Hypothyroid symptoms.....being ignored

[Penguinz68]

Hello.  I have had increasing hypothyroid symptoms for almost a year now and am at a loss as to what to do because I feel like I am being ignored.  My general doctor and an endocrinologist have dismissed my symptoms because my blood work levels are "in the normal range".  I've been told it's probably just my body getting ready for menopause (I will be 44 next month).

Symptoms:  I gained 12 lbs in 2 weeks despite no other lifestyle changes (up to 20 lb gain).  I am tired (told it was no doubt due to stress....work, 4 kids, etc) yet have trouble staying asleep, I am always cold to the point that my fingers and toes get totally numb (even when my house is 75 degrees) and I can't get feeling back unless I run hot water over my hands and then I get the worst tingling.  It doesn't take long before they are numb again.  My hair is breaking off, eyebrows are thinning but on the outside yet oddly enough I have increased facial hair (under chin), big time decreased libido, I could go on and on.  I should also note that prior I was a size 4-6, had run marathons (I am struggling to train for a marathon right now because I am so stinking tired or sore).  I've also been told I have low vitamin B and D levels.

My question is despite "normal lab values" could they not be normal for MY body?  I feel like I don't know my body anymore...the weight gain is in my abdomen and hips (not usual for me) and I am at a loss.  If it helps my serum testosterone levels were 13 ng/dL (normal being 8-48), and my Free Testosterone (Direct) was 0.3 pg/mL (normal range being 0.0-2.2).  TSH was 1,270 uIU/mL (normal being 0.450-4.500).

Any advice would greatly be appreciated!

[Penguinz68]

I found some test results from 2 years ago when I first started really noticing some symptoms starting.  These results showed the tests you were talking about.  I know they are 2 years old so who knows what the levels are now, I am curious to see if there is a difference.

2 years ago:

T-4 Free 1.1 Normal range 0.8-1.8 (the year before it was  0.6)
TSH, 3rd generation 1.08 Normal range: 0.4 - 4.50
T3 Free 318 Normal range: 230-420

DHEA Sulfate was 63 Normal range: 25-220

Progesterone <0.5

[gimel]

That will be a big step forward if she treats clinically, based on symptoms and not just lab tests.  One further question that is important is whether she is willing to prescribe T3 type meds such as Armour Thyroid, Nature-Throid, and Cytomel, when necessary to increase Free T3 levels.

[Penguinz68]

Thank you for all of your helpful information!  I made an appointment with a new doctor for the end of the month, I will let you all know what she says.  Her staff said she treats patients based on symptoms, not just lab test results, so that sounds very promising.

[Penguinz68]

I forgot to mention.....I was diagnosed with insulin resistance 2 years ago, but the same doctor said since my blood sugar levels are fine I can take Metformin for it or not, it was up to me.  He said I needed a low carb diet.  I took Metformin for a while but stopped a few months ago when he said it wasn't needed, figuring why put something in my body if I didn't need it.  He said although my blood sugar levels were fine, my pancreas was producing one and a half times the amount of insulin it should produce to keep the levels normal...but again, a low carb diet was all that was needed.

[Red_Star]

A TSH test can miss a diagnosis of thyroid disease. If you want a better picture of your thyroid health, more indepth testing is needed. This includes TSH, Free T3 and Free T4, Reverse T3, and thyroid antibodies - TPOAb and TgAb. The Queen Anne's sign or Sign of Hertoghe is a thinning or loss of the outer third of the eyebrows. This is a classic sign of hypothyroidism.

Abominal fat (high hip/waist ratio) occurs for any of the following reasons: high insulin, high cortisol, high estrogen, low testosterone, low DHEA.  Your hair growth may be signs of peri menopause. It could also be due to insulin resistance.  Insulin resistance makes it impossible for your body to balance its hormones including estrogen, progesterone and testosterone.  Keeping your blood sugar in normal range depends on healthy thyroid function.

[gimel]

Just because your test results are in the so-called "normal" ranges, does not mean that they are adequate for you.  The ranges are far too broad.  In addition, TSH is totally inadequate to use for diagnosing and treating a thyroid patient.  TSH is a pituitary hormone that is affected by so many variables that at best it is an indicator to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, Free T3 and free t4 (not the same as Total T3 and T4).  

If you have a look at this list of hypo symptoms, I expect that you will find many that you have.  

http://thyroid.about.com/cs/basics_starthere/a/hypochecklist.htm

Did your doctors suggest what you should do about your low Vitamin D, and B12 levels?  You really need to get those above the middle of their range.  If they don't plan to give you shots then you should start using supplements.

The most important thing for you right now is to find a good thyroid doctor.  by that I mean one that will treat you clinically, by testing and adjusting 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.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

I suggest that you should find a new, good thyroid doctor because I have very little confidence that you will be able to change your current doctor's beliefs.  He has ignored your hypothyroid symptoms to date because of the "Immaculate TSH Belief".  The next hurdle would be that even if you were able to get tested for Free T3 and Free T4, the doctors would most likely use "Reference Range Endocrinology" and tell you that a thyroid test result that falls anywhere within the range is adequate for you.  That too does not work.  Many members, myself included, report that symptom relief for them required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the midpoint of its range.  

While trying to locate a good thyroid doctor, I would suggest that you go in to your current doctor and go ahead and request testing for Free T3 and Free T4.  If the doctor resists, then you should insist on it and don't take no for an answer.  Since you already know you are low in Vitamin D and B12, you don't need to test those again right now, but I would suggest a full test panel for iron anemia.

When test results are available, please get a copy  of the lab report and post test results and reference ranges shown on the report and members will be able to help interpret and advise further.

[Penguinz68]

One more thing...I feel like I can't focus or concentrate on anything, I don't remember things people tell me....to the point that others are noticing.