Thyroid numbers
So, I got some blood work back from the lab today. I haven't spoken to my doctor yet but wanted to see what the group thinks about the thyroid numbers. I'll save the cholesterol rant for another day(236), Not sure I'm ready to give up ice cream or beer just yet.
My T3 and TSH numbers are really off. Based on what i've seen online am I to correctly to assume that my T3 numbers are related to my fitness lifestyle or should I be running to the emergency room. And how can my TSH be zero? The normal range was provided to me on the lab sheet.
FREE T3 7.9 ng/mL (Normal Range 1.5-3.5)
FREE T4
FT4 (FREE THYROXINE) 0.98 ng/dL (normal range 0.71-1.85)
TSH 0.00 mIU/mL L (Normal Range 0.49-4.67)
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Comments
Hey Nate,
I'm not a doctor but went through getting diagnosed as hypothyroid last year. It can be very confusing to understand. The numbers are confusing, and many doctors don't not understand them very well either. It may be best to find an endocrinologist to go over them with you, especially one who understands athletes.
What I understand (docs pipe in and correct me) Your TSH (Thyroid stimulating hormone) number: 0 indicates that the endocrine feedback system is telling your thyroid don't produce anymore T3/T4, this is likely because you have high T3 which is basically a storage form of T4, which is what your body really uses, so your body says it has too much thyroid hormone and is not producing more. That would be a hyper-thyroid (overactive ) condition. You may or may not have symptoms to go with hyper-thyroid. Think carefully about what symptoms you might be experiencing that are unusual even if its subtle (there are lots of potential ones, but you can google it) I by contrast am hypo-thyroid (under active thyroid) so my TSH is usually high telling my body to make more T3/T4 because I don't have enough. In either case this sometimes shows in your T4/T3 levels and sometimes it doesn't, TSH is the diagnostic factor. Unfortunately my thyroid can't make more, so I'm constantly short, and have to take levothyroxine (t4) daily to supplement. There are some conditions where you swing back and forth hypo/hyper because your thyroid over and under compensates as it struggles. Ask to get your Thyroid Antibodies Level tested to see if its possible you have something like hashimoto's thyroiditis (what I have.) This would help diagnose whether you are hyper vs hypo vs swinging back an forth with both. Most likely the doc would want to put you on a thyroid supplement hormone (*like me) to see if that normalizes production. There are non synthetic options as well. You may have to do a couple rounds of tests to confirm if your stable hyper or not.
There is evidence to show that endurance athletics can strain the endocrine system and in particular the adrenal / pituitary / thyroid chain and might cause or aggravate thyroid conditions, but its not clear. There's also evidence that gluten or other allergies can initiate/aggravate thyroid disorders as well.
In my case the daily supplement is easy to take, stabilizes my levels and made me feel the most normal I've felt in years. I've never been healthier or more energetic. So in some ways it was good luck that I finally got diagnosed with hypo thyroid.
Good luck! Keep us in the loop! If you want to PM me with Q&A anytime please do!
wow, thanks for chimming in. Lots of info.
I will be making a follow up appointment with my doctor to discuss ASAP. Some of those side effects I have and none of them seem like a big deal, but put it all together with a blood test to show a number out of whack and it all adds up.
1. You need to get antibody levels measured, both TPO, and Tgb which if elevated is diagnostic of Hashimotos. But with TSH at 0.0 I would get TSI and TSH receptor antibody levels checked also, which if elevated is diagnostic of Graves.
2. While Hashimotos can (but doesn't always) cause symptoms of hyperthyroid, it essentially is a cause of hypothyroidism. The periodic attacks on the gland in some people cause such a rush of T4 and T3 into the bloodstream that they have symptoms of hyperthyroid, but the progressive destruction of the gland eventually causes steady hypothyroid. So it's not really a swinging back and forth between the two conditions, it's just the sudden release of hormone into the bloodstream mimics hyperthyroid for a period of time early in the disease, but again, this is only in a percentage of those with Hashimotos. In Hashimotos the enzyme TPO (in the gland) and or thyroglobulin( the building-block from which T3 and T4 are made), are recognized as foreign and attacked by the immune system, resulting in destruction of the gland.
3. Graves is true hyperthyroid because the receptor sites on the gland for TSH are attacked by the immune system, causing constant stimulation of the gland with subsequent over-production of hormones.
All of this is in my mind leading up to explaining what I think is most important, and what's unique to a functional medicine approach....
