Diagnosed with Hashimoto with normal TSH but feeling symptoms

[EnigmaticUsername]

Back in November I had blood work done because I was feeling tired all the time, always felt cold, hair loss and couldn't lose weight despite eating well and exercising. My TSH came back at 5.11 so since it was barely above the normal range I was told to wait a few months and get the test again. I've still been feeling the symptoms over the past few months and the exhaustion has gotten worse. I just got blood work done last week and my TSH levels were normal (3.11). They tested for antibodies this time and found out that mine are higher than normal (145; normal is <50). The doc explained that it's Hashimoto's but since my TSH levels are normal they're not going to do anything about it and I should just keep an eye on it with blood work once a year.

My concern is that I don't think I can put up with these symptoms for a whole year. I'm only 22 and I'm worried that if I don't get a handle on this is will have implications later in life. The exhaustion is affecting me at work and I'm worried that I won't be able to go back to school for grad studies if I'm always so tired. I'm also really struggling with the unexplained weight gain and it's taking a real toll on my self confidence. Does anyone have advice on what I can do to advocate for myself when dealing with doctors? Also, if there are any doctor suggestions for Edmonton, Alberta, I would be really grateful.

[flyingfool]

the Original post is maddening, but unfortunately all too common.  

Think about this.  having Hashi's means that "sooner or later" you WILL be on medication.  So what this genius Dr is suggesting, is that he (or she) is willing to let you feel miserable and symptomatic, and wait to start you out on medication that he knows is virtually  inevitable.

He is saying you have to feel absolutely horrible terrible, before he will do some thing that he knows he will end up doing at some later point.

Ask yourself this:  What kind of Dr would let a patient feel horrible for some undetermined length of time, when he could treat you now to feel well?

Does that make ANY logical sense?

[ALStarke]

Hello, I am also only 21-years-old but also suffer with Hashimoto&#39;s disease and had a similar situation to happen to me. I was just barely out of the normal range but still was experiencing all of the symptoms and my antibodies were out of this world. My hair was falling out, I couldn&#39;t get out of bed, and I start gaining a ton of weight. My end I said we&#39;d &quot;monitor&quot; it but I couldn&#39;t deal with it any longer. I just switched practices and endocrinologists and so far I have been treated much better. I&#39;m on 25mcg of Synthroid and my hair has stopped falling out and my energy improved(still waiting on the weight loss). My advice to you would to do the same. Switch practices and specialists!

[gimel]

Note that a starting dose of thyroid med usually has little effect because it causes a drop in TSH, which then reduces output of natural thyroid hormone.  Only when the dose is increased enough to suppress TSH, will further dose increases start raising FT4 and FT3 levels.  A good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