Hypothyroid

[Kiki7777]

I have been steadily gaining weight over the past 5 years now, after I gave birth I actually GAINED 35-40 pounds.   I have had my thyroid checked numerous times and twice for hashimotos and all levels are normal.  My finger and feet swell up, my face is puffy, my hair is thinning and breaking off, my skin is flaky and dry.  I also have body pain.

I have gone to several doctors and they just give up after tests come back normal, I am sooo frustrated!!!!   What else could this be besides thyroid or should I go to an endo on my own, but the problem with that is that the endo's near me want a referral from your doctor and mine won't do it.

[Gibbon1]

I'll just toss out another thing to look at, adrenal insufficiency. That will cause similar symptoms as hypothyroidism, but is much harder to diagnose and thus requires a high degree of suspicion on the part of the doctor.  

A major problem is the lab ranges for healthy people and people with adrenal insufficiency overlap.  And another is cortisol levels vary a lot on a daily basis and person to person.  Stress causes levels to rise, which can put a sufferer into the 'normal' range. So diagnosis is tricky and easily derailed.

First place to start would be an AM Fasting Cortisol test.  Note, very low (less than 3 mcg/dL) is or high (above 15mcg/dL) is definitive, you have it, or don't. In between requires further tests.

PS: Misdiagnosis of adrenal insufficiency is perilous. It you do not have it, you utterly do not want to be put on meds.

PSS: If you are on any other meds or herbal supplements, you should be suspicious of those too.

[Kiki7777]

I have some lab work from 2 years ago..

TSH 0.685 ref range 0.450 - 4.500

T4 free 1.36 ref range 0.82 - 1.77

TPO 11 ref range 0 - 34
antityhroidglobulin Ab <20 ref range 0 -40

[Kiki7777]

Thank you, I did the skin test on myself then had my husband.  You cant pull any skin off me.  I wonder if thats why my legs always feel so stiff and puffy.

I did call an endo today with a good rep, but they are scheduling out to June and really wont see me without abnormal test results from a gp.  So I left a message with an endo who had so/so feedback online, but it was the best I could do.

[flyingfool]

I asked about the thick tongue because it is a classic sign along with some of the other symptoms of being myxedemic.

I think another sign/test you can do to test for being myxedema is to try to pinch you skin between your thumb and index finger on your upper arm and/or thigh.  If you can't grab any skin t his is a classic sign of being myxedemic which is DIRECTLY tied to being low thyroid.

I think you should be able to look on youtube or whatever for the pinch test for myxedema test.

[flyingfool]

You MUST make sure that the testing is the FREE T3 and FREE T4 hormones.

"total" T3 and "total" T4 are different and outdated and far less valuable.  The "free" hormone tests actually counts the hormone that is used by your body. The "total" test counts both usable AND useless hormone that has become attached to a protein.

Also please post your results along with the reference range.  If you don't have them ask your DR. By lay the Dr must provide  you with the results. The reference ranges are usually in parenthesis adjacent to your test result.

MANY people find that they need to be SIGNIFICANTLY up into the range in order to feel well.  In fact the consensus seems to be that the rule of thumb is to have BOTH of the following:

1) Free T4 to be in the MIDDLE of the range (50%) or slightly more

AND- that means in addition

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

Notice they are well up above.  Many people who are within the normal range but hover around the very bottom often still have symptoms.

One question.  Does your tongue feel thick or enlarged?

Do you have other classic hypo symptoms?

Do you have fatigue?  If so you may want to also have tested for a few other things as well.  Such as Vitamin D3, Vitamin B-12, Iron & Ferritin.

Also especially for B-12 many people find they need to be well up into the range if not towards the very top. D3 you want over about 60 from what I understand.  These ranges are also very wide and you may easily fall into the "normal" range but that doesn't mean you have enough.

[Kiki7777]

No idea, I know they tested t3 and t4 in the past.  I am done doctor shopping though.  My husband and family thinks I am in denial, even though I suddenly gained weight which is not like me. They keep telling me doctors have tested everything and I am fine.    Even though I ache, thinning hair, weight gain, puffy fingers, feet and face.    Yep i am just a picture of health.  However my step mother just tells me I let myself get fat and lazy, thats why this is happening.  

[Red_Star]

I had severe insulin resistance for over a decade with no abnormal labs.  I just recently was confirmed moderate glucose intolerance with and OGGT test. My fasting glucose is perfect. So an OGGT test might show up something. Also have you checked reverse T3 and the free T3/reverse T3 ratio? It's your cells that need the free T3 and too much reverse T3 gets in the way!

[Kiki7777]

Actually they said my estrogen was a little low, but said it could be because of the time of month the test was taken.  I have been tested for blood sugar issues and I am fine.

I am a little disapointed because I went to a new doc and he seemed he wanted to help.  He even told me he could SEE there was something wrong ny looking at me.  The puffy pale face, puffy fingers etc....

The test came back neg for hashimotos and he just told me to see a rhumatologist.  

I have become extremely depressed now, I dont even want to do anything.  I snap at people because i am just so frustrated.  I have distanced myself from my friends because of the weight gain, my family makes rude comments.  I really dont know what to do anymore.

[Red_Star]

I had a look through your questions and every symptom you have mentioned can be traced to one condition that i can see - high insulin. Is may be possible you had Gestational Diabetes (can develop during pregnancy) and it continued after pregnancy.  

Tests for diabetes: fasting blood glucose test, random blood glucose test, oral glucose tolerance test (OGGT). Insulin resistance may or may not show up on blood tests.

Abdominal fat causes: high insulin, high cortisol, high estrogen, low testosterone, low DHEA