Aa
Chronic fatigue, always cold
Hi. I am having symptoms of chronic fatigue, always cold, headaches. Family history of hypothyroidism. Last t3 was 119, t4 0.98 (checked last year)... tsh 0.837 (checked this year bc np said don't need other labs). The np said my thyroid gland was big normal, but everything else was ok. Is this true or should I get a second opinion?
I'm sorry, for clarification-
Tsh: 2014=1.674, 2015=1.465, 2016=1.259, 2017=0.837
Free t4 (I didn't realize there was a difference): 2014=0.78, 2016=0.98
Total t3: 2014=96, 2016=119.
Today, she checked tpoab and it was <6 (normal) and my vitamin d was also normal.
I just am feeling like my adls are altered due to my fatigue, and I'm frustrated feeling like am I making these symptoms up because the endocrine np said everything was fine minus her note of thyromegaly which she also said was high normal due to my size. This was the first time I have seen a specialist...the other labs from the past years were from my pcp. Thank you for your speedy response-I feel less frustrated already. I will try to get another opinion.
Tsh: 2014=1.674, 2015=1.465, 2016=1.259, 2017=0.837
Free t4 (I didn't realize there was a difference): 2014=0.78, 2016=0.98
Total t3: 2014=96, 2016=119.
Today, she checked tpoab and it was <6 (normal) and my vitamin d was also normal.
I just am feeling like my adls are altered due to my fatigue, and I'm frustrated feeling like am I making these symptoms up because the endocrine np said everything was fine minus her note of thyromegaly which she also said was high normal due to my size. This was the first time I have seen a specialist...the other labs from the past years were from my pcp. Thank you for your speedy response-I feel less frustrated already. I will try to get another opinion.
4 Comments
Thanks for the clarifications. What were the reference ranges for the Free T4 and Total T3 results. Those vary from lab to lab, so have to come from your own reports.
What was your "normal" vitamin D result? There are so many of these things that fall within a normal range, but are really anything but normal, if they're too low in the ranges. This holds true for the Free thyroid hormones, as well as vitamin D, vitamin B-12.
It's good that she tested TPOab, but she still might be missing Hashimoto's by not testing TgAb; however, with your TSH and FT4 levels, I'd lean more towards Central/Secondary hypothyroidism than Hashimoto's, because with FT4 that low, we'd expect to see TSH higher than yours. Even though Total T3 is considered obsolete, yours appears to be low in most ranges we, typically, see, so we can figure that your Free T3 would be low, as well.
If you'd like to know the difference between Total T4 and Total T3 and Free T4 and Free T3, I'll be happy to explain it to you...
What was your "normal" vitamin D result? There are so many of these things that fall within a normal range, but are really anything but normal, if they're too low in the ranges. This holds true for the Free thyroid hormones, as well as vitamin D, vitamin B-12.
It's good that she tested TPOab, but she still might be missing Hashimoto's by not testing TgAb; however, with your TSH and FT4 levels, I'd lean more towards Central/Secondary hypothyroidism than Hashimoto's, because with FT4 that low, we'd expect to see TSH higher than yours. Even though Total T3 is considered obsolete, yours appears to be low in most ranges we, typically, see, so we can figure that your Free T3 would be low, as well.
If you'd like to know the difference between Total T4 and Total T3 and Free T4 and Free T3, I'll be happy to explain it to you...
I don't know why I'm just seeing your response...
Free t4 ranges (0.71-1.51 from 2016). The free t 4 I had drawn today which was 0.67 was from a different lab (reference range was 0.58-1.64).
Total t3 ref range is 60-180.
Free t4 ranges (0.71-1.51 from 2016). The free t 4 I had drawn today which was 0.67 was from a different lab (reference range was 0.58-1.64).
Total t3 ref range is 60-180.
Vitamin D, 25-hydroxy (taken on 2/23/2017) was 52 with a reference range of 30-96.
What kind of work do you do?
I really appreciate you taking the time to help me out. I just want to know if to focus on thyroid or if I should follow up with my pcp or an allergist because I've been having allergies lately also (but feeling tired/cold for a lot longer than allergy symptoms).
What kind of work do you do?
I really appreciate you taking the time to help me out. I just want to know if to focus on thyroid or if I should follow up with my pcp or an allergist because I've been having allergies lately also (but feeling tired/cold for a lot longer than allergy symptoms).
I'm sorry-if you don't mind me asking, what kind of work do you do. I'm also 30 years old I don't know if that helps paint a picture. Thanks again so much.
