hypothyroidism?

[NTC1028]

I had a blood test which indicated hypothyroidism, but I don't have any of the symptoms of it.  How is this possible?

[Barb135]

TSH can vary a lot over the course of a day. You need to be having the FT3 and FT4 tests done each time. These are the actual thyroid hormones, with FT3 being the most important, since that's the one the body uses directly.  FT4 must be converted to FT3 in order for the body to use it.

TSH is a pituitary hormone is not a good indicator of what the thyroid is actually doing.  It should never be used as the sole diagnostic.  

If your doctor is dosing you strictly on TSH, he's most likely going to keep you sick for a long time --- I had one who did that, too.

Have you had antibody testing or ultra sound done to see if you have an autoimmune disease (Hashimoto's Thyroiditis)?  It's common in those of us with Hashimoto's to "swing" back and forth between normal, hyper, hypo, until our thyroid finally stops producing enough hormones and we go hypo.  

[NTC1028]

When I first had the TSH done in 2005, it was 23.742 and my doctor then followed up with the T4 and T3 free.  They were 1.03 and 3.4 - within normal limits. My doc at that time said it was subclinical hypothyroidism and no medication was needed, that I just had an elevated TSH. When I first went to my current doctor in 2007, my TSH was 9.612 - a dramatic decrease considering I was not taking any meds for it.  I later had a normal TSH level. My last was 5,78 and my new doc insists I have to take Synthroid, which I feel is making me worse.  What could be other causes of an elevated TSH level?  I also had an elevated creatinine level - 1.1 (normal was said to be 0.57-1.0) and had a kidney ultrasound, which came back normal.  What could be causing these two elevations? Could they be related?  

[Barb135]

I agree with everything goolarra said; and if your doctor refuses to order the proper blood work, you may have to look for another doctor......

[goolarra]

TSH is a pituitary hormone and a very poor diagnostic of thyroid dysfunction.  The actual thyroid hormone levels, free T3 and free T4, are much more important in diagnosis and treatment (meds adjustments).  No doctor should treat based on TSH alone.  It is a recipe for misery.

If I were you, I'd request that my doctor order FT3 and FT4.  These two blood tests will tell you what your thyroid hormone levels actually are.  TSH can be influenced by many other factors besides thyroid hormone levels.

You have to listen to your body.  We usually know when something's just not right.

You might also ask for thyroid antibody tests (TPOab and TGab) to see if you have autoimmune thyroid disease, the most prevalent cause of hypo in the developed world.  

TSH means very little...get the rest of these tests so that you can evaluate if you really need meds at this point.  Don't let your doctor make you miserable by not ordering proper blood work.

[dana1031]

I have had hypothyroidism for 10 years now and actually was diagnosed with it during a visit to my ENT for an earache.  He noticed that my throat looked swollen (a goiter) and sent me to an endocrinologist and through blood work was confirmed that I do have hypothyroidism and I never had the symptoms so who knows how long I would of went without treatment if it wasn't for the ENT.  Hypothyroidism is also genetic, not long after my diagnosis, both my brother and mother found out they have as well so even if you are not experiencing the symptoms, it could be a genetic thing.  Either way, the TSH level doesn't lie and I felt the same exact way you did about synthroid, I am currently on .125mcg and did not take regularly but that only leads to more problems because when you go for follow up bloodwork, the doctor cannot determine the exact dosage you need to be on because he will not be able to tell the true TSH levels.  If you take the medicine regularly and TSH is still high, he knows you need to go a little higher, or if the TSH is starting to go down, you may just be at the proper level, you just have to be 100% honest with yourself and the doctor.  I do definitely recommend you go to an endocrinologist as this is their prime focus and will give you the best treatment. Hope this helps a little.  Good Luck

[NTC1028]

Thank you for your response.  The TSH was 5.78 and the range given was 0.45 - 4.5.  The results have been similar for almost a year, and I still have no symptoms.  My doctor put me on 25 mcg Synthroid, and since taking it I have developed lack of energy, insomnia, loss of appetite. extreme fatigue and weakness, where before taking it I felt fine.  My doc wants to increase the dose, but I know my body and its telling me NOT to take that medicine. I would lilke to see an endocrinologist, but my pcp doesnt think I need it and won't give me a referral.  Like I said, I know my body, and something is not right here. Any suggestions would be greatly appreciated.

[goolarra]

Can you post the results of any thyroid tests that you've had?  Also, next to the result (usually in parentheses) is the reference range for that test.  Please post that also as ranges vary from lab to lab, and we have to see ranges from your own lab report.

Sometimes people will have lab tests that are out of range before they develop symptoms while others will develop symptoms while their tests are still "normal".  

If you post your results, we can suggest where you might go from here.