Thyroid Disorders Community
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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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Finding Help

I have felt that I have a Thyroid problem for a while now, and have many of the symptoms (fatigue, very sensitive to cold, hoarse voice, goiter, muscle aches, depression/anxiety, loss/lack of hair, etc.....) and Dr.'s send me for bloodwork and then say that I am fine.  About 6 months ago I noticed a goiter and went through several tests (sonogram, Neuclear guided scan, biopsy) then was referred to an endrocrynologist (pls. excuse sp. errors) and he said that I was fine and didn't need any meds.  Said they cause more side effects than not taking anything.  I have since then notice my hair is thinning, and have read up on some other indications of a thyroid problem and am overwhelmed at all they symptoms that I have.  Does it all come down to my TSH #'s and why can they (Dr's) not do anything to help.
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Avatar_m_tn
No, it definitely does not all rely on TSH.  TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as the sole diagnostic for thyroid problems.  At best it is an indicator, to be considered along with more important indicators such as symptoms, as well as levels of the actual biologically active thyroid hormones, which are free T3 and free T4 (not the same as total T3 and total T4).  Unfortunately many doctors have the "Immaculate TSH Belief"  and don't want to do the additional testing that should be done for a patient with your symptoms.  

In my opinion, the best way to treat a thyroid patient is to test and adjust levels of  FT3 and FT4 with meds as necessary to relieve symptoms, without being constrained by resultant TSH levels.  FT3 is the most important because it is the most active.  It largely regulates metabolism and many other body functions.  Studies have shown that FT3 correlates best with hypo symptoms and that FT4 and TSH did not correlate at all.  The most difficult part is finding a good thyroid doctor that will treat your symptoms as I've described.  

The first thing I'd suggest is to go back and request  that you be tested for FT3 and FT4, along with TSH.  If the doctor resists or doesn't want to test for both FT3 and FT4, then  you should insist on it and not take no for an answer.  Remember that you are the customer.   You should also be aware that just having FT3 and FT4 results anywhere within the range is frequently inadequate to relieve symptoms.  Many members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least the midpoint of its range.  

If you will get the additional testing done and get a copy of the lab report and post the results and reference ranges for each, shown on the lab report, members will be glad to help interpret and advise further.  The doctor is required to provide a copy upon your request.
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Avatar_f_tn
thank you very much for the information and quick response.  I will call the Dr.'s office tomorrow.  I am supposed to get blood work again next week anyway.  Also, would it help if I told you that my TSH 3rd generation was 1.12 mIU/L , my FSH 17.3 mIU/mL and my LH 11.7 mIU/mL.  I am a 49 year old, female.

Thank you :) for all your help!
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Avatar_m_tn
Being male, I know next to nothing about the FSH and LH tests.  Perhaps some of our lady members can fill you in about those.  I do want to give you this link to a good article written by a doctor.  I think you should read it thoroughly and then take a copy of it with you and give it to your doctor to maybe stimulate him to reassess your thyroid status and treatment.  Hopefully if you are insistent about getting the right testing done and being treated clinically, for symptoms, as I outlined above, the doctor will relent and do the right thing.  If not, you will have to locate a good thyroid doctor that will treat you in this manner.

http://www.hormonerestoration.com/Thyroid.html  
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