hypothyroid w/normal TSH? Is that possible or am I crazy?

[tornadochaser]

I certainly feel crazy.  In August, my TSH was 6.16.  The Dr wanted a repeat TSH 6 weeks later before trying Rx.  My repeat TSH was 2.49.  I was literally in tears when they told me.  Not that I want anything to be wrong with me, I just want an answer to why I feel this way.  I have every hypothyroid symptom--can't lose weight despite diet and exercise, brittle and vertical ridges nails, dry skin (even my scalp is dry), extreme irritability and anxiety, joint pain, etc.  I have 3 beautiful children who deserve me at my best, not this sub-standard, tired, over-weight person I've turned into.  Thankfully, I have a physician who listens to symptoms and doesn't rely on lab reports only.  When I requested the free T3 and T4 labs this morning, the nurse told me he had already added those on and asked that I make an appointment with him to go over the results.  So my question is this, is it possible to have hypothyroid disorder and have somewhat "normal" test results?  Also, I should include that I have a microadenoma on my pituitary gland.  Can the microadenoma askew the test results or even cause hypothyroid symptoms?  Thank you for your help.  Any advice is most welcome.  I want to be as educated as possible and know all my options prior to my f/u appt.

[Mark Lupo, M.D.]

Would look at thyroid antibodies (TPO and Tg) -- this could be hashimoto's with a struggling but mostly functional thyroid gland -- in which case thyroid hormone treatment may be helpful.  There are cases of transient thyroid problems -- this is why we repeat these borderline TSH results 6 weeks later as much of the time they normalize.  But if the antibodies are positive, the chance of developing definitive hypo over time is high, and treatment (with your symptoms) may be indicated.

Also, symptoms of thyroid disease are suggestive, but not specific to thyroid -- there are many other potential causes of these symptoms.

[curious26]

I also felt bad with all of the symptoms but with "normal" test results.  Found a goiter in April, had a biopsy in May, removed a cancerous thyroid in July.  The pathology report stated that I had Hashimotos.  No I am really feeling "bad" waiting for my medication to catch up to my out of whack levels,  But like you, if I had gone on tests alone I would have been on that roller coaster for a long time.

[alysmum]

Many specialists believe the TSH level should be below 2.0 (even though in 2002 the American Association of Clinical Endocrinologists established a normal TSH margine of 0.3 - 3.04)-- before that the normal range was 0.35 - 5.5 which some Labs still use and is obviously rediculous considering what the AACE established as normal.  Good doctors will always take into account the way that you are feeling with their diagnosis.  Did they check your Antithyroglobulin level and your TPO level?  My 9 year old daughter had symptoms like yours, then tested high TSH (like you), then tested again in the (so-called) normal range of TSH like you.  I researched and insisted on other tests where they determined she has Hashimotos Thyroiditis (Autoimmune Hypothyroidism) which is the most common form of Hypothyroidism.  She tested very high in anti-thyroid antibodies; These antibodies are attacking her thyroid and destroying it, but from research I did studies show that the antibody level goes down with medication.  Ask for a Comprehensive Thyroid Assessment blood panel (from Genova Diagnostics).  Find a doctor (preferably an Endocrinologist) who will do this for you.  Upon further testing we found out that my daughter had greater than 5000 anti-thyroid antibodies, and the normal range at that lab was less than 61.  She has been on Levoxyl for more than a year now (along with an organic diet, good source of water, good vitamins, lots of sleep and excersize) and she is doing well.  She is happy and no one would know that she has anything at all because she looks phenomenally healthy again.  I watch things closely and have already raised her Levoxyl dose because it did not quite reach all of her symptoms at first.  You have to give it a little bit of time to see how your body reacts to a dose or a particular thyroid med.  Now and then I see she needs to slow down and take better care of herself---and as a mom, I'm sure that's what you need to do.  If you do get diagnosed with this, read up on diet reccomendations etc.  If you don't have this, check your other hormone levels because estrogen dominance and low progesterone can cause many of these symptoms.  I just started using natural progesterone cream (USP certified - from a health food store) 2x a day to help balance out  my hormones.  I hope that this is helpful in some way- if it is and you have any more questions let me know.  Take very good care of yourself and I wish you the very best.      