Levothyroxine does not cause the symptoms you mention. Symptoms are mainly the result of insufficient levels of thyroid hormones, Free T4 and Free T3, which are not the same as Total T4 and Total T3. What was your daily dose of Levothyroxine? What were your thyroid test results before and after starting on the Levo?
I'm 21 years old. I was taking Levothyroxine for about 7 months, I never really took them properly as I was so bad at taking my tablets so nothing really improved. I was frustrated with myself because when I was taking Levo and doing really well with taking them I felt like absolute ****. So I didn't feel like I was getting anywhere with them whatsoever and on top of that I was getting symptoms like hives, constipation, weight gain, hair loss, grey hairs, increased appetite, cold all the time and big time DEPRESION. I was miserable I started weaning myself off them I know I shouldn't do it. But Hypothyroidism is so hard to understand and people don't tell you all the **** that comes with taking Levo, you've just got to find out for yourself. I even tried a gluten free diet at one point to see if it helped. But no. It's been a week since I've been of Levothyroxine and I feel ******* AMAZING i kid you not. I'm actually staying awake the whole day and not needing a 4-6 hour nap during the day, I have lost weight! HORAY. Hopefully I get back down to my size 10. I am happier i'm drinking a lot more which I did find very hard to do while taking Levo I was never thirsty which probably didn't help with the constipation too. Just to point out I was 9 and half stone before I even knew I had hypothyroid. Then I started eating more and my weight shot up so went to drs to find out I had hypothyroidism and that's when they put me on these tablets, I was putting on weight at the time so I'd thought I'd give it a shot to see if I could loose this weight but NO. Honestly if you have hypothyroidism I would avoid Levothyroxine, or any drug for that matter. I don't know how it works for hyperthyroidism but I suspect it's similar. I just need to figure out what I can do to cure my hypothyroidism and not damage my brain and body at the same time while curing this disease and if I find some miracle I will defo update you.
I know how hard it can be it's horrible especially if you suffer from aniexty and depression like I do. Just hold on in there. your life is worth living and if no one has ever told you I just have. :) and if you feel like you don't want to be here anymore Trust me I know. You are here for a reason don't let some stupid disease ruin that for you.
Georgina x
I know how hard it can be it's horrible especially if you suffer from aniexty and depression like I do. Just hold on in there. your life is worth living and if no one has ever told you I just have. :) and if you feel like you don't want to be here anymore Trust me I know. You are here for a reason don't let some stupid disease ruin that for you.
Georgina x
COMMUNITY LEADER
Sometimes, it's difficult to see new comments...
Did you get a new TSH, along with the Free T4, today? You should always get Free T3 with Free T4, not Total T3, as the Total T3 is considered obsolete and doesn't really give the information we need. However, both of your previous Total T3 results were below mid range, so we'd figure Free T3 would have been low, as well.
Your Free T4 from today, is only at 8% of its range; it should be, at least, mid range, so it's way too low and it's no wonder you don't feel well. I don't see a T3, at all with today's labs... did you not get one?
Your vitamin D at 52 is okay, but optimal is 60-80, so if you're supplementing, you should stay at daily dose that's high enough to keep moving your level up a bit.
There's a problem with trying to focus on just one thing, such as thyroid, allergies, B-12 deficiency, etc because symptoms from one condition can mimic those of another. It has to be a process of elimination, in which a variety of things are tested and more than one condition/deficiency can actually be contributing to the symptoms.
I had several going on at once, but because my doctor kept thinking that each thing we found was "it", it took years to get to the bottom of it all and I'm still not sure we've found it all, because I'm suspecting I'm dealing with some food allergies that nobody has considered yet. I just got done dealing with an H. Pylori over growth that I suspect has been part of my trouble for some time
I'm retired now, but I used to be a water treatment facility operator. I came to the forum in 2008 looking for help with my own thyroid issues, because I had a terrible doctor who wouldn't do the proper testing, etc and I wasn't getting any better. Members of the forum helped me learn what tests I needed, etc and that I needed to be my own advocate. I started doing a lot of research and learning as much as I could about thyroid and related issues and I stayed around to help others get better. Most of the members who helped me are no longer active on the forum.
Did you get a new TSH, along with the Free T4, today? You should always get Free T3 with Free T4, not Total T3, as the Total T3 is considered obsolete and doesn't really give the information we need. However, both of your previous Total T3 results were below mid range, so we'd figure Free T3 would have been low, as well.
Your Free T4 from today, is only at 8% of its range; it should be, at least, mid range, so it's way too low and it's no wonder you don't feel well. I don't see a T3, at all with today's labs... did you not get one?
Your vitamin D at 52 is okay, but optimal is 60-80, so if you're supplementing, you should stay at daily dose that's high enough to keep moving your level up a bit.
There's a problem with trying to focus on just one thing, such as thyroid, allergies, B-12 deficiency, etc because symptoms from one condition can mimic those of another. It has to be a process of elimination, in which a variety of things are tested and more than one condition/deficiency can actually be contributing to the symptoms.
I had several going on at once, but because my doctor kept thinking that each thing we found was "it", it took years to get to the bottom of it all and I'm still not sure we've found it all, because I'm suspecting I'm dealing with some food allergies that nobody has considered yet. I just got done dealing with an H. Pylori over growth that I suspect has been part of my trouble for some time
I'm retired now, but I used to be a water treatment facility operator. I came to the forum in 2008 looking for help with my own thyroid issues, because I had a terrible doctor who wouldn't do the proper testing, etc and I wasn't getting any better. Members of the forum helped me learn what tests I needed, etc and that I needed to be my own advocate. I started doing a lot of research and learning as much as I could about thyroid and related issues and I stayed around to help others get better. Most of the members who helped me are no longer active on the forum.
COMMUNITY LEADER
Get new labs - any labs done a year ago are irrelevant now, because a lot of things could have changed over the past year. Besides, it looks like your T4 might have been on the low side, last year, anyway.
Also make sure the T3 and T4 are Free T3 and Free T4, not Total T3 and Total T4. Free T3 and Free T4 are the active hormones, while Total T3 and Total 4 are considered obsolete.
And yes - while you're at it, get another opinion; it doesn't look like your NP really knows her thyroid stuff... A low TSH, with low T4 could indicate Secondary hypothyroidism, which many doctors (and NP's) miss because they don't test anything but TSH. Secondary (also known as Central hypothyroidism) means there's a problem with the pituitary or hypothalamus gland, rather than with the thyroid gland, in which there isn't enough TSH to stimulate the thyroid. Either way, it's hypothyroidism and needs to be treated.
It would also be good to get thyroid antibody tests to rule out/confirm Hashimoto's Thyroiditis. Those tests are Thyroid Peroxidase Antibodies (TPOab) and Thyoglobulin Antibodies (TgAb). You need them both, because some of us have one or the other and some have them both.
Because of the fatigue, also ask to get vitamin B-12 tested. B-12 deficiency can cause horrible fatigue/exhaustion.
When you get new labs please post results with reference ranges so we can see how you're doing.
Also make sure the T3 and T4 are Free T3 and Free T4, not Total T3 and Total T4. Free T3 and Free T4 are the active hormones, while Total T3 and Total 4 are considered obsolete.
And yes - while you're at it, get another opinion; it doesn't look like your NP really knows her thyroid stuff... A low TSH, with low T4 could indicate Secondary hypothyroidism, which many doctors (and NP's) miss because they don't test anything but TSH. Secondary (also known as Central hypothyroidism) means there's a problem with the pituitary or hypothalamus gland, rather than with the thyroid gland, in which there isn't enough TSH to stimulate the thyroid. Either way, it's hypothyroidism and needs to be treated.
It would also be good to get thyroid antibody tests to rule out/confirm Hashimoto's Thyroiditis. Those tests are Thyroid Peroxidase Antibodies (TPOab) and Thyoglobulin Antibodies (TgAb). You need them both, because some of us have one or the other and some have them both.
Because of the fatigue, also ask to get vitamin B-12 tested. B-12 deficiency can cause horrible fatigue/exhaustion.
When you get new labs please post results with reference ranges so we can see how you're doing.
1 Comments
So I got a cbc and free t4 drawn today. Here are some of the results (I wasn't able to get the other labs at this time):
Free t4: 0.67
Wbc: 4.3
Rbc: 4.71
Hgb: 13.2
Hct: 39.7
Do you think with these results I should make another appointment with a different endocrine specialist? Do you think this shows secondary hypothyroidism? I have been to several doctors over the years, and I feel like they dismiss me, so I just want to make sure I follow up with the correct physician...Or do you think I should follow up with my pcp for b12, ana screen? Thanks so much for your help!
Free t4: 0.67
Wbc: 4.3
Rbc: 4.71
Hgb: 13.2
Hct: 39.7
Do you think with these results I should make another appointment with a different endocrine specialist? Do you think this shows secondary hypothyroidism? I have been to several doctors over the years, and I feel like they dismiss me, so I just want to make sure I follow up with the correct physician...Or do you think I should follow up with my pcp for b12, ana screen? Thanks so much for your help!
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
