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Symptoms and Lab Result

I am a 39 yo female, recently diagnosed in Early Menopause. My symptoms have not changed despite increasing my Estrogen. My symptoms are:
dizzy, lightheaded, vertigo, feeling of fluid in ears, feeling lump in throat esp. swallowing, fatigue, hot flashes, panick attacks, extreme adrenaline rushes, nervousness, headache, severe numbness & tingling in arms and legs, sensitivity to light esp. flourescent, intolerant to heat, nauses, muscle aches in arms & legs, new onset of motion sickness esp. while driving and several others.
Labs:
Estradiol <20
Fsh 58
TSH 4.4
All others labs are normal. Including MRI & CT of head, EEG.
It is my understanding that thyroid problems can cause early menopause and make symptoms worse. Thyroid problems do run in my family (mom, sister, grandma, great-grandma died from goiter)
My doctor says that TSH of 4.4 is normal and that testing for antibodies is useless as you don't treat unless TSH is over 10. I even showed doctor the new recommendations and she said that this is not thyroid related.
Any test you could recommend? Is my TSH normal? Is all this just menopause or could it be thyroid related?
Thanks.
12 Responses
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Avatar universal
GET TO A GOOD ENDO. I AM NOT A DOCTOR BUT,I HAVE BEEN BOTH HYPER AND HYPO . FROM WHAT YOU SAID ABOUT  HOW YOU FELT . BEING NERVOUS ETC. THAT IS HOW I FELT WHEN I WAS HYPERTHYROID. NOW THAT IM HYPO . I CANT HARDLY GO TO WORK MY BODY HAS NO ENERGY. AND MENTALY DEPRESSED AT TIMES. I HAVE HAD A FEW ILLNESSES IN MY LIFE INCLUDING CANCER.  MY THYROID HAS AFFECTED ME THE MOST MENTAL, PHYSICAL,BUT THINK GOD NOT SPRITUAL. ANYWAY IT TOOK 3 DIFFERENT ENDO BEFORE I FOUND ONE THAT REALLY CARED AND IS TREATING ME WITH GREATCARE. TAKE CARE OF YOURSELF YOUR WORTH IT. LAURIEL
Helpful - 0
Avatar universal
Hi again...
I, too, am doctor shopping.  I am going the route of D.O. as I've found some of the MDs and endo's I've been seeing too hung up on only trying one course of treatment or relying too heavily on lab values and not taking symptoms into account.

I went on Armour's site (www.armourthyroid.com) and you can search for a provider there...or

Another good site to check out is
www.drrind.com

He has some good info and also some links to find a holistic doctor or DO.

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Avatar universal
Hi -

Not a stupid question at all!  Since you're friends with your GP, I would tell her that you've been doing some of your own research and you would really feel a whole lot better if she'd just "humor you" on this and test your antibodies.  Then tell her you'd really like to do a trial on thyroid meds, because at this point you feel that you don't have anything to lose.  (The website for Armour Thyroid has a doctor locator that might be helpful in finding a thyroid specialist - or at least a GP that works with a lot of thyroid cases.)  And as I posted earlier, print out what Dr. Mark tells you and bring it with you.  Stress to your GP that you really are at wit's end here and you need to do something NOW.
Helpful - 0
Avatar universal
I don't mean to sound stupid but...
How does one go about finding a new dr? My dr. now is actually one of my close friends but being a GP I know she can't be up on everything but I thought she would listen to me a little better about the thyroid thing. She is great about everything else.
I am to embarassed to see a OB/GYN here in town as my husband is a Nurse Anesthetist and we see them all on a social basis. Other than that, he works mostly with surgeons and what would a cardiovascular surgeon know about treating thyroid. My husband doesn't know any of the 2 endo's here, I guess they don't do much surgery.
After visiting Dr. Mark's website, my husband and I both think we remember him from his residency. We both worked in Gainesville from 92-99.
Should I call around to different dr.'s and if so, what questions would I ask? Would I just take all my lab results and ask for a second opinion? How does one actually go about DR. shopping?
Thanks.
Helpful - 0
Avatar universal
Hi Gatorgal -

After Dr. Mark has a chance to post, I would print out his response and take it back to your doctor.  Then insist that they test you for antibodies and give you a trial on thyroid meds.  If they won't, then definitely find another doctor.  I've been going to a D.O. (doctor of osteopathy) and she's been really helpful with trying different things until we found something that worked for me.  If you can't find an endocrinologist, then look for an M.D. or D.O. with experience actually treating thyroid issues.  For me, when I got my thyroid treated properly, ALL those weird symptoms finally went away.  Since you're in Florida, Dr. Mark can probably recommend someone closer to home for you.  Good luck!  

Julie
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MEDICAL PROFESSIONAL
Get a second opinion from an endocrinologist.  It may all be menopause but I think the TSH is borderline high and antibodies are appropriate.
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Avatar universal
I do feel like ****. I have never even had a doctor until recently except for OB/GYN. I ended up in the ER in May thinking I was having a stroke or a heart attack. I have not been the same since. Now, I have a Neurologist and a GP.I am trying to find an Endocronologist, but there are only 2 in this town. I might have to go to Gainesville, or maybe Sarasota to see DR Mark.  The Neuro just said that is was some "weird phenomonom" possibly related to the migraines that I started having only 1 year ago. He just wanted to put me on anti-seizure meds which made me feel even worse! I have alway been non stop go from sun up till sun down. Now, I can barely get out of bed to get the kids to school on time.
I have been reading so many posts were people have taken years to get correctly diagnosed and treated. There is no way I can let that happen to me. I have only been this way for almost 4 months and I just cannot take it! My husband and I both work in the medical field and are circle of friends include numerous doctors. Unfortunately, none of them are Endocrinologists and are not up on the new guidelines or treating thyroid problems. Fortunately, I can get seen easily but no one will listen to me this time about the thyroid. I cannot imagine what most other people go thru!!!!
Helpful - 0
Avatar universal
I just wanted to give you an example of my own situation regarding the doctor's opinion of testing for antibodies, TSH <10, etc.

I began being treated for hypothyroidism when my list of symptoms continued to grow.  My doctor ran my blood work: TSH was about 4.  I was put on a low dose of Synthroid.  But, honestly, I didn't feel any different.  Now, 3 years later, I began to complain of the same symptoms as you (the feeling in the neck being my most bothersome as it was extremely tender.) I was also being treated for reflux, so I assumed the tightness/fullness/tenderness was related to the reflux.  A different doctor told me that what I was feeling was NOT reflux and ordered more blood work and thyroid ultrasound.  The blood test found antibodies indicating Hashimoto's. The ultrasound found that my thyroid was enlarged with several nodules.
At the time of this most recent blood work, my TSH was around 1.3 or 1.4
My original doctor would have never tested for the antibodies.  She was content that my TSH was "normal."  She just had me adding medications as new symptoms cropped up.

I share this with you because I think doctors can rely on misinformation or outdated information.

I think you could benefit from, at least, a second opinion.
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Avatar universal
Are you being treated? If so, how?
I noticed they originally treated you with a TSH of 4. Mine is 4.4 and the dr says that is fine even knowing my family history and symptoms.
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Avatar universal
Q:  Are you being treated? If so, how?

*I saw an endocrinologist who increased my Synthroid to 88mcg per day.  I feel somewhat better, but not great...not like my old self.  I did notice an immediate difference with the tenderness in my neck though.  I've been on this new dose for 1 month and just had my blood drawn last night so I'm not sure how the numbers look yet.

That's another thing though...an important thing to consider is, with ranges and numbers, you may still feel horrible even if your numbers look good.  It's important to talk to a doctor who will treat you as a patient and not a lab value.  

Q:  I noticed they originally treated you with a TSH of 4. Mine is 4.4 and the dr says that is fine even knowing my family history and symptoms.

*Different doctors rely on different guidelines.  I would guess your doctor is going off older information.  I've read that the "new normal range" is .3 to 3.3...and anything above that could possibly be treated as hypothyroidism.  Since mine was above, my doctor wanted to bring my TSH down.

In reading some of the posts on here, I've noticed references to sites and have checked them out for my own research.  You might take a look:

http://www.stopthethyroidmadness.com/

http://thyroid.about.com/



Helpful - 0
Avatar universal
Forgot to add:

More labs-
MCV 101  (norm. 78-99)
MCH 34.7 (norm.27-31)

The doctor has now order B-12 and folate testing.

Thanks.
Helpful - 0
Avatar universal
My best advice - find a new doctor and have your antibodies tested.  If you're positive for Hashimoto's thryoiditis (which is what I have), you can have ALL of the symptoms you list.  I have had all of those symptoms myself.  And when my TSH gets up over 2 or 3, I feel bad.  When it hits 4, I feel like ****.
Helpful - 0

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