[Madmaggie]

What are 'good labs'? I'm curious as to what I should be asking my doctor about besides TSH. I have hypo - TSH of 3.6 and my doc wants that at 1. However I don't know what my T3 or T4 levels are nor what kind of underfunctioning thyroid disorder I have (Hashimotos or autoimmune or just general poor function) and if there is different levels I should be looking at!
Thank you.

[alysmum]

Use this link for very good info and a great article on what is considered "normal" TSH levels.     http://thyroid.about.com/od/gettestedanddiagnosed/a/garbertsh_2.htm
Mary Shomon is a very informed advocate for thyroid patients (a thyroid patient herself) and you can sign up for her free newsletters at    -     about.com        
The 0.3 - 3.04 are the reccomended "normal" TSH guidlines by the AACE for diagnosing thyroid problems (when a patient has symptoms), but many doctors want to keep it under 2 if you are symptomatic, and for my daughter her TSH level is almost exactly 1 when she is symptom free.   Your TSH level may still be on the high side.

[21cats]

I had my tsh level retake in Sept. and the result was 4.69. My first was 5.96 in July and my doctor put me then on 100mcgs every day. After I got my results back  he lowered my dosage to 25mcgs per day. Was that standard procedure to lower it that much or should I still be taking the 100mcgs. I see a GP not a thyroid specialist. Should I make an appointment with one, or can I trust my GP? My T4 was 6.6 is this high or normal?
Should I ask him to give me a higher dosage or what?

[SECRET29]

Before 7 months my levels were:
FREE T4   1,1ng/dl
TSH           1,4 mIU/ml
Anti-Tg      35,0 IU/ml
Anti-M      12,0 IU/ml
TG            40,0 ng/ml

I had a cold nodule 2,5 cm.  i started T4 100mcg and the FNA was ok.
Now my levels are:
FREE T4  11,0 ng/ml
TSH          1,16 mIU/ml
the nodule 3,5 cm and i found out 2 more nodules. The FNA was good again.
What should i do? I dont know anything about T3. SHOULD I?  
To:

[whiteorchid]

What is a "normal" range for some may not be right for you.   I once had a doctor tell me I was in the normal range when my TSH was at a 4 and I felt like ****.  This was the same doctor who didn't want to test my thyroid because she said "there's no way you are hypo, you're too thin."  She shouldn't be practicing medicine with statements like that.  She wasn't listening to my symptoms at all.  The new TSH range is anywhere between 0.5-3 and most people feel better around a one, although you might feel better at a 0.5 or even below.   Find an endo or a more holistic-minded doctor who is willing to prescribe a natural hormone (armour, thyrolar) if necessary and/or change your dose.  Try everything until you feel better.  What works for me may not work for you, so listen to your symptoms, find a good doctor who will listen to you, not just your labs.

[whiteorchid]

If you're still not feeling well, I would suggest you shoot for a TSH more around a 0.5-2.  I've done A LOT of reading on this subject since I've spent the last 3 years dealing with my own thyroid issue.  I was around a TSH of 4 for a long time (my doctor kept telling me I was in the normal range) and felt absolutely horrible.  It wasn't until I was below a 2 that I felt better.  I'm still having some issues (I have hashimotos so it goes up and down) but I'm SO much better than I was.  

A 6.6 sounds very high to me.  If you're currently taking 100mcgs, he should not be lowering your dose by so much.  He should be doing it in increments.  Take it down to 88mcgs, retest at 6-8 weeks, then 75mcgs and so on.   I would definitely recommend finding an endo or thyroid specialist as most GP's just don't understand the thyroid.  

Trust me - I've had some BAD experiences with GPs!   Check out the about.com website written by Mary Shoman, she has her own thyroid disorder and there is so much info that might behelpful to you.