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Registered users can submit a thread (each thread is a single question) on any autoimmune, thyroid or health-related topic – including questions about your pet! Questions will be answered by Elaine Moore.  Because this is not a community forum, members will not be able to reply to threads once questions are asked and answered. Questions may be edited for brevity and grammar. If you need technical help, contact Admin.

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ForumForumDiscussionsDiscussionsQuestion and An...Question and An...Still low or no TSH 4+years post opStill low or no TSH 4+years post op
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 2/28/2009 11:02 AM
 

Hi Elaine,

Battles continue with the doctors treating me because I struggle to produce TSH 4+ years post op with FT-4 in mid range and FT-3 in low range.  I have finally begun a test of additional Cytomel to raise mt FT-3 and the TSH immidiately disappears completely.  What if any tests should I be requesting to make the doctors feel at ease with my lack of TSH?  They are afraid to increase replacement for fear of malpractice and bone deterioration.  I have shared the Brokken articles but they just won't accept the medical facts of antibodies.  I tested TBII 18 months ago which cane back at 22 (<16 normal) I see a GP now because she has been  more willing to work with me, my Endo flat refused to replace me on any figure but TSH.

Thanks!

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 3/1/2009 9:04 PM
 

Hi Lake Lover,

I have the same problem and don't secrete TSH. It's actually a pretty common problem after permanent treatment for hyperthyroidism.  Fortunately for me, my doctor looks at my FT4 and FT3 levels. Some endos understand this and don't even order TSH levels on Graves' patients on replacement therapy. You could ask for a bone density scan to see if the concern over bone loss is legitimate.

A TRH test could also be helpful for showing if patients like us produce TSH in response to thyroid-releasing-hormone stimulation. Before Brokken's reports showed the antibody connection causing a low TSH, other researchers noted that patients on full replacement hormone often have an intact pituitary-hypothalamic-thyroid axis. this just means that the brain is smart enough to realize we no longer produce thyroid hormone and don't have a need to make TSH.  Ordinarily, if thyroid hormone levels are low, the hypothalamus secretes TRH and this causes us to produce TSH. there's a question as to whether we stop producing TRH or no longer respond to it. I'm not sure if this has ever been researched but if it has, such studies could also be used to show why we're not secreting TSH. A TRH would be more helpful academically than for us since it could potentially raise our thyroid hormone levels. In this test, TRH is administered and TSH levels are tested before and twice after the administration to see if there's an increase in TSH. I'll try to find out if there are any studies on this that could help with interpreting our test results. Best, Elaine

 

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