Thyroid question

  1. I had my thyroid tested a year ago ...TSH only...and it was 1.80.
    Is this ok? The NP said it was normal...
    I have been having health problems so I have gone for a second opinion. He did a T3, T4 and TSH. I am waiting for the results. My friend told me that my previous TSH was very low...
    My mom has a severe thyroid disease and it was not discovered with just TSH testing...now I am nervous.
    I am not overweight, never hungry, stay extremely cold, dry skin, depression, shakes, and extremely fatigued, and memory is blitzed!
    Dr. said my thyroid felt a little large, but he was unsure until he received results from blood work. He prescribed Effexor, said it may be my nerves...
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  2. 15 Comments

  3. by   cargal
    Whoa, you sound just like me. I don't know what my TSH was, but I was finally diagnosed as hypo and when I started on Synthroid, I felt much better. Now I am taking 1 mg thyrolor and feel even better still. Good luck, and with those symptoms, keep getting tested periodically.


    Blessings,
  4. by   adrienurse
    Been on Synthyroid for 2.5 yrs. According to what I have read, MDs are advised to do T3 and T4 levels as well as TSH, because the TSH level is not always sensitive to a problem. Hypothyroidism is a notorious cause of depression, you should be treating the underlying problem and not just the depression. Another thing that I didn't know is never take a multivitamin with the synthyroid, because it will decrease the absorption of the synthyroid.
  5. by   darla80
    It is very important to test the free T4 as well as the TSH. THe thyroid is amazing and good thryoid function is esssntial

    with your S/S and family HX repeated testing is wise

    This info is from :: http://www.amarillomed.com/howto.htm

    There are 2 types of thyroid hormones easily measurable in the blood, thyroxine (T4) and triiodothyronine (T3). For technical reasons, it is easier and less expensive to measure the T4 level, so T3 is usually not measured on screening tests.

    Please be clear on which test you are looking at. We continue to see a tremendous amount of confusion among doctors, nurses, lab techs, and patients on which test is which. In particular, the "Total T3", "Free T3" and "T3 Uptake tests" are very confusing, and are not the same test.

    Thyroxine (T4) . This shows the total amount of the T4. High levels may be due to hyperthyroidism, however technical artifact occurs when estrogen levels are higher from pregnancy, birth control pills or estrogen replacement therapy. A Free T4 (see below) can avoid this interference.

    T3 Resin Uptake or Thyroid Uptake. This is a test that confuses doctors, nurses, and patients. First, this is not a thyroid test, but a test on the proteins that carry thyroid around in your blood stream. Not only that, a high test number may indicate a low level of the protein! The method of reporting varies from lab to lab. The proper use of the test is to compute the free thyroxine index.

    Free Thyroxine Index (FTI or T7) : A mathematical computation allows the lab to estimate the free thyroxine index from the T4 and T3 Uptake tests. The results tell us how much thyroid hormone is free in the blood stream to work on the body. Unlike the T4 alone, it is not affected by estrogen levels.

    Free T4 : This test directly measures the free T4 in the blood rather than estimating it like the FTI. It is a more reliable , but a little more expensive test. Some labs now do the Free T4 routinely rather than the Total T4.

    Total T3: This is usually not ordered as a screening test, but rather when thyroid disease is being evaluated. T3 is the more potent and shorter lived version of thyroid hormone. Some people with high thyroid levels secrete more T3 than T4. In these (overactive) hyperthyroid cases the T4 can be normal, the T3 high, and the TSH low. The Total T3 reports the total amount of T3 in the bloodstream, including T3 bound to carrier proteins plus freely circulating T3.

    Free T3: This test measures only the portion of thyroid hormone T3 that is "free", that is, not bound to carrier proteins.

    Thyroid Stimulating Hormone (TSH) : This protein hormone is secreted by the pituitary gland and regulates the thyroid gland. A high level suggests your thyroid is underactive, and a low level suggests your thyroid is overactive.

    Anyway this is some good info for you

    It is a little disoncerting that your doc would give Effexor without looking at the lab values first.
    I work for Internal Med so it is always about looking at the physiological basis for care

    I do think Effexor is a great drug and we see much success with it. But in your case Physiology is the first KEY!!

    Good Luck!

    Joy and Smiles *Darla**
  6. by   globalRN
    As NPs we learned that the new TSH tests are so sensitive that that is all you need to order as an initial thyroid screen.

    That is current practice in Canada (my preceptor GP) and in the US(all PCPs).

    Normal range: 0.15-4.0mU/L....
    Last edit by globalRN on Nov 17, '02
  7. by   nursegoodguy
    My cnp told me that the tsh was not a conclusive test and if you are syotomatic and take the medication your syptoms will go away. Well....
  8. by   Mimi2RN
    If he's putting you on Effexor, for depression, you would also need a good counselor, as part of the tx. And you probably need to be on Thyroid, too. I had a goiter, thyroid low for me. I've been on regular old thyroid, 3 gr, for 25 years......I've never heard of anyone else using it, but it works for me..
  9. by   shabookitty
    Thanks guys! All was great info! I guess I will know more on Monday. This will be the first T3,T4 test I have had ran.

    I have been on anxiety/depression meds before for about a year. Well, this was 3 years ago. This particular Dr also just ran a simple TSH and said it was low...but not enough to medicate. So, he also said it could be anxiety/depression and gave me Celexa.
    I stopped taking it after a year. But the symptoms came back.
    To make a long story short, knowing that I had previously taken anti-depress. this Dr prescribed Effexor. It has definitely "perked" me up with no side effects! And he wanted to run a more thorough thyroid test...

    thanks for the input and I will keep you updated.

    And Darla, thank you! :kiss
  10. by   nursegoodguy
    depression is definitely a symptom of hypothyroidism... there are so many more: cold feet, weight changes, swollen thyroid, (of course) tiredness...
  11. by   adrienurse
    About 6 years ago I was going through a very rough time, having lots of problems with asthma and the like. My thyroid felt enlarged to me so I told my doctor about my concerns (my Mom also has hypothyroidism). He took a TSH level and said everything was fine. 2 years ago, I was continuing to have problems with my health, losing hair, I couldn't sleep at night etc,. My TSH level was taken again. It took a long time to get the levels stabalized, but I'm feeling a lot better and am on quite a high dose of l-thyroxine (200 mcg). Just goes to show you.
  12. by   mattsmom81
    I have had symptoms of hypothyroidism for years and was also prescribed anitidepressants (this seems to be the pat answer today)

    My thyroid functions were always NORMAL. Then...I went for a preop mylogram before neurosurgical repair of cervical spine problems...and lo and behold masses on both sides of my thyroid!

    Thank God it was benign...it was actually a goiter.....it had to come out and now I am very hypothyroid and taking meds for it, and the depression is gone.

    But...strange how the thyroid labs were all normal during the growth of this tumor isn't it?

    Good luck and I hope your docs get to the root of your problem!
  13. by   cargal
    Question:
    Those of you diagnosed with hypothyroidism- how old were you? Can this be a condition in the very young? ( meaning early twenties to me, lol).


    Thanks,
  14. by   2banurse
    Hi Cargal,

    There is no specific age to have problems with your thyroid, particularly hypothyroid. I was actually diagnosed at birth, almost 38 years ago. My family and I just thank god that I was diagnosed at that time. I've been on Synthroid over 20 years (taking other thyroid medications before). All I can say is Thank God for Synthroid...

    Also, it is not uncommon that people with a hypothyroid experience depression. Many MDs will make sure to test for thyroid problems when a patient complains of depression.

    Kris

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