WWTBAM Bored

I've been diagnosed with hypothyroid and referred to an endocrinologist. They can't see me for six weeks. They explained there are only three in this area of over one million population!

If you know of any in your area that could use better weather, send them here, please!

Just avoid being overdosed when you do get to the doctor. The line between high & low thyroid is a little murky.

A couple weeks ago when I went to my cardiologist for a consult prior to doing a treadmill stress test, my resting heart rate was 50. I am not a runner. Used to be, but that was 15 years ago. He thought that was too low so he had my thyroid tested. It's fine. My resting heart rate was back to my normal 59 the day of the treadmill test.

I'm good for another 30 million beats.

ghostjmf wrote:Just avoid being overdosed when you do get to the doctor. The line between high & low thyroid is a little murky.

My TSH is zero. My thyroid couldn't pump out more. I expect it will be removed.

BackInTex wrote:A couple weeks ago when I went to my cardiologist for a consult prior to doing a treadmill stress test, my resting heart rate was 50. I am not a runner. Used to be, but that was 15 years ago. He thought that was too low so he had my thyroid tested. It's fine. My resting heart rate was back to my normal 59 the day of the treadmill test.

I'm good for another 30 million beats.

Mine is 90. I'm sure that's what caused my Afib.

Bob Juch wrote:

ghostjmf wrote:Just avoid being overdosed when you do get to the doctor. The line between high & low thyroid is a little murky.

My TSH is zero. My thyroid couldn't pump out more. I expect it will be removed.

Sounds like your thyroid is significantly overactive.
Most of the time treatment of hyperthyroidism is anti-thyroid medications or radioactive iodine therapy, much less commonly is surgery performed.
The American Thyroid Association website can give you good background information on your condition.
https://www.thyroid.org/hyperthyroidism/

I'm not sure what restrictions are for your health insurance/network regarding who you can see, but there are more Endocrinologists in the Phoenix area. WebMD lists 101 Endocrinologists within 25 miles of Phoenix.
https://doctor.webmd.com/find-a-doctor/ ... na/phoenix
Unfortunately I don't know anyone in Phoenix, so I can't give you any recommendation.

- Tim H.

thguy65 wrote:

Bob Juch wrote:

ghostjmf wrote:Just avoid being overdosed when you do get to the doctor. The line between high & low thyroid is a little murky.

My TSH is zero. My thyroid couldn't pump out more. I expect it will be removed.

Sounds like your thyroid is significantly overactive.
Most of the time treatment of hyperthyroidism is anti-thyroid medications or radioactive iodine therapy, much less commonly is surgery performed.
The American Thyroid Association website can give you good background information on your condition.
https://www.thyroid.org/hyperthyroidism/

I'm not sure what restrictions are for your health insurance/network regarding who you can see, but there are more Endocrinologists in the Phoenix area. WebMD lists 101 Endocrinologists within 25 miles of Phoenix.
https://doctor.webmd.com/find-a-doctor/ ... na/phoenix
Unfortunately I don't know anyone in Phoenix, so I can't give you any recommendation.

- Tim H.

Thanks! I hope I don't need surgery. Phoenix is a 2.5-hour drive from here.

Bob Juch wrote:

thguy65 wrote:

Bob Juch wrote: My TSH is zero. My thyroid couldn't pump out more. I expect it will be removed.

Sounds like your thyroid is significantly overactive.
Most of the time treatment of hyperthyroidism is anti-thyroid medications or radioactive iodine therapy, much less commonly is surgery performed.
The American Thyroid Association website can give you good background information on your condition.
https://www.thyroid.org/hyperthyroidism/

I'm not sure what restrictions are for your health insurance/network regarding who you can see, but there are more Endocrinologists in the Phoenix area. WebMD lists 101 Endocrinologists within 25 miles of Phoenix.
https://doctor.webmd.com/find-a-doctor/ ... na/phoenix
Unfortunately I don't know anyone in Phoenix, so I can't give you any recommendation.

- Tim H.

Thanks! I hope I don't need surgery. Phoenix is a 2.5-hour drive from here.

