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Thyroid lab results--this is blowing my mind!!


PeterPan
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Ok, so I'm utterly flabbergasted here. I just redid my labs after 3 weeks entirely off the kelp, and I've gone HYPERTHYROID! So I'm on 3/4 gr nature-throid, and where I thought I was going to need a dose increase (by going off the kelp), instead it's just the opposite.

So then the timeline

-1998-200?--lived under high tension power lines, body crashed, basal temps of 95.3 armpit (yes, for real), put on 5 gr armour

-200?--started with nutritionist who put me on kelp, weaned off armour, tested at various times, TSH7+

-2018--decided to add some naturethroid and drop some kelp, TSH was 5+

-2019--decided to drop kelp completely ($$, that's a long time on one thing, blah blah), 3 weeks later ran labs and TSH is 0.007, Free T3 4.6 (range 2.0-4.4), Free T4 1.67 (range 0.82-1.77)

So when I dropped the kelp, at first I was crazy tired, crazy cold. Then I was sort of in the middle and thought ok I'm just getting used to it. Now I'm actually HOT. Like at night I have to turn down the air a degree. All in the span of three weeks! And when I started feeling hot, I was like oh you're 43, you're having hot flashes, kwim?

It just totally, totally didn't occur to me that my thyroid function would go UP. This is crazy.

So now I have no clue, lol. I paid for the labs privately and didn't go through my doc. I didn't want to bug him if the TSH wasn't going to change quickly. I started at 6 weeks out from the appt, so I see him in 3 weeks. 

It seems like my first move is to drop to 1/2 grain immediately, mercy. With those labs, clearly I need to. I could call and mention it to the nurse. Honestly, like I really like my doc, but I accept the hairbrained (or is it harebrained?) nature of the service, lol. Clearly I'm not waiting around for someone's opinion at this point. And I think retesting in 3 weeks at that appointment would be wise.

So I guess the real curiosity at this point is how low it will go! Like if we decrease the naturethroid to 1/2 grain and retest and I'm still hyper, that would be astonishing. That's like my body really saying hey, you're not under those high tension lines anymore, I'm ready to perform. 

I don't know, kinda wild, eh? 

Oh, and just to back up, the nutritionist had put me on a small/moderate amount of kelp (6-12 capsules 3X/day) and I had increased over the years. But at her dosing my TSH was still 7+. And the (no nice words here) MD who prescribed my armour years ago never ran labs, if you can imagine. But with temps that low, clearly my body was a mess. It took us a while to get out of that house after we realized the problem (don't get me started on that either). So I've been in this house 15 years, away from the high tension lines. Now look at me, going hyper, haha.

I don't know, this is blowing my mind.

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13 minutes ago, soror said:

How son after dosing did you take your labs?

Taking NDT my dr. prefers I wait 24 hrs for labs, I usual 12-15 hrs.

Hmm, good question. Now I'm trying to remember what I did for my last labs like 9-10 months ago. 

I take my NDT at night, at least 4 hours after food, so it's usually some time between midnight and 2am. I *think* maybe for my last labs I just went ahead and took my thyroid labs the night before and had the labs at like 7 am, since he was only running TSH at that point. 

These labs were at 11:45-ish, and I had taken my NDT at maybe 1am the night before. TSH should be very stable, right? Like I thought they were saying the TSH shouldn't go up/down irrespective of dosing, not that close. But that makes sense the T3/T4 could have been high from meds if too close. But 11 hours? You're right I could look at the half-lives.

Still, that TSH is crazy. And the other thing is now I'm having that kind of afternoon grump, perks at 5pm gig that, to me, is a sign of adrenal strain. 

I don't know. But you're right I should figure that out before seeing the doc. He's just easy going, not hard core or driving on any of this. 

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So is it possible my T3 was high because I was within 11-12 hours of the dose and I should stay at the 3/4 gr till my appointment? I'm just hesitant to ignore that TSH. The TSH should have been stable, yes? Or does it fluctuate during the day with the dose? I thought it didn't and that that was the point. 

Ugh.

