TSH help!

[Confused]

I hope someone might have the time to answer a quick question on TSH.  I have been on the same dosage since 2007 and it never varies.
I now have the symptoms of hypo thyroid--can barely stay awake, hair loss.  (Know you cannot give me an actual dx but it is highly important I am somewhat coherent as my hubby needs some help)
It seems my TSH has now jumped down to .09 which my new GP immediately sent out a message I did not get. I did see her Friday for something else and my new GP jumped on that TSH, and ran another test. This made it 3 weeks since the first test she ran.  TSH was a tiny bit higher.
I have no thyroid and it was removed during a round of surgeries in 2007.  I had 3 surgeries within a year.  The thyroid removal followed the hysterectomy by 2 months.
I actually have hypo symptoms and am exhausted, hair loss and such. 
Is this normal?  Need to clear up whatever is wrong asap as hubby needs me to be able to help him and I can barely function.  If I switch out TSH meds how quick before I might not be so tired I can not think?  Husband is recovering from cancer surgery and is seeing orthopedic doc as it looks like that  will be aurthoscopic surgery so I have to be able to move.
Any information would be helpful.  We have no family left and since I was hit with everything from sjogrens (actually had the blood work for sjogrens turn up twice  GP sent in one panel and top Rheumy for Denver ran his panel and it was a definite sjogrens right after so really had no time to make friends. 
Any ideas outside of trying the new med the doctor called in for me (if pharmacy willever get it to somehow be able to be able to be helpful.)  Hubby had the other knee operated on 20 years ago and it was a hard time so I expect the same if this turns into he needs surgery.  I need to be able to think straight and move.
Any suggestions appreciated and I know whatever might be sent does not really count but this is a new doc and I have to know a bit more of what I am trying to tell her.  At least no stairs this time.  Thank you

[Linda196]

TSH is a test that relies on the levels of other tests to give an accurate diagnosis.
TSH is the hormone that activates thyroxine production, and therefore is an "inverse ratio" reading, that means the lower it is, usually the higher amount of thyroxine is in the body. Because of that, a low TSH usually indicates hyperthyroidism, not hypo.

In some cases of secondary hypothyroidism (sometimes related to pituitary disease, sudden weight loss or failure to absorb thyroid replacement)it can indicate hypo, but your doctor needs to assess the TSH with the T3 and T4 as a full equation.

In order to call it hypo based on a low TSH, both the T3 and T4 have to be low as well.

[Scottietottie]

Hi 

I still have a thyroid. I've needed various adjustment to thyroid medication. every time it goes wrong - sometimes hypo - sometimes hyper - my symptoms are the same.
It's not meant to work like that - but it has with me.
Who deals with your thyroid? I used to see an endocrinologist. She told my GP not to let my TSH to go above 2. I personally feel best when it is less.

I totally agree with everything Linda said.
You need to see a specialist to get back in balance.

Take care - Scottie 

[Confused]

Thanks Scottie and Linda,
I know the doctor ran a bunch of other tests but for the life of me the lab she uses I cannot understand a bit.
She knows how weird I can be with meds so she is no doubt trying to get a good feel for what I generally do. 
I am not sure what the deal is with the doctors here but they seem to be joining up with one of 3 different hospital groups.  I forget what the word is for that but I do not like it and will refuse to let anything that a doctor has on me have to stay in her office or since everything has gone electronic, I will insist the tests and write ups have to stay in the place she works.  Another doctor can call and set it up so they read whatever is in my file but right now I have a file full of completely wrong information.  I had wanted to change things earlier but my therapist (who thinks people really are good) told me not to worry as a good doc would check me out first and then maybe read a report.  Forget that they read the reports which are all wrong and why the are still in the system at all makes no sense.  A 15 year report is not much help.  Doctors don't pay attention to what goes into the write ups but luckily I do.  I have a genetics test that was run twice and for the life of my therapist she cannot tell you why I cannot metabolize a med at all or if the med words I can not have an extended med as it will metabolism within 3 hours.
An endo will be good to see as long as he is not like the first one I ever saw who told me if I worked with him no other doctor could see any of the results.
GP took one TSH. This is not as scary as when I first got it as it was the first time with a new doctor.  She is really on top of things and for once I think I have a real GP who cares about her patients which is a first for me since moving to Colorado.
It will no doubt take 4 to 6 months to get into a specialist.  This place is darn right weird, but then so am I.  Will try for apt with TSH specialist and thanks Scottie.  Good to hear about your doctor Scottie
Hubby is going to have to have knee surgery and will try to look up spelling on some weird thing in lungs that is supposed to be fine but I have never hear of having little pieces of something that starts with an M.  Too much happening all year and I cannot get a handle on anything. I just hope the deal that said people could take weird mushrooms did not pass.  Bad enough on the other drug.  It is not properly watched and the grow deals stink.  Why can't they make a drug from the plants that will be all the same so you know what you are really getting.
Sorry for the ramble but thank you both for the info and I actually won't be able to use the plant.  My doctors group and hospitals will not allow you to use that.
Thank you again.

[meirish]

I have hypothyroid and Hashimotos and have dealt with my TSH going up and down at times. During this time my med would be increased or decreased and then test again in 6-8 weeks or so. Gets old but that is the way it is. Takes many months to get things settled down sometimes.

