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653142 tn?1224801220

Highly symptomatic, but normal test results

I was recently diagnosed with Hashimoto's thyroiditis.  My test results showed normal thyroid hormone levels (I'm not sure if they did an antibody test as well).  I've been experiencing overwhelming fatigue, trouble concentrating, forgetfulness, muscle weakness, joint and muscle pain (sometimes severe), sensitivity to hot and cold temperatures, sleepiness (I never wake up feeling rested), and sensitivity to medications.  I have experienced fatigue since the age of 11, but it has worsened in the past few years. I am a 22 year old female.  I have so many of the symptoms of hypothyroidism, could my thyroid still not be functioning very well despite normal test results?

I am a senior in college and I have every intention of attending graduate school programs but I simply will not be able to effectively do what I want to do with this level of fatigue.  Even if I felt only 20% better it would be like being reborn.  I'd be a thousand times more confident about continuing my education.  Any advice would be great.
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Avatar universal
That result of 3.2 sounds like TSH, rather than T4, since you gave a range of .5-5.0.  By the way, that is the old range for TSH.  About 7 years ago, the Amer. Assn. of Clinical Endocrinologists decided that based on actual data, that a more correct range would be .3-3.0, which would place your result in the hypo area.  Unfortunately it seems that very few labs and doctors have even adopted the new range.  In addition, with your other symptoms and your temperature, I would confidently make a bet that you are hypo, and the sooner you find a doctor that recognizes that and prescribes meds. that you need, the faster you will get better.  Since you are in the process of finding another doctor, I suggest that you try to find one that does not determine dosage by testing TSH level only.  In my opinion you also need free T4 and free T3, along with your symptoms and body temperature, in order to make good decisions.
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653142 tn?1224801220
I first had an ultrasound.  The doctor saw what she claimed was "classic Hashimoto's", though I am questioning that diagnosis based on the blood work.  I don't have the exact numbers, but my thyroid levels were basically all mid-range normal.  Like, I think the T4 was something like 3.2, when normal is .5 - 5.  I'll ask my doctor to give me the test results so I can bring them to new doctors.

I haven't started any thyroid meds. I had one thyroid level that was closer to hyper- rather than hypothyroidism, but still well within the range of normal.  If my thyroid is fluctuating a lot (which is possible) it seems a bit risky to give me more of a hormone I potentially have too much of.  I mean, how do you treat a fluctuating thyroid without taking it out or otherwise disabling it?  I think I'd like more information about what exactly is going on with my thyroid before I start treatment.

I wasn't aware of the relationship between thyroid and bipolar, I'll check out the link, thank you.
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Avatar universal
I'm getting lost in all these posts.  What thyroid test was run?  What was the actual result?  Don't ever accept from a doctor that it was "normal". Always get a copy of the results.  By the way, are you aware of the relationship between thyroid problems and bipolar disorder?  If interested, check this link.
http://www.psycheducation.org/thyroid/introduction.htm

Have you started on any thyroid med. yet?  If not, why not?
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653142 tn?1224801220
Thank you both for the advice.  Jules, the 97 value was of some antibody, but I didn't recognize which one.  I thought it was maybe the one associated with Hashimoto's.  The bladder inflammation was looked at briefly with an ultrasound by a urologist that I really didn't gibe with. He recommended a weird over the counter medication I'd never heard of and the way he told me to try it, it felt like he had to be getting kickbacks from the company.  I did try it, but soon after I started to have a flare-up of whatever my GI problem is.  I don't think they were related, but I don't want to risk it.  I'd like to see another doctor about it.  My GP suggested an interstitial cystitis but didn't offer any suggestions to either confirm the diagnosis or treat it. My GP also thinks I have something called neurally mediated hypotension, I'm gonna try andget into see a cardiologist and get a tilt table to confirm that because it could explain my symptoms as well, it's just really tricky to treat.

I'm not sure if my sed rates have been tested, but they probably were and looked normal, I think I remember seeing them.  As for the elevated white count, what do you do if I don't have any distinct symptoms but my white count is high?  Doctors noted it but it was never high enough for them to be particularly concerned.  They usually just asked if I'd been sick lately and even if I said no they just shrugged it off.  I began to just assume my white count was naturally high (which maybe it is).  I did have mono a couple of years ago (long after the high white count started, by about 6 years), but I didn't notice an increase in fatigue after, like the infection never cleared or something.  It's a route I'm also just really afraid to go down because there is very little you can do for a virus that won't clear your system.  I do probably carry it, my boyfriend came down with it about six weeks to the day after we started dating.  But things were going really downhill even before I got it, the fatigue that accompanied it was hardly the worst I'd ever had.