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A few thoughts:

1. Are you dealing with the autoimmune side of things? If you have had positive antibodies, it is absolutely normal to have swings in your labs as your thyroid gland gives up the ghost. I have also had times when I've been almost hyper but it's my body making another effort to try to produce more hormone natural. It can't keep up the pace and it crashes again.

2. There is some evidence in the literature that going off kelp can cause you to go hyper for a bit and then hypo mimicking the natural swing of things I mentioned above: https://www.ncbi.nlm.nih.gov/pubmed/25355748  This isn't an exact match to your situation as this woman wasn't hypothyroid before, it's just a quick link  I pulled off because I don't have time for a deep dive. My point is, it happens. Kombu does the same thing: https://www.ncbi.nlm.nih.gov/pubmed/18689954

 

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I can't find the link that I want this morning, but if you are also doing l-tyrosine, wanted to throw this connection out there if you weren't already aware: https://www.amymyersmd.com/2017/05/thyroid-health-part-vi-the-iodine-thyroid-connection/

We use bromine in our hot tub, and I take l-tyrosine, but if my labs are really wonky, I usually want to understand the whole overall picture.  I don't notice differences in my labs between high hot tub use and low hot tub use or if I do l-tyrosine, but some people do....

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5 minutes ago, prairiewindmomma said:

A few thoughts:

1. Are you dealing with the autoimmune side of things? If you have had positive antibodies, it is absolutely normal to have swings in your labs as your thyroid gland gives up the ghost. I have also had times when I've been almost hyper but it's my body making another effort to try to produce more hormone natural. It can't keep up the pace and it crashes again.

2. There is some evidence in the literature that going off kelp can cause you to go hyper for a bit and then hypo mimicking the natural swing of things I mentioned above: https://www.ncbi.nlm.nih.gov/pubmed/25355748  This isn't an exact match to your situation as this woman wasn't hypothyroid before, it's just a quick link  I pulled off because I don't have time for a deep dive. My point is, it happens. Kombu does the same thing: https://www.ncbi.nlm.nih.gov/pubmed/18689954

 

Ok, that's really helpful. I'm going to read it 3X till it makes sense, lol. 

It sounds like maybe I should ride this out? I don't know.

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1 minute ago, prairiewindmomma said:

I can't find the link that I want this morning, but if you are also doing l-tyrosine, wanted to throw this connection out there if you weren't already aware: https://www.amymyersmd.com/2017/05/thyroid-health-part-vi-the-iodine-thyroid-connection/

We use bromine in our hot tub, and I take l-tyrosine, but if my labs are really wonky, I usually want to understand the whole overall picture.  I don't notice differences in my labs between high hot tub use and low hot tub use or if I do l-tyrosine, but some people do....

I will go read that. I like hitting the hot tub when I can, hehe. We were in one for a couple days at the end of the first week, and after that I started getting warmer. I have no clue, lol. 

I've done l-tyrosine in the past, but it's a methyl donor and not really something I can take constantly. 

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Sorry I'm not the most coherent this morning. I would ride it out 12 weeks and retest....and if I felt like crud 8 weeks from going off of kelp, I would assume that I'm re-entering a hypo state and not wait it out to the 12 week window.

I think this is your body trying to kick in making more thyroid---that you still have a partially active gland--but that this will be a short-lived phase.

I'm not saying you should go back onto kelp.....just that this is a transitional period.

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6 minutes ago, prairiewindmomma said:

I think this is your body trying to kick in making more thyroid---that you still have a partially active gland--but that this will be a short-lived phase.

Ok, that actually makes sense, that my body is screaming and trying.

So then should I be decreasing the meds *while* I'm in this hyper state??

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I know I had a LOT Of ups and downs until getting on a replacement dose of meds. I deeply regret that I didn't up my meds at the beginning. 

I would not decrease the meds, heaven help me I did that twice, it was BAD really, really bad. I ended up so low, so hypo, so fatigued when I went to sleep I didn't know if I would wake up.  You don't have accurate labs to say you are hyper for one thing and also it can be other things making you feel that way. You are stressing your adrenals when you are not taking a proper dose of medication.

