MEG: Thyroid Questions

[Guest guest]

Hi, Meg:

You raise some good thyroid questions, and I'm afraid I don't know all (or

even *many*!) of the answers. But, I know for a fact that there are many Ladies

of the List (LOL) here who have been treated for hypothyroidism, and

Hashimoto's,so maybe they'll jump in to share their knowledge and ongoing

experiences

with hypothyroidism and thyroid testing.

I do know that it's no exaggeration to say that the thyroid affects EVERY

single cell and system in our bodies, so it's crucial to have it functioning

well.

It's also true that some people may have UNDIAGNOSED hypothyroidism because

the proper tests are not ordered--which is part of what I think you were

wondering about.

As far as I know, T3 and T4 (as well as TSH) are the key blood tests to have.

T3 is the more active hormone that controls metabolism, so it's important to

test that. And, the " Free Thyroxine Index. " is another test on the thyroid

panel.

But, wasn't it just recently that the official " normal values " were LOWERED

to

EXPAND the lab value definitions of hypothyroidism? One would assume that

labs everywhere would adjust their " out of range " values to reflect this change,

but maybe not. Double check your lab's numbers to make sure they are

consistent with the REVISED " within normal limits. " hem standard.

I think testing for thyroid is tricky because some patients have one dominant

symptom, while other patients have many more, while still many others, have

the full range. Even with the long laundry list of symptoms, docs don't always

put the pieces together.

From what I remember reading, thyroid tests can come back " normal " despite

having a thyroid that is clinically underactive.

To be honest, I think I've read both good science along with some " junk

science " about thyroid so I'm not 100% confidant about what's considered

mainstream

medical thinking with regard to the testing.

However, if you feel that you have some of the classic physical symptoms, in

addition to your low ferritin...symptoms like...

Fatigue

Course hair

Difficulty tolerating cold

Weight gain

Mental sluggishness,

and many many more........

You might check your basal body temperature (in the morning, before getting

out of bed). Supposedly, a low basal temp is convincing evidence of

hypothyroidism, no matter what the tests reveal.

You may want to go to a doctor who is current on the latest thyroid research

and literature. Seems like the latest thinking is NOT to rely *exclusively*

on lab results when diagnosing/treating hypothyroidism. That is--IF you, indeed

have hypothyroidism.

As you might have figured out by now, the symptoms of iron deficiency and

hypothyroidism overlap to a certain extent.

ANEMIA ADDENDUM

Also, just to clarify-- low MCV is just ONE of the parameters that are used

to diagnose Iron Deficiency. But, needless to say, it's not the only one.

The MCV helps pinpoint what KIND of anemia a patient has. For example, a

patient with pernicious anemia would have a HIGH MCV, while someone like you

with

IDA would have a LOW MCV.

It really helps clarify for your hematologist because knowing what KIND of

anemia you have will determine what KIND of treatment. (Example, Procrit is not

appropriate for iron deficiency because red cell production isn't your

problem--and that's what Procrit addresses. An iron deficient patient would have

to

take MUCH MUCH more iron just to keep up with Procrit--which would ultimately

be counterproductive, because you're already struggling to take in enough iron.)

The average size of the red blood cells (MCV) of an iron deficient patient,

like you are UNDERsized. Because iron is crucial to make hgb, your red blood

cells are kinda " malnourished " (my term) and because of this iron/hgb lack,

your RBCs can be normal in QUANTITY, but still smallish in size--and therefore

not as healthy.

But restoring your iron will " beef up " those red cells, (if it hasn't already

done so) because of the restoration of normal hgb levels.

-Roma

In a message dated 5/8/2004 7:08:57 PM Eastern Daylight Time,

galations522@... writes:

Hi Roma,

Wow! What an informative response! I'm definitely printing this out.

Yes, my MCV was still low as of my 2/27 blood check. On 2/3 my MCV

was 73 (normals 82.7-96.8) and on 2/27 was 78.6. I'm only guessing

until I get my lab print-out, but perhaps the MCV is still low if the

doctor said on the message that I was " still certainly iron

deficient. " Platelets were 388 on 2/3 (normals 149-375). I don't

see a platelet count on 2/27 and don't have the reading from 5/6 if

taken for platelets. Every other red blood cell value and iron value

is there, though. The doc's note on 2/27 was " reticulocytes are

newly produced red cells and you are making them abundantly. " My

retic count was 0.1035 on 2/27 (normals 0.035-0.092). I didn't know

the difference between iron-lacking (stores) and iron deficiency

(MCV).

My thyroid was not tested on 2/3. My sensitive TSH on 1/30 was 2.79,

and back in 8/01 it was 1.08 and 8/00 2.04, and 3/99 1.71. Does the

2/3 reading as 2.79 (normals 0.30-5.0) sound normal enough not to

need more investigation? I've heard even a sensitive TSH reading can

be misleading in terms of " normal. " What do you think?

Thanks for your great response!

Meg