low T4 + normal TSH - hypothyroidism or something more?

I've been dealing with endocrine disorder type symptoms for the past year, but this summer things have really started to go downhill. Starting in May, I put on 40 pounds (all in abdominal area and back) despite 12 hours of exercise a week, a reduced calorie diet, and perscription weight loss meds, nothing will take it off; period irregularity (two very short, light periods in seven months), extreme fatigue, insomnia, loss of appetite and very bad migraines.

My PCP tested my TSH, which came back at 2.7 (range: 0.4- 4.2) which was up from 0.8 a year ago, and referred me to an endo.

He ordered preliminary tests to look for Hypothyroidism, Cushing's, and PCOS. Although it doesn't look like Cushing's or PCOS are an issue, several results came back abnormal or borderline abnormal.

TSH: 1.9 (down 0.8 from the week before?)
Free T4: 0.9 - (borderline low?) range: 0.8-2.7

FSH: 2.3 (low) range: 2.5-10.2
IGF-1: 136 (low) range: 138-410
C-peptide: 0.8 (borderline low? Serum glucose is normal) range: 0.8 - 3.1
ATCH: 44 (high) range:5-27

However the endo said the results didn't mean anything, and he didn't see any evidence of endocrine disorder at this time. I thought it was possible to be hypothyroid if you had low T4 and normal TSH, and with a handful of other abnormal results I thought it would have at least merited a closer look. Meanwhile my symptoms are getting worse, and I'm about at my wit's end. Am I crazy? Should I seek more testing and a second opinion? I'm only 25 and use to being very active. I don't know who's body I'm currently living in, but it certainly doesn't feel like mine. Help!

[TamraW]

My TSH is a 2.74. I have Hashimoto's Thyroiditis. 2.7 is NOT normal IMHO. Many on this site will agree. If you want proof for your endo, just google TSH levels and you will get tons of articles citing that labs need to consider values above a 2 or 2.5 as hypo. Your TSH and FT4 values look hypo to me.

I think FT4 of .09 is low. My FT4 is currently 0.8. A few months ago it was a 1.3. It seems to bounce as my thyroid fights this disease. The first two endos told me my symptoms were in my head. I don't know what your other labs mean because I don't think they relate to Hashi. I'm not saying you have Hashi, either, but what I am saying is that just because one lab thinks your levels are normal, doesn't mean that those levels are normal for you. Everyone is different. If I would have listened to my first endos when they told me my labs were normal, I would not have switched endos and found out I have a serious thyroid disease.

My Anti-TPO is 221 (below 35 is normal). That's how the new doc finally figured out I have Hashi.

MY TGlob is 15.2 (Above 20 is high). TGlob is another Hashi test, but you only need to be high on one or the other to have Hashi.

I noticed your endo didn't do an FT3 test. I think if docs would run the whole gamut of tests, rather than a few at a time, a lot more people would be diagnosed with endocrine diseases sooner.

SWITCH ENDOS!!!

Take care...
:) Tamra

[TamraW]

BTW - I was VERY active before this all started. I'm 25 lbs. heavier than two years ago. I did advanced spinning and aerobics. My spin bike has cobwebs now. It is frustrating! I am able to do light pilates and walking now thanks to my Synthroid that I started two weeks ago. My endo put me on Synthroid before the Hashi test came back because she thought TSH of 2.74 was high and she wanted to bring it to a one.

:) Tamra