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Under-active Thyroid
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Tineyem,welcome.
I'm not really a fan of trying to influence a test result by what I take or when I have the test. One of the most important things I've leared about being hypo is that consistency matters....... consistency of the time you get tested, of whether you take pills beforehand, of when your take your pills every day, of what you eat or drink with you pills etc.
Having said all that, TSH can vary by up to 3.0 points in the course of 24 hours. It is highest (inconveniently) between approx. midnight and 2am so if you wanted to get the highest TSH reading possible (and assuming your surgery won't open in the wee small hours) then early morning is likely to give the highest TSH reading.
Mava
Everything is still crossed for you!
was diagnosed underactivethyroid after a medical for a new job in 1997.
have been on thyroxine ever since increased from 25mcg to my current level of about 165mcg perday.
i have never felt i have any symptoms of hypo, certainly not dry skin and hair loss.my weight changes depending on my laziness at running!
but the wife lately comments on my possible depression?
i have put my grumpiness down to marriage and 3 small kids, but will speak to my doctor about hypo and depression on my next visit.
have certainly been a bit depressed lately .
has anyone got more info on hypodepression??
good luck to all hypo brothers and sisters!!!
Welcome to the club!
Unfortunately depression is one of the major symptoms of hypo. This is what Thyroid Disease Manager has to say about it:
"Depression is so often associated with hypothyroidism that thyroid function tests should be performed in the evaluation of any patient presenting with this symptom."
"At times, this manifestation of hypothyroidism is more severe than are many of the other clinical manifestations of the disease."
http://www.thyroidmanager.org/Chapter9/9-frame.htm
Before the advent of modern anti-depressant drugs, T3 (liothyronine, the active thyroid hormone converted in the body from the inactive T4 thyroxine) was often used to treat depression. Even today, it is still used by a few psychiatrists in preference to anti-d's.
One of my lingering symptoms that didn't go away even on 300mcg of thyroxine was mild depression. I take both thyroxine and liothyronine and am fine now.
Maybe time for another blood test for you?
i have been taking 6 monthly blood tests for a few years.
i will try to discuss this with doctor over next few weeks.
i cannot be too sick, as i hate going to see the quack, normally i have to wait atleast 2 hrs to see her for 5 mins and the outcome is not up to much!
Fingers still crossed Mava.
Shirl - I wish someone had tested my thyroid when I first suffered from depression, it might have saved me an awful lot of hard times. I'm not concerned about influencing my blood test really - just didn't want to go if there was a time it would be artificially high (e.g. just after taking my morning dose). Incidentally the only advise that I've been given on taking it is 'preferably first thing in the morning' what affects its absorbtion?
Hiya Macky, welcome
Calcium and iron both affect absorbtion of thyroid hormone so theoretically taking the pills with breakfast if you have e.g. milk/dairy or OJ fortified with iron would be a problem.
However, as I mentioned before, consistency is key so if you take your pills every day with breakfast, you will probably just end up on a marginally higher dose to compensate.
There are many things that can interfere with thyroid hormone - a long list of vegetables, nuts and fruits known as goitrogenics, soya, drugs such as NSAIDs, some SSRIs, contraceptive pills, HRT etc. etc. It is possible (and I've heard of cases) to let TD take over your life and obsessively avoid all of the things that might be a problem.
I think to go to these lengths means that the disease has won - your quality of life suffers if you are always watching the clock to figure out what you can 'safely' take and when or avoiding things like brocolli which have health benefits and are yummy anyway!
The only thing I make a bit of an effort to avoid is soya. My assessment of everything I've read good and bad is that I prefer to avoid it (I think I would feel this way irrespective of its anti-thyroid properties). Which is hard because it's hidden in so many guises in most processed things - TVP, lecithin etc. Bur again, I don't go to ridiculous lengths - I wouldn't have a meal with soya as the protein source but if I felt like having a cereal bar that happened to contain lecithin I probably would. Moderation wins every time.
