Advice please?

[aly995]

I am a 30 year old female. Over the course of a decade I have felt that it was inevitable I would have hypothyrodism. My mother was diagnosed at 40, my aunt also has it. In the past two years or so, I have developed studdering, there are patches on my legs where my hair doesn't grow, and I am always cold, in 90 degree weather I am comfortable (not something that is normal when you are overweight). I recently went back to school and am having massive memory retention problems, comprehension isn't the problem. I have always had memory problems, but they seem to be getting progressively worse, I haven't had to study for over a decade so I can't really say when my memory started to go downhill. After googling that there is a known memory deficit associated with hypo I decided to get blood work done. I don't have insurance, so I did it though the college I attend. The TSH results came back in the "normal" range at 3.08. That was all they tested for. Now, if my mother didn't reach the "out of range" until she was 40, is it reasonable to think I'm headed in that direction? I don't want to wait a decade to be diagnosed with something that, in my opinion, is effecting me now. Would there be severe effects to taking a thyroid medication now to see if it helps me?

[Barb135]

You need both the FT3/FT4 and antibody tests in order to determine whether you have a thyroid condition or not.  The FT3/FT4 will tell us what your thyroid is actually doing now and the antibody tests will tell us whether or not you have Hashimoto's, which will progressively cause your thyroid to produce less hormones.

Please be forewarned that many doctors consider TSH as the "gold standard" for thyroid issues and will refuse to run the FT3/FT4 tests.  They may also refuse the antibody tests, too, based on the "normal" TSH.  

You may have to do as goolarra suggested and order the tests online. You order them, they send you a lab order and tell you what lab to go to, then after you have the blood draw, they e-mail you the results and follow up by mailing a hard copy.  This lets you get the tests you need without dealing with a stubborn doctor.  The TSH, FT3 and FT4 cost about $85; the antibody tests will be more, but I don't know the exact cost.

[aly995]

Thank you so much, that's kind of how I felt when I saw the results and was just told your normal, that it just didn't make sense. But if Hashi's shows symptoms before normal labs indicate a problem, that makes sense. I was also thinking that the dr. may not be really 'up' on the new range, because he may not run into this a lot with being a college campus dr. Do you think it would be better to do the FT4/FT3 tests first and then the antibody tests you suggested? or would the antibody tests just indicate a problem right away, so doing those tests first would simply rule out a possible misdiagnosis?

[aly995]

I don't remember my mother saying Hashi's, but I remember her telling me that her thyroid eventually just stopped working.

[goolarra]

Close to 10 years ago, AACE recommended that TSH range be changed to 0.3-3.0.  Your lab, like most of them, still uses the old range.  Furthermore, TSH is a pituitary hormone.  It can be affected by any number of factors other than thyroid hormone levels, so it's a screening test, in the absence of symptoms, only.  In order to see what your thyroid is really doing, you would also have to test FREE T3 and FREE T4.  These are the actual thyroid hormones and give a much clearer profile of thyroid status.

I agree that, with the information available now, it would be very difficult to get a doctor to prescribe thyroid meds.  

Can you have further testing at your college?  If not, you can order tests online.  They're about $85 for TSH, FT3 and FT4 (all three are $85).  With that information, you'd be much better prepared to know if you should pursue this further or not.

Your symptoms do sound hypo, and you have a family history.  Do your mother and/or aunt have Hashi's?

[Barb135]

TSH is a pituitary hormone and should never be used, alone, to diagnose/rule out/treat a thyroid condition.  You need the Free T3 and Free T4 tests, as well.  Those are the actual thyroid hormones, with Free T3 being the one that correlates with symptoms.

That said, AACE recommended a new range for TSH, 10 yrs ago.  That "new" range is 0.3-3.0, in which case, your level would be out of range.

You should try to get thyroid antibody tests (Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) done.  If either of those tests were positive, that would indicate Hashimoto's Thyroiditis, which is an autoimmune thyroid disease, associated with hypothyroidism.  Hashi's is a progressive disease, that attacks the thyroid, so it continuously produces less and less hormones until eventually, it will produce none.  Hashi's the most common cause of hypothyroidism in the developed world.  

With Hashi's, it's not unusual for symptoms to show up long before regular labs (TSH, FT3 and FT4) indicate a problem.  

[Gretta96]

I don't think taking a thyroid supplement would hurt you, but I'm not sure if a doc would prescribe it.  If he did, how much would he prescribe?  You're levels are within normal range, but I am the first to acknowledge those ranges don't fit everybody the same.  I personally need to be below 2 to feel good/normal.