unclear thyroid issues or who knows what.

[CinLou24]

Hopefully I can get some insight from those of you who understand this stuff.

TSH  1.4       ref .5-3.0
Free T3  2.7  ref 2.4-4.2
Free T4 1.0   ref .7-2.4
TPOab 37     ref 0-34

51 yr old female
I feel awful, constant fluish feeling, I had acdf surgery 6 months ago.
I'v gained 20+lbs, I have alopecia areata, after surgery, all my hair came in! Now it's falling out again.
I ache in hands, feet, hips, back.
I've now developed a wind/sun type burn looking rash on face (mask across nose to cheekbones) and tops of my fingers. my knuckles turn white then yellow.
I am retaining water, constant ear ringing, feeling of something in my throat, feeling of sore throat and swollen tonsils, they are fine when examined.
The fatigue is wiping me out.

A month ago my WBC was 4.3  ref 4.0-10.0     (new test it's 6.2)
neutrophils 40%   ref is either 45-75 or 50-80   (new test it's 46%)
monocytes 12.5%  ref is 2-10                            (new test it's 13%)
neutrophils  1.7# (means absolute)   ref 2.2-4.8(new test it's 2.2)
monocytes .5# ref .3-.8                                      (new test it's .8)
He redid the tests because of the first numbers.

I've also tested twice with abnormal low serum iga.  once at 68 once at 73 with ref being 87-352.
I am gluten, dairy, soy, msg intolerant.

Thank you for any help.

[gimel]

Yes, the TPO ab is slightly over the range.  That is a possible  indication of Hashimoto's Thyroiditis, but your TSH has not gone up.  So that means either early stages of Hashi's, or if the TPO ab test is a flier, then central hypothyroidism might be the problem.  With central there is a dysfunction in the  hypothalamus/pituitary system resulting in low output of TSH and thus low inadequate levels of FT4 and FT3.  In either case, you have many symptoms that occur more frequently with hypothyroidism than otherwise.  Symptoms should be the most important indicator of thyroid status, confirmed with tests for FT4/FT3/RT3.  

When you have symptoms like yours, I don't understand how the doctor can ignore them as being possibly hypothyroidism, and point in other directions.  Instead he should be starting you on a therapeutic trial of thyroid med adequate to raise your FT4 and FT3 into the upper half of the range and evaluate the effect on your symptoms.  Such a trial would not be detrimental.  If there were any indication of becoming hyper as a result of the med, you just stop the med and your thyroid system returns to prior.  Nothing lost that way, but a lot of potential gain if the tentative diagnosis is verified.  

If your insurance restricts your choice of doctors, and you can't get a referral except to a specialist , which your doctor resists, then you are going to have to become very insistent that he read the link I gave you and do all the recommended tests, including  cortisol, Vitamin D, B12 and ferritin.   Also you might be able to get his attention with a one page overview included in my Journal, on my personal page.  Just click on my name and then look for the Journal.   If nothing works to get him to reconsider, what options do you have by complaining to the insurance company, or the medical group he is in,  about your inadequate treatment?  

[gimel]

With your symptoms and test results I am going to focus on thyroid.  Just because thyroid test results are within the so-called "normal" range does not mean they are optimal for you.  Everyone can have different levels at which they feel best.  In addition there are other variables that affect your thyroid status besides serum thyroid levels.  In addition, the FT4/FT3 ranges are far too broad due to the erroneous assumptions used to establish ranges.   The ranges are not established based on test data from healthy adults with no thyroid issues.   For a better way to assess your test results note the following quote from an excellent thyroid doctor.  The ranges are different than for your results, but the message is clear because your FT4 and FT3 are only at 18% and 16% of their ranges, which is far too low.


"The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

You haven't mentioned what your doctor has had to say about your symptoms and test results.  I can tell you that a good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results when taking thyroid med.  Many of us have found that we needed FT4 at least mid-range, and Free T3 in the upper third of its range, and adjusted from there as needed to relieve symptoms.  In addition hypo patients are frequently deficient in Vitamin D, B12 and ferritin, so you need to get those tested and supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at lest 100.  You can confirm what I say by reading at least the first two pages of the following link, and more if you want to get into the discussion and scientific evidence for all that is recommended.  

http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf

So I suggest that you should discuss all this with your doctor and ask to be treated clinically, as described above.  If he resists, give him a copy of the paper and ask him to read and reconsider.  If that fails, then you need to find a good thyroid doctor that will do so.  

[CinLou24]

Ty for the help gimel.
As you can imagine, he said all is well, in fact he said my blood is perfect.

But yesterday he drew blood, not a repeat or more in depth for thyroid, he says that is not my problem,  the draws were for ANA, GSR and CRP, because maybe it's Lupus, nope it's not. or maybe it's Sjogren's, well I had never even heard of that until yesterday.

My Ortho Surgeons PA said it's fibromyalgia, but I have to be diagnosed by a rheumatologist, of which my primary will not send me to.
I have to be referred to these all per insurance.
My primary is a CNP.
He then said, that I need a psychiatrist LOL, that I have leaky gut and my water retention will resolve on it's own in a few months or so.
After reading the link you provided, I am cold all the time, have constipation and have a low body temp, yesterday at my checkup it was 97.8.
Needless to say I won't be sent to a thyroid doctor either. Nor a doctor that deals with auto immune. Is that the same kind?

What I was reading is the TPO being over, yes it's only a few points, bt that should have been enough to warrant further investigation.

I'm so frustrated. Everyone said after my ACDF surgery, mind you, my spinal cord was compromised over 50% I would be so much better, now with the continuing problems they are saying it will be 2 years before I know what will and will not resolve. I am better. This is all such a vicious circle!