TSH 2.68 with Hypothyroid family history and symptoms

[Lynn533]

As both my mom and sister have Hashimoto's, I try to have a thyroid test done annually with my OB exam.

I was suspicious that the results may come back abnormal this time as I have had some suspect symptoms in the past year.

I have gained 15 lbs. on an average 5'3" frame with no change in diet or exercise.  This is highly unusual for me.  And no amount of dieting is taking it off - in fact I continue to gain weight at a rate of 1-2 lbs. per month.  

I also have moderate to severe fatigue that cycles off and on, along with intolerance to cold and low body temps....although I've had those symptoms for years. I've also experienced constipation and fairly alarming brain fog and clumsiness.

I recently turned 30 and started taking Zoloft for PMS a year ago.  Thinking that the Zoloft may be part of the problem, I stopped taking it last month but haven't seen improvements yet.

My TSH came back at 2.68, which the nurse said was normal.  Given my symptoms and family history, however, I am wondering if I shouldn't see my primary physician and ask for a full thryoid panel.

[PNWBabe]

I had the same thing happen to me. When I was diagnosed with Hashimoto's my TSH was 1.57, but my antibodies were over 1,000!!!! I am now treated with 3 grains of Armour thyroid and feel better than ever. I would definitely request a full thyroid panel with Free T3 and FreeT4..the free's because those are the unbound thyroid hormones that your body has available for use. Make sure you also ask for antibodies to be checked!

[ancientmariner]

Have you had thyroid antibodies tested? Hashimoto's disease has a genetic component, and almost always can be diagnosed by elevated TPO antibodies. You might want to ask your doctor to check. And I've read that if you have the antibodies, TSH isn't dependable. Also, the range for TSH now used by the AACE has a high of 3.3, but you're pretty close to that.

[Mark Lupo, M.D.]

With the family history, would check thyroid antibodies -- if they are positive and the TSH is still >2.5 then given your symptoms a trial of thyroid hormone to get the tSH around 0.5-1.0 would be reasonable.  There are no studies to prove this, but it may be worth a trial and I have had some patients benefit from this approach --- I would usually only start treatment in such a case if the thyroid antibodies (TPO and /or Tg) are positive.