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Suggest Treatment For Thyroid Problem
Question: My symptoms are:
itching
insomnia
increased appetite and food intake with no weight gain
(after 1 hour of eating I am hungry again)
dizziness while eating
increased energy, "feel wired"
bruising
foregetfulness
TSH is 4.8 but t3 and t4 normal. I don't feel like these are symptoms of hypothyroidism, I feel more hyperthyroidism.
I have no swelling in my neck upon palpation
I am 5'6 and 120 lbs.
itching
insomnia
increased appetite and food intake with no weight gain
(after 1 hour of eating I am hungry again)
dizziness while eating
increased energy, "feel wired"
bruising
foregetfulness
TSH is 4.8 but t3 and t4 normal. I don't feel like these are symptoms of hypothyroidism, I feel more hyperthyroidism.
I have no swelling in my neck upon palpation
I am 5'6 and 120 lbs.
Brief Answer:
Thyroid
Detailed Answer:
Sorry to hear about your symptoms.
May I assume these TSH and other lab test results were done before starting armor correct?
I see what you are saying that your doctor prescribed thyroid hormone based upon symptoms suggestive of hypothyroidism.
However as you have rightly surmised some of your symptoms are suggestive of hyperthyroidism.
I would like to emphasize two things that have been reiterated by the ATA (American Thyroid Association) in their updated guidelines, and echoed by most practicing endocrinologists worldwide:
A It is unreliable to make a diagnosis of hypothyroidism on the basis of symptoms alone.
TSH and free T4 are reliable blood tests that can give an accurate idea as to whether or not Primary Overt or Sub clinical hypothyroidism is present
These tests do not require fasting and can be done at any time of the day.
I see your TSH is just above the upper limit of normal, generally considered to be 4.12 although many endocrinologists believe it is closer to 3.5
So yes a case can be made in your instance to treat.
But if I saw someone in my practice like you, I would approach things like this:
1 Ask if thyroid problems run in your family
2 Check thyroid auto antibodies (Anti TPO and Anti Thyroglobulin antibodies)
3 If antibodies positive then I would treat with a small dose of levo thyroxine and recheck levels in 6 weeks
4 If antibodies negative but free T4 low, I would still treat with a low dose of levothyroxine
5 If antibodies negative and free T4 normal and no first degree relatives with hypothyroidism, then I would recheck TSH in 6 weeks
B Armor thyroid is not recommended for the treatment of hypothyroidism. Levo thyroxine alone suffices
Thyroid
Detailed Answer:
Sorry to hear about your symptoms.
May I assume these TSH and other lab test results were done before starting armor correct?
I see what you are saying that your doctor prescribed thyroid hormone based upon symptoms suggestive of hypothyroidism.
However as you have rightly surmised some of your symptoms are suggestive of hyperthyroidism.
I would like to emphasize two things that have been reiterated by the ATA (American Thyroid Association) in their updated guidelines, and echoed by most practicing endocrinologists worldwide:
A It is unreliable to make a diagnosis of hypothyroidism on the basis of symptoms alone.
TSH and free T4 are reliable blood tests that can give an accurate idea as to whether or not Primary Overt or Sub clinical hypothyroidism is present
These tests do not require fasting and can be done at any time of the day.
I see your TSH is just above the upper limit of normal, generally considered to be 4.12 although many endocrinologists believe it is closer to 3.5
So yes a case can be made in your instance to treat.
But if I saw someone in my practice like you, I would approach things like this:
1 Ask if thyroid problems run in your family
2 Check thyroid auto antibodies (Anti TPO and Anti Thyroglobulin antibodies)
3 If antibodies positive then I would treat with a small dose of levo thyroxine and recheck levels in 6 weeks
4 If antibodies negative but free T4 low, I would still treat with a low dose of levothyroxine
5 If antibodies negative and free T4 normal and no first degree relatives with hypothyroidism, then I would recheck TSH in 6 weeks
B Armor thyroid is not recommended for the treatment of hypothyroidism. Levo thyroxine alone suffices
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes, levothyroxine is the standard treatment. I am an RN and work in the hospital, which probably is the cause of my adrenal system failing me. WE are so STRESSED! all the time. how are we supposed provide quality patient care when our patient load is double and triple what it should be. that goes for Doc's too. Only one hospitalist on at night is ridiculous! (sorry, had to throw that one in there)
I guessed it was hyperthyroidism prior to my diagnosis based on my symptoms but my labs indicate hypothyroidism. Why would I be having the opposite symptoms? My sister was diagnosed the same week I was, also with hypothyroidism but she had the classic symptoms. (fatigue, weight gain, swollen glands). (I am skinny, no swollen glands, and wired!) It just doesn't make sense?
The reason why I chose this website because its difficult to talk to my PCP. I have to go through his nurse and that's like talking to a wall. I requested additional labs such as thyroid antibodies, DHEA, progesterone and ferritin but due to my HMO, they won't cover. Only wellness labs are and others are subjected to deductible. So I am trying to figure this out on my own. Like I said I was prescribed levothyroxine 0.05 daily. Perhaps I will just try that but I feel that a piece of the puzzle is missing.
I want to cure my health issue not just treat it for the rest of my life with medicine. Any suggestions??
thank you for your time in this matter.
I guessed it was hyperthyroidism prior to my diagnosis based on my symptoms but my labs indicate hypothyroidism. Why would I be having the opposite symptoms? My sister was diagnosed the same week I was, also with hypothyroidism but she had the classic symptoms. (fatigue, weight gain, swollen glands). (I am skinny, no swollen glands, and wired!) It just doesn't make sense?
The reason why I chose this website because its difficult to talk to my PCP. I have to go through his nurse and that's like talking to a wall. I requested additional labs such as thyroid antibodies, DHEA, progesterone and ferritin but due to my HMO, they won't cover. Only wellness labs are and others are subjected to deductible. So I am trying to figure this out on my own. Like I said I was prescribed levothyroxine 0.05 daily. Perhaps I will just try that but I feel that a piece of the puzzle is missing.
I want to cure my health issue not just treat it for the rest of my life with medicine. Any suggestions??
thank you for your time in this matter.
Brief Answer:
Follow up
Detailed Answer:
Unfortunately clinical symptoms can be non-specific in both hyper and hypothyroidism, and as you know patients dont read text books.
It is very common for endocrinologists to see this virtually every day.
Some people with classic hypothyroidism have many typical signs and symptoms but still have other contrasting ones. The converse applies to hyperthyroidism too i.e.many classic symptoms are present most of the time but every now and then complaints generally associated with hypothyroidism are also seen.
Adrenal fatigue is another myth. You either have adrenal insufficiency or you don't, and your endocrinologist is the best judge of that. I suggest you see one in person.
Follow up
Detailed Answer:
Unfortunately clinical symptoms can be non-specific in both hyper and hypothyroidism, and as you know patients dont read text books.
It is very common for endocrinologists to see this virtually every day.
Some people with classic hypothyroidism have many typical signs and symptoms but still have other contrasting ones. The converse applies to hyperthyroidism too i.e.many classic symptoms are present most of the time but every now and then complaints generally associated with hypothyroidism are also seen.
Adrenal fatigue is another myth. You either have adrenal insufficiency or you don't, and your endocrinologist is the best judge of that. I suggest you see one in person.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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