Re: UPDATE High TSH no lab error Re:Pituitary you think?? WAS Re:sw

[Guest guest]

At least you have ruled out a lab error in the high TSH reading

[actually, not 100%; but close]. What you need to find out IMHO is what

the heck could cause your TSH to go so high so fast. To me as a lay

person it still points to the pituitary, I guess more because I cannot

fathom what else it could possibly be. But frankly I didn't know that

it was even possible for the pituitary to raise your TSH that much in so

short a time. With a TSH increase that great in so short a time it's

not even clear to me that it is a thyroid problem.

Best,

..

..

>

> Posted by: " le " danosova@...

>

<mailto:danosova@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20e\

rror%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> danosova <danosova>

>

>

> Wed Jan 7, 2009 12:24 pm (PST)

>

>

> Here it is for those following this one:

> The story condensed:

>

> Went to endocrinologist on Dec 11. He said go off Armour (1.5 grains

> per day) because he was not sure I had primary thyroid disease at

> all. My TSH that day fasting and without taking my Armour was 0.27

> (ref range 0.32 - 5.00), fT4 0.6 (ref range 0.7 - 1.9) and TT3 was 102

> (ref range 59 - 174). He said I was hyperthyroid.

>

> On the night of Dec 26 I was suffering splitting headaches and felt

> really lousy. My option was to head to the ER and here are the

> results from their labs only 15 days off Armour:

> TSH 115.35 (ref range 0.45-4.50)

> fT4 0.1 (ref range 0.6 - 1.6)

> no TT3 run

>

> Clearly in hypothyroid hell.

>

> I went in to a first available with my primary care doctor's office

> staff on Dec 29. Here are the labs from that morning, still off

> Armour and fasting:

> TSH 128.13 (.4 - 4.5)

> fT4 .4 (.8 - 1.8)

> TT3 83 (230 - 420)

>

> If all of you made it through all of that HELP!

> My TSH slide even higher than the 115 we all thought was lab error.

> Apparently, not. My fT4 is sitting in a holding pattern of sorts -

> low, low, low. And my TT3 is now going to the dogs after being

> initially normal prior to the stopping of Armour. The last lab shows

> it is seriously low?!

>

> What is going on here? I have an appointment tomorrow morning at 11

> with my primary doctor and need to go in with all of your ideas sorted

> through. My mind is not sharp now so please I need your collective

> wisdom.

>

> A bit shaken by all this and hoping you all can help,

>

> le

[Guest guest]

So I take it you do not find the TSH increase in 15 days to be so

surprising? I have never heard of TSH jumping that high that fast. I

was more under the impression that a very high TSH reading was normally

found from someone untreated or under treated for an extended time.

Thanks,

..

..

>

> Posted by: " gumboyaya@... " gumboyaya@...

>

<mailto:gumboyaya@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20er\

ror%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> gumbo482001 <gumbo482001>

>

>

> Wed Jan 7, 2009 2:39 pm (PST)

>

> le,

>

> You wrote:

> > ... What is going on here?

>

> The tests indicate that you obviously needed those medications. If

> your doctor won't give them back to you, find another doctor.

>

> The " rapid " rise in TSH was not all that rapid, after all. You just

> gave us that impression by the sequence of labs. When there is a

> sudden change in dosage, the pituitary reacts more quickly,

> anticipating a further change. This can lead to " oscillations " if

> there is partial thyroid function left. In this case, the TSH jumped

> in response to the suddenness of the medication drop.

>

> Chuck

[Guest guest]

Recommended by whom??? Don't you think you should make it clear that

the highest dosage recommended by the manufacturer is only 180 mg? FAIK

she may in fact need more, but the way you state it it appears that some

credible source or authority is recommending up to 300 mg. If they are

I'd like to know who it is.

..

..

>

> Posted by: " Gracia " circe@...