You probably checked this already, but the list for the Tucson area shows 25 Endocrinologists.

https://doctor.webmd.com/find-a-doctor/ ... ona/tucson

- Tim H.

thguy65 wrote:

Bob Juch wrote:

thguy65 wrote:
Sounds like your thyroid is significantly overactive.
Most of the time treatment of hyperthyroidism is anti-thyroid medications or radioactive iodine therapy, much less commonly is surgery performed.
The American Thyroid Association website can give you good background information on your condition.
https://www.thyroid.org/hyperthyroidism/

I'm not sure what restrictions are for your health insurance/network regarding who you can see, but there are more Endocrinologists in the Phoenix area. WebMD lists 101 Endocrinologists within 25 miles of Phoenix.
https://doctor.webmd.com/find-a-doctor/ ... na/phoenix
Unfortunately I don't know anyone in Phoenix, so I can't give you any recommendation.

- Tim H.

Thanks! I hope I don't need surgery. Phoenix is a 2.5-hour drive from here.

You probably checked this already, but the list for the Tucson area shows 25 Endocrinologists.

https://doctor.webmd.com/find-a-doctor/ ... ona/tucson

- Tim H.

No, I checked my insurance company's link. I have an appointment in the middle of September.

Bob Juch wrote:

thguy65 wrote:

Bob Juch wrote: Thanks! I hope I don't need surgery. Phoenix is a 2.5-hour drive from here.

You probably checked this already, but the list for the Tucson area shows 25 Endocrinologists.

https://doctor.webmd.com/find-a-doctor/ ... ona/tucson

- Tim H.

No, I checked my insurance company's link. I have an appointment in the middle of September.

Ouch. Sounds like the other Endocrinologists in the area aren't too keen on working with your insurance company.
I hope things go OK until you are seen in September. Feel free to send me a Private Message if you want.

- Tim H.

thguy65 wrote:

Bob Juch wrote:

thguy65 wrote:
You probably checked this already, but the list for the Tucson area shows 25 Endocrinologists.

https://doctor.webmd.com/find-a-doctor/ ... ona/tucson

- Tim H.

No, I checked my insurance company's link. I have an appointment in the middle of September.

Ouch. Sounds like the other Endocrinologists in the area aren't too keen on working with your insurance company.
I hope things go OK until you are seen in September. Feel free to send me a Private Message if you want.

- Tim H.

Thanks!

I went to a different endocrinologist. She triages her appointments and got me in ASAP.

She did a sonogram which showed I have normal vascularization which rules out cancer and Grave's disease.

The blood test she did on Wednesday had puzzling results:

TSH undetectable - that's the only thing my GP's test had, the rest weren't tested
FT4 1.67 which is rather high
TT3 1.09 right in the middle of the range, that's strange
Tg 1.63 which is way low
TgAb 3.59 on the high side of normal
TpoAb 0.6 very low

TSH (thyroid-stimulating hormone) stimulates the thyroid to produce the three hormones it makes. The FT4 (free thyroxine) level regulates how much TSH the pituitary makes, so that's consistent.

TT3 (total triiodothyronine) being average when T4 is low is strange as T3 is made from T4.

Tg can be decreased by TgAb (anti-thyroglobulin antibodies) so those numbers are consistent. That would indicate hypothyroidism so that's confusing.

High TpoAb (Anti-thyroid peroxidase antibodies) can indicate Grave's disease so it being low rules that out.

I have a follow-up on Monday.

Bob Juch wrote:I went to a different endocrinologist. She triages her appointments and got me in ASAP.

She did a sonogram which showed I have normal vascularization which rules out cancer and Grave's disease.

The blood test she did on Wednesday had puzzling results:

TSH undetectable - that's the only thing my GP's test had, the rest weren't tested
FT4 1.67 which is rather high
TT3 1.09 right in the middle of the range, that's strange
Tg 1.63 which is way low
TgAb 3.59 on the high side of normal
TpoAb 0.6 very low

TSH (thyroid-stimulating hormone) stimulates the thyroid to produce the three hormones it makes. The FT4 (free thyroxine) level regulates how much TSH the pituitary makes, so that's consistent.

TT3 (total triiodothyronine) being average when T4 is low is strange as T3 is made from T4.

Tg can be decreased by TgAb (anti-thyroglobulin antibodies) so those numbers are consistent. That would indicate hypothyroidism so that's confusing.

High TpoAb (Anti-thyroid peroxidase antibodies) can indicate Grave's disease so it being low rules that out.

I have a follow-up on Monday.

