Thyroid problems or not?

[husker123]

Hey,

So I've been having some health problems for around 3-4 years now. I'm male and 25 years old. Symptoms include severe constipation, depression, dry skin and lips, reduced tolerance to cold, occasional light hand tremors, tiredness/fatigue, trouble gaining weight and memory problems.

I think my symptoms may have something to do with my thyroid, or something that affects it. My TSH has risen from 2.4mU/L to 3.5mU/L (range 0.3-4.5) since 2010, during the last test it was 3.3mU/L, which was last week. My free T4 was 17pmol/L which is more than it was in 2010, when it was around 11pmol/L (range 10-21pmol/L). I haven't tested free T3 yet, but I want to have that done as well.

However from what I understand is that if you have classic hypothyroidism TSH should be high and T4 low. As your body needs more thyroid hormone so it produces more thyroid stimulating hormone. But my TSH is above the new US standard range (0.3-3.0) and my T4 is at the higher end of the range. I've heard T4 gets converted to T3 before it's actually put to use in the body. So I'm going to have the T3 checked as well.

Could my symptoms have something to do with my thyroid? What are your opinions and experiences?

Cheers

[Barb135]

Since TSH neither causes, nor alleviates symptoms, you really need to get the Free T3 and Free T4 tests done........

I'm glad to hear that you have access to healthcare and can readily get testing you need.  

[Red_Star]

I live in Australia so we have free healthcare too. Good eh? :)

My TSH rose from 2.8 mU/L (Hashimoto's thyroiditis confirmed at this time) to 3.7 mU/L in six months. I've had 1.4mU/L or 1.5mU/L for decades there was buckley's chance my TSH was "normal". Also, you can try to pinch your skin (myxedema pinch test). Myxedema is unique to hypothyroidism.

[husker123]

I have no insurance but I live in Finland where we have free public healthcare or subsidized private healthcare, so lab tests are not too expensive.

[Barb135]

Labs can be expensive, but we hope husker has insurance to pay for them.  LOL  

It does often take time to even get in to see an endo and if you can walk in with labs in hand, sometimes, things can move along a lot faster.  Of course, if it takes TOO long to get in to the endo the labs will be too old, so the timing will have to be right.

I had difficulty with my pcp when I was first diagnosed and had to have another doctor refer me to an endo.  It was 3 months before I could get in to see the endo, but I'd found a local lab from which I could pay out of pocket for tests that my pcp refused to order; I got them done just in time for my visit with the endo........ that netted me a script for cytomel on my first visit to the endo, whereas I'd have had to go through all the testing if I'd not done that.  We can now point people to online sites from which they can order the labs at a reasonable price.  Hate to be sneaky, but hey, we do what we have to get well......... lol

[Gibbon1]

A good point about the labs, since they're not very expensive to run.  Often an endocrinologist will want to rerun labs over a period of time to make sure.  Considering it can take a while to just see an endo, doing them now might mean getting treated a few months earlier.

[Barb135]

You might try asking for the tests mentioned, before you see a specialist as that will save you some time, since you'll be able to take the test results with you to the specialist and s/he can begin treatment right away.

[husker123]

Thanks Barb and Gibbon, I will have those checked out as well. My GP said there's "nothing wrong" as far as she knows based on the tests we've done, and suggested I talk to a specialist for more information.

[Gibbon1]

I'll agree with Bard, antibodies to rule out auto immune disease which can lead to strange lab results. (And my suggestion to have testosterone and cortisol checked)

[Barb135]

You need to have the Free T3 (not the same as just T3) tested in order to know what's really going on, since that's the hormone actually used by the body. You're right that FT4 has to be converted to FT3 and not all of us do that efficiently.

You should also ask for thyroid antibody tests, to confirm/rule out Hashimoto's.  The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  You need them both, because either one or both may be present.  

Your TSH *is* above the new standard of 0.3-3.0; and with Hashimoto's, it's not unusual for symptoms to show up before actual thyroid labs indicate a real problem.  

[Gibbon1]

I think doctors are often penny wise pound foolish on lab work.

I had labs done at UCSF, with no actual indication of thyroid issues, but these included

1st Lab: General Lab workup and TSH (normal)
2nd Lab: TSH, T4, T3 (normal)
3rd Lab: Free T4 and T3, antibodies (all normal)

Years ago when I first go sick.  I remember the endo did

Testosterone, Cortisol, Growth Hormone. TSH and T4 (testosterone was at the end of the low range with symptoms)

So, have the doctor hit all the endocrine glands. Any of them can cause very similar symptoms.