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Multiple symptoms of hypothyroid with "normal" lab results
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Multiple symptoms of hypothyroid with "normal" lab results

I am experiencing multiple symptoms of hypthyroidism yet my endocrinologist wants me to wait another FOUR weeks to have my labs re-done because she says my levels are in the "normal" range and there is no way the thyroid could be causing my symptoms.  Here are my most recent labs with reference ranges:

TSH: 2.58   range 0.40 - 4.5
Free T4:  0.9  range 0.8 - 1.9

My previous test results from four weeks ago were:

TSH: 0.24  range 0.40-4.5
Free T4:  1.4

I have been dealing with thyroid issues since OCTOBER.  I started HYPER then had about TWO weeks in late January early February where I felt somewhat decent then I started having these HORRIBLE symptoms that are really taking a toll on my life.  Here is a list of they symptoms I am experiencing:

Insomnia (don't understand this one as everything I've read about hypothyroid says you sleep all the time)
Extreme fatigue
Dizziness
Dry eyes
Constipation (this one is especially hard because I had colon cancer and only have 5 inches of colon left!)
Nails breaking
Head feels "foggy"  I feel like I walk around in a daze and get easily confused.  Takes me 5 minutes to come up with an answer to questions I normally would be able to answer easily.

My doctors are trying to tell me now that I have anxiety and depression and my primary care doctor actually said to me the other day that I should take a Xanax!!  I don't see how that could be.  I didn't even take anti-anxiety medication when I had CANCER!!

Thank you for listening to me vent if nothing else.  This is so frustrating and I feel like NOBODY will LISTEN to me!!
11 Comments Post a Comment
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Hello!  I'm sorry you feel lousy and hope you get relief soon.  Please know  you are being heard here.  I had GI issues (constipation and more) before beginning levothyroxine.  My recent labs showed I was a bit overmedicated, but my doc didn't want to adjust down so as not to interfere with my now working nicely gut until I see my gastroenterologist in a month to get his input.  Wondering if while you are waiting for a month if perhaps you could see your GI?  Honestly, I think I would have to be committed if I had to endure again what I dealt with for 10 months.  Good luck.

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Your symptoms are classic hypo and from your description of the past few months, I'd go out on a limb and guess you have Hashimoto's Thyroiditis, which, while usually associated with hypothyroidism, can be characterized by periods of hyper in the early stages.

You should ask to get tested for thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin  Antibodies (TGab).

I also notice that your endo is leaving out the main thyroid test that correlates best with symptoms.  That's Free T3, which is the hormone that's actually used by the individual cells.  Free T4 is a storage hormone and must be converted to FT3 for actual use.

That said, your latest TSH is near the top of the AACE recommended range, which is 0.3-3.0, even though many labs, thus doctors, don't go by it.  Additionally, your FT4 is very low in the range and simply being "in range" isn't good enough to make us feel better.   Most of us need our levels considerably higher than that.

Insomnia is a definite symptom of hypo and contributes to the extreme fatigue.  Anxiety/depression are also symptoms of hypo.

You might also want to get tested for vitamin B12, which can also cause extreme fatigue.  
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Thank you for your reply.  I will give my GI doc a call and see if he has any suggestions.  I haven't been started on any kind of thyroid replacement yet.  My endocrinologist thinks I have thyroiditis and she is sure I will need thyroid replacement "someday" but thinks that my labs don't warrant it now.  At this point I'd do just about anyting if I thought it would make me feel better!!
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Different docs approach thyroid issues differently as is obvious by reading experiences here in this group. I was dx'd just as my doctor was relocating. She sent me a notice with labs and suggested I see a partner and get retested in three months.  I took results to the partner who treats thyroid issues aggressively/seriously and started me on meds right away.  I would have taken the wait and see approach but am I ever glad she didn't.  Besides already being treated by a GI, the added thyroid medicine my new doctor added helped so, so much.  

I totally agree with Barb that you could have further testing that would provide more information.  After my initial labs, I had labs which determined my hypothyroidism is autoimmune.  Treatment is the same, but it helps the doc realize that other AI issues may be lurking around.  

Also, I have extreme insomnia.  I still do even with the new medication, but when I do sleep, it is better sleep.  I've had chronic insomnia for years (20 years) so I don't think it is because of hypothyroidism, but again, I am sleeping more restfully when I do.  

Again, good luck to you.  
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I called my endo's nurse yesterday and asked for the tests that you mentioned and when she called back she said that my doctor didn't want to test ANYTHING for at least another three weeks!!  I thought a doctor was supopsed to work for the patient??

I have NEVER had a problem with insomnia.  Sleep is one of the things I do best so this is very difficult for me.

I have tried to get in with another doctor for a second opinion but I have to have a referral and it would take more than three months to get into a new endo anyway.  I do have an appointment in a week with an internal medicine doctor since all my current primary care doctor wants to do is throw Xanax at me. I asked if I could start a low dose thryoid replacement just to see if the symptoms would improve and he said he'd rather give me Xanax.

I'm sorry to hear about your chronic insomnia.  I've only had the insomnia for the last three weeks and I feel like I'm going nuts.  All of this is making it VERY hard for me to work full time and still care for my family.  I sound like I'm whining now!  

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Try the internal med doctor; maybe s/he will be more cooperative.  It's unfortunate that doctors only want to throw antidepressants at people rather than try to treat an underlying problem.
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Hi, Just thought I would add I have the same symptoms minus the insomnia. But I"m on a lot of other drugs for migraine that would make me sleep but prior to that I slept well too. I agree you are at the high end of normal. But every lab has their own reference range depending on the kit and equiment they use so one can't fit their range into someone elses results. I am new to being hypothyroid and will probably post a question too. But wanted to say that I wouldn't go on Xanax. For me it is a terrible drug and made me and my husband ( who is also hypothyroid) feel lousy. My husband has the chronic insomnia, but most of the time can sleep. He uses an MP3 player with news and falls asleep to it. But whatever works for you. I have all of these symptoms you posted:
Extreme fatigue
Dizziness
Dry eyes
Constipation (this one is especially hard because I had colon cancer and only have 5 inches of colon left!)
Nails breaking
Head feels "foggy"  I feel like I walk around in a daze and get easily confused.  Takes me 5 minutes to come up with an answer to questions I normally would be able to answer easily.
So, I am being tested by my family practise doc every 6 weeks and I at 8.5 and he started me on 25mg of Synthroid. So far I sleep fine but I'm still fatigued. He said no napping in the daytime. So even though I want to sleep I have to force myself to stay awake.
I sympathize.
mkh9
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the website is stop the thyroid madness . com (remove all spaces.)
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649848_tn?1357751184
The website you're referring to is a competitor and links to it are not allowed on MH.
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Thank you all so much for your replies. It is nice to hear that there are others out there who were helped. I will definitely ask the IM about all the tests that have been mentioned here.
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Bailey, no question you are hypo.  My endocrinologist wants me to avoid any TSH value over 2.0 and when I did go over 2.0 I started to have hypo symptoms.   Don't settle for poor treatment.
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