Thyroid Disease Manager has a very good chapter on "Effects of the Environment, Chemicals, and Drugs on Thyroid Function"
http://www.thyroidmanager.org/Chapter5/5a-frame.htm
I shall have a look at your link with interest. It could be that seasonal foods are making the depression worse by suppressing the thyroxine - now that would be a goody.
Why don't doctors tell you these things instead of leaving you feling like a total whinger the whole time?
the soya thing is a pain as soya has some benefits for menopausal symptoms doesnt it ?
i wanted to start using soya milk but stopped because of the possibility of iy affecting thyroid function
what are the other problems with it Shirl?
It's only because a proportion of patients remain chronically under-medicated that they have to go looking for the facts themselves.
Before the 'exquisite sensitivity' of the TSH test, doctors used to examine patients physically and use their clinical judgement based on signs and symptoms. Sadly, now a lab technician looks at the test results and scrawls euthyroid on the test slip and the patient is deemed 'normal'.
The properties that theoretically make it 'good' for menopausal women are the same properties that make it a problem for thyroid patients - phyto-oestrogens.
Here is the website for the anti-soy lobby. It is quite extreme but some of their sources are good enough for me to have doubts and wish not to use it.
http://www.soyonlineservice.co.nz/home.htm
Even bigger thanks for decoding this stuff and spreading the word.
This is the bit from TDM - it's heavy going I know, but is the most authoritative source on TD, unfortunately! Brocolli is of the Brassica family.
"Other important classes of antithyroid compounds arise from hydrolysis of the thioglucosides.132,136,137 These compounds are metabolized in the body to goitrin or thiocyanates and isothiocyanates, and ultimately to other sulfur containing compounds, or are excreted as such. They are important in the goitrogenic activity of seeds of plants of the genus Brassica and the cruciferae, compositae, and unbelliferae. Among the plants containing these compounds are cabbage, kale, brussel sprouts, cauliflower, kohlrabi, turnip, rutabaga, mustard, and horseradish."
http://www.thyroidmanager.org/Chapter5/5a-frame.htm
Here is a more user friendly source with some useful advice too:
http://www.whfoods.com/genpage.php?tname=george&dbid=47
Here is another list complied by a lady researcher (who is a thyroid patient herself) in the USA:
Almond Seeds
Babassu
Bamboo Shoots
Broccoli
Brussel Sprouts
Cabbage
Canola Oil
Cauliflower
Cassava
Horseradish
Kale
Kohlrabi
Lima Beans
Maize
Millet
Milk (see below)
Mustard
Peaches
Peanuts
Pinenuts
Radishes
Rape seed
Rutabaga
Sorghum
Soybean and soy products
Spinach
Strawberries
Sulphur-containing compounds (even some water supplies)
Sweet potatoes
Tofu
Turnips
Walnuts (listed as interfering with thyroid meds on several thyroxine prescribing information inserts)
These are the sources she used to complie the list:
http://www.whfoods.com/genpage.php?tname=george&dbid=47
http://www.thyroidmanager.org/chapter5/5a-2.htm
http://www.thyroid-info.com/articles/thyroid-drug-faq.htm#
url:http://extoxnet.orst.edu/faqs/natural/goi.htm
url:http://www.ithyroid.com/goitrogens.htm)
I take your point tota;lly about not being obsessive about it. I'm like that with the wheat - if it's less than 50% on the ingredients list I will still eat it - e.g. veggie sausages.
If I ever get to meet you in person I'll buy you a big glass of what ever is your poison!
No LMH, results not in yet. Well, they probably are but my practice seems to have lost my notes. Sorry, let's rephrase that. According to them they just can't seem to find them. They're not lost. There's a marker on the shelf saying the doctor has them but the doctor can't seem to lay her hands on them. And although the results are there on the computer (or probably are) the receptionist can't give them to me. That I guess I understand.
So a fax is off to the hospital to ask for a fax copy. But since my practice won't give out results in the morning and they're shut tomorrow afternoon....wednesday afternoon at the earliest and only then if the doctor has seen them.
Any visit of any description to that practice causes my blood pressure to rise dramatically.