You have a complicated situation and I am wondering if you see an endocrinologist? Many times a family doctor hasn't had enough information to solve some of these thyroid issues. I hope you can find a doctor an endocrinologist to at least have an assessment and then that doc could maybe work with your family doctor if traveling is too much for you. I would get this checked out.

The thing is you could be having something other than thyroid that needs to be addressed. Sometimes these bothersome health issues can be serious and we don't realize it. Not to scare you but just know that waiting around hoping it will get better can get us in trouble at times. Good luck and keep us posted on how things are going for you. meirish

[Confused]

Thanks Irish,

I hate this disease as it mimics so many other things and I could do without finding out there is something major going on.  My new doc appears to be if the test has made a major change she wants to try to get a handle on it quickly which is why I wound up with an earlier than expected blood work on the TSH and whatever else they check for.  My TSH had come up a bit but the doc wants me to start the new dose of synthroid now.  It always worries me when a doc is in a hurry on a test and I can tell she is thinking something but she was not about to let me know what her thoughts were.
On the good side, I finally have a doctor who is actually listening to me and it was the blood work that she was not happy with and insisted on another draw.
This is the first doctor I have had in years who actually is really watching the blood tests and really concerned enough to check out the doseage as soon as it did not look like it was going to go where it usually is.
I had not realized how bad the doctors I have seen really were. 
I will say it is darn hard to get a new GP especially if you are not typical.  It took 4 months for me to get in to see her and she took me as her patient right then.  I had a bit of trouble with the second appointment but found out it was the receptionist that was the problem.  I suspect I won't be having that problem in the future.
T day and Christmas are when I generally come down with something major.
I am going to ask the new GP who to try to see for an endocrinologist but I suspect that will take a few months to get an appointment.  I am finding that most of the doctors who have the knowledge have retired or are about to retire.  I think that is because a number of reasons and the new doctors do not have much experience.
It took about an hour and 1/2 to pick up a script that was filled and ready to be picked up.  We have an acute shortage of pharmacists.
I am so tired I really cannot think straight.

I am fairly used to blood tests .  I just wanted to make through this year without being sick.  You have solid advice. I could really use 2 weeks with nothing going wrong!

Thank you for writing and when I have some solid information I will write to you again.  I think I am having trouble actually having a doctor who cares!

Have a good T-Day.

[meirish]

I think that you are very fortunate to have a doctor who is doing more blood work. Some of the doctors most of us see don't always know when to draw blood or why they are drawing it. I have smooch blood work because of all my health issues. Diabetic, chronic anemia since early 2000's, Hashimotos and hypothyroid, chronic kidney failure and AVM's (artial venous malformations that cause weird capillary problems that cause bleeding from my large and small colon walls plus can happen in stomach also.) So, need a ton of blood work many times....every time I go to the doctor which is often.

I need iron infusions, also. The doctors I have now are all really super vigilant about doing blood work. I have medical and a wonderful supplement that pays well. I am so fortunate that our insurance agent talked us into this policy many years ago. Know that having blood work done, especially when something is puzzling and hard for the doctor to find a diagnosis is what usually ends up making your life better when all is said and done. It does get old though.

Hope things settle down for you. This up and down with our health is another "blessing" from the autoimmune diseases. We seem to have an issue, get things settled down and may have few weeks or months of relative calm only to be waylaid by something else. This is why people with autoimmune diseases become so strong emotionally and physically. We are weak many times but we learn that our diseases are not going away and we learn to sink or swim.

Most of us "swim" and are able to maintain our family life and other issues. We think we are not doing well as we set our goals so high....but I would bet that most of you get more done sick than a lot of your acquaintances do with good health. We learn to forge ahead and many times teach our kids a little about endurance. Take care and God Bless. meirish

[jazzlover]

It's very hard for me to read large blocks of print, but I'll throw this out there.

You may find much more help with a functional med doctor. They will test for more than just the TSH levels. That does not give you a full picture.

I'm not a fan of endocrinologists when it comes to the thyroid.

I do very well on my NP thyroid, which is similar to Armour Thyroid. Endos are not a fan, but I don't care. MY PCP handles my care very well.

You can also find help on Thyroid Advocates on Facebook if you need more help.

[meirish]

 That is interesting that you are on the Armour thyroid. I have not talked to anyone who is on this in a long time. It was quite popular when I was in nurses training. I started on thyroid med in 1989 and my doc wanted me to go on Synthroid brand only and I did that for years until my insurance company started replacing it with the Levothyroxine. I fought with them for awhile and then just went with it as I was getting so many meds that keeping the cost down was important.

I have to admit that I have not had any issues for many years. I just had to lower my dose from .125 to .112 awhile back and this helped me a lot. I think my large weight loss affected my dosage so that was interesting. Glad that you are getting along so well on your med.

Also, it is always interesting how we can have issues with different specialists. I have been to 4 rheumatologists with absolutely no luck. I just don't understand this whole thing when it seems so many people have good luck. I moved to a larger populated area about 1 1/2 years ago and have had to change all my doctors and it is heck. I had my same awesome neurologist from 2006 to 20021 and I will be seeing my third neurologist in a few months.

It is hard to find a doc who is interested in myasthenia gravis. I could write some stories about a couple of doctors I have seen I moved and I have had referrals to them. Unbelievable!!! I have also just walked in and started with some clinics and had some of the best Family Practitioners and Nurse Practitioners in all my years doctoring. Keeps us on our toes that is sure. God luck and take care. meirish