You are not quite correct in your interpretations of the antibody tests.
Both TPO antibody and Tg antibody are indicative of autoimmune thyroid disease, and TPO antibody is most often associated with hypothyroidism. Your Tg antibody level being elevated indicates your immune system acting against your thyroid gland, and it can make the measurement of Tg (Thyroglobulin) itself have false high or low readings.
The antibody which is most consistently associated with Graves disease is called TSI (Thyroid Stimulating Immunoglobulin). Perhaps your endocrinologist ordered that test but the result is not back yet from your laboratory. This is the test which would be most indicative of whether you have Graves disease or not.
If you have high thyroid hormone levels (which the high free T4 and low TSH indicate) but normal vascularity of your gland, your endocrinologist may want you to get a radioactive iodine scan to see if either
a) your thyroid gland is actually over-producing thyroid hormone (which would be indicated by a high level of iodine usage by your gland)
or
b) the thyroid antibodies are causing inflammation (thyroiditis) and "leakage" of thyroid hormone out of your gland into your blood in an uncontrolled fashion (indicated by a low level of iodine use by your thyroid)

If your thyroid gland is actually doing too much work, then treatment should be given to calm it down. If the thyroid is just leaking extra hormone due to inflammation, the problem usually gets better on its own over the course of weeks to months.

If you haven't looked at these pages from the American Thyroid Association, these will be helpful references for you.

https://www.thyroid.org/hyperthyroidism/
https://www.thyroid.org/thyroid-function-tests/

- Tim H.

thguy65 wrote:

Bob Juch wrote:I went to a different endocrinologist. She triages her appointments and got me in ASAP.

She did a sonogram which showed I have normal vascularization which rules out cancer and Grave's disease.

The blood test she did on Wednesday had puzzling results:

TSH undetectable - that's the only thing my GP's test had, the rest weren't tested
FT4 1.67 which is rather high
TT3 1.09 right in the middle of the range, that's strange
Tg 1.63 which is way low
TgAb 3.59 on the high side of normal
TpoAb 0.6 very low

TSH (thyroid-stimulating hormone) stimulates the thyroid to produce the three hormones it makes. The FT4 (free thyroxine) level regulates how much TSH the pituitary makes, so that's consistent.

TT3 (total triiodothyronine) being average when T4 is low is strange as T3 is made from T4.

Tg can be decreased by TgAb (anti-thyroglobulin antibodies) so those numbers are consistent. That would indicate hypothyroidism so that's confusing.

High TpoAb (Anti-thyroid peroxidase antibodies) can indicate Grave's disease so it being low rules that out.

I have a follow-up on Monday.

You are not quite correct in your interpretations of the antibody tests.
Both TPO antibody and Tg antibody are indicative of autoimmune thyroid disease, and TPO antibody is most often associated with hypothyroidism. Your Tg antibody level being elevated indicates your immune system acting against your thyroid gland, and it can make the measurement of Tg (Thyroglobulin) itself have false high or low readings.
The antibody which is most consistently associated with Graves disease is called TSI (Thyroid Stimulating Immunoglobulin). Perhaps your endocrinologist ordered that test but the result is not back yet from your laboratory. This is the test which would be most indicative of whether you have Graves disease or not.
If you have high thyroid hormone levels (which the high free T4 and low TSH indicate) but normal vascularity of your gland, your endocrinologist may want you to get a radioactive iodine scan to see if either
a) your thyroid gland is actually over-producing thyroid hormone (which would be indicated by a high level of iodine usage by your gland)
or
b) the thyroid antibodies are causing inflammation (thyroiditis) and "leakage" of thyroid hormone out of your gland into your blood in an uncontrolled fashion (indicated by a low level of iodine use by your thyroid)

If your thyroid gland is actually doing too much work, then treatment should be given to calm it down. If the thyroid is just leaking extra hormone due to inflammation, the problem usually gets better on its own over the course of weeks to months.

If you haven't looked at these pages from the American Thyroid Association, these will be helpful references for you.

https://www.thyroid.org/hyperthyroidism/
https://www.thyroid.org/thyroid-function-tests/

- Tim H.

Thanks doc. I was supposed to see her tomorrow morning but I'm in the E. R. right now and won't make it. I am expecting the next step to be a scan.

Bob Juch wrote:

thguy65 wrote:

Bob Juch wrote:I went to a different endocrinologist. She triages her appointments and got me in ASAP.

