Am i hypothyroid?

[quiona88]

Hi there,

Since long time, i am dealing with hormonal issues. I have pcos with insulin resistance and slightly high adrogens and am now treated with metformin for this and i used diane 35 for one year long with no success and quitted it regarding its future side effects .

My symptoms are diffuse hair loss, weighting gain, acne, constipation, shaky hands, anxiety attacks, eczama, chest pain sometimes ,fast bovel movements and stomach issues, and my eyebrows are also thin.  I have these symptoms since my puberty and my mother is also treated for diabetes and hypothyroidism.

Concerning my test results , i have a fluctuating tsh value. Since two years my tsh value have been fluctuating in those numbers 1, 1.5 , 1.8 ,2.8 and 3 with optimal T3 and T4 levels, but my last tsh level couple weeks ago was 4.5 with reduced T4 level. Now i am waiting to for next test result whether i begin to use medicine for under active thyroid.

My question is what does a fluctuating TSH mean which is sometimes even crossing the border line for ranges. I have seen many doctors saying like but your last TSH was ok, lets do another test and observe your levels again. Just because i had a TSH level at 4.5 once, does it make me hypo? i could not get any remarkable answer from doctors and since i am suffering crayz symptoms for long time with no improvement, i just want to know what is happening to me.

Thanks for reading this post by the way!

[Barb135]

Most of us find that we feel best with FT4 at about mid range; your latest FT4 was 62% of its range, which is higher than recommended.  We also find that we feel best with FT3 in the upper half to upper third of its range; your last FT3 was 83% of its range, which is also higher than recommended...

You should make sure you get FT3 every time you get FT4 and TSH tested, since FT3 correlates best with symptoms.

Even though your TSH is fluctuating and has been at the top of the range, your FT3 and FT4 are borderline hyper and there's no reason to think you need replacement thyroid hormones, but of course, you should monitor your levels periodically.  

Have you been tested for thyroid antibodies to determine if you have Hashimoto's?  Hashimoto's is an autoimmune thyroid condition in which antibodies destroy the thyroid... The antibody tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  

It would seem that your weight gain and other hypo-like symptoms may be coming from the PCOS, which is often accompanied by insulin resistance, also known as pre-diabetes.  A diet, low in simple carbohydrates and higher in healthful fats may help you lose weight.  The diarrhea, anxiety, etc may come from high thyroid hormone levels.

[Barb135]

Why not start by posting your "optimal" T4 and T3 results, with reference ranges, since ranges vary lab to lab and have to come from your own reports?  Also, please tell us if the T4 and T3 were Free T4 and Free T3 or if they were Total T4 and Total T3... They aren't the same tests and don't give the same information...

A fluctuating TSH really means nothing, since TSH can vary by as much as 75% over the course, of a single day and is affected by many variables, other than thyroid hormones.  Free T4 and Free T3 are the best indicators of actual thyroid status.

[quiona88]

Thanks for your answer.
These results are what i could find at hand.
01/08/2014
TSH  : 1.8     0.27 - 4.20
FT3 : 5.35     3.10 - 6.8
FT4 : 23.43   10.30 - 23.20

15/08/2014
TSH : 3,04     0,27 - 4,20
( no free hormones tested this time)

10  / 01 / 2015
TSH : 2,8       0,27 - 4.2
FT4 : 21,08    10,30 - 23,20
FT3 : 6,18      3.10 - 6,8

29/12/2015
TSH : 4.5        0,25 - 4,55
FT4 : 18.65     11,5 - 22,7
( no FT3 tested)