Labs come back normal...Need Advice.

[stephc79]

Hello All, I'm new here and need some advice, please.

Long story short, my mom, grandmother and great grandmother all had thyroid cancer.  When I was a child I had labs done every 3 months over the course of 2-3 years because my thyroid fluctuated up and down rapidly and because of my family's history they kept an eye on it.  I'm not really sure why they stopped checking, we moved and lots of things happened and I think the dr visits fell to they wayside.  

I am now 34 and for the past 4-5 years I have progressively gotten worse, I have at least 90% of the hypothyroid symptoms.  Over the past 2 years I had my dr do my labs (tsh, t3 & t4) and according to my dr they are within the normal range.  While I don't recall the exact numbers at the moment for my tsh levels, it has gone up.  2 years ago it was around 2.0 and last year it was around 4.7.  I don't know if that is normal.  

Anyway, in the past year alone my life has degraded so much, I can barely keep up with basic house work and I no longer enjoy anything I loved before.  My question is, even though my dr says the labs are normal, can I still ask her to try me on meds for hypothyroid and see how things go?  Do they do that?  I just can't take it anymore, I miss my life!  

I would get a second opinion but I don't have insurance because I have been too sick to work so my options are very limited.

Thank you for any advice.

[stephc79]

Thank you all for your input. I have an appointment with my DR on Friday, so we shall see how it goes.  I'll try to update you when I know more.

[flyingfool]

The ranges are set up by simply taking all the tests that the lab has done and throw out the very highest 2.5% and the very lowest 2.5%.  So that means that the remaining 95% is the "normal" range.

That is a bunch of bunk!  Think about it.  Who is likely to get their FreeT4 and Free T3 checked?  It is only checked on people who are feeling sick.

So they take a population to establish the reference range of sick people and then take the very sickest and throw them out.  Leaving 95% of the remaining sick people and then have the audacity to define the remaining 95% as "normal".

You can see this is total B.S.

For that reason many people here have found that if you are symptmatic and within the normal range that you need to slowly add medication to obtain a target much higher in the range..   In fact the rule of thumb that has proven a good target is to have BOTH of the following in order to feel well.

1) Free T4 to be in the exact MIDDLE of the range if not slightly higher (50% of the range.

and - that means in addition...

2) Free T3 to be in the UPPER 1/3 of the range (66.7%) of the range.

Notice that both of these are substaintially higher than simply being "somewhere" in the range, typically below the 50% of either.

It also should be understood that everyone feels well at different ranges and should be worked up slowly until you feel well and then stop.  It is just a MUCH better target to shoot for than simply accepting that being at the rock bottom of the range is "normal".  What s bunch of Bologna!

[Amey33]

You can be in normal range and it still can be your thyroid. I did that for a year and a half found a new dr who said what's normal for person is t for another so I was the. 2 points out of range so sick and she removed it. Felt better don't give up find a new doctor

[Barb135]

I agree that a TSH of 4.7 is out of range unless your lab is using an outdated range.  Over 10 yrs ago, the AACE recommended that labs change the reference range to 0.3-3.0, so while your 4.7 wouldn't horrible, it's still out of range.  

Aside from that, TSH is only an indicator of actual thyroid hormone status.  Free T3 and Free T4 vs just T3 and T4, which are Total, are the tests to get.  Of the total T3 and T4 in your blood, approximately 90-95% will be bound by protein and unusable.  You have to look at the Free (unbound portions) of each.

Additionally, FT4 is a storage hormone and must be converted to FT3, which is the hormone used by individual cells.

If anything goes wrong in the whole process, you can have hypothyroid symptoms.

You should always get copies of your labs, so you have them for your records.  Your doctor is obligated to provide you a copy, upon request.

Some doctors will treat clinically, and prescribe a small dosage of thyroid hormones, just as a trial, but those are few and far between, as are good thyroid doctors.  

The first thing to do is get the proper tests done.  If you can't afford to go get them done through you doctor, you can order them online for $75-$100 for the TSH, Free T3 and Free T4.   It would also be good to get thyroid antibodies tested, but it's okay to just start with the thyroid panel and see how that turns out.  When you order online, you order and pay for the tests, they send you a lab order and tell you which lab to go to (usually LabCorp), you get the blood drawn and in a couple of days, they e-mail you the results, which you can then take to your doctor.   LabCorp is a national company, so the results are hard to dispute.

Once you have the test results, you may be able to get your doctor to take a closer look.  It's not just a matter of labs being "in range"; for the FT3 and FT4, it's as much about where they fall within the range, because if they are too low in the ranges, you'll still have hypo symptoms.

[Red_Star]

Finding a doctor to treat you is quite difficult when you are in "normal" range. But to add, a TSH of 4.7 isn't in normal range anyway unless your lab's reference range are out of date.