>

<mailto:circe@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20\

error%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> graciabee <graciabee>

>

>

> Wed Jan 7, 2009 3:52 pm (PST)

>

>

> recommended dosing for Armour is 180--300mg. you need to get at least

> 180mg. don't go to endo--they just aren't educated in this. just get

> thyroid meds to treat symptoms. this isn't rocket science you can

> look for exotic diseases later.

> gracia

[Guest guest]

,

You wrote:

>

> So I take it you do not find the TSH increase in 15 days to be so

> surprising? I have never heard of TSH jumping that high that fast...,

It can with a very sudden, large change in medication. When hypoT is

starting there is usually some thyroid function left, so the change is

much more gradual. The pituitary responds with very tentative changes.

It detects the rate of change, the derivative.

Chuck

[Guest guest]

what is considered high t s h? mine today was 35.35.i have no clue what is what.

 

robyn

IF I HAVE TO KNOCK ON EVERY MANSION DOOR,RUN MILES ON GOLDEN STREETS,SEARCH A

MILLION FACES SITTING AT JESUS FEET,I WILL RUN ALONG THE JASPER WALLS,CALL YOUR

NAME IN THE WIND.I WILL FIND YOU AGAIN.

>

> So I take it you do not find the TSH increase in 15 days to be so

> surprising? I have never heard of TSH jumping that high that fast...,

It can with a very sudden, large change in medication. When hypoT is

starting there is usually some thyroid function left, so the change is

much more gradual. The pituitary responds with very tentative changes.

It detects the rate of change, the derivative.

Chuck

------------------------------------

[Guest guest]

It depends on the range from your lab.

Standard US is .5 to 5.5 though anything over 2 is suspect.

Sue

On 1/8/09 5:51 PM, " Chapman " <granmere48@...> wrote:

>

>

>

> what is considered high t s h? mine today was 35.35.i have no clue what is

> what.

>  

> robyn

>

> IF I HAVE TO KNOCK ON EVERY MANSION DOOR,RUN MILES ON GOLDEN STREETS,SEARCH A

> MILLION FACES SITTING AT JESUS FEET,I WILL RUN ALONG THE JASPER WALLS,CALL

> YOUR NAME IN THE WIND.I WILL FIND YOU AGAIN.

>

[Guest guest]

I feel like the high scorer on those old Pac Man games in the arcade - my 128

TSH is still a mystery the doctor wants to explain away as my pituitary working

very effectively.  His example:  T4/T3 supply getting less and less in the blood

so pituitary goes KNOCK KNOCK thyroid hence a rise in TSH.  Thyroid is all drunk

(burned out) after partying for years with those nasty antibodies and can't get

to the door.  Pituitary says, " how rude " and knocks again louder, resulting in

higher TSH reading and so on.  I embellished the story but it makes sense.  I

have never read anything that suggests a high TSH indicates a pituitary problem.

[Guest guest]

Chuck,

 

I posted the funny anecdote my doctor used to explain my high, high, high TSH of

128.  However, I am not entirely sure I buy it.  I was only on 1.5 grains per

day which I took all at once in the early a.m.  Is my body THAT efficient?!

 

le

 

>

> So I take it you do not find the TSH increase in 15 days to be so

> surprising? I have never heard of TSH jumping that high that fast...,

It can with a very sudden, large change in medication. When hypoT is

starting there is usually some thyroid function left, so the change is

much more gradual. The pituitary responds with very tentative changes.

It detects the rate of change, the derivative.

Chuck

[Guest guest]

,

 

I hear you loud and clear.  We are looking slowly into this now.  The doctor I

am seeing is having me do the saliva test for DHEA and cortisol, and the sex

hormones.  When that is back in a week or two we can proceed with a wider

picture.  The pituitary will be my research topic of choice for a few days to

come.

 

le

 

From: <res075oh@...>

Subject: Re: UPDATE High TSH no lab error Re:Pituitary you

think?? WAS Re:sw

hypothyroidism

Date: Thursday, January 8, 2009, 3:41 PM

At least you have ruled out a lab error in the high TSH reading

[actually, not 100%; but close]. What you need to find out IMHO is what

the heck could cause your TSH to go so high so fast. To me as a lay

person it still points to the pituitary, I guess more because I cannot

fathom what else it could possibly be. But frankly I didn't know that

it was even possible for the pituitary to raise your TSH that much in so

short a time. With a TSH increase that great in so short a time it's

not even clear to me that it is a thyroid problem.