4. Both of these conditions are autoimmune, meaning the central problem is a dysfunctioning/imbalanced immune system. And while those with Hashimotos may need to have thyroid hormone (actually some of my Hashimotos patients have not needed it), the hormone replacement does absolutely nothing to balance the dysfunctioning immune system, and so the attacks/destruction of the gland just continue on. With Graves, a person should be on meds to prevent the sudden heart racing, called "cardiac storm", which can happen and be very dangerous. But those meds also do nothing to address the dysfunctioning immune system, which is the core problem
5. What docs who practice functional medicine know and recognize, is there are always underlying causes to the imbalanced immune system that can be investigated, identified, and addressed. When this is done, it slows down the attacks dramatically, which equates into a very happy patient, much happier than when going the meds alone route.
6. A very common stressor to the immune system, and a contributing cause to it becoming "autoimmune", are food sensitivities...this is just ONE example, usually the source of stress is Multi-faceted. Of the many food items a person can become sensitive to, gluten is a very common culprit. This is why gluten sensitivity is associated with Hashimotos (and Graves) like Rian mentioned. There are MANY things that can, and should be done beyond just giving meds for autoimmune thyroid suffers.....almost half my practice is based on this fact.
I'm really just kind of scratching the surface, so feel free to PM me as well. I know everyone has a different "mindset" on these kind of issues....trust me I know, I've been practicing over 20 years in alternative health care. But there are just TOO many people with thyroid conditions who continue to live with sub-par improvement, especially when looked at long term...ie..they may feel better after initially going on hormone, but have a steady decline in the near future. And this is, IMO, because the one size fits all traditional approach of "go on hormone", fails to recognize all the significant relevant issues involved.
That was really great Steve. I've researched quite a bit and have lots of materials on diet related adjustments for addressing the immune system issue you discuss. I would definitely be interested to hear what/where you point your Hashimotos patients to start. I've gotten through my 1st year now on synthroid, and just retested to find TSH levels high again so we've upped the dosage. The doc shrugs shoulders and says we'll just keep upping dosage as the thyroid shuts down, and eventually it will just burn out all together. As you've indicated, thats a very symptomatic solution to the problem not really addressing the cause of the auto-immune reaction.
Hi Nate,
I am a beginner triathlete and new to EN, but I am seasoned thyroid patient! First, what are your symptoms that prompted your doctor to run a thyroid panel? How are you feeling? Weight loss, fast heart rate, hair loss, irritable, or all of the above? And it was good that your doctor did a complete panel that includes the free T4 and the free T3 test and not just a TSH. It completes the picture of what is really going on. Second, I recommend you find a reputable endocrinologist to help you work through the numbers that are good for you, since you are not a typical patient i.e. triathlete. You might also want to request a TPO to test for TSI antibodies, which would indicate Grave's disease. I have Hashimoto's disease, which is more related to hypothyroidism rather than hyper. You may also want to rule out pituitary problems, which could cause other symptoms such as low testosterone or other hormone imbalances in women. I don't want to be alarming. but you need to take care of this and not put it off. If this turns out to be an autoimmune disease, it is progressive and can cause health problems you may not be able to fix easily later. Good luck to you Nate and you can e-mail if you want.
Kim
I don't have a lot of symptoms other than maybe a slightly "pounding" heart beat(thought that was normal) and being slightly more agitated the last few months than before.
I'm headed back to my internal medicine guy next Tuesday and assume I will then find an endo guy soon after.
But at this point all I'm going off of is the blood test results that I posted.
you are missing the free t4 number.
regardless, you are hyperthyroid. much different than hypothyroid. in the short term, hyperthyroid probably more potentially dangerous.
imo, the voices that have chimed in so far are complicating it more than needed.
your regular family doc or internist may be able to further diagnose and treat. or he may want you to see an endocrinologist.
Thanks for chiming in.
it made the discussion about how to lower my bad cholesteral seem so simple. I'm on a 4-6 month slightly altered diet plan to see if i can bring my numbers down.
Life is full of curve balls and I feel like I just got two in a row. I will be ready for the next one when the nnew results are back in a week or two.
on the plus side, I got a flu shot so my wife can't give me crap about that this year.
I will update again when the new results come back in.
Thats good news Nate! Hope the new tests come back normal. Thanks though for sparking some good conversation, and letting a little hijacking happen. Thyroid disorders are surprisingly common ~ 10% of population, and may be increasing, especially in ultra-endurance athletes.
@Danielle: Indeed I need to be more religious about gluten and sugar. I had never felt better when off of those things completely last year, I've slowly slacked back to occasional gluten, and daily sugar and coffee. Guess its time eliminate again. I never thought of eliminating coffee, I assume thats because of avoiding caffeine in general not coffee itself? That will really suck.