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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by MB on July 10, 2001, at 4:07:53
I just got some test results back from the doctor. I went in because I was so headachy and fatigued with a feeling like my heart was beating irregularly and harder that usual. I am currently taking l-thyroxine, and thought I might be taking too little (or too much?). He ran a THS test, and it turned out to be .8 uIU/mL. I just read on this web page (http://thyroid.about.com/library/howto/hthyperthyroidism.htm) that the range is between .5 and 5.5 uIU/mL. The page also said that if you are in the low range, you might be hyperthyroidic. Does anybody understand this stuff? I feel like I'm poisoned. could I be taking too much thyroxine? The doctor doesn't seem concerned, but I am.
Posted by noa on July 10, 2001, at 10:57:16
In reply to Too much thyroxine?, posted by MB on July 10, 2001, at 4:07:53
.8 is low, but it depends on the person and their needs. Usually, doctors are quick to get worried about hyperthyroid symptoms accompanied by a low TSH, so your doctor is unusual. My TSH is that low, but on purpose, because at higher levels, I still have hypothyroid symptoms (the opposite of hyperthyroid), which make me feel not well at all, and at this level I have no signs of hyperthyroid. If I did, I am sure my doc would want to adjust my meds accordingly.
I would ask the doctor why he isn't concerned, and if he doesn't beleive it is the thyroid, what is causing your symptoms. I might also go for a second opinion. What kind of doctor is your doctor? Perhaps going to an endocrinologist?
Also, did you have other Thyroid tests run besides the TSH? The about.com page has a link to a page about thyroid tests and results.
Posted by MB on July 10, 2001, at 20:37:40
In reply to Re: Too much thyroxine?, posted by noa on July 10, 2001, at 10:57:16
> .8 is low, but it depends on the person and their needs. Usually, doctors are quick to get worried about hyperthyroid symptoms accompanied by a low TSH, so your doctor is unusual. My TSH is that low, but on purpose, because at higher levels, I still have hypothyroid symptoms (the opposite of hyperthyroid), which make me feel not well at all, and at this level I have no signs of hyperthyroid. If I did, I am sure my doc would want to adjust my meds accordingly.
>
> I would ask the doctor why he isn't concerned, and if he doesn't beleive it is the thyroid, what is causing your symptoms. I might also go for a second opinion. What kind of doctor is your doctor? Perhaps going to an endocrinologist?
>
> Also, did you have other Thyroid tests run besides the TSH? The about.com page has a link to a page about thyroid tests and results.It was a GP in an "in-and-out" style HMO environment that ran the tests. He is a smart guy, but impossible to pin down for more than 7 minutes at a time. He only ran the TSH, and did not check for T3 levels, which I thought was weird, but then again, I'm not a medical doctor, so I deferred to him. He wants to wait three months to see me again...said all the test were normal (guess he's not as uncomfortable with my symptoms as *I* am--and I *am* uncomfortabe, literally). Over the past two days, I made a mistake and took three of my l-thyroxine pills instead of two. The symptoms got really bad: pounding headache, ability to feel my heart beating in my chest along with tachycardia everytime I stood up, sweating and feeling thirsty and parched like I was dying in the desert. This seems like hyperthyroidism to me, but then again, it's totally subjective, it could be psychosomatic or due to something else...won't know without more tests. I like your endocrinologist idea. I didn't take a thyroid pill today. I've missed a week before without getting hypothyroidic, so i might take a few days off from the medication and see if I feel better.
Posted by noa on July 11, 2001, at 8:55:48
In reply to Re: Too much thyroxine? » noa, posted by MB on July 10, 2001, at 20:37:40
I don't think Stopping the thyroid meds is a good idea. I have a feeling that abrupt changes aren't good. Get the endo consult right away.
Posted by Pattisun on July 12, 2001, at 14:52:06
In reply to Re: Too much thyroxine?, posted by noa on July 11, 2001, at 8:55:48
1. Why do you take thyroid supplements? Did you have your thyroid removed (all or partially, or killed via RAI)?
2. Is your treating doc a family gen'l pract or an internist or endocrynologist?
Here's my own personal hell (story):
I have Graves disease and had RAI (no thryoid gland). Things fine since '95. In Dec '99 TSH showed my thyroid low (13-15 maybe). The family doc upped (Levoxyl) to .137. After 6 weeks I complained of "hyper" symptoms. She took a test, TSH at 3 and she said I was fine. I continued to complain that I felt lousy (hyper-racing heart, emotional outbursts, etc.). They took another test, this time TSH 1. Doc said your fine.Okay, I gave up, figured it was just my imagination. Then, my eyes starting bothering me, referred to thyroid eye doctors--my left eye was bulging (thyroid eye disease). GREAT!! So, now I was having hyper symptoms and my eye made me look like a wierd lizard or something.
