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Sudden Menstrual Issues

Hello! This is my first time posting here. I saw another post by googling and thought someone might be able to offer some advice/help. The back story: I've had zero thyroid function since I was at least 12 when I was diagnosed. I'm not sure if they ever told my parents if it was Hashimoto's or not (they don't remember). I've been on Levothyroxine since then.
I'm currently 27. It has taken me a little while to be concerned/interested enough to try to understand it more than I had before. I'm a Tricare Prime patient, which means I have to see a doctor on base (unless I can get a referral--which is what I'm hoping you can help me in advocating for).
Since having children, I've had more trouble keeping a "normal" range, and that's what peaked my interested in learning more about it.

In July, I asked for a lab test so that I could get a refill on my medicine. (The doctors don't follow or keep up with anything---it's all up to the patient, for the most part). They called to tell me that my lab results were only "slightly above" normal and that they weren't going to change my medicine. It was fine as I noticed no symptoms to indicate that I was having an issue.

I realized afterward that my periods were being closer together, despite being on birth control (same one for the last 2.5 years, which I take at night so as not to interfere with my morning thyroid pills). In August, I started tracking them specifically. My last period was August 21 and lasted for 8 days (about 2 days longer than usual) and today (september 12) I started another period. I decided to call the doctor back and ask for another lab test, even though it hasn't been very long. They were obviously irritable about it, but they ordered the test and I won't have the results for 7 days. I stopped by and got a copy of the last lab results (from July 15).

TSH: 5.38
Thyroxine Free: 1.5
Thyroxine: 11.3

If my TSH is on the high side, my T4 should be lower than that, right? I know the T4 is in the "normal range", but it's on the very high side of normal for both, and I am confused about how that could be. If my body is producing more TSH, doesn't that mean it isn't detecting enough T4, which would mean the T4 should be low? Or could it be that it isn't detecting enough T3? Does synthroid give you T3, too? Is T3 probably the answer (they haven't checked T3).

The last thing I need to mention is that I have been very steadily trying (very hard) to lose weight, and I have been successful. Since November 2012, I have lost 31 pounds (which I realize isn't very much for working on it almost an entire year). I've exercised 4 times a week and use myfitnesspal to track my food, which I keep between 1400 and 1600 calories per day.

In order to be referred to be seen by a "specialist", I'm going to have to know what to ask for and what I need and why this could be my thyroid. I can't just say, "this doesn't make sense",  or they're going to tell me to deal with it.
I want to have another baby at some point, and I don't want my fertility to be all messed up just because I have a sucky doctor.
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Avatar universal
Free T3 is different from just T3 (also known as Total T3). It is the case for both T3 and T4 that more than 99% of the hormone in your blood is attached to a protein called thyroxine-binding globulin. It is only the remaining <1% which is unbound (Free) that is usable by the body and affects tissue function. Hence why it makes the most sense to measure the usable T3 and T4 (Free), rather than the usable and unusable (Total).

Your Free T4 looks to be pretty high, but it could be the case that your body is not converting it properly to T3, leaving your Free T4 (storage hormone) high and your Free T3 (active hormone) low. We can only speculate at this point. If you are having other symptoms though, I would think they are related, unless you have other contributing health conditions.
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Avatar universal
Thank you for your response. This is what the lab says under "Ref Range" category.

TSH: 0.3-4.5
Thyroxine Free: 0.9-1.7
Thyroxine: 4.5-12.0

I made an appointment and planned to print out a few of the things I read (from reputable places) about T3 and T4 so I can ask for the T3 test without having to explain it myself. I also have a few other symptoms, but I couldn't say for sure if they're related. I'm just hoping when I *finally* get to see the actual doctor, he will be more understanding/knowledgeable than the nurse. Last time I saw the actual doctor, he SEEMED like he was more concerned about the whole thing. I just wanted to be sure that I know specifically what I am wanting...if I understand correctly, that's the T3 test, right? I've never, ever had issues with periods (they last 6 days, but they're not usually too heavy and they aren't painful), so I know there's SOMETHING going on. I wish the labs didn't take so long (7 days).

I appreciate your help!
Helpful - 0
Avatar universal
Please post the ranges for your lab results. They vary from lab to lab, except for the TSH, which is .3-3 (other labs may use an outdated range for TSH that's something like .4-4 or .5-5). The TSH is usually not very accurate, and we look to Free T3 and Free T4 to tell us more about the actual levels of usable thyroid hormone circulating in the blood. When you take levothyroxine (T4 - storage hormone), your body is supposed to convert what it needs into T3 (active hormone). Studies have found that Free T3 levels best correlate with hypothyroid symptoms, not TSH and not Free T4, though it is helpful to look at those numbers as part of the big picture. You weren't tested for Free T3 and therefore we have no idea if you are converting the T4 to T3 properly. However, your TSH is definitely out of range, and you are having symptoms (heavy periods). If you'd like to see a specialist, explain that you are having hypothyroid symptoms despite your current dosage. Heavy periods were a symptom for me, and since you are on birth control no doctor can try and tell you it's because you're not on birth control (docs tried for years to convince me I should just try birth control to shorten my periods). Perhaps your regular doctor will be persuaded to raise your dose once you explain your issues; otherwise, seeing a specialist may not hurt, though they can sometimes be as dismissive as any other doctor. Just assert yourself when you declare that something isn't right-- you know yourself better than anyone else!
Helpful - 0
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