I would instead put that energy into finding a good dr that looks at the full panel and get on a replacement dose and regular labs done until you are stabilized. 

Ugh I think this came out grumpier than I planned, I am fighting a cold and am grumpy and have strong feelings after such a horrible experience trying to follow the natural people and their suggestions and guilt trips that you don't really need meds.

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15 minutes ago, PeterPan said:

Ok, that actually makes sense, that my body is screaming and trying.

So then should I be decreasing the meds *while* I'm in this hyper state??

I wouldn't.  I mean, do you *feel* hyper right now? I feel best when I'm around 0.5-1.0. I actually feel pretty awful once I push towards 2.0 and my 2.5 my butt be draggin', iykwim. (My initial TSH was >10.0, but I've got a good internal "feel" of things now.)

If your heart rate is racing, you feel unusually anxious, you have diarrhea, you've developed a hand tremor....then I would maybe think about backing down and easing back in in six weeks, but no.....otherwise I wouldn't do a thing. 

And, yes, with soror, you need a dr at this point, re-read Stop the Thyroid Madness, and get yourself sorted.

 

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1 hour ago, soror said:

Ugh I think this came out grumpier than I planned, I am fighting a cold and am grumpy and have strong feelings after such a horrible experience trying to follow the natural people and their suggestions and guilt trips that you don't really need meds.

Oh that's fine! Your experience is interesting. And yes, that's what I'm concerned about, that the minute I take it down and test ok he'll balk at taking me back up. And this really could be a matter of weeks. And I agree I should have been more careful to have longer from my dose to the labs. When you're *that close* on decisions, it could matter.

1 hour ago, soror said:

I would instead put that energy into finding a good dr

Good luck on that one. This guy is at least congenial. He gave me the med I wanted, will take the TSH below 2, and is just pretty easy to work with. When I tried to find docs that supposedly used NDT, etc. from lists, they usually screamed that's not what they did. Or they were the no labs idiot I used. So this guy at least is safe, kwim?

56 minutes ago, prairiewindmomma said:

I wouldn't.  I mean, do you *feel* hyper right now? I feel best when I'm around 0.5-1.0.

So at .007 I'm below that even. I'm a little warm, but not much else exciting really. 

As far as TSH, all my doc had said was he'd take me below 2, which he did. It landed where it did (like 1.55) and he was like fine you're below 2. I was able to work out, lose weight, and he said to up my kelp if I wanted to tweak. I was fine with that for 9 months, haha. Then I was like let's blow all that up and go completely off all the kelp and recalibrate with meds. I figure when I'm done grossing with meds, I can fine-tune with kelp. But the amount I was taking was just excessive. 

What I could do is give it a week, watch my symptoms, and re-test more carefully, with the longer space between the dose and labs. At the very least my current labs explain my current symptoms (warm, good stamina for exercise, etc.).

51 minutes ago, Lawana said:

Another perspective: I am on 3/4 gr Armour and 25mcg Cytomel and my TSH is always 0.01 or less and my ft3 and ft4 are within range. My prescribing doc is fine with it but everyone else freaks out. No hyper symptoms at all. 

Interesting. He really wasn't really picky or specifying where under 2.0, lol. 

I guess I'll just ride it out, see what happens.

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You write about taking Kelp.  But the more important issue, is how much Iodine you are having daily?  With the RDA being about 150mcg.
When the T3 and T4 hormone levels are low?  This triggers an increase in TSH levels.  Which concentrates iodine in the Thyroid Gland, and increases production of the T3 and T4 hormones.
 

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I went hyperthyroid when I hit menopause.  Never had I been anything but hypo, pretty crazy. 

I started taking Myo- inositol powder with selenium capsules along with my thyroid meds and now, 6 months later, my numbers have never been better.  There is a lot of good research on it for Hashimotos but I started with this article.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331475/

I felt so much worse hyper than I ever did hypo.

Never took kelp so I don't know how that all works.

I hope you get it straightened out soon!

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