Is this Hashimoto's?

[Winterwillowghby]

Hi I just received my new lab results. I've had the typical symptoms of hypothyroidism for the last 2 years, and I get sent home with "solutions" to my problems however they don't go away in fact they get worse everyday.
Weight gain (unwarranted) Im a pretty healthy and active person, I train 3 times a week it's pretty much my life. In the last two years i've gained 27 pounds of those 15 in the last 3 months can't lose them in fact im only gaining more by the week, I am extremely fatigued (comes and goes without warning) , sensitivity to cold, constipation and really dry itchy skin, and interrupted sleep followed by night sweats. For all these symptoms i've been given: sleeping pills, laxatives, i've been told to eat healthy (doctors seem to NOT believe me when i say i already eat a healthy diet), i've been told it's old age (welcome, you've never been 37 have you?), i've been also sent to the psychiatrist for depression (gave me a dosage of Klonopin of which i never took as i don't believe it's depression) and i could go on and on.
by the way  my TSH levels have been on the lower "normal" range.

I finally got a private doctor to run some tests based on the symptoms and he ran TSH Free t3 and t4 and thyroid peroxidase Abs it all looks like a mess to me but i really can't afford him and my Kaiser doctor WON"T listen or believe me.  
I don't know what to do at this point.
Here are my lab results (with the values)

TSH       1.2                                     range: 0.27 - 4.2
T3 Free  2.6                                    range: 1.8 - 4.8
T4 Free 1.07                                   range: 0.9 - 1.7
Thyroid Peroxidase Abs   103.2      Range : <35

My GP won't send me to an endocrinologist as he doesn't think there are valid reasons for me to go as my TSH is normal. I know there is something wrong, but maybe im just being stubborn. maybe it's old age, and i just need to accept it.
can anyone look at the results ? thanks.

[gimel]

Not sure where it went.  LOL  I just tried again.  

[Winterwillowghby]

Thank you so much.
i didn't see the message with the name of the doctor.
would you please re-send?

thank you!!!!

[gimel]

Not quite.  If you have really low or suppressed TSH due to Graves' Disease, then yes you can lose weight, eyes pop, etc.  The test for Graves' is TSI.  Your TSH and symptoms don't match that.

You have relatively low TSH and also low-in-the-range Free T4 and Free T3, which is more like central hypothyroidism, yet your TPO ab test was above range.  These results are somewhat inconsistent, because with TPO antibodies, which are frequently associated with Hashi's, we would expect higher TSH results.  

So as mentioned you need medication to raise your Free T4 and Free T3 levels adequately to relieve all those hypothyroid symptoms you have.  Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin you also need to get those tested, and supplement as necessary to optimize those levels.  It also might be beneficial to get an ultrasound of your thyroid gland to assess any effect from the antibodies.

I also sent you a PM with some doctor recommendation.  To access, just click on your name and then from your personal page, click on messages.

[Winterwillowghby]

wait, so my levels are on the lower range with hypo symptoms...now just to make sure ....

low levels of tsh = Hyperthyroid (meaning you lose weight, eyes pop...etc)

high levels of tsh = Hypothyroid (gain weight, inability to lose it, fatigue...)

right?

[Winterwillowghby]

thanks! i think i had read that before...so I assumed it could be Hashimoto but of course the Kaiser doctor told me
"nah antibodies don't matter because your TSH is normal"

Pffff. ok. so my symptoms are totally made up  and i love to take the day off to go to a doctor and lose money while im at it. ha!

[Winterwillowghby]

Sure, im in san diego California.

I am doing as much research as I can, and the only think i find is these sort of "cosmetic" Drs advertising hormone replacement therapy?

i dunno about how helpful that would be, not to mention is incredibly expensive.

[gimel]

Red_Star is correct.  It could be central hypothyroidism or primary (Hashi's)  as well.  The most important thing is that your levels are much too low and causing the hypo symptoms.  So you need a good thyroid doctor who will treat clinically as described.  As I mentioned, unfortunately you can't assume that an Endo will be a good thyroid doctor.  If you will tell us your location perhaps we can suggest a doctor that has been recommended by other hypo patients.  

[Red_Star]

Ikr. :)

Excerpt from The Health Science - Antithyroid Antibody...

"The presence of serum thyroid antibodies usually indicates an autoimmune thyroid disorder, but elevated levels may also be detected in other conditions.

Conditions associated with elevated serum TPOAb levels include the following:

* Hashimoto disease (90%-100%)

* Graves disease (50%-80%)

* Other autoimmune diseases (eg, type 1 diabetes mellitus) (40%)

* Pregnancy (14%)

* Sporadic multinodular goiter, isolated thyroid nodule, and thyroid cancer

Relatives of patients with an autoimmune thyroid disorder (40%-50%) may have elevated serum TPOAb levels."

[Winterwillowghby]

a diet pill ...yeah why am i not surprised?

[Winterwillowghby]

Wow thanks for that info.

I guess I'm pretty much over Kaiser doctors, even if i get a referral from my GP to an endo i have a feeling the endo is going to end up sending me home as well.

but now i have a clearer idea of my labs bc they didn't make sense to me in regards to being hypothyroid (thanks for the link, it was helpful!)

so you don't believe i there is any indication of Hahsimotos?

and i've never heard of central hypothyroidism, Im doing my reading about it now that you mentioned it! thanks so much.

i guess im going to have to dish out the money and find a good endocrinologist with a specialization in thyroid issues.....

[Red_Star]

My sister has Hashimoto's thyroiditis and her lab result was TSH 0.4 mU/L and free T4 12 (10 - 20) pmol/L. She is cold, gaining weight etc. At the time of that lab draw she had dengue fever which explains the lower TSH. The doctor gave her duromine to lose weight. smh.

[gimel]

I'd say it is central hypothyroidism characterized by TSH level low in the range, along with Free T4 and Free T3 that are also in the lower half of the range.  In the words of a good thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."  

Your Free T4 is at only 21 % of its range and Free T3 is only at 27 % of its range which typically causes hypo symptoms.  The ranges are far too broad due to the erroneous assumptions used in establishing ranges.  Many of our members say that relief from hypo symptoms required Free T4 at the middle of its range, at minimum, and Free T3 in the upper part of its range.  

We've heard lots of similar complaints from members about the Kaiser system.  They mainly rely on TSH and a Free T4 or Free T3  that falls  anywhere within the range is acceptable to them, even if the patient has hypo symptoms.  

A good thyroid doctor will treat a hypo patient 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 link written by a good thyroid doctor.  

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

So you are going to have to push your doctor to accept that you have central hypothyroidism and start you on thyroid med, or you will need to find a good thyroid doctor that will treat clinically as described.  And just going to an Endo doesn't guarantee a good thyroid doctor.  Many of them specialize in diabetes, not thyroid.  Many of them also have the "Immaculate TSH Belief" and only pay attention to TSH.  If they do test beyond TSH then they use "Reference Range Endocrinology" and do nothing if your FT4 and FT3 tests are within the so-called "normal' ranges.