Need Some Help....

[SuzisGoinCrazy]

I hope you can give me some insight b/c I feel like I am going crazy. Background info is that I am almost 39, I had a complete hysterectomy 12 yrs ago and have been on HRT the whole time. I did great for about 5 yrs, when I started having additional symptoms. It was shrugged off as "menopause" and the estrogen was increased and then an antidepressant was added. I started having a discharge from my breast and a growth was detected, biopsied and removed that was in 04. My HRT was decreased and testosterone was added for a while....I didn't like the side-effects, so I went back to just an estrogen HRT at a minimal dose. I have just recently have gotten my hands on all of my labs b/c I am constantly tired, horrible night sweats, joint pain, awful brain fog, can't maintain a conversation b/c I can't stay focused, no sex drive (not good recently remarried), my hair is thinning, just feel awful. Here are my test results that are "normal"
11/04:
TSH 3.083  (limits .350 - 5.5)
T4  8.8      ( 4.5 - 12.0)
T3  18   (24 - 39)
FTI 1.6 (1.2 - 4.9)

8/05:
TSH 4.065 (same limits as above)
T4  4.9
T3  30
FTI 1.5

7/07:
TSH 2.983
T4  7.1
T3  24
FTI  1.7

My cholesterol has been increasing even though I have been on Weight Watchers and managed to loose 20 lbs and have been watching my diet like crazy!
Please help me.....

[Mark Lupo, M.D.]

You likely have mild hypothyroidism from Hashimoto's -- would test antibodies but most of my patients with TSH levels that go from 2.5-5.0 like this are antibody positive and many (but not all) benefit from thyroid hormone treatment.

[SuzisGoinCrazy]

Dr. Lupo, Thank you for your response. So maybe I'm not going crazy?!  It is a relief to think that there maybe some answers to what has been going on with me. I have an appointment to see an Endo in about a month. He is supposed to be a good one for this area (Savannah, GA). If I may ask a question, Is the Free Thyroxine Index a useful test or is it irrevelant?

Thanks again for your response

[Mark Lupo, M.D.]

FTI is not that useful if a free T4 is available.

[SuzisGoinCrazy]

Dr. Lupo, I need to get some advice, if I may. I was seen by the endo, he reviewed the labs that I had previously posted, felt of my neck and said that it was not my thyroid. He wanted to test me for something else, but doubted that I had it (he never said what he was thinking of, but I'm guessing Cushings). He had some blood drawn, test for cortisol - supposedly that was normal, but I don't have that lab. I then took a 24-hr urine test, again for cortisol, my level came back at 82 "normal" b/c it was under 100. I have read that over 50 for 24hrs is considered high, but I'm have no idea at this point. The endo has referred me back to my GP stating that I have nothing endocrine in nature going on. Do you know of any doctors in the Savannah GA area that may be more aggressive in getting to the bottom of my symptoms? What tests do you recommend that I push for? Can you offer any suggestions on where I need to go from here?
All your input is greatly appreciated and thank you for your time.