Thyroid Disease Page 2
L. B. male – CA
Thyroid Problems and Low Testosterone
At a very young age I had developed problems and was maturing too slow for my age and fell behind my peers who were growing much faster than me. My parents took me to a hormone specializing doctor after our family GP recognized my problem as being hormone imbalance after a physical exam of me. After lots of testing including an MRI, I was found to have less than half of my thyroid gland and a very low testosterone level. My growth hormone level was also low but not as deficient as testosterone. Since that time I’m now in my late 20s and still taking thyroid hormone but no longer needing to take growth hormone. At times, about every two or three years I still need to take a round of testosterone which is retested about every six months and if found to be low.
I’m grateful my growth didn’t stay stunted and I caught up with my peers and look average size as an adult. I’m concerned about the possibility of being sterile and unable to conceive children when I get married and start a family. My doctor is going to have me tested for sperm count when I’m ready, to see where I am on that and if I am found to be sterile, I’ll let my future wife know that we will have to adopt, which will be perfectly fine with me or that we can look into artificial insemination as a possible option. I’m just glad the thyroid problem was found early enough to keep other serious problems from happening as I entered adulthood.
Jim Lowrance ARTICLE HERE>> Properly Timing your Thyroid Hormone Dose _________________________________________________________________________________________________________________
My Response/Question- “TSH Thyroid Stimulating Hormone Monitoring”
The TSH reflects thyroid hormones opposite to what you would think. When TSH is high (above normal), this means thyroid hormones are low and if TSH is low (below normal), this means thyroid hormones are too high. It is a pituitary hormone and not actually a thyroid hormone, like T4 & T3 are. TSH backs off and goes low when you have hyperthyroidism/thyrotoxicity and it goes into overdrive/higher with hypothyroidism. It stands for "Thyroid Stimulating Hormone" because it nudges the thyroid gland to make normal amounts of hormone but the process gets out of whack when the gland becomes diseased or disrupted.
In regard to sex hormones, they too, like thyroid, are "endocrine gland" produced (glands that supply hormones). In fact the sex hormones are made directly or converted from others produced by the adrenal glands. The endocrine system works in-sync, meaning in-a-loop so that if one becomes dis-regulated, others may also. This is why with endocrine problems of any kind, like thyroid, sex, adrenal or pancreas/insulin, even if caused by a certain gland, the others should be re-checked about once or twice a year. This just means all hormone levels need evaluated and not just the initial ones that first caused a problem. Any doctor who wouldn't see the need to be thorough with testing hormones, especially in women with endocrine disease or disorders, I would be in question about. A doctor who has the compassion to listen to patients is an extremely valuable thing in itself!
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My Response/Question-“Female Thyroid Cancer Treatment Patient”
When a person undergoes thyroid destruction (radioactive ablation) or a thyroidectomy, the thyroid gland is no longer there to supply the hormone to regulate metabolism. This then requires the thyroid hormone therapy to replace the missing hormone. There is no alternative to prescription replacement such as Synthroid or natural type hormone like Armour. Thyroid booster type supplements that are over-the-counter in the U.S., cannot contain actual thyroid hormone in them because drugs that do must be regulated by USP and FDA guidelines to make sure doses in each pill consistently contain the same amount of hormone. If you've been on replacement for a couple years and your follow up blood retests show you still need replaced (only exception is if all the gland wasn't totally destroyed and some has grown back-rare), it's very important to continue the replacement therapy. If you don't, over time you'll experience worsening hypothyroidism which can eventually cause severe and even life-threatening complications. There just is no substitute for thyroid hormone replacement despite many claims out there you find online.
I've been searching and researching for 6 years on thyroid since my own diagnosis and I know that with thyroidectomy or Radio Active Ablation of the thyroid to treat cancer, they replace low thyroid hormone afterward to suppress TSH lower than they normally do for other types of caused-hypothyroidism. They also usually recheck the "thyroglobulin" level to also make sure it remains low (a marker for malignant cells not returning) which I'm sure they did after your thyroidectomy until it was no longer necessary to retest. If the parathyroid glands are also removed during thyroidectomy, they also replace low calcium which I'm sure has also been done for you. If a patient has symptoms of being over-replaced on thyroid hormone, they should test the T4 and T3 levels as well to get a more through picture. If either of these are flagged high, above normal values, this would mean the replacement dose is too high.
I'm limited in the area of knowledge on menopause but do know it also is a matter of blood retesting hormone levels, including the sex ones. If it causes your thyroid hormones to start going a different direction, blood retests will reveal what your doctor needs to do for it dosage-wise (increase or decrease). I do believe over-treated hypothyroidism (dose induced thyrotoxicity) can aggravate symptoms of stress-related conditions like RLS (Restless Leg Syndrome). That might also be a sign your dose is too high. This of course isn't an absolute but I would think it is important to get T4 and T3 added to TSH on the next blood retest, if it wasn't done on a previous one. I would ask the Dr. to order it for you right away. If he's stubborn about it for any reason, I would consider a second opinion from a doctor willing to order more thorough blood retest evaluation. It only takes a stroke-of-the-pen so would be difficult to understand why a doctor wouldn't be willing, You or your insurance are footing the bill so would cost him nothing but a tiny bit of added time.
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My Response/Question-“Thyroid Hormone Therapy Optimization”
Tweaking a dose of thyroid hormone replacement to get it better optimized, requires having a doctor willing to do so but if you feel strongly that you need a trial of a dose to get you down to 1.0 TSH level, I would be firm in requesting it. If your current doctor refuses, you may have to find a doctor who is willing and that's not to cast dispersions on your current one but it is your life & health after all! It's very possible your current one will be willing to do so. Below are some quotes from Endocrinologists and MDs who have found "1.0" to be a successful target range for TSH. You might consider printing this and sharing with your Doc at your next office visit. I would recommend not including any of my writing in it because you'll likely be told I'm a non-professional quack and that online info is all bogus when not offered by medical professionals.
"Alan Cohen, MD: "The Depression/Thyroid Disease Connection Explored (May 2002) Many patients seem to need replacement hormone sufficient to get the TSH down around 1.0 or less, even below .50....my impression is that most patients with fatigue, anergia and depression need TSH levels in the lower zone <1.0."
"John Dommisse, MD: "Unique Theories About Hypothyroidism Treatment" (May 2002) Finally, I found some patients with several symptoms and signs of hypothyroidism whose TSH was between 1.0-1.5; so I lowered my range, for the last time, to 0.1-1.0; I now treat primary hypothyroidism with a TSH of >1.0 (if the FT4 and FT3 are low-normal, not above the middle of their 'normal ranges')."
Mark Lupo, M.D. Thyroid & Endocrine Center of Florida Sarasota - FL "With the history, would check thyroid antibodies-- if they are positive and the TSH is still >2.5 then given your symptoms a trial of to get the TSH around 0.5-1.0 would be reasonable."
My own final added comment: Patients vary and some may feel well with TSH at "2.0" or even higher but some doctors have found 1.0 and even between 0.5 and 1.0 to be a better level for symptom relief.
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