Thyroid Panel "Norms" and Difficulty Losing Weight

[Katzavetsky]

I am a 32 yr/old female, and have been morbidly obese for over 10 years, weighing 245 at 5'7".  The last 5 years, I have worked very, very hard to completely change my lifestyle.  I exercise 3 times a week and eat less than 1200 calories with lots of lean protein, fruits and veggies.  I have had little to no success in losing weight.  Approximately 8 months ago, under the recommendation of my GP, I underwent the Lapband surgery.  I now eat between 800-1000 calories per day and continue to exercise 3 times a week.  I have lost less than 10 pounds in 8 months on this strict regimen. My surgeon says that at this point, I should have lost between 40-50 lbs. I am extremely frustrated.  My surgeon recommended that I have myself tested for Thyroid issues and told me to look up symptoms associated with Hypothyroidism.  I was astonished to find that I display an abundance of symptoms associated with this ailment, and asfter speaking to my mother, found out that two of my aunts were diagnosed with this, though not until their 50's.

I am exhausted all the time, I have no sexual drive, I have difficulty swallowing, I have chronic sinus infections (3-4 a year), my voice is hoarse, my hair is thinning (which is not hereditary), I have difficulty concentration, get eye ticks...and the list goes on and on.  My GP ordered a full metabolic and hormone panel, but everything came back within the "normal range."  

My question is this:  Is it possible to be in the normal range and still have thyroid issues?  I should also mention, I take OTC metabolic enhancers (Hydroxycut and SlimQuick), birth control pills, and several multi-vitamins to supplement my low caloric intake.  My doctor says this shouldn't effect the test results.  My results are as follows:  T3, Free 3.1 (Range 2.3-4.2); TSH, 3rd Gen 0.95; T4, Free 1.1 (Range 0.8-1.8).  My Glucose came back at 89 (Range 65-99).  

The only thing I notice about my numbers is that my T4, while still in the normal range, is on the low end of normal.    

Please help!  I don't know how to proceed!  I am working so hard, with zero results, and feel terrible most days with no energy, no desire, and no focus!  

[gimel]

Sorry, forgot to give this link.


http://www.thyroid-info.com/topdrs/california.htm

[gimel]

The main thing I notice is that your Free T3 is too low in the range.  The range is too broad.  FT3 is the most important thyroid test because FT3 largely regulates metabolism and many other body functions.  Scientific studies have also shown that FT3 correlated best with hypo symptoms, of which you have an abundance, while FT4 and TSH did not correlate.  Many of our members report that hypo symptom relief for them required that FT3 was adjusted into the upper third of its range and FT4 adjusted to around the middle of its range.  

Hypo patients also frequently are low in other areas as well, so it would be good to get tested for Vitamin A, D, B12, and tests for iron anemia.  Similar to FT3 and FT4, test results for these additional tests may also not be adequate if they are in the lower end of their ranges.  

I think your highest priority right now is to find a good thyroid doctor.  By that I mean one that will treat ou clinically, for symptoms, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.   Symptom relief has to be all important, not just test results.

You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.  

http://hormonerestoration.com/files/ThyroidPMD.pdf

I happened to remember this post from a member that is a nurse.  Notice that she was getting nowhere with her doctor.  Finally she found a doctor that allowed her to try thyroid medication.  She then documented her Basic Metabolic Rate before and after the thyroid meds.  Very interesting.  

pickdaisies |  Apr 18, 2009

You know your body best!!!!!!!!!!!!!!!!!!!!!!!
I was having some major problems with my metabolism.  I am a nurse and I thoroughly researched all the scientific research on the internet and at the medical library.  I, too was going to see doctors who would not help me.  Fortunately, I found a doctor who gave me armour thyroid despite "normal" levels. I brought him a RMR test that showed my BMR in 750-900 range which is very low, I was cold all the time. I was fatigued. When you have to get in the tub 2-3 times a day to warm up your body, you got a problem  I have fake nails and suddenly I wasn't needing to go as normally to have them filled they had really slowed in growth. I put together my own research on my body.   I started taking the medication as prescribed and he adjusted accordingly until I was free of symptoms.  I documented all the thyroid lab work before and after treatment.  I went and had metabolic testing to test my Basic Metabolic Rate and it measured normal for my age and weight and I was symptom free.  I then tapered myself off the thyroid and within 2 months all symptoms returned and metabolic testing once again was done, and BMR was extremely low. Back on meds. normal. You know your body best and I am not afraid to put the research in front of a doctor's face.  The human body is not black and white.
________________________

I've been collecting a list of good thyroid doctors recommended by fellow members, but I don't have one for your area.  I suggest that you might look through this site and see if any look interesting.  Besides a location near you, the things to look for are indications that the doctor is willing to consider symptoms, not just blood tests results, and that he is willing to prescribe T3 type meds, rather than just T4.  

If you find one that looks like a prospect, instead of a suspect, then I suggest a call to the office.  Tell them you need a good thyroid doctor, but before making an appt. you would like to ask a nurse two questions.  Then when the nurse is available, ask if the doctor is willing to 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.  Then ask if the doctor is willing to prescribe T3 type meds such as Armour Thyroid, or Nature Throid, or Cytomel.  If either answer is no, then just keep looking.