Question regarding lab tests

[Roth55]

Hello,  I have always been a  very active, healthy person.  Over the past 2 years, however, I have been feeling really fatigued, foggy in my brain,  lost lots of hair, my nails are oddly dry and brittle now, and my fingers and toes were all of a sudden discolored and prickly when cold, which a physician diagnosed as Raynaud's.  

I used to attribute all of the above to the fact that I recently turned 50, and it may just be age.   But, as I continue to feel so sluggish, it has really become draining to me,  At my annual exam last month, my new Physician ordered blood tests, and said I have:
1.  a TSH of 2.75 and
2. TPO Ab of 14,
that the above 2 were in the "normal range" so I could not have a thyroid issue
AND
3. A BUN of 26
4. A BUN/Creatine ratio of 38
Sine the above were "high" she said it could be due to dehydration.
Does anyone have thoughts on this?    
I am so frustrated with feeling so down and not like my usual self all the time.  
Thank you!

[gimel]

As you become your own advocate, I suggest clicking on my name and then scroll down to my Journal and read the one page overview of a paper titled,  "Diagnosis and Treatment of Hypothyroidism? A Patient's Perspective. "  The overview and the full paper should give you more than enough info and references to scientific studies that support clinical diagnosis based on symptoms first, followed by extended biochemical testing.  You should be able to make good use of this with your doctor.  Also, when you are able to get a doctor to treat you, note the conclusion from a recent excellent scientific study  that ,   "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range".

[Roth55]

THANK YOU!!   I am beyond grateful for your feedback and advice.  

[gimel]

You have gotten very good information from Red_Star.   I would just like to give you a link to a survey of sources on iron deficiency that concluded that ferritin should be at least 100.  This link is referenced in the paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.  Ferritin is a storage form of iron, and a precursor to serum iron levels,  so you need to supplement as needed to optimize.   If available to you, I have found that VitronC is a very good supplement.  Others include ferrous fumarate, ferrous sulfate, and ferrous bisglycinate.   Having adequate ferritin is very important for you. since it affects conversion of T4 to T3 and also is important for good hair growth.  

https://www.ncbi.nlm.nih.gov/pubmed/26561626

[Roth55]

Thank you for the amazing information above.  I am going to work on adding exactly as you recommend and really hope to get to a physician who will be more helpful to me.   I have spent 2 years feeling sad, depressed, and thinking I can muscle through this situation.   That approach has not gotten me anywhere and I really need to learn how to be my own advocate.  Thank you again!    

[Red_Star]

Excerpt from Hypothyroid Mom - Top 5 Reasons Doctors Fail To Diagnose Hypothyroidism...

"Thyroid Tests "Normal" But You Don't Feel Well?

If you're undiagnosed, or a thyroid patient taking thyroid hormone replacement medications, being in the "normal" range does not mean you feel well, or that your treatment is optimized. What levels are considered "optimal*" by many integrative physicians?

~ TSH - Typically less than 2.0
~ Free T4 - Top half of the reference range
~ Free T3 - Top half - top 25th percentile of reference range
~ Reverse T3 - Lower end of normal range
~ Thyroid Peroxidase Antibodies (TPO) - Within reference range
~ Vitamin D - Above 50
~ Ferritin - Above 60 (Above 80 if experiencing hair loss)

* we are all different, one size doesn't fit all, so these are guidelines. Your optimal levels may vary."

Just to add, for those who don't live in the US, Vitamin D - above 125 nmol/L.

[Roth55]

Thank you so much for the information.    I am very grateful.  

With my TSH at 2.75 the doctor thought there was no need for any more testing and did not do the Free T4,  Free T3 or Reverse T3 tests,    I have since requested to have those done if possible

In addition, I did notice that the blood work showed:  
Vitamin D = 50 ng/Ml
Ferritin Serum = 52.   ng/mL

Thank you again, I appreciate the feedback!

[Red_Star]

The other thyroid antibody to test is thyroglobulin antibodies (TgAb).