Normal levels and LOTS of symptons hyper
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| Wed, 12-29-2004 - 10:08pm |
Hello all:
My tsh, T3, T4 levels are all in the normal range although latter two on the lower end of normal/higher end of normal. Yet I have the following symptons:
ridiculously insomniac
shortness of breath
light periods (don't mind this at all!- plus heavy cramping)
weight loss (despite the fact I eat nuts alot and following doctor's suggestion eating the junk( burgers, pizza, fries-though not every day of course)
irritable beyond belief
slight fatigue
stress(but then again who wouldn't be at the thought of losing job/possible health issues)
anxiety
chest pains every now and then
heart beating really fast (already have a heart murmur-irregular heart beat)
extremely heat intolerant
very forgetful easily
gross TMI sorry- diaarhea, constipation/frequent bowel movements-really getting uncomfortable/embarrassing
very light sensitive
redness in one eye (but then again I'm a paralegal/already technically only use one eye)
my internist brushed me off and said it's depression. Depression causes heat intolerance? diaarhea/other bodily issues? never heard of that.
I have an appointment with an endo on 1/26/05 but am I wasting my time? By the way the weight loss started a couple of years ago my senior year of college. It was the nurse practitioner at my health center who first said could be my thyroid...results normal but then again I wasn't symptomatic other than weight loss. I just don't know what else this could be and again, I seem to have almost all the symptoms for hyper/Graves.
What other tests are there? Should I try another internist after going to endo?
and something about bilarubin...out of range from both bloodwork I have done. I don't drink grapejuice, nor do I eat alot of grapes nor do I drink wine that much(don't drink hard liquor at all). What does it mean if bilarubin level is high? liver problems?
so confused, stressed.
thanks,
benita

Hi benita - I'll get back to you later this afternoon. I have to bring my kids to different places and so some errands. This is what bilirubin is:
bilirubin: http://www.drhull.com/EncyMaster/B/bilirubin.html
Bilirubin is the waste product that results from the breakdown of hemoglobin molecules from worn out red blood cells. Ordinarily, it is excreted from the body as the chief component of bile. Excessive levels of bilirubin stain the fatty tissues in the skin yellow; this condition is called jaundice. Very high levels of bilirubin in the bloodstream can cause permanent damage to certain areas of the brain of newborn infants - kernicterus. This can cause a characteristic form of crippling known as athetoid cerebral palsy. To prevent this from happening, bilirubin levels are monitored in newborns, and excessive levels of bilirubin are treated by either phototherapy ("bilirubin lights") or exchange transfusion.
High levels of bilirubin are another symptom of either hypo or hyper thyroidism. I don't exactly know why but I've read that somewhere. I'll see if I can find that source for you. It seems that you are hyper, even if it isn't showing in your blood tests. You are NOT wasting your time going to the endo at the end of January. It seems to me that it's critical for you to go and get diagnosed. You really can't play around with undiagnosed hyperthyroidism. It isn't good for your heart or other bodily functions, not to mention how bad you must feel every day.
I'll see if I can find some info that will help you with the endo when you go. Is this the first time you're seeing this doctor? Cathy :)
Hi again - well, there is subclinical hyperthyroidism, just as there is subclinical hypo. Here's an article on it: http://www.aafp.org/afp/20020201/431.html
Getting a doctor to treat subclinical hypo, where you have all the symptoms but normal test results, is usually difficult so I imagine it might be the same with subclinical hyper.
Here's some good info on the different tests available: http://64.233.161.104/search?q=cache:vrf6Z9yqba8J:www.thyroid.org/patients/brochures/FunctionTests_brochure.pdf+Normal+TSH+hyperthyroid&hl=en
Tests to evaluate thyroid function:Blood tests to measure TSH, T4 and T3 are readily available and widely used.
TSH TestsThe best way to initially test thyroidfunction is to measure the TSH level in ablood sample. A high TSH level indicatesthat the thyroid gland is failing because ofa problem that is directly affecting thethyroid (primary hypothyroidism). Theopposite situation, in which the TSH levelis low, usually indicates that the personhas an overactive thyroid that is producing too much thyroid hormone(hyperthyroidism). Occasionally, a low TSH may result from an abnormality in thepituitary gland, which prevents it frommaking enough TSH to stimulate thethyroid (secondary hypothyroidism). In most healthy individuals, a normal TSH value means that the thyroid is functioning normally.
T4 Tests - T4 circulates in the blood in two forms: 1)T4 bound to proteins that prevent the T4from entering the various tissues that needthyroid hormone and 2) free T4, whichdoes enter the various target tissues toexert its effects. The free T4 fraction is themost important to determine how thethyroid is functioning, and tests tomeasure this are called the Free T4 (FT4)and the Free T4 Index (FT4I or FTI).Individuals who have hyperthyroidism will have an elevated FT4 or FTI, whereas patients with hypothyroidism will have a low level of FT4 or FTI. Combining theTSH test with the FT4 or FTI accurately determines how the thyroid gland is functioning. The finding of an elevated TSH and low FT4 or FTI indicates primary hypothyroidism due to disease in the thyroid gland. A low TSH and low FT4 or FTI indicates hypothyroidism due to aproblem involving the pituitary gland.