Best,

..

..

>

> Posted by: " le " danosova (DOT) com

> <mailto:danosova (DOT) com?Subject=%20Re% 3A%20UPDATE% 20High%20TSH%

20no%20lab% 20error%20% 20Re%3APituitary %20you%20think% 3F%3F%20WAS% 20Re%3Asw>

> danosova <http://profiles. / danosova>

>

>

> Wed Jan 7, 2009 12:24 pm (PST)

>

>

> Here it is for those following this one:

> The story condensed:

>

> Went to endocrinologist on Dec 11. He said go off Armour (1.5 grains

> per day) because he was not sure I had primary thyroid disease at

> all. My TSH that day fasting and without taking my Armour was 0.27

> (ref range 0.32 - 5.00), fT4 0.6 (ref range 0.7 - 1.9) and TT3 was 102

> (ref range 59 - 174). He said I was hyperthyroid.

>

> On the night of Dec 26 I was suffering splitting headaches and felt

> really lousy. My option was to head to the ER and here are the

> results from their labs only 15 days off Armour:

> TSH 115.35 (ref range 0.45-4.50)

> fT4 0.1 (ref range 0.6 - 1.6)

> no TT3 run

>

> Clearly in hypothyroid hell.

>

> I went in to a first available with my primary care doctor's office

> staff on Dec 29. Here are the labs from that morning, still off

> Armour and fasting:

> TSH 128.13 (.4 - 4.5)

> fT4 .4 (.8 - 1.8)

> TT3 83 (230 - 420)

>

> If all of you made it through all of that HELP!

> My TSH slide even higher than the 115 we all thought was lab error.

> Apparently, not. My fT4 is sitting in a holding pattern of sorts -

> low, low, low. And my TT3 is now going to the dogs after being

> initially normal prior to the stopping of Armour. The last lab shows

> it is seriously low?!

>

> What is going on here? I have an appointment tomorrow morning at 11

> with my primary doctor and need to go in with all of your ideas sorted

> through. My mind is not sharp now so please I need your collective

> wisdom.

>

> A bit shaken by all this and hoping you all can help,

>

> le

[Guest guest]

,

You wrote:

>

> what is considered high t s h? mine today was 35.35.i have no clue what

> is what.

That's definitely high. For an initial screening, anything at the upper

end of the lab range (typically 0.3 to 5.0) indicates at least

" subclinical " hypoT that should be treated. A 35 is way above " clinical. "

Once you are on medication, the meaning of " high " changes and will vary

between physicians. For a T4 medication, most of us would recommend you

keep TSH below 2 at the very most. Add T3 to the mix, and it should be

much lower, around the bottom of the range. Some will recommend below

the range.

The issue we were discussing was based on the idea that TSH is normally

very slow to change.

Chuck

[Guest guest]

Sue,

You wrote:

> Standard US is .5 to 5.5 though anything over 2 is suspect.

There is no such thing as a Standard US range. It varies with the

manufacturer of the reagents used by the labs. I just had mine done (in

the US), and the range was 0.3 to 5.0 . That is what it was last year,

as well.

Chuck

[Guest guest]

le,

You wrote:

> ... I have never read

> anything that suggests a high TSH indicates a pituitary problem.

No, what suggested that was your statement that TSH " jumped " from 0.27

to double digits, when TSH normally changes rather slowly. However, you

later said that the " jump " was over a 15 day period, which is plausible

for a TSH change due to a sudden change in dosage.

Chuck

[Guest guest]

le,

You wrote:

>

> I posted the funny anecdote my doctor used to explain my high, high,

> high TSH of 128. However, I am not entirely sure I buy it. I was only

> on 1.5 grains per day which I took all at once in the early a.m. Is my

> body THAT efficient?!

