Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Normal TSH
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Normal TSH

I have symptoms of hypothyroidism (muscle aches, fatigue, chronic constipation, thinning hair, and so on). My mother has hypothyroidism. My TSH was tested last week. It's normal (1.76), so my dr. has dismissed hypothyroidism. Can I have the disease and still have a normal TSH? Where do I go from here? I haven't felt well in years. A previous dr. looked at my long list of symptoms. Before he even examined me, he said he expected to find nothing wrong and that antidepressants might relieve my symptoms. I'm tired of feeling like a hypochondriac. I need someone to believe me when I say I am barely making it through each day. I want to find answers, not mask the symptoms. Thank you for any insight or next steps.
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97953_tn?1193367871
Most likely you have a normal thyroid if the TSH is 1.76.  To be complete about it, you could have T4, T3 and antibodies tested - but if all normal, it's not thyroid.
22 Comments
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245460_tn?1238008096
Yes you can be hypotT with normal TSH. DId you have Free t4,T3 and Thryoid antibodies checked, if so can you post them for the Dr. to see. It would help.
Many people are treated with antiety meds or antiD before they are dx with  Thryoid disease. Take care and let us know how your doing.

Deedee
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Avatar_n_tn
Yes, you could be hypothyroid.  Like Deedee said, get your free T4, free T3, and thyroid antibodies checked.  It could be that your problem is with your pituitary gland not responding properly (i.e. not increasing production of TSH) in response to low thyroid hormone levels.
If it turns out that you really don't have a thyroid problem, don't let your doctor make you feel like a hypochondriac! If he won't look into to other possible causes, get a new doctor.
Depression can cause some of your symptoms, but not all.  Have you had your iron levels checked? Families with Hashimoto's hypothyroidism also have increased risk of pernicious anemia and that may account for some of your symptoms.
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Avatar_f_tn
Deedee and Hypofuzz,
Thanks for your encouragement. No, my dr. hasn't checked T3, T4, or antibodies. Drs seem to resent when they tell you something is "normal" and you insist on more testing. At least now I know what tests to request. I'm seeing him again next week. It's been such a long battle. I just want the answer. When I'm disappointed with a "normal" result, the drs can't understand why I'm not relieved!
DeeMarie
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Avatar_f_tn
Thank you, Dr. Lupo. If that's not it, I'm out of options. I'll have extreme muscle aches and debilitating fatigue for the rest of my life. Not a fun prospect.
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97628_tn?1204465633
Have you seen a rheumatologist? If not, you may want get a referral.
I have Hasimoto's and fluctuate between hyper and hypo TSH and have muscle aches, but it didn't seem an adequate explanation for them. While hyper I lost many hours of sleep every night for months. I sleep better now that I am in a normal range period, but the rheumatologist said the sleep deficit could have contributed to the pain cycle.  She gave me something for the muscle aches and it has helped a lot.  My
x-rays showed bone spurs and calcifiaction in soft tissues so I am off for an MRI.
If you haven't seen a rheuma, give one a try.
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Avatar_n_tn
I am having the same problem..  I am on 100 mcg of levothyroxine, but I've felt that I needed an increase.  However, my last TSH came back 2.5, and my doctor siad that it is normal and fine, and that I am to stay at this dose.  BUT I have been experiencing major hair loss, fatigue, lack of concentration..all indications that my thyroid is out of whack.  
I am getting from this webiste (I am new) that I should requet T3 and T4 tests done, as well.  
I, too, was not relieved when I was told everything is normal..  UGH.  Let us know what happens?  Thanks.
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Avatar_n_tn
Dx hashimoto's 7 yrs. ago. When my tsh climbs to 2.5 I feel terrible. Actually I start feeling something is wrong when it goes past 1. Try to persuade your MD to target your tsh to 1. Dr. Lupo has would agree. He has said that much many times on this site.
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Avatar_n_tn
Thanks!  I will talk to him about it on Friday.  
What is the difference between hypothyroid and Hashimoto's?
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541234_tn?1266678697
i too have a whacky goitoris thyroid normal levels suffering all those symptoms  wt gain concentration air head  achy bones and muscles and joints and my endo is putting my  thryoid to sleep started on 50mcg graduating to 100 mcg and only on it for 3 days and i feel better ? now the funny scoop is Vit D 3 mine was dangerously low so he put me on 50,000 iu 1 day per week so alot of my muscles pain and aches are getting less noticable sooooo everyone test for VITD its also suppose to curb colo rectal cancers so my ergo D was low  but i have a super sensitive scalp  scabs and dry patches and itches or burns is this a Vit d issue or an allergy or thryoid  i had a thermo perm march  could this be a burned scalped ? which is still bothering me  i'm running out of ideas on this
jmbirds
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Avatar_f_tn
Thank you to everyone for the support. Some days are okay. Yesterday was not. I attended an outdoor event with my husband and my legs got so heavy and tired that I thought I might pass out. Although he insisted I didn't, I felt like I ruined his day by having to get into the shade, sit down, and rest all the time.
To Kitcurious, yes, I have seen a rheumo. She agreed that something is wrong, but couldn't find it. She suggested a neuro just to rule out MS. MRI showed no lesions, so it's not MS, but did show a herniated disk. That only explains my neck discomfort, nothing else, so he is going to do some kind of nerve damage test this week. He's the one who ordered the thyroid test, but only the TSH as far as I know. And, as I mentioned, since that's 1.76, he's dismissed that as a cause. He's very nice, one of the few drs I've seen who is willing to investigate my symptoms. In the end, though, it will be the same story. My tests will be normal and he'll just want to treat the symptoms. I'm not interested in treating symptoms without knowing the cause.
