help, possible secondary hyothyroid

[helpmeplsss]

My wife has all the classic signs of hypothyroidism,  lateley(past 6 months) she has become increasingly tired, fatigued, irritable, ect.. she has been down the classic trail of being treated for depression(which she is a chemical experiment for the doctors) in which she has just become numb to the world, and she is reported as unresponsive to treatment  She had part of her thyroid removed about 15 years ago for a goiter, and the doctor told her she didn't eat enough salt??? if you know my wife she puts salt on everything, and lots of it. anyway she has had the normal TSH testing done ,and the test I have is a couple years old, but her level was 1.24 mIU/ml, well within normal range. I would take this as o.k., but she just has to many symptoms. She also had another test done earlier this year which came back in the normal range . I guess our next step is to go have a free t4 test done on our own to check for a pituitary problem.  Any advice would be greatly appreaciated, help her get her life back.

[waytoohandsome]

One condition that mimics low thyroid is low cortisol. Have you checked her adrenal gland function? "Numb to the world" is a pretty good description of how low cortisol makes you feel.

My daughter has it, until she got treatment, it was like she was slowly dying.

Most doc's only recognize the most severe cases, but that's only the tip of the iceberg.

[gimel]

You'll find those symptoms and others on the listing in this link.  You'll also notice in the link that there is a mention of having hypo symptoms with relatively low TSH and that it can sometimes be associated with pituitary issues.  Accordingly I expect that you will find that the FT3 and FT4 tests will be low in their range, which is frequently typical of being hypo as well.

http://www.endocrineweb.com/conditions/thyroid/hypothyroidism-too-little-thyroid-hormone

I live in Michigan as well and I have been trying to help another Michigan resident find a good thyroid doctor.  The best we could do for her was a doctor in the Grand Blanc area.  If that is of interest, let me know and I'll forward the info in a PM.

[helpmeplsss]

thank you for your quick responce. we are located in the central michigan area, south of Lansing. I agree with everything youv'e said. I was sure that her TSH levels would be high with the history of thyroid surgery(goiter), but it isn't.  I have been doing research this week on this and it seems more like she would be prone to a thyroid problem, not a pituitary???  we will have the fee t4 and t3 testing done, I guess I want to make sure we are on the right track before we go and have all these tests performed.  Also my wife is slightly anemic, she is a nurse for the american red cross, and gives blood on a regular basis. many times her iron is low and cannot give. she has taken iron pills, but this in no way helps with the severe constipation she suffers with. again thank you .

[gimel]

TSH is a pituitary hormone that is totally inadequate as the sole diagnostic for thyroid problems.  At best it is an indicator, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, which are free T3 and free T4.  FT3 is the most important because FT3 largely regulates metabolism and many other body functions.  Studies have also shown that it correlated best with hypo symptoms, while TSH and FT4 did not correlate very well at all.  

So yes it is important that she get tested for FT3 and FT4 (not total T3 and total T4), along with the TSH that the doctors always run.  If the doctor resists doing these tests, you should insist on it and don't take no for an answer.  Even more important for her will be to find a good thyroid doctor that will be willing to treat her clinically by testing and adjusting FT3 and FT4 levels with meds adequately to relieve her symptoms, without being constrained by resultant levels of TSH.   Symptom relief should be all important, not test results.  You may also want to get testing for her for Vitamin D, B12, iron/ferritin, and selenium.  If there is a need to determine the cause of her being hypo, then tests for the thyroid antibodies are TPO ab and TG ab.

If you will tell us your location, members may be able to recommend a good thyroid doctor in that area.  I think you will also benefit from reading this link.  It is a form letter written by a good thyroid doctor.  It is sent to the PCP of patients that he is consulting with from a distance, because they have no good thyroid doctor locally.  The important thing is the direction given to the local doctor as to how to treat the patient clinically.

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