Elevated TSH - Subclinical Hypothyroidism: Does Anyone Have This?

[Inchlingblue]

I got my latest labs yesterday and they looked very good overall: 686 CD4s, undetectable and good liver and kidney panels.

Over the past two years I've had intermittent elevated TSH levels, not super high but slightly above the normal range and not every time, only sometimes.

I don't know why but I'm having a harder time accepting having to take thyroid replacement hormone than I did accepting HAART. Once one starts taking it, it's for life, or so I've read. For some reason, it just makes me feel so broken and useless. I know I need to get over it but I was reading online that "subclinical hypothyroidism" is not always treated.

I don't seem to have any of the classic symptoms of low thyroid, although my skin is a bit dry.

I was just wondering if others have had this issue and what they did about it.



  

[BT65]

I have to take synthroid, and have been taking it for years.  Treating hypothyroidism is probably one of the easiest things I've dealt with, given other illnesses much harder to treat.  And yes, I'll be on the synthroid for life, but it's a tiny pill, and it keeps things under control.  Hell, my HIV meds are bigger than the synthroid, so it's really not a big issue (for me, I mean). 

[Miss Philicia]

Inchling, so what's your doctor saying?  In my experience it's not unusual to have different things on labs out of range, and you did say "only sometimes" not every time.  And you also said it's not super high.  I can't say I've had this particular lab line out of range as I didn't even recognize what TSH is, but I thought I'd just throw that out there.

I'm surprised, however, to see you write feeling "broken and useless" over this and I hope you can shake out of that quickly.

[Inchlingblue]

Thanks BT and Miss P

My doctor is basically saying I should start thyroid replacement therapy but he's one of these doctors who loves writing prescriptions. The medication is inexpensive (generic) and I'm already on ARVs so it should not be a big deal,  I'm just having a hard time psychologically for some weird reason. As I mentioned before it's for life.

For now I'm going to hold off a little more and research it more. I have read that it's not always treated at my numbers but maybe I'm just prolonging the inevitable.

I was curious if this was HIV-related but I guess it's not or it would be more common on these forums.

 

[max123]

inch,

are your t3/t4 values within normal limits? has thyroid hormone testing been done? the results of these, when combined with the tsh, should be fairly conclusive in ruling out a true hypothyroidism.

maintaining adequate thyroid hormone levels (naturally or via medical management) helps ensure a healthy cardiovascular & immune systems....food for thought.

max

[Inchlingblue]

are your t3/t4 values within normal limits? has thyroid hormone testing been done? the results of these, when combined with the tsh, should be fairly conclusive in ruling out a true hypothyroidism.

 

In the past couple of years I had only one time where they did the t3/t4 and they were fine (I have not always been asking for this complete Thyroid Panel but from now on I will) . . . I think I'm going to wait until my next appointment and get the whole Thyroid panel done and take it from there

I've also decided on my own that I'm not going every 3 months for my HIV stuff . . . I'm going to go every 4 months this year and if all is still good, I'll go every 6 months next year . . . I do think that HIV treatment is not a "one size fits all" and not everybody should have to go every three months if they are stable and adherent

[max123]

inch,

sounds like a good plan.

the choice to manage hypothyroidism through medical management is an important decision that must be medically justified, because it's hormone therapy. too little or too much l-thyroxine can invite other problems. i too would insist on the full gamut of testing to make the best informed decision.

max

[tednlou2]

I'm curious why thyroid meds would be started if you aren't having any problems??  I'm not saying you shouldn't.  I just wondering if it is normal to start thyroid meds if you aren't experiencing problems?  I have a doc appt next week about the fatigue I've been having.  They said they would check liver, thyroid, etc.  I've read thyroid can cause fatigue and even panic attacks--so they say.

[Inchlingblue]

I'm curious why thyroid meds would be started if you aren't having any problems??  I'm not saying you shouldn't.  I just wondering if it is normal to start thyroid meds if you aren't experiencing problems?  I have a doc appt next week about the fatigue I've been having.  They said they would check liver, thyroid, etc.  I've read thyroid can cause fatigue and even panic attacks--so they say.

When you read a list of typical symptoms of hypothyroidism, many of them are things that can be cause by other things too:

Fatigue
Weakness
Weight gain or increased difficulty losing weight
Coarse, dry hair
Dry, rough pale skin
Hair loss
Cold intolerance (you can't tolerate cold temperatures like those around you)
Muscle cramps and frequent muscle aches
Constipation
Depression
Irritability
Memory loss
Abnormal menstrual cycles
Decreased libido

I do have some of the symptoms above but who's to say if it's due to the thyroid.

I'll probably try the thyroid replacement but for now I need to research the crap out of it first, lol.

[veritas]

Inch,

I know once you start researching something, you leave no stone unturned. I don't know how I missed this post before but if I can help you out with your research I will. I'm sure you have already seen many of  these abstracts, but in case you haven't, here goes:

http://www.google.com/search?sourceid=navclient&ie=UTF-8&rlz=1T4ADBR_enUS308US309&q=TSH+and+hiv+abstracts+2009

I know all will not pertain to you, however, in the spirit of "researching the crap out of it", they should keep you busy until your next appt.(lol)

Hope you zero in on the problem.

v

[Inchlingblue]

Thanks, v

I look forward to delving in.

[BT65]

Inch, don't get too upset about this.  If it does turn out you truly have hypothyroidism, it's fairly easy to treat.  I've been on thyroid replacement for years, and have never had a serious problem.  And the pills are pretty small also, which is always nice compared to some of the horse pills we have to take.