On an initial screening, that level of TSH would indicate that you had

been hypoT for a long time. Thyroid output probably runs out long before

that point, though, perhaps around TSH = 20.

In your case of stopping the medication, the T3 component would have

disappeared in a few days, which would trigger an unusually rapid rise

in TSH. If you were taking the Armour with food or coffee, the

proportion of T3 would have been much higher, making this scenario even

less surprising.

Chuck

[Guest guest]

that's a disease maintenance range, so that other drugs can be given in place

of thyroid meds. $$$$$

AACE actually recommends .3--3

gracia

It depends on the range from your lab.

Standard US is .5 to 5.5 though anything over 2 is suspect.

Sue

On 1/8/09 5:51 PM, " Chapman " <granmere48@...> wrote:

>

>

>

> what is considered high t s h? mine today was 35.35.i have no clue what is

> what.

>

> robyn

>

> IF I HAVE TO KNOCK ON EVERY MANSION DOOR,RUN MILES ON GOLDEN STREETS,SEARCH

A

> MILLION FACES SITTING AT JESUS FEET,I WILL RUN ALONG THE JASPER WALLS,CALL

> YOUR NAME IN THE WIND.I WILL FIND YOU AGAIN.

>

[Guest guest]

once again

http://www.stopthethyroidmadness.com

insist on testing for FT3 and FT4

insist on treating symptoms, not lab values.

Gracia

Recommended by whom??? Don't you think you should make it clear that

the highest dosage recommended by the manufacturer is only 180 mg? FAIK

she may in fact need more, but the way you state it it appears that some

credible source or authority is recommending up to 300 mg. If they are

I'd like to know who it is.

.

.

>

> Posted by: " Gracia " circe@...

>

<mailto:circe@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20\

error%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> graciabee <graciabee>

>

>

> Wed Jan 7, 2009 3:52 pm (PST)

>

>

> recommended dosing for Armour is 180--300mg. you need to get at least

> 180mg. don't go to endo--they just aren't educated in this. just get

> thyroid meds to treat symptoms. this isn't rocket science you can

> look for exotic diseases later.

> gracia

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AM

[Guest guest]

you might be interested to know that TSH can rise significantly for up to 6

months when using high dose iodine! I guess it would be interesting to do my

TSH! for ppl who do frequent testing, once again iodine docs go by the Frees,

not TSH.

gracia

So I take it you do not find the TSH increase in 15 days to be so

surprising? I have never heard of TSH jumping that high that fast. I

was more under the impression that a very high TSH reading was normally

found from someone untreated or under treated for an extended time.

Thanks,

.

.

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[Guest guest]

And some may need to go below three grains - way below three. I belong to a

group who have " failed " to be able to push Armour up to 3 - 5 grains, even

by ever- increasing their HC. One is happily settled at 1/2 grain and

another is at 1/4 grain + some T4.

Val

Posted by: " gumboyaya@... "

Gracia wrote:

>

> recommended dosing for Armour is 180--300mg....

Please note that is " recommended by Gracia. " The manufacturer, Forest

Pharmaceuticals, says that dosing above 3 grains (180 mg) suggests

" noncompliance, " meaning that you are not taking it properly. IOW, 180 mg is

the maximum recommended dose, although some may need to go above that.

Chuck

[Guest guest]

That makes sense, but I had never heard of it.

Thanks,

..

..

>

> Posted by: " Chuck B " gumboyaya@...

>

<mailto:gumboyaya@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20er\

ror%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> gumbo482001 <gumbo482001>

>

>

> Thu Jan 8, 2009 3:42 pm (PST)

>

> ,

>

> You wrote:

> >

> > So I take it you do not find the TSH increase in 15 days to be so

> > surprising? I have never heard of TSH jumping that high that fast...,

>

> It can with a very sudden, large change in medication. When hypoT is

> starting there is usually some thyroid function left, so the change is

> much more gradual. The pituitary responds with very tentative changes.

> It detects the rate of change, the derivative.