She did a sonogram which showed I have normal vascularization which rules out cancer and Grave's disease.

The blood test she did on Wednesday had puzzling results:

TSH undetectable - that's the only thing my GP's test had, the rest weren't tested
FT4 1.67 which is rather high
TT3 1.09 right in the middle of the range, that's strange
Tg 1.63 which is way low
TgAb 3.59 on the high side of normal
TpoAb 0.6 very low

TSH (thyroid-stimulating hormone) stimulates the thyroid to produce the three hormones it makes. The FT4 (free thyroxine) level regulates how much TSH the pituitary makes, so that's consistent.

TT3 (total triiodothyronine) being average when T4 is low is strange as T3 is made from T4.

Tg can be decreased by TgAb (anti-thyroglobulin antibodies) so those numbers are consistent. That would indicate hypothyroidism so that's confusing.

High TpoAb (Anti-thyroid peroxidase antibodies) can indicate Grave's disease so it being low rules that out.

I have a follow-up on Monday.

You are not quite correct in your interpretations of the antibody tests.
Both TPO antibody and Tg antibody are indicative of autoimmune thyroid disease, and TPO antibody is most often associated with hypothyroidism. Your Tg antibody level being elevated indicates your immune system acting against your thyroid gland, and it can make the measurement of Tg (Thyroglobulin) itself have false high or low readings.
The antibody which is most consistently associated with Graves disease is called TSI (Thyroid Stimulating Immunoglobulin). Perhaps your endocrinologist ordered that test but the result is not back yet from your laboratory. This is the test which would be most indicative of whether you have Graves disease or not.
If you have high thyroid hormone levels (which the high free T4 and low TSH indicate) but normal vascularity of your gland, your endocrinologist may want you to get a radioactive iodine scan to see if either
a) your thyroid gland is actually over-producing thyroid hormone (which would be indicated by a high level of iodine usage by your gland)
or
b) the thyroid antibodies are causing inflammation (thyroiditis) and "leakage" of thyroid hormone out of your gland into your blood in an uncontrolled fashion (indicated by a low level of iodine use by your thyroid)

If your thyroid gland is actually doing too much work, then treatment should be given to calm it down. If the thyroid is just leaking extra hormone due to inflammation, the problem usually gets better on its own over the course of weeks to months.

If you haven't looked at these pages from the American Thyroid Association, these will be helpful references for you.

https://www.thyroid.org/hyperthyroidism/
https://www.thyroid.org/thyroid-function-tests/

- Tim H.

Thanks doc. I was supposed to see her tomorrow morning but I'm in the E. R. right now and won't make it. I am expecting the next step to be a scan.

I do hope all is all right?

Bob Juch wrote: Thanks doc. I was supposed to see her tomorrow morning but I'm in the E. R. right now and won't make it. I am expecting the next step to be a scan.

I hope things check out OK. I take it that since you are still monitoring the Bored, your situation is not that dire.

- Tim H.

thguy65 wrote:

Bob Juch wrote: Thanks doc. I was supposed to see her tomorrow morning but I'm in the E. R. right now and won't make it. I am expecting the next step to be a scan.

I hope things check out OK. I take it that since you are still monitoring the Bored, your situation is not that dire.

- Tim H.

Not dire, I caught it early. It went from tachycardia to atrial flutter while I was there. I'm not one to rush to the doctor for little stuff but I knew this was a problem.

Bob Juch wrote:

thguy65 wrote:The antibody which is most consistently associated with Graves disease is called TSI (Thyroid Stimulating Immunoglobulin). Perhaps your endocrinologist ordered that test but the result is not back yet from your laboratory. This is the test which would be most indicative of whether you have Graves disease or not.

- Tim H.

Thanks doc. I was supposed to see her tomorrow morning but I'm in the E. R. right now and won't make it. I am expecting the next step to be a scan.

You were right, the TSI test just came in today: <0.10 IU/L. No Grave's.

I'm seeing her tomorrow morning.

I am slightly radioactive today. I swallowed iodine-123 for a scan of my thyroid. I should get the results back on Monday and then know which treatment will be best.

Bob Juch wrote:I am slightly radioactive today. I swallowed iodine-123 for a scan of my thyroid. I should get the results back on Monday and then know which treatment will be best.

Enjoy that "healthy glow" while it lasts!

- Tim H.