1314782 tn?1323184185

HypeTwo Opinions: Thyroiditis and Subclinical Hyperthyroidism - Help!

I am reaching out for help for anyone who might have insight into my situation.
There are many variables, and I will be as succinct as possible.

Over the last ten years, my TSH has remained (invariably) suppressed
(by that I mean, out of the 10 tests, there were 3 that came back very low, but not "flagged"

Also over the last ten years, my T4 has always been normal (with one test showing it flagged as low)
but most all showing it in the borderline low, but normal range.

Moreover, over the same time frame (10 years)  my t3 is invariably within the normal range
(but always 'high normal) yet never flagged as high.


Recent Complete Blood work showed a suppressed Total and Free Testosterone level  (it was flagged)
as well as a --profoundly-- low DHEA-Sulfate Plasma level   78      (195-600)

I am male in my early 30's and in the process of getting an opinion of this.

In 2005 I had an Iodine Up-Take scan, which demonstrated a LOW uptake  (5.3%)
but without hot or cold nodules.  

Also a brain MRI R/O pituitary problems, and other hormones such as LH/FSH are normal
to R/O central hypothyroidism.


My first Endo Dx me with Subacute lymphocytic thyroiditis.


Recently I received a second opinion in which the Dr. thought my dx was Subclinical Hyperthyroidism.
stating that:

        "I understand why Dr _______ initially dx him with lymphocytic thyroiditis at that time,
         but given his consistent lab results over an extended period, a more reasonable dx would be
         subclinical hyperthyroidism"
      with possible "Moldering Graves"   -not sure what "moldering" means


Symptoms:  Fatigue, extreme intolerance to ---cold--, which is very odd..... I am cold ALL THE TIME,
and my temperature always runs around 97.2, on-and-off paresthesia  and dyskinesia in lower front legs.


Right now I am experiencing what I would describe as a "pinched nerve" sensation on the top
of my foot, close to the ankle.  

It is an area of about (2) inches that is sensitive to touch,and I can feel the nerve pulsating about
every 15 seconds, yet there is no pain except in the shower when warm water is directed to that area.

My Current symptoms:   excessive daytime fatigue, extreme intolerance to COLD (which is odd)
and just recently (within the last 6mo)  I have experienced unexplained (mild) nerve pain
which I would describe as similar to shin splints  (the pain is a pins and needles type sensation,
which comes and goes (ie weeks w/o symptoms, and weeks with symptoms.)


Recently, I have noticed a "sensitive area" on the top of my left foot, close to the ankle, but on the foot

The area isn't painful (unless touched), or when in the shower, when warm water is directed to that area.  
The sensitive area is only about 2 inches in this area of my foot.)

The most anxiety-provoking aspect is the feeling of what I would describe as the nerve "pulsating" --
buzzing/tingling sensation in this very small area.  This may be a completely non-related variable,
but wanted to mention it, because I also have a history of fasciculation in my lower legs.

** Possible differential for this is:  ---  took Levaquin about 6mo ago ---
But wanted to mention this.

MRI of brain  -  Normal
Nerve Conduction Test of lower leg  -- Normal
Neurology Exam - Not MS or a demyelinating disorder.  Was very frustrated with this doc
b/c she never gave me a clear dx at all.
Glucose levels - Normal
Lyme Test  -  Negative

Complete Metabolic Blood work and CBC W/ Differentials
   -  Normal.   Note: Slightly low Red Blood Cells,
      but hematocrit was 37.9, which doc said was not significant.   No history of anemia.

Only flagged blood tests, as stated, were:  low Free and Total Testosterone and DHEA-Sulfate.
and have not been evaluated for this yet....

Only confirmed   --- "opposing" --- diagnosis:

1. Subclinical Hyperthyroidism    2. Silent Thyroiditis

Lower Leg dyskinesia  Issue: No specific dx ever given.

This is my current situation.    

I am so sorry this was so lengthy, but wanted to mention all variables, and am reaching out for help
(thoughts, suggestions, opinions...)

I am really needing feedback, as these symptoms are very anxiety provoking for me.

Thank you --so very much-- for your time!!
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649848 tn?1484935765
Please post the actual thyroid test results (should have been at least TSH, Free T3 and Free T4), as listed on your lab report.  Be sure to include the reference ranges, since these vary from lab to lab and must come from your own report.

With the sensations in your lower legs/feet, it seems strange that your doctor didn't do a vitamin B12 test.  Additionally, vitamin D deficiency can cause some symptoms, which are often attributed to thyroid issues.

I'd also have to wonder why your doctor didn't test for thyroid antibodies to confirm/rule out an autoimmune thyroid disease, which would be either Graves Disease or Hashimoto's Thyroiditis.  Graves Disease can be confirmed/ruled out via a Thyroid Stimulating Immunoglobulin (TSI) test.  Hashimoto's Thyroiditis can be confirmed via Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  Since some people only have TPOab, some only have TGab and still others have both antibodies, it's necessary to test them both to get an accurate dx.

Thyroid antibodies and symptoms of thyroid disease can be present even if other tests are in the so-called "normal" range.

Once you post your actual thyroid test results, members will be able to better assess your situation and comment more fully.
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