Hello,
I am new to this forum as I found out about this website while searching for some answers. Here's the deal. I live in northern Idaho and as soon as the temperature dips below 40 outside I am ALWAYS cold. The thermostat is set at 70 degrees in my home but I cannot stay warm. I end up taking up to 4 showers or baths a day to warm up my core. Often my lips are purple as are my fingernails. I have had raynaulds for the past 10 or so years. I am 37 years old, female, very healthy. I exercise at least 3 times a week, have run two marathons, don't smoke, rarely drink and don't do drugs. Other symptoms recently include puffy, stiff hands in the morning and the appearance of fluid in the middle knuckle of the fingers, spotting between periods (which has never happened before), sore breasts pretty much the whole all month every month, some constipation in the past year, cannot lose weight no matter how much I monitor my food intake and exercise. However, I am not overweight, just could stand to lose 5-10 pounds. Hx of depression, currently no longer taking antidepressant and mood is stable. I had my thyroid tested in 2006 which came back with a TSH level of 1.37, in 2007 it was 1.95 and I just had it tested again and it was 2.8. My doctor said it was normal and wants to do metabolic and cbc panels now. He also did a sed rate panel to test for inflammation and it was normal. I asked about the change in the TSH level and he was unconcerned. Any thoughts anyone? Thank you.
Thyroid?
(11 posts) (4 voices)-
Posted 9 months ago #
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Hey Glaciergirl
Seems like a bad place to be living for someone who hates the cold;) As you know I can't offer medical advice on the internet but looking at your symptoms and thyroid levels I suspect you are in fact experiencing symptoms of thyroid hormone deficiency. Have a look at my article regarding the changes in guidelines for diagnosing hypothyroidism at: http://www.metabolism.com/2009/06/26/major-revision-guidelines-diagnosing-treating-hypothyroidism/
In that article I describe a situation almost identical to the one you describe.
After reading the article you may want to explain the situation to your doc. In light of the new guidelines your doc may just be convinced that your complaints warrant a second look in regards to thyroid hormone deficiency.
Good luck and keep us posted.
GPepper
Posted 9 months ago # -
Thank you much for your thoughts. I read your article with much interest and will return to my doc. And yes, I have thought many times about moving somewhere warm and sunny (: (Although I love skate skiing)
Thanks again!
Posted 9 months ago # -
I returned to my physician today who said that if my symptoms were being caused by a low functioning thyroid, he would expect my TSH level to be very high. Further, he said he is very careful about when he prescribes TSH tx because he said too high of a thryroid hormone level can lead to osteoporosis. Does anyone know about this?
ThanksPosted 8 months ago # -
Glaciergirl
The experience you are having is familiar. Check out the posts of other members of metabolism.com and you will see how many others went through the same sequence of events. As I mentioned in my response a week ago, Dr. Wartofsky who is one of the most respected thyroid authorities today, is proposing that a TSH above 2.5 can be associated with symptoms of thyroid hormone deficiency potentially requiring thyroid hormone replacement therapy.
Did you refer your doc to this authoritative source?
It is true that excess levels of thyroid hormone are associated with loss of bone mass (osteopenia or osteoporosis). This requires that thyroid levels are raised to levels above normal. What you are trying to accomplish is to get your levels into a normal range (possibly levels higher than your own body can produce but still below levels that cause bone loss).
Others in a position such as yours have obtained a second opinion or tried to educate their own doc to these issues.
Keep us posted.
My comments are not intended as medical treatment or advice and are for educational purposes only. The disclaimer of metabolism.com applies to all of my posts here.
Posted 8 months ago # -
Thanks for your comments, Dr. Pepper. I did bring in the article to my doctor and he said he was familiar with differing opinions on this issue. He went on to say that he is firm in not treating TSH levels below the 5.0 threshold because of the risk of osteoporosis. He also said that if my symptoms were due to poor thyroid functioning he would expect my TSH levels to be 'through the roof'. He said he wanted to consult a rheumetologist before ordering additional tests to determine what is causing my symptoms. I believe I will seek a second opinion. Can bone density testing be done regularly to monitor changes? Do most people's TSH levels remain relatively constant across the lifespan (those who have normal functioning thyroids?)i.e. have nearly the same level year after year?
Posted 8 months ago # -
Your clinician is relying on his experience in trying to determine if your symptoms are thyroid related. This is what makes medical care an art as well as science.
Your point about monitoring bone density is a good one. Bone density changes very slowly so a bone density is usually conducted at 2 year intervals if bone loss is a concern. Excess thyroid hormone can cause some bone loss so a bone density is not a bad idea if that is a concern. From the history you provided of high levels of physical activity, non-smoker and your premenopausal status, I am assuming you are at low risk in general.
Your question about variability of TSH levels is a good one. TSH levels can be expected to vary a small amount even within a single day. However, if the TSH is creeping up in a steady progression, underlying hypothyroidism should be suspected. In my practice I have seen levels above 2.5 associated with moderate symptoms of thyroid deficiency. Some people are extremely sensitive to these changes and others feel absolutely fine.
I have a feeling you will get to the bottom of your problem since you are persistently thoughtful. Good luck. Keep us posted.
G.Pepper
Posted 8 months ago # -
hello..Thank you much for your thoughts sharing with us. I read your article with much interest.is is acupuncture treatment works for thyroid?please let me know if you have answer.any help would be appreciated.
http://doctorhermann.com/tampa-acupuncturist.htmlPosted 8 months ago # -
Acupuncture is a method of stimulating nerve endings in the skin and muscle. I understand it works for a variety of painful conditions caused by disorder of the muscles, nerves, central nervous system and bone. I don't believe in any mysterious connection between acupuncture and the immune or endocrine system I haven't heard of any benefit of this procedure on thyroid disease and can't see any real way it could work.
Hope that helps.
gp
Posted 8 months ago # -
Hi Dr. Pepper:
I had Graves disease at 23 and then had RAI at 28 and have been on synthroid for 18 years. I did try ARmour once, but I found it had too much t3 (I think the pig's ratio of t4 to t3 is much more potent than humans) and I actually had a real hard time regulating. I don't have a thyroid anymore, and I take 225 synthroid. i still suffer a bit with impossible weight loss (despite running, dieting, etc) and some depression that feels quite hormonal at times. My dr. brought up adding t3 last visit and tested me, and then said, oh, you don't need any xtra t3, you seem to be converting fine.
what are the levels that the t3 should be, and is this free t3 or t3? thanks.Posted 4 months ago # -
Your question regarding the correct level for thyroid functions, is frequently raised on this website. I would respond to your question with this question, " What is the correct shoe size?" Obviously, the answer is, whatever shoe size fits best. Similarly with thyroid function, everyone has a different "comfort zone" where their body functions best. That is their "correct" thyroid hormone level. You also refer to a t4 to t3 ratio for pigs versus humans. These ratio's are averages of several hundred individuals (human or pig)and do not apply to any particular individual. Some people function better at a t3 to t4 ratio which is higher than the average. As pointed out in my article,http://www.metabolism.com/2009/11/07/breakthrough-discovery-thyroid-hormone-therapy-part-2/ , there is recent evidence that due to genetic differences, a percentage of the population does not convert t4 to t3 efficiently and therefore are likely to require t3 supplementation when treated for hypothyroidism.
Rather than spend the money for genetic testing to discover whether the genes for conversion of t4 to t3 are abnormal, some doctors recommend simply adding an appropriate dose of t3 to the standard t4 (levothyoxine)treatment and following the patient for improvement in clinical symptoms. You might want to consider discussing this approach with your doctor.
Gary Pepper, M.D
Posted 4 months ago #
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