The fatigue did actually get worse back in high school when I took up gymnastics again and landed on my head trying to do a back flip.  (The spotter thought I had it.) It was a subtle change, more weakness than anything, but I did notice it.  I put it together later when I had a brain-scan done and they said it looked like I'd had an injury.  I tried some treatments called neurofeedback, which were utterly ineffective.  Though the brain scans did show what I've been feeling: a lot more slow waves that are associated with sleep, a lot more fast waves associated with anxiety, and a lot less middle waves associated with concentration and focus.

As for the bipolar, it's under good control.  I don't think I'm crazy.  I accept that I have it and even see it as an advantage in some ways.  I experience life more intensely than most people, it helps me be creative.  I appreciate the suggestion for joining a support group for it, but the few I've looked at just depress me.  I have plenty of support.  My brother is also bipolar, and my mother has been with me through the treatment so closely that there isn't the usual divide between those who are bipolar and those who are not.  My boyfriend is learning.  (Actually, if there's anyone who needs the support group, it's probably him.  He needs to see how good he has it that he has a girlfriend who takes care of her meds, never stops them carelessly, doesn't get psychotic, takes care of her mental and emotional needs, and recognizes when she's suffering from irrationality associated with instability! I started therapy at the age of 9 and I wasn't diagnosed until I was 17.  The therapy was at times extremely intense, and given the improper medication I was being spoon-fed, it was the only thing that let me regain any functionality.  I am extremely self-aware.  Not much in my psyche slips by unnoticed.)
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Avatar universal
I just found this site again and read your posts. My old computer crashed and I lost everything.   I just have to comment, of course.  I was finally diagnosed in 1963 with Hashimotos.  I was diagnosed by biopsy in Chicago by a Dr. that flew in.  I was young then and remember most but not all.  I had radiation treatment, I believe also after but not sure.  I was mostly stable until I hit 40, now I guess hormones kicked in and I can not get stable in my tests.  I am now on Synthyroid 300mcg, up from 275mcg.  Their site offers great info and coupons. I have symptoms still as you though and can not seem to get "normal" lately.  Unfortuneately, I have gained 50 lbs since going on the Effexor XR and am not happy about it.
It's great you are eating well and on gluten-free. Celiac disease runs in my family and Gluten-free is what you have to be to be without the digestive trouble.   http://digestive.niddk.nih.gov/
I too am bipolar, have colitis, nerve damage,and am highly hyper most of the time, or completely drained to the point I can not get up for days.   I take meds for ADHD but not sure if they work well.  The amphtamine type worked better but made me feel too drugged.  I have a few other things but I am not writing to talk about myself now.  Don't know if you know that you have an autoimmune disease or not.  I am a member of that society and have found out the thyroid goes hand in hand with the others many times.  I've done extensive research on the thyroid disease and think it is the root of my other problems.  Check out the Mayo Clinic site, it has alot of great info. and up to date testing suggestions.  I also would try to find a good Endocrinologist that specializes in your diagnoses.  I think Synthyroid is the best, the generics are just not the same and made from different things.  One is from Sheep hormone, one is man made, and one other is from something else. I wouldn't mess with high levels of B-12.  It could be toxic to you, I believe.  Some is good, too much I'd be leary.
One thing I do know from experience is don't EVER stop taking the meds.  I did 30 years ago when I was pregnant due to some quack saying I didn't need them, and I was barely coherent and on the verge of coma by the time I was treated by a specialist.  I've never met anyone with the disease who's had it longer than I, so, I guess I was one of the first ones.  I was about 6 or 7 only.  But now I go every 3 months for blood work and have completely changed my diet. 1200 mg of salt sodium a day was the hardest, I think but now am used to herbs and spices instead.  
Good luck to you with your battle.  I hope you are feeling better soon.  Also, try to find a DMDA group( I think they changed the name) for the bipolar.  It helped me alot knowing I was not crazy, and not alone.
Helpful - 0
534785 tn?1329592208
Blue nailbeds suggests a cardiac issue...the CO2 levels being abnormal is definitely important...and the urge the urinate (especially if it is independent of any actual bladder inflammation--was this measured or noted on a CT scan or something?) would indicate a neurological problem. If your bladder really does swell more often than it should, that could be musculoskeletal in nature, or potentially even some type of vasculitis. Have you ever had your Erythrocyte Sedimentation Rate (ESR) measured? This is good for measuring, in general, whether or not there is significant or systemic inflammation occurring in your body--just another generally useful number.

I'll get you a website or two regarding your cortisol results, because I've definitely found some in the past...but if your level started out at 36 and didn't increase much within the hour, I would definitely say that's an issue. It looks like primary adrenal insufficiency, but if you have TSH values that are out of whack, it's likely to be your pituitary.

Elevated white blood cell count would suggest infection...over several years though...did your doctors ever think this was strange, and order further tests?

I'll think about all your symptoms/test results and get back to you with any ideas. The information is very helpful! The value of 97 that you speak of is probably not signifcant. I'm trying to think what it could be...maybe one of the cholesterol levels? Or one of the ions (like potassium).
Helpful - 0
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