A low TSH with an elevated FT4 or FTI is found in individuals who have hyperthyroidism.
T3 Tests- T3 tests are often useful to diagnosis hyperthyroidism or to determine the severity of the hyperthyroidism. Patients who are hyperthyroid will have an elevated T3 level. In some individuals with a low TSH, only the T3 is elevated and the FT4 or FTI is normal. T3 testing rarely is helpful in the hypothyroid patient, since it is the last test to become abnormal. Patients can be severely hypothyroid with a high TSH and low FT4 or FTI, but have a normal T3.
Thyroid Antibody Tests - The immune system of the body normally protects us from foreign invaders such as bacteria and viruses by destroying these invaders with substances called antibodies produced by blood cells known aslymphocytes. In many patients with hypothyroidism or hyperthyroidism, lymphocytes make antibodies against their thyroid that either stimulate or damage the gland. Two common antibodies that causet hyroid problems are directed againstthyroid cell proteins: thyroid peroxidaseand thyroglobulin. Measuring levels of thyroid antibodies may help diagnose thecause of the thyroid problems.
For example, positive anti-thyroid peroxidase and/or anti-thyroglobulin antibodies in a patient with hypothyroidism make a diagnosis of Hashimoto’s thyroiditis. If the antibodies are positive in a hyperthyroid patient, the most likely diagnosis is Graves’ disease.
Non-blood tests - Radioactive iodine uptake - Because T4 contains much iodine, the thyroid gland must pull a large amount of iodine out from the blood stream in order for the gland to make an appropriate amount of T4. The thyroid has developed a very active mechanism for doing this.Therefore, this activity can be measured by having an individual swallow a small amount of iodine, which is radioactive.The radioactivity allows the doctor to track where the iodine molecules go. By measuring the amount of radioactivity that is taken up by the thyroid gland(radioactive iodine uptake, RAIU), doctors may determine whether the gland is functioning normally. A very high RAIU is seen in individuals whose thyroid gland is overactive (hyperthyroidism), while a low RAIU is seen when the thyroid gland is underactive (hypothyroidism). In addition to the radioactive iodine uptake,a thyroid scan may be obtained, which shows a picture of the thyroid gland
Me again - after you read through all of this, let me know if you need more info or if you have any questions, ok? Cathy :)
hi Cathy,
thanks for the info. So glad to know that I'm not imagining these things/losing my mind. So I might be SUBclinical hyper instead of actually hyper??? What's the difference? Does this mean I won't receive any treatment until I actually become hyper? I'm dying here. I feel really uncomfortable and it's affecting me at work.
Should I request FT4 test this time? I've had TSH, T3 and T4 done but not the free 4/3 tests.
Shouldn't doctors take it seriously that the bilarubin level is high considering I don't drink, eat grapes that much and I didn't have jaundice as a baby (though VERY premature)?
Are endos aware of the link between high bilarubin levels and thyroid issues?
thanks and Happy New Year!
-benita
Hi, I was just wondering what tests you got that were low end of normal? Was it your t3 and t4? PLease tell us what they were
T4 was 9.6 normal reference range was between 4.? - 12.0
T3 was 126 normal reference range was ?- 180.
I am in range by these numbers although T3 was on the low end of "normal" and T4 on the high end of "normal."
As noted in my first post I am VERY symptomatic for hyper yet "normal" by numbers. This is really uncomfortable physically.
hmmm....I would try for the subclinical hyperthyroid or perhaps something else is causing it.
Hey there,
I wanted to tell you I read somehwere that you can have hyper symptoms with normal blood tests - but you will test POSITIVE for graves or hashi's antibodies.
Hi - yes, you might be subclinical - I'm just guessing here but there are quite a few cases of subclinical Hypothyroidism, so it just makes sense that if you're on the low end of normal, if left untreated, eventually your numbers will bring you fully into the hyper range. I think having the Free T4 and T3 tests is a good idea, and the antibody test as well. The one for Graves is the TSAb - the thyroid stimulating antibody test. It isn't conclusive for Graves but it may help to get you a diagnosis.
I have some other info for you from The Thyroid Solution but can't type it now. I'll post it here sometime tomorrow, ok? Cathy :)
Hi Benita - this is from the book, The Thyroid Solution:
"Recently, doctors have become more aware of the wide range of physical and mental effects of low-grade hyperthyroidism. This condition is defined as thyroid hormone excess that has not yet resulted in abnormally high thyroid hormone levels but has caused the TSH levels to become low. Low grade hyper often results from on overactive thyroid gland due to Graves' disease or to thryoid lumps that porduce excessive amounts of thyroid hormone.
Low grade hyper can cause symptoms of depression, rapid heartbeat, weight loss, heat intolerance, increased appetitie, increased sweating and trembling of fingers. It is likely to make a person more irritable and anxious. This minimal thyroid excess can also result in bone loss over time, particularly in menopausal women. Low grade hyper may provoke heart rhythm problems in older patients. In addition, it can affect the normal functioning of your heart and lower your cardiovascular fitness."
So I think this is well worth pursuing, either with this doctor or with another one that will take all your symptoms seriously. What do you think? Cathy :)
thanks for the suggestions. I'm just tired of feeling sick/uncomfortable and letting it affect my work.
Benita