Comments on: Major Revision Possible in Guidelines for Diagnosing and Treating Hypothyroidism

By: Amy

Amy — Tue, 19 Jan 2010 20:55:51 +0000

Theresa, the thyroid forums I’m on I am always pushing the connection between inadequate thyroid treatment and heart disease.
There is a very good Norwegian study called the HUNT study that indicates that a TSH above 1.4 significantly increases the risk of heart disease and death in women. Their conclusion:
“Thyrotropin levels within the reference
range were positively and linearly associated with Coronary Heart Disease (CHD)
mortality in women. The results indicate that relatively
low but clinically normal thyroid function may increase
the risk of fatal CHD.”
While low TSH is not a good indication of how hypothyroid we are, any increase in TSH (and by increase I mean levels over 1) is often a very good indication that the body is suffering from inadequate thyroid activity.

By: Theresa

Theresa — Tue, 29 Sep 2009 06:13:58 +0000

I find it odd that on all the thyroid forums I have seen, not one mentions the risk of cardiovascular fatality due to under medication of hypothyroidism.

In 1988 I had radioactive iodine ablation therapy and was euthroid for 8-years. Diagnosed in 1996 as hypothyroid. Prescribed Synthroid and have never felt well.

On Synthroid, my TSH, Free T3, and Free T4 are in the normal range, with a myriad of continued hypothyroid symptoms… My new doctor ordered a Reverse T3 test. All levels look ok except my Reverse T3 level is 399 pg/mL. The Reverse T3 reference range: 90 to 350 pg/mL.

Due to the prescribed non-treatment (Synthroid) of my hypothyroidism, I have become deficient in Vitamin B12, B6, Folate, and Vitamin D. All of which are required for cardiovascular health. The result is that my homocysteine levels are off the charts.

The high sensitivity C-reaction protein test (hs-CRP) test measures homocysteine (inflammation of arteries). The high-sensitivity CRP test (hs-CRP) is done to find out if you have an increased chance of having a sudden heart attack or stroke.
http://www.webmd.com/a-to-z-guides/c-reactive-protein-crp?page=2

Inflammation can damage the inner lining of the arteries and make having a heart attack more likely. Multiple studies now show that elevated C-reactive protein (CRP) levels are correlated with increased risk of cardiac events and mortality.

CRP Levels: Low Vitamin B and Elevated Homocysteine:
http://www.doctorsofusc.com/services/health-tips/heart-attack-risk

There is a correlation that the lower the vitamin B levels the higher the homocysteine levels. High homocysteine levels are linked to damage to the arteries, which can cause atherosclerosis and thrombosis.
http://www.doctorsofusc.com/services/health-tips/heart-attack-risk

There is also a link between low Vitamin D and cardiovascular disease.
http://www.sciencedaily.com/releases/2008/07/080714162515.htm

By: Leslie

Leslie — Sun, 09 Aug 2009 13:48:53 +0000

Any – I’m gearing up for my next appointment with my doc. Once in the past he became concerned that I would be hyper and had me back off my meds a bit. The result was pretty bad. I gained back the small amount of weight that I had lost, and pretty quickly developed bad hypo symptoms again. I recently convinced him, in spite of a TSH of around 1.9 that I was under-medicated. So he reluctantly increased my meds. Not I feel really good again. In fact, I feel like myself again. I feel happy again, and my moods are more steady. I have good energy again. I’ve lost 20 lbs over the last 5 months. I have NO hyper symptoms at all. It’s hard to argue with such success. I have a great doc who really listens and trusts my assessment of how I’m doing. I hope he will see that the numbers don’t mean much – how a patient feels is really what counts.

By: Amy

Amy — Sat, 01 Aug 2009 17:23:11 +0000

Leslie, we aim for high levels of T3 and T4 but a suppressed TSH. Most doctors see the low TSH and assume we are hyper.

All I can say is tell your doc you feel fine and that you are very well aware what the symptoms of hyperthyroidism are and you will tell him if you have any.

The hard part for many of us is when we are still hypo and working our way up to a therapeutic level and a doctor sees a low TSH and wants to stop or reverse treatment. This seems to happen all the time. I recently saw my doc’s NP and she told me I had to back off my meds because my TSH was below 1. I just assured her that I was still somewhat hypo and that I was well aware of what hyper symptoms were. I convinced her but not every practitioner is going to be that easy.

By: Sue

Sue — Sat, 01 Aug 2009 17:04:45 +0000

My levels before were 4.1 and now at 1.75

By: Leslie

Leslie — Fri, 31 Jul 2009 02:28:52 +0000

What about the acceptable “lower level” of the range? I have a feeling that after my most recent medication increase, my TSH is going to make me look hyperthyroid – but I feel good….actually pretty great. I feel better than I have anytime in the previous 4 years! There is no way I will want to back off of the medication.

Can anyone offer some way for me to help my doctor “get it?”

By: Amy

Amy — Tue, 28 Jul 2009 00:05:37 +0000

Diana, I’ve been repeatedly tested for antibodies and they’ve always come back normal . But my free T3 and free T4 were below or at the low end of range. So either the antibody tests have very poor sensitivity or I just don’t have them and am simply hypothyroid.

Wanda: you are an excellent person to consider going over to natural thyroid hormones. I suggest Stop the Thyroid Madness website if you are interested in learning more. http://www.stopthethyroidmadness.com/

By: WANDA NEESE

WANDA NEESE — Mon, 27 Jul 2009 03:49:41 +0000

I WAS INFORMED BY A ENDOCRINOLOGIST TO ALWAYS GET FREE T3 & T4 RUN ON ME! STARTED AT 32 YRS. OLD AND WAS HYPER. I HAD NEUCLEAR MEDS & AND NOW I’M HYPO! GAINED LOTS OF WEIGHT AND ACHES AND PAINS FROM EVERYWHERE! HORRIBLE SWELLING IN ANKLES AND FEET TOO! I’M ON 125MG
SYNTHROID! I HATE HOW I FEEL!

By: Diana

Diana — Mon, 27 Jul 2009 00:18:38 +0000

A patient experiencing symptoms of thyroid sluggishness despite a “normal” TSH should be tested right away for anti-thyroid antibodies. This will save the patient from suffering more than they already are.

By: Amy

Amy — Thu, 09 Jul 2009 14:52:08 +0000

I think the TSH needs to be discarded completely as a screening tool for hypothyroidism (as well as a treatment gauge). Symptomatic patients need to have their free T3 and T4 drawn to see how much hormone is actually circulating in their bloodstream as well as antibody tests for hashimoto’s. TSH can be any number, as was evidenced by myself for many years. I had a recent TSH of 1.65 while my T3 was below range and my T4 was 40% of range. Obviously if my TSH was the only tool used to screen me I would be told my thyroid was “normal”… now how bout we put you on an SSRI and prescribe some NSAIDs for those joint pains… and here’re some laxatives and how bout some Lyrica for those Fibro symptoms? I know you’re bucking a big tide here Dr Pepper but I would hope that Endos would finally figure out that TSH is useless for many of us (millions by some estimates).