Unsure

[jclaire1970]

TSH 3.760 (0.450-4.500)
FT4 0.83 (0.82-1.77)

Although both numbers WNL, is it still possible to have a problem?

[gimel]

Artfemme has pretty well covered things.  I totally agree that you need to get additional tests done.  It is very important to get the Free T3 and Free T4 done each time you go in for tests.  If the doctor resists just insist on them and don't take no for an answer.  When you go for blood draw, make sure they know it is to be Free T3 and T4, not Total T3 and T4.  I would also suggest that you test for Reverse T3, Vitamin D, B12, ferritin, and a full iron test panel (serum iron, TIBC, and % saturation).  I would also suggest a 24 hour saliva ( or urine) cortisol test.  

When test results are available, please post results and reference ranges shown on the lab report, and members will be glad to help interpret and advise further.

[artfemme]

It seems to me that ALL of your symptoms relate to hypothyroidism and your labs would indicate that as well. Has your cholesterol been rising ? How is your glucose level ? B12 ? Vit D ? Calcium, iron, ferritin, TIBC ? You mention post-partum depression, and recent research identifies this as being so possibly related to thyroid disfunction that thyroid testing is being suggested as a standard part of pre-natal and post-natal care. Depression is often one of the first signs of hypothyroidism, as a low level of T3 in the brain makes the transmission of seratonin impaired. Antidepressants such as Wellbutrin are supposed to raise the level of seratonin which, in the presence of other hypothyroid symptoms and a family history such as yours, might be more appropriately addressed by balancing thyroid hormones instead. Memory problems and blurry vision and problems with ones period are all well-known symptoms we all complain about when we are under-medicated....I actually use the return of those things as a kind of personal alarm clock since they become so pronounced when my medication isn't working properly. The edema you are experiencing in your extremities and see reflected in your face, given your labs, would seem to be a very clear sign of under-medication, as is the cessation of hair growth on your legs. All of these things happened to me too. If, when you press your finger into your swollen leg, the flesh bounces right back and doesn't leave a lingering impression, this is called "non-pitting edema," one prominent symptom. When I first added T3 to the T4 I was already taking, I lost 15 lbs. of this fluid (which is not just water) in 3 weeks without changing a thing. When T3 was lowered by an endo who said I didn't need it, I gained the 15 lbs. back in 3 weeks. So I also use edema as a personal alarm clock as well.

Have you had your FREE T3 tested ? As I'm sure you have read in other posts, FREE T3 levels seem to correspond more clearly with symptoms, and with edema particularly, everything I have read trying to cure my own points to T3 as being most effective in reducing it. You can even read about this on the official Cytomel website under "myxedema."

I'm sure that Gimel will agree that if you have your TSH, FREE T4 and FREE T3 levels tested and post them here, it will be easier for us to help you understand what is going on. If your doctor balks at retesting so soon, then just try to get FREE T3 tested, as it will help us to help you further.

All the best.

[jclaire1970]

I am female; 42 years old (43 in January). I have a family history of thyroid disease (hypo, cancer). I currently weigh 241. I have always been overweight and struggle with this. However, in the last 6 months I have gained another 12# with no changes in exercise or diet - and it was during the busiest time of the year when I usually lose weight just from all the outdoor activities and running around at kid activities.
I work in a warm nursing home. Most days I am cold when the rest of the staff is not.

My past medical history includes post-partum depression in 2001 for which I was taking Wellbutrin XL 300mg through the beginning of 2012 (I guess it was no longer just post-partum depression but not requiring meds at this point.)
Migraines. I was taking Zonigran for them, but quit same time I quit the Welbutrin because I can't remember so much stuff and was afraid it was a side effect. I still have mush for memory and write a lot down to help me remember. But if I am called on a detail I need to recall from last week or even a day or more ago - I have to go look up the answer - I can't recall it typically.
I just had labs done and my total cholesterol was 199, HDL 64 and LDL 106. (I read on the Mayo site cholesterol levels are a factor).
I am retaining water - my usually oval face has become round, I continue to gain weight in spite of no diet change (matter of fact, I am "loosely" on Weight Watchers and drink at least 48 ounces of water - most days I  reach my 64 ounces). My feet, ankles and lower legs swell without diet change til I can leave a finger print in my skin. My skin is dry and itchy and the hair on my legs is no longer growing much.
My heart feels like it is hopped up on caffeine and occasionally I have to clear my throat to make the "weirdness" go away.
I have what I call good days and bad days. Days when I have to focus on being active because I am fatigued much of the time. I get at least 8 hours of sleep nightly.
My joints hurt in my neck, hands, wrists, knees and heels, which I attributed to getting older and being obese - but I'm 42, not 64.
My periods are off - I had 21 days cycle in January, none in Feb or March, normal in April, none in May or June, one in July, none in Aug or Sept, then the last three months have been normal.
This sounds like I am a mess, but I am really not. I just deal with all of this like it is normal for me. I can still "function" but as I get older, it is more difficult. And I just want answers. If I am crazy, I just want to know. If I have a heart issue, I just want to know. And if I have a thyroid problem that is treatable, then by all means... I want to know.
Thank you for your opinion! I appreciate your time.

[gimel]

Over 10 years ago the AACE changed the reference range for TSH down to .3 - 3.0.  Unfortunately most labs and doctors have not changed.  So your TSH is over the new range, and a possible indicator of being hypothyroid.  I say possible because TSH is a pituitary hormone that is supposed to reflect accurately the levels of the biologically active thyroid hormones, Free T3 and Free T4; however, it cannot be shown to correlate well with either, much less with symptoms, which are more important.  


Your Free T4 is also at the very low end of its range, and the range is also too broad.  This is further indication of being hypo.

As I mentioned, symptoms are the most important consideration, so tell us about your symptoms, and then we can talk more about additional tests that would be advisable, and the treatment your need.