>

> Chuck

[Guest guest]

It's quite possible for the TSH to take a high jump if medication is

abruptly removed according the the recent posts from Chuck. I'm sure

he's correct, but I had never heard of it.

Best,

..

..

>

> Posted by: " le " danosova@...

>

<mailto:danosova@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20e\

rror%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> danosova <danosova>

>

>

> Thu Jan 8, 2009 6:55 pm (PST)

>

>

> ,

>

> I hear you loud and clear. We are looking slowly into this now. The

> doctor I am seeing is having me do the saliva test for DHEA and

> cortisol, and the sex hormones. When that is back in a week or two we

> can proceed with a wider picture. The pituitary will be my research

> topic of choice for a few days to come.

>

> le

>

>

>

>

>

> From: <res075oh@... <mailto:res075oh%40verizon.net>>

> Subject: Re: UPDATE High TSH no lab error

> Re:Pituitary you think?? WAS Re:sw

> hypothyroidism

> <mailto:hypothyroidism%40>

> Date: Thursday, January 8, 2009, 3:41 PM

>

> At least you have ruled out a lab error in the high TSH reading

> [actually, not 100%; but close]. What you need to find out IMHO is what

> the heck could cause your TSH to go so high so fast. To me as a lay

> person it still points to the pituitary, I guess more because I cannot

> fathom what else it could possibly be. But frankly I didn't know that

> it was even possible for the pituitary to raise your TSH that much in so

> short a time. With a TSH increase that great in so short a time it's

> not even clear to me that it is a thyroid problem.

>

> Best,

>

[Guest guest]

I sincerely doubt this! with all due respect. I work with a woman who is

only allowed to take 90--120mg Armour. I think maybe she alternates doses.

she looks like hell and is constantly having physical pains--she is the one with

alligator eyes (eyes so puffy and barely open).

if you don't get adrenal support and sex hormones, then you will have to

suffer along on the lower doses.

Gracia

I am one of those that is doing well on 2 grains. I tried 3 grains

and ended up with a reverse T3 issue. That is now resolved and I

feel much better. On 3 grains I was having heart palps and extreme

sweating even in the winter. That is all gone sine I have taken care

of the reverse t3 and am taking only 2 grains of Armour. I do believe

I was getting too much T4 with 3 grains which caused the reverse t3.

Venizia

> >

> > recommended dosing for Armour is 180--300mg....

>

> Please note that is " recommended by Gracia. " The manufacturer, Forest

> Pharmaceuticals, says that dosing above 3 grains (180 mg) suggests

> " noncompliance, " meaning that you are not taking it properly. IOW,

180 mg is

> the maximum recommended dose, although some may need to go above that.

>

> Chuck

>

>

>

>

[Guest guest]

That site is a mish-mash of the good, bad and bull sh*t.

..

..

>

> Posted by: " Gracia " circe@...

>

<mailto:circe@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20\

error%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> graciabee <graciabee>

>

>

> Fri Jan 9, 2009 8:54 am (PST)

>

>

> once again

> http://www.stopthethyroidmadness.com

> <http://www.stopthethyroidmadness.com>

> insist on testing for FT3 and FT4

> insist on treating symptoms, not lab values.

> Gracia

>

> Recommended by whom??? Don't you think you should make it clear that

> the highest dosage recommended by the manufacturer is only 180 mg? FAIK

> she may in fact need more, but the way you state it it appears that some

> credible source or authority is recommending up to 300 mg. If they are

> I'd like to know who it is.

>

>

> .

> .

>

> >

> > Posted by: " Gracia " circe@... <mailto:circe%40fairpoint.net>

> > <mailto:circe@...

> <mailto:circe%40fairpoint.net>?Subject=%20Re%

>

3A%20UPDATE%20High%20TSH%20no%20lab%20error%20%20Re%3APituitary%20you%20think%3F\

%3F%20WAS%20Re%3Asw>

> > graciabee <graciabee

> <graciabee>>

> >

> >

> > Wed Jan 7, 2009 3:52 pm (PST)

> >

> >

> > recommended dosing for Armour is 180--300mg. you need to get at least

> > 180mg. don't go to endo--they just aren't educated in this. just get

> > thyroid meds to treat symptoms. this isn't rocket science you can

> > look for exotic diseases later.

