Thyroid Disorders Community
Confusion....
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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Confusion....

Hi - this is my first post as I'm entirely new to the site and really anything thyroid related.

In a nutshell, I've had a pretty complicated health history my whole life. I am 30. Terrible seasonal allergies until around the age of 21 when I had my tonsils removed. Diagnosed with Chronic Fatigue Syndrom (syndrome) at 19 along with migraines and possible connective tissue disorder. Diagnosed with Ulcerative Colitis at 29 (my father also has it) and around a year and a half ago, I began to experience symptoms of thyroid problems. I had unexplained weight gain that I couldn't lose - which by the way I am VERY active and health conscious (15 lbs gained back and this was after losing 45 - 6 years ago...) I was cold all the time, my voice was raspy, I was tired etc. My first PCP wouldn't run the tests for Hashi. So, I switched and then told the new doctor that in deed these were the tests he was going to run for me. He did and they came back:

Free T3 - 2.7
Free T4 - 1.0
TSH 0.68
Thyruglobulin AB - <20
Anti TPO - <10

All to which he said - nope, you're fine, eat more food and you'll feel better. Okay... fast forward to two months ago when things like depression, irritability, lack of sex drive, cold hands and feet, pale skin and itcy ears set in. Not to mention, 2 weeks ago I had the stomach virus and once my fever went away, my body temperature has maintained at a steady 96.6 degrees (three times a day: wake up, 3pm and bedtime). I am also having trouble breathing, especially when working out. But the weight gain is a major sign to me.

I am so iritable that I can't even stand myself anymore - and this isn't me as a person by any means. I'm patient, always smiling and have had the ability to get through any life challenge. I'm a special ed teacher that loves to laugh and smile. Both of which are gone. Monday I am finally going to see an endocrinologist and hoping for something.... but can anyone offer any help for me? Any suggestions or thoughts? I've spent far too much time on Google and have noticed many many people have a wide range of problems/symptoms and it seems as if many aren't the same.  Is there anything I should say to the doctor other then - please re-run these tests?

Your experience is really appreciated. I'm at the bottom right now and just hanging on.
6 Comments Post a Comment
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4987347_tn?1361977937
I should also add I now have very brittal nails....
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Avatar_f_tn
Please post the ranges on your FT3 and FT4 when you get a chance.  Ranges vary lab to lab and have to come from your own lab report.

Both TPOab and TGab are in range, so it doesn't look like you have Hashi's, but that doesn't mean you're not hypo.
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4987347_tn?1361977937
I had no idea labs had varying ranges. Here you go:

Free T3 - 2.7 (2.5 - 4.0)
Free T4 - 1.0 (0.8-1.8)
TSH - .68 (0.5 - 5.0)
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Avatar_m_tn
You are Hypo. While still in the normal range.  Many people have found that they need to be substaintially up into the range if symptomatic which you are.

The two most important tests are the Free T4 FT4) and Free T3 (FT3).  TSH is virtually worthless and the problem is that many Dr's that is the ONLY thing that they use.

Many people have found that they need to have BOTH of the following to feel well.

1) Free T4 to be in the MIDDLE of the range (50%).  You are at teh bottom of the range at only 13% of the range

AND - that means in addition to

2) Free T3 to be in the UPPER 1/3 of the range (66.7%).  You are again towards the very bottom of the range at only 20%

Everyone feels better at a different level. But the above is FAR better target to shoot for.  You need to start with medication SLOWLY and work up.

Your body's thyroid produces both T4 and T3 but mostly T4.  T4 is a storage hormone and is NOT used directly. When you body need thyroid, the T3 in your body is converted into T3.  This is done mostly in the liver but also in other places.

The term "free" is used to denote a hormone that is "free" from being attached or stuck to a protein molecule. Your body ONLY uses the "free" unattached hormones to either convert (T4 into T3) or to be used at the cellular level ONLY Free T3 is used.

Your previous tests for Hashi's are both negtive. At least so far.

Traditional standard would be to start on a low dosage of synthetic T4 medication.

T4 as a storage hormone takes up to 6 weeks to stabilize in your blood. So any adjustment in medication will need re-testing of blood every 6 weeks.

Also if starting on T4 medication note that you will almost assuredly NOT feel an imediate improvement. Because of the 6 week build up and your body needs to convert the T4 into T3 and that takes time.

Also note that many people actually feel worse when they first begin taking thyroid meds. Not everyone but many people do. This is most likely the result of your body having to adjust to actually getting hormone again.  As your body and adrenals' etc tried to make up for the lack of Thyroid. So when the medicine starts, this "shocks" the system so to speak and it takes time for this to all balance out.  This is also the reason why to start out with a very small dose and work up slowly.

At lot of info here in a short time. I  hope this helps.

One final warning.  Don't assume because you are going to an End that they have a clue.  many Endo's now concentrate on diabetes and do hardly nothing with thyroid and they really don't know much more than your average primary care Dr about thyroid.

If ANY Dr you see ONLY uses the TSH. RUN, don't walk away and find a different Dr. They will almost assuredly keep you feeling like crap.
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4987347_tn?1361977937
This is what I've read many places and just wanted to address it personally - and have others help me. This doctor I will see on Monday came greatly recommended to me by a friend who was recently diagnosed in the last year. I am a strong advocate for my health, so I will be sure to stress what I feel is important. I can't stand to feel this way anymore, it's not me at all. While your answer was long, it was an explanation I needed. I appreciate you taking the time to break it down for me.
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Avatar_m_tn
I see from your profile that you are a marathon runner.

Understand that MAY be contributing factor.

"excessive" strenuous exercise can be seen as your body as a shock and essentially put your body into protection mode.  This can affect the rate of conversion or the type of conversion from T4 to T3 or into reverse T3 (RT3 which is also worthless to your body).  I doubt this is your problem given your relatively low in range results.  Normally this would be more indicative if your blood labs show you well up into the ranges but still symptomatic for being Hypo.

About the single best website for information on Thyroid I've found is:

http://nahypothyroidism.org/

The articles along the left side of this site are very good.  The discussion about strenuous exercise I think is the 1st article under the heading of "Thyroid Hormone Transport"
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