I am still curious to know if anyone has experience with the TRH test:
http://patientsmedical.com/ThyroidTest.html?gclid=CLSHlO-M-ZMCFR8cagoddRJgWw
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Avatar_n_tn
I am going to get my T4 done on Firday, have you suggested that to your doctor?  
My mother has that problem with her legs..  she has Fibromyalgia.  I remember they tested her for MS, too, but she ended up being diagnosed with Fibro instead.  But she also is hypo, so..
Don't settle if you feel that there is more..  If it comes down to getting another doctor, you are worth it.
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541234_tn?1266678697
have you had your VIT D level tested? my endo said mine was dangerously low i'm on 50000 units 1 pill per week for 30 days and retest , i had myofacial pain  trigger point and bones aches like an old woman insomnia  by night  and fatigue so  i'm 43 female  and they said it was the VIT D 3 , since my thyroid is normal yet i'm goitorus and hypo symptoms  i'm on synthryoid 50 mcg graduating to 100 mcg so endo is putting my thryoid to sleep becuz my neck and muscles were so painful and choked on food and liquid so perhaps its the VIT D 3
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Avatar_n_tn
I have heard the expression "putting my thyroid to sleep" twice on this website..  what does it mean?
Thanks!
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541234_tn?1266678697
well my endo said your organ is not functioning right yet my levels are normal  i'm growing goitors and my levels are normal  so now i had alot of neck pain and tenderness choking on food and drinks so hes giving me the pill to TRICK my organ the thyroid, so by slipping me the mickey  the synthyroid my thyroid says ok i can stop working she has enough hormone so as i gradually increase my synthroid my thyroid will decide to stop making hormone so i can get the same dose daily and maybe my goitors will shrink and my hypo symptoms will  go away , its also linked the a VIT D 3 condititon mine was dangerously low  so i'm feeling better after 3 days now  on this treatment
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456874_tn?1218143341
WOW-I have all the same symtoms (symptoms) as you, plus hair loss etc.etc.etc,and have gone thru the same as you with Dr's.  My TSH has only gone up to 1.78, so they are not willing to treat me.  URRRRRR.  They have ruled out any RHuem issue with me.  The blood specialist just ordered a PET scan on me and hopefully this will sow so,ething.  When I first went to an Endo a couple of weeks ago, she said that I was borderline HYPO and sent me for more tests----but now I called her to get the results over the phone and she said they were normal.  URRR.  I need help just like you.Please let me know if you get any relief.
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541234_tn?1266678697
my ergocal-ciferol vit D 3  was LOW ,  have yours tested it mimics hypo and fibro symptoms i take 50000 unit  1` x week i'm on synthryoid for my multi goitor normal TSH  my endo said my VIT D was dangerously low and its been 4 days and i am feeling mostly normal compared to tight painful throat choking and gagging on liquids  food and pills this d 3 looks like a green vit E easy to swollow  the only pain i feel is my MPS on my shoulder injury  other wise alot of my symptoms have disappeared or are in hiding  if everyone can have this VIT D  issue you would feel like a new person per sae
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456874_tn?1218143341
Thanks for that information.  I will ask my Doctor to check it next time I go in (next week.)
Thanks, again!
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523918_tn?1244553431
I agree with kitcurious, find a rheumatologist. Ther are many autoimmune diseases that have symptoms like yours (if it isn't thyroide related...., need to check TPO, anti-Tg and free T3 and free T4).  Fibromyalgia is a possibility, anemia too....; I agree  with jmbirds, need to check your vitamins. I'm like some of you, Hashimoto, high antibodies but TSH "normal" range, so no medications, checking other autoimmune diseases, anemias etc....
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541234_tn?1266678697
HI tell your endo what my endo is doing , the VIT D level and say why ca'nt we try jaynes therapy she swears shes feeling human again? high ANA normal tsh ft3 ft 4 multi goitor my thyroid is a GLOB its not butterfly shape any more  hypo symptoms wt gain and freezing and sweatin i  drink pure pomagranite juice 4 oz daily cn't hurt to try and i swollow biotin b at walmart my nodules shrunk no needle biopsy last year
now i have some sort of scalp rash itch scabs  like scalp burn does anyone else suffer it only started make me nutso in march?  shampoo allergy ? thermo permenant redkin or low VIT D or thyroid  grrrrrrrrrrrrrr
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523918_tn?1244553431
Sorry what is jaynes therapy?; I didn't check my Vit D yet, I'm going to see my results on monday (nervous about it....). I'm having Selenium and some anti-oxidant vitamins, people say it helps to lower my antibodies (I have TPO more then 1000). Biotin is a good option , pure pomegranate, do you prepare that??? You felt better with that? What I didn't expect in my analyses was my ANA's (1:640)....
About your problems in your scalp, could be an allergic dermatitis (eczema); Fungus (Tinea); Psoriasis, much more things, it iwould be a good option for you to go to the dermathology doctor.

Thanks
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541234_tn?1266678697
i answered but my answer is MIA? jayne;s therapy is ME  endo is putting my thyroid to sleep  due to my HYPO symptoms normal TSH and multigoitors  my thyroid is a GLOB not a butterfly shape now last year i had a serious bout of thyroiditis  FNB scheduled but i was drinking pomegranet juice 100 % 4 oz every night well my neck was swollen hot and burning  i was sure it was CANCER well i went for my USound and they said they cna't find anything to biopsy so between this juice and the churches praying for me i was good for about 8 mos and i started the severe muscle pain and bone pain and insomnia and this scalp rash and more and the endo said my VIT D was dangerously low so on this new therapy putting my thyroid to sleep i feel better its only been 1 wk i finished  50 mcg wk 1 i'm on 75mcg now  wk 2 then wk 3 100 mcg wk 4 100 mcg then 2 mos he test my TSH unless i have something weird happen then it will be sooner
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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