> > gracia

[Guest guest]

But you'll never convince those whose religious leaders say otherwise! [ggg]

..

..

>

> Posted by: " Valarie " val@...

>

<mailto:val@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20error\

%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> val1198 <val1198>

>

>

> Fri Jan 9, 2009 10:59 am (PST)

>

> And some may need to go below three grains - way below three. I belong

> to a

> group who have " failed " to be able to push Armour up to 3 - 5 grains, even

> by ever- increasing their HC. One is happily settled at 1/2 grain and

> another is at 1/4 grain + some T4.

>

> Val

>

>

> Posted by: " gumboyaya@... <mailto:gumboyaya%40cox.net> "

> Gracia wrote:

> >

> > recommended dosing for Armour is 180--300mg..

> ..

>

> Please note that is " recommended by Gracia. " The manufacturer, Forest

> Pharmaceuticals, says that dosing above 3 grains (180 mg) suggests

> " noncompliance, " meaning that you are not taking it properly. IOW, 180

> mg is

> the maximum recommended dose, although some may need to go above that.

>

> Chuck

[Guest guest]

Some do; some don't. You totally ignore those whose opinions and

results do not fit your world view. As does the web site you mentioned.

..

..

> Posted by: " Gracia " circe@...

>

<mailto:circe@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20\

error%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> graciabee <graciabee>

>

>

> Fri Jan 9, 2009 8:07 am (PST)

>

>

> no the dosing is recommended by patients who use Armour successfully.

> http://www.stopthethyroidmadness.com

> <http://www.stopthethyroidmadness.com>

> Gracia

>

> Gracia wrote:

> >

> > recommended dosing for Armour is 180--300mg..

> ..

>

> Please note that is " recommended by Gracia. " The manufacturer, Forest

> Pharmaceuticals, says that dosing above 3 grains (180 mg) suggests

> " noncompliance, " meaning that you are not taking it properly. IOW, 180

> mg is the maximum recommended dose, although some may need to go above

> that.

>

> Chuck

[Guest guest]

you will never convince those who have BTDT and know what proper treatment is.

(thyroid/adrenal/sex hormones/iodine).

Gracia

But you'll never convince those whose religious leaders say otherwise! [ggg]

.

.

>

> Posted by: " Valarie " val@...

>

<mailto:val@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20error\

%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> val1198 <val1198>

>

>

> Fri Jan 9, 2009 10:59 am (PST)

>

> And some may need to go below three grains - way below three. I belong

> to a

> group who have " failed " to be able to push Armour up to 3 - 5 grains, even

> by ever- increasing their HC. One is happily settled at 1/2 grain and

> another is at 1/4 grain + some T4.

>

> Val

>

>

>

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PM

[Guest guest]

Every quack product under the sun has its own group of devout believers

who have " BTDT " . Unfortunately when credible research is done the

results fall to chance or placebo. Or sometimes worse. Chuck recently

listed a dozen or so of such products or procedures that once were

supported by a large number of not only patients but also well educated

and highly intelligent medical practitioners. All worthless beyond the

placebo or some psychological effect.

..

..

>

> Posted by: " Gracia " circe@...

>

<mailto:circe@...?Subject=%20Re%3A%20UPDATE%20High%20TSH%20no%20lab%20\

error%20%20Re%3APituitary%20you%20think%3F%3F%20WAS%20Re%3Asw>

> graciabee <graciabee>

>

>

> Sat Jan 10, 2009 8:29 pm (PST)

>

>

> you will never convince those who have BTDT and know what proper

> treatment is. (thyroid/adrenal/

> sex hormones/iodine).

> Gracia

>

> But you'll never convince those whose religious leaders say otherwise!

> [ggg]

>

>