Family docts telling me I was crazy (sent my to a psychiatrist); they told me I had a possible brain tumor; (NOT-had to endure CAT scan, MRI and snotty Neurologists).
Well, finally retested and whalla I was over the mark and 0.32 --hyper!! I TOLD THEM THAT ALL ALONG!
So, they over-react. Have me stop all supplement. Then restart at .100. Long story, I ended up so severely low thyroid I was out on disability. I think them giving me too much supplement set off my eye disease.
Bottom line, thyroid level is VERY, VERY IMPORTANT. Don't leave your care to family docts. Go to an internist or an endocrynologist. If you feel hyper, complain LOUDLY. Change docts if you need to. It's more than just numbers, it's also how you feel. And, for me, they should have just had me take .125 then .137--alternating doses and I would have been fine.
Good luck!
Posted by MB on July 12, 2001, at 16:04:36
In reply to IMPORTANT WARNING!!, posted by Pattisun on July 12, 2001, at 14:52:06
> 1. Why do you take thyroid supplements? Did you have your thyroid removed (all or partially, or killed via RAI)?
A psych started me on l-thryoxine in mid-early nineties because of depression.
> 2. Is your treating doc a family gen'l pract or an internist or endocrynologist?
I think he's a general practitioner. I seldom see patients in the waiting room younger than 60 yrs. I think he specializes in cheap preventative medicine for the elderly. Plus the HMO situation means I can't talk with him for more than 10 minutes (otherwize i have to schedule 2 appointments back to back!).
> Here's my own personal hell (story):
> I have Graves disease and had RAI (no thryoid gland). Things fine since '95. In Dec '99 TSH showed my thyroid low (13-15 maybe). The family doc upped (Levoxyl) to .137. After 6 weeks I complained of "hyper" symptoms. She took a test, TSH at 3 and she said I was fine. I continued to complain that I felt lousy (hyper-racing heart, emotional outbursts, etc.). They took another test, this time TSH 1. Doc said your fine.
>
> Okay, I gave up, figured it was just my imagination. Then, my eyes starting bothering me, referred to thyroid eye doctors--my left eye was bulging (thyroid eye disease). GREAT!! So, now I was having hyper symptoms and my eye made me look like a wierd lizard or something.
>
> Family docts telling me I was crazy (sent my to a psychiatrist); they told me I had a possible brain tumor; (NOT-had to endure CAT scan, MRI and snotty Neurologists).
>
> Well, finally retested and whalla I was over the mark and 0.32 --hyper!! I TOLD THEM THAT ALL ALONG!
>
> So, they over-react. Have me stop all supplement. Then restart at .100. Long story, I ended up so severely low thyroid I was out on disability. I think them giving me too much supplement set off my eye disease.
>
> Bottom line, thyroid level is VERY, VERY IMPORTANT. Don't leave your care to family docts. Go to an internist or an endocrynologist. If you feel hyper, complain LOUDLY. Change docts if you need to. It's more than just numbers, it's also how you feel. And, for me, they should have just had me take .125 then .137--alternating doses and I would have been fine.
>
> Good luck!My TSH level was .8 uIU/mL. I think it is in the very low area of the normal range, but, like you said, it's the way I feel that scares me. My muscles just feel "toxic" and my heart races any time I stand up. I'm always thirsty...just feel toxic, that's the only way I can describe it: headachy, stomach upset, fatigue, muscle weirdness and the feeling like my heart is beating in my throat (except my blood pressure and pulse rate are normal...), aching in my eyes and throat. I was so fatigued that I thought I might add some l-thyroxine, so for two days I took a little extra, and my symptoms became unbearable. Then I quit for two days, and I felt really good...relieved, like my body was finally able to rest after months of this poisonous-feeling speediness.
Posted by Pattisun on July 12, 2001, at 16:21:53
In reply to Re: IMPORTANT WARNING!! » Pattisun, posted by MB on July 12, 2001, at 16:04:36
Okay. I have an HMO and they let me switch primary docts (and I found an internist instead of a g.p.).
See if you can switch docts? OR, if you like your doc, go back and tell him:
You felt better NOT taking the supplement 2 days. After you started taking it, the symptoms returned.
My warning is just that don't stay on too high a dose of thyroid supplement for too long, because I feel it could be damaging.
But, of course, you can't just stop either because that could have adverse affects as well.
Good luck and DON"T just settle for "you're okay, the blood test is fine". Be a pain in the butt and get someone to listen. Wish someone had given me this advice!
Post back if you need me!
Pattisun >
Posted by susan C on July 12, 2001, at 22:13:06
In reply to IMPORTANT WARNING!!, posted by Pattisun on July 12, 2001, at 14:52:06
Dear Pattisun, I am looking at my test for TSH and it is .75miU/ml. As I understanding the range is 1.0-3.0
If I may take you up on your offer,Would you explain it in plain english. I have been trying to educate myself on hypo and hyper and the thyroid...and I cant get it straight. Docs say, not to worry. If I look for an internist and or endrochinologist what, in your opinion are good questions to ask from a bipolar/thyroid point of view. Thank you in advance..
> 1. Why do you take thyroid supplements? Did you have your thyroid removed (all or partially, or killed via RAI)?
> 2. Is your treating doc a family gen'l pract or an internist or endocrynologist?
> Here's my own personal hell (story):
> I have Graves disease and had RAI (no thryoid gland). Things fine since '95. In Dec '99 TSH showed my thyroid low (13-15 maybe). The family doc upped (Levoxyl) to .137. After 6 weeks I complained of "hyper" symptoms. She took a test, TSH at 3 and she said I was fine. I continued to complain that I felt lousy (hyper-racing heart, emotional outbursts, etc.). They took another test, this time TSH 1. Doc said your fine.
>
> Okay, I gave up, figured it was just my imagination. Then, my eyes starting bothering me, referred to thyroid eye doctors--my left eye was bulging (thyroid eye disease). GREAT!! So, now I was having hyper symptoms and my eye made me look like a wierd lizard or something.
>
> Family docts telling me I was crazy (sent my to a psychiatrist); they told me I had a possible brain tumor; (NOT-had to endure CAT scan, MRI and snotty Neurologists).
>
> Well, finally retested and whalla I was over the mark and 0.32 --hyper!! I TOLD THEM THAT ALL ALONG!
>
> So, they over-react. Have me stop all supplement. Then restart at .100. Long story, I ended up so severely low thyroid I was out on disability. I think them giving me too much supplement set off my eye disease.
>
> Bottom line, thyroid level is VERY, VERY IMPORTANT. Don't leave your care to family docts. Go to an internist or an endocrynologist. If you feel hyper, complain LOUDLY. Change docts if you need to. It's more than just numbers, it's also how you feel. And, for me, they should have just had me take .125 then .137--alternating doses and I would have been fine.
>
> Good luck!
Posted by MB on July 13, 2001, at 2:53:49
In reply to Back to MG, posted by Pattisun on July 12, 2001, at 16:21:53
> But, of course, you can't just stop either because that could have adverse affects as well.Does taking thyroid hormone suppress the normal thyroid function the way taking prednisone suppresses the adrenal glands? In other words, if a normal person took thyroid hormone for a year and then quit without tapering, would they go hypothyroidic?
> Good luck and DON"T just settle for "you're okay, the blood test is fine". Be a pain in the butt and get someone to listen. Wish someone had given me this advice!
Yeah, I need to call and be a pain in the butt...get to the bottom of the whole deal.
Posted by Pattisun on July 13, 2001, at 10:11:18
In reply to Re: IMPORTANT WARNING!!, posted by susan C on July 12, 2001, at 22:13:06
> Dear Pattisun, I am looking at my test for TSH and it is .75miU/ml. As I understanding the range is 1.0-3.0
Here's a good place to start:
>
http://thyroid.about.com/library/weekly/aa042100a.htmBut, what they say is if your TSH comes out 0.33 and above, you are considered "hyper" thyroid, i.e., your body has too much thyroid hormone and you may need to be tested for Graves.
If it is above 5.0, doctors will tell you that you're a little low thyroid and they may offer some thyroid supplement.
Bottom line, however, should be your symptoms. I hate when doctors get hung up on numbers, because numbers don't tell how you feel.
Check out the website and do some reading. And, check your symptoms. Then, you ask what the doctors can to do alleviate your symptoms--which ones can be thyroid and which one are are from your bipolar. Ideally, you find a doct that knows both, or have two that can work together as a team.
Good luck
Posted by Pattisun on July 13, 2001, at 10:23:25
In reply to Re: Back to MG » Pattisun, posted by MB on July 13, 2001, at 2:53:49
Hey MG,
I don't really know. But, if you've been taking this for a while (which you have, then I would think that you are probably hypothyroid (at least somewhat). Maybe the docts will have you stop taking the supplement for 8 weeks (long enough to get a good TSH level), and see where you are at?? Or maybe have you take 1/2 dose for 8 weeks and see where that puts you? It takes about that long to get an accurate TSH after you adjust the meds.
My point was just that if you've been taking a supplement for a long time you probably shouldn't just stop on your own.
And I don't know if taking the supplement for so long has suppressed your thyroid gland? I don't think it is supposed to, but your thyroid is such a delicate and essential part of your whole system--??? In theory, I guess you just stop taking it and if you feel draggy you go back to the docts. But, I stopped taking mine a long time ago and later was diagnosed with Graves. I wish I'd been more diligent about blood tests and such. Just hated going to doctors. Now I go ALL the time!
GOOD LUCK MG. Hope you get to feeling better.
> Does taking thyroid hormone suppress the normal thyroid function the way taking prednisone suppresses the adrenal glands? In other words, if a normal person took thyroid hormone for a year and then quit without tapering, would they go hypothyroidic?
>
Posted by Noa on July 13, 2001, at 11:01:24
In reply to Re: Back to MG, posted by Pattisun on July 13, 2001, at 10:23:25
Symptoms are important. The drawback of the inexpensive, accessible TSH test is that doctors rely too much on it and stop listening to their patients.
The about.com site has a page on how to read your thyroid tests. It also has a page of recommended doctors. That is how I found my endocrinologist and he is great--turned my life around.
BTW Low TSH indicates high thyroid (hyper). High TSH indicates low thyroid (hypo). This is because TSH is the thyroid *stimulating* hormone put out by the pituitary. If it is sending out a lot, it could mean the thyroid is not responding normally to the TSH. If the TSH is low, it means the thyroid could be very active, not need much to stimulate it.
But you really need to have other tests, too to see what your actual levels of usable thyroid hormone are.
Posted by Noa on July 13, 2001, at 11:26:18
In reply to Re: Back to MG, posted by Pattisun on July 13, 2001, at 10:23:25
At top of Babble page, there is a link to the Thyroid and Depression folder at Psycho-Babble-Tips. Here are a couple of sites I clipped from there:
Clinical Practice Guidelines for Evaluation and Treatment of Hyperthyroidism and Hypothyroidism
The American Association of Clinical Endocrinologists
http://www.aace.com/clin/guides/thyroid_guide.htmlKey Thyroid Function Tests
From Mary Shomon's website
http://thyroid.about.com/health/thyroid/library/weekly/bltest-values.htmThyroid Symptoms Chart
diagram of hyper- and hypo- thyroid symptoms throughout the body
http://www.thyroidfoundation.org/thyroidsymp.htm
Posted by MB on July 13, 2001, at 13:42:05
In reply to Re: Back to MG, posted by Pattisun on July 13, 2001, at 10:23:25
> GOOD LUCK MG. Hope you get to feeling better.Thanks!
Also, thanks for the information
Posted by MB on July 13, 2001, at 13:43:06
In reply to Thyroid info, posted by Noa on July 13, 2001, at 11:26:18
> At top of Babble page, there is a link to the Thyroid and Depression folder at Psycho-Babble-Tips. Here are a couple of sites I clipped from there:
>
> Clinical Practice Guidelines for Evaluation and Treatment of Hyperthyroidism and Hypothyroidism
> The American Association of Clinical Endocrinologists
> http://www.aace.com/clin/guides/thyroid_guide.html
>
> Key Thyroid Function Tests
> From Mary Shomon's website
> http://thyroid.about.com/health/thyroid/library/weekly/bltest-values.htm
>
> Thyroid Symptoms Chart
> diagram of hyper- and hypo- thyroid symptoms throughout the body
> http://www.thyroidfoundation.org/thyroidsymp.htmThanks for all the good info!!
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