There is a school of thought (not proven yet as far as I've been able to find) that cooking destroys the enzyme that is responsible for the antithyroid effect in the brassicas so you're probably OK if you are cooking your veg.
One thing on the list is however worse than others in its effect on thyroid - I'm afraid that soya is the real baddie.
lmh
You could try eliminating soya from your diet for say a month and see if you notice any difference in your fatigue and depression. If you don't feel any better, then you've not lost anything. Have you tried quinoa - very full of amino acids and other nutrients and yummy too - you can cook it up in soup, as a main course or pudding.
mava
any news yet. My fingers are numb from crossing!
If I thought it would be better at another practice I'd move but it wouldn't be, not in a rather deprived area of London with a huge refugee population.
You know, even when I get the results, if I want to make an appointment to see the specific doctor who ordered this test, I will have to wait 10 days to see her.
The reason I think I will never be normal is because I have suffered like this for over 5 years, although there was one period during that time that I felt good but I have no idea what my results were then, it was about a year after I was diagnosed and I was more timid about gettin what I want than I am now. I alays have my T4 and T3 checked. My T4 is about 20 with the top of the range being just below 24 and my T3 is in the middle of the range - I haven't got the exact figures on me at the mo....my results have been pretty similar for the last couple of years so my specialist has seen these results and said I didn't need extra T3
I have had some fantastic Doctors over the years and I have a pretty good one now, so could perhaps broach the subject again.
Good Luck everyone else! And thanks for all the info!
Mava - that's an appalling practice! If I were you I'd make that appointment now - you can always cancel it if you decide you don't need it and anyway, if the thyroid comes back normal you'll want to see what else is causing your symptoms won't you?
Tinyem - perhaps it's time to explore other reasons for the way you feel?
Shirl, I'll ditch the soya as far as possible. I haven't got as far as Quinhoa yet. I keep seeing it reccommended (especially with the non-wheat thing) but haven't got round to it yet. Must try harder!
What is the actual level I ask. 2.5 she says. perfectly normal.
I said what is that a measurment of. Your thyroid she said.
No, I said, what is the substance being measured? thyroid stimulating hormone she said.
So it doesn't have a name then. No she said.
I can't say I'm any the wiser. Are any of you?
Ho hum.
Right, off to the gym for a weights session.
I'm not a doc (as you know) but I would suggest you ask your GP for the following testing:
1. Another thyroid test that includes antibodies and ideally FT3 and FT4. If you have antibodies and are symptomatic it's a good bet your thyroid is failing. If you can get FT3 and FT4 done you will get a better idea of what your actual thyroid hormones are doing - you may find one or both are very low normal or outside bottom end of range. If your GP won't run these and doesn't have any better ideas, you can get the tests done by a lab through the post for a reasonable cost www.nptech.co.uk
2. Female hormones. Perimenopause could account for your symptoms.
3. Iron - make sure the test includes ferritin. Anaemia could also be a reason for you feeling off.
Hopefully your GP will consider all these anyway and you won't have too much of a battle. Let us know how you go.
I had my 2nd blood test today that will determine whether I have an underactive thyroid or not.
I asked the hospital (Lister, Stevenage) out of TSH, FT4, FT3, T4 and T3 which readings they would be taking. Out of the 5, my GP has only asked for TSH and FT3.
Any comments (Shirl?).
They said they would not do the other readings without the GPs say so.
I'm now playing the waiting game (upto 5 working days) for the results to go to my GP.
Ho hum.
If you can only get one test other than TSH, FT3 is the most informative so you got lucky there!
FT3 is the measurement of the active thyroid hormone (T3 aka liothyronine aka triiodothyronine) that is free and available for use at the cellular level.
A significant proportion of the thyroid hormone you produce naturally or take exogenously becomes bound up by proteins in the blood and therefore cannot be used.
Total T4 and T3 tests measure all the hormone, both free and bound. The importance of knowing free levels is that there are other drugs and substances which increase the level of binding proteins and therefore cause more thyroid hormone to become unavailable.
Looks like I need to cross my fingers again - just uncrossed them after mava's long wait!