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I have read through a lot of posts on this site, and everything seems quite willing to assist ... I'm hoping I can get some answers and moral support.   I have been complaining about symptoms of low thyroid for years and years and years.  Most prominent:    always very cold, extreeme abnormal fatigue,  muscles cramps - cramp and  releaseright before a charlie horse in my arms.  Constant bouts of anxiety and depression,  but neither consistently or all the time - and neither respond much to medication. Mood swings,  now those are ALL THE TIME!   Horrible constipation that I can't get under control. And last but not least ...  heart palpitations.   My Doctor faithfully tested my thyroid year after year,  checking only my TSH and telling me always that it was normal.  Finally I insisted on seeing an Endocrinologist.  He just tested my Ft3 Ft4 and antibodies.  Here are the results and ranges:  
TSH                2.          0.27-4.2 mU/L
T4 Free          14.7      10.5-20.0 pmol/L
T3 Free          3.9         3.5-6.5  pmol/    
Thyroperoxidase Ab    7 <35 IU/mL

Once again,  everything is testing within the "acceptable normal range" and it makes me want to cry to think that I am going back to discuss these results in two days and I'm probably going to be told that I am fine and there is nothing that can be done to help me .... can anyone suggest anything I can ask, beg for, insist up on - or other plead for ... that might help me when I am sitting infront of the Doctor, burnt out,  fatigued and tongue tied?
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7899924 tn?1395184712
ChitChatNine,  I agree ... I need to have my vitamin D checked,  I have had stomach surgery and I was told I will never absorb it right and it needs to be checked often, but neither my GP nor the Endo will test it ... even knowing this info??? What the?  I don't know.  Thanks for the push. I will find out how to get my own test and pay for it :)
Helpful - 0
7899924 tn?1395184712
Klax79 ... your FT3 and FT4 are very very similar to mine.  My endo is willing to treat me based on my symptoms and he now agrees that people with these numbers (as low as ours) are actually hypo and can benefit from treatment.  My GP had the same attitude as yours - so I insisted on seeing an endo - mind you I have serious migraines as well - which helped plead my case.  But still - if I were you  I would be inclined to find an endo who will treat you ...  this illness is so debilitating and so frustrating ...  the advise on here helpful - but we really do have to stomp our feet and insist on Dr's listening to us ... we are not insane,  we are sick!  Good luck!  
Helpful - 0
168348 tn?1379357075
I would really try to get in to see another doctor that will run not only your Vitamin D levels, but magnesium and some of the other elementals, too.  The cramping I get with low Vit D, as well as it can mimic depression, etc.  I am on 100 mcgs of Synthroid and when my Vit D is low I know it without needing a blood test to confirm it.  My Vit D was 9 while 32+ was normal. I hope you can find an answer .. so many great people/ideas on this community to draw from, too.

Maybe others on this community know -- isn't there a Vit D test you can pay for yourself and take the results to your doctor?

C~
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Avatar universal
Your numbers are better than mine but my GP says its normal, even when there r multiple nodules on both lobes. So she concluded that my weight gain & other symptoms r not Hypo since blood test numbers r "within range". You are not alone.

I just got the results today & wondering if I should just go to an Endo instead of going for another blood test 3mths later & another ultrasound 6mths later. Sigh......

TSH: 4.06 (0.12-5.29)
FT3 3.5 (3.0-7.8)
FT4 14.6 (12.0-22.0)

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7899924 tn?1395184712
Thank you for the info!   I will look for that book, for sure!  I have had some antibodies tested and they were negative.  In Canada,  because we are so short on Doctors,  you can't "move on" as easily as you say,  sad but true.    Once you have a family Dr.  you cannot leave him - because none of the other Doctors will take you on unless your moved, or your last Doctor retired.   Doctor "shopping" is more or less prohibited.  Best you can do is go to "walk in clinic" or the emergency room and see another Dr. on a one time basis for a second opinion.   But these are all General Practice.  As for specialists ... it's even harder,  we have even less of them to choose from and you will wait up to a year to see a different one ... if he will even see you!  So while our health care is "free"  it's is not "plentiful".
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7899924 tn?1395184712
Thanks gimel!  I will post my ferritin when I get it.  Not for 6 weeks though,  as he put it on the lab requistion I need to use for my thyroid tests just prior to my next visit.  He did say that he was "ahead of the curve" with his approach, and that he closely followed the US Endocrinology advances and many of his colleagues would not be willing to treat as he does, but he does treat symptoms ... so if anyone on the site lives on Vancouver Island,  Victoria BC, I am happy to pass his name along.  Thank again for kind and wise words! I'm so glad I found this site!
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Avatar universal
Have you heard of Datis Kharrazian? Author of WHY DO I STILL HAVE THYROID SYMPTOMS When My Labs Are All normal. He is the master of Thyroid research and explains so much in his book. This book has been the number one thyroid book on the market since its release in 2010. definitely  get a new doctor and ask to have your TPO antibodies tested for Hashimotos (explains erradic symptoms especially heart palps). If you ever feel frustrated with a doctor again like your pulling teeth or begging for something...... move on sister.
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Avatar universal
It is a step in the right direction anyway.  People sometimes report no progress when starting on thyroid med.  One of the usual causes is that as you start with the med, it will tend to reduce your TSH level and thus reduce your output of natural thyroid hormone,  That is why people frequently need to continue with thyroid med increases until their serum levels start to rise and then continue until symptoms diminish.  

Your doctor is right about not taking T3 only.  That is an extreme approach that is rarely needed, only when having a Reverse T3 dominance problem.  I agree about his reaction to your questions.  It is not like you are listening to just internet chatter.  We can provide links to scientific studies that support what we say.  Refusal to test even Vitamin D is unbelievable.  Vitamin D needs to be around the middle of its range. I'm surprised that the doctor considered adding some T3 to your med.  That is somewhat unusual for Canada doctors, so maybe all is not lost with him.

I'll look forward to seeing your ferritin result.    
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7899924 tn?1395184712
Thank you for all your help.  I saw the endo again today.  He flat out refused to test my Vitamin D & Selenium, says it's nonsense & a waste of tax payer money.  He agreed to test my ferritin & will test my hemoglobin as well.  He pointed out that my B12 was tested previously as is good - checked against your numbers, it is :)   He started me on synthroid .05mg and will do labs again and see me in 6 weeks at which point he will consider adding T3.  I asked why not treat me with T3 only?  He said it doesn't work that way and to stay off the internet sites?!? He's such a jerk.  I'm so anxious about taking this synthroid - I read about so many people who's symptoms go from bad to worse when they start taking it ... gah, maybe I should stay off the internet. I can't bear the thought of feeling any worse, even if it's temporary! But I will grin and bear it - I guess,  apparently I have no choice anyway.  Are going anywhere near the right direction with this synthroid?
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Avatar universal
That is always a possibility, but is a very infrequent problem.  More likely is that you are just not converting T4 to T3 very well.  Hence the need to do the tests suggested.  You might have enough difficulty getting those done.  It might blow the doctor's mind if you ask for an RT3 test right now.  
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7899924 tn?1395184712
I just wrote out a post and now its gone?  Oh dear! Short version .... ty ty ty ty very very much!  And what about RT3. That wasnt tested.  Wont it help explain my low T3?
Helpful - 0
Avatar universal
Your situation is a very familiar one.  Your TSH is low enough in the range that many doctors, especially Endos, only pay attention to that info and don't pay any attention to the most important consideration, which is symptoms.  They either don't pay any attention to Free T3 and Free T4, or they use "Reference Range Endocrinology", by which they will tell you that a thyroid test result that falls anywhere within the range is adequate.  Obviously that is not the case.  Due to the erroneous method used to establish ranges, they are far too broad.  

So one possibility is that your symptoms are caused by an inadequate hypothalamus/pituitary response to thyroid levels, resulting in TSH levels too low to adequately stimulate your thyroid glands.    Another possibility is that your body is not adequately converting T4 to T3.  Free T3 has been shown in scientific studies to correlate best with hypo symptoms, while Free T4 and TSH did not correlate at all.  Your Free T3 is low in the range, to the point that it is associated with having hypo symptoms for many people.

As I mentioned, since your Free T4 is around the middle of the range, but your Free T3 is much lower relatively in its range, your may be missing some of the essentials for adequate conversion of T4 to T3.  Two of the most important ones are ferritin and selenium.  That might be a good place to start with your doctor.  Ask to be tested for both of those, as well as Vitamin D, and B12.  For Vitamin D and selenium you want to be around the middle of the range.  Ferritin for women should be around 70-80,=. and B12 should be in the upper end of the range.

Be aware that a good thyroid doctor will test and adjust Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  I know that being in Canada, and relying on the NHS creates some special problems getting adequately tested and treated.  I suggest that you start with the above approach and see how that works for you.  If you run into roadblocks, please let us know and we can try to provide some info to convince your doctor of what you need.  

I think you can also help yourself prepare for any discussion with your doctor by reading this link.  

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

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