting link in the post to Phillipa. I couldn't quite figure out whether his advice about monitoring without bloodwork was particular to Hashimoto's patients or not.

In my opinion, it should be part of any thyroid-replacement treatment program. The secondary measures. Your bloodwork will still be meaningful, if you don't have Hashimoto's. The secondary measures help to individualize treatment. It's not enough to just be in the normal range of hormone concentration. You may need more than most people do, to really feel well.

Statistics don't apply to individuals. Somebody (a whole bunch of somebodies), was on the high side of normal when they developed the normal ranges, right? So, how do we determine if you're a low normal, midrange normal, or high normal somebody? Secondary measures.

Statistically, there are also normal people who are "off the chart" high. Even doctors sometimes forget simple statistical principles.

> So he also says osteoporosis isn't a risk at those dosages, yet most doctors say it is. It's confusing.

Ya, it's confusing. I think that the confusion arose because they just lumped all thyroid-replacement (hypo) patients in together. What I discovered was that it seems that hyperthyroid patients who received RAI (radioactive iodine) ablation, to destroy thyroid tissue, were the ones who skew the bone density values. They're artificially hypo, and I think that makes a difference.

Hey, the geek in me is coming out. I'll take another look at it.

> I did try a thermometer for a while-- before I started the T3, my temperature was pretty normal and seemed to vary a lot day to day (I was doing it in the morning before moving at all), so I lost interest in the method. I didn't keep it up more than a few days anyhow. Maybe I'll give it a shot again. I've read stuff saying it's a great measure, and stuff saying it's useless. Another confusing issue.

Ya. Some mornings I wake up hot, because I piled too many blankets on myself while I slept. Or cold, because I kicked them off. I think it's the trend (the average?, or best line on a graph?) that gives the useful information.

If you do it religiously for a period of time (two menstrual cycles, say), I think you'll have your answer, for yourself.

I am speaking about other people's experiences. I admit straight out that I don't know what it's like. Other than a short trial of T4, where I was accidentally given 10 times the dose I should have been on. I felt *so* bad. If that's hyperthyroid, you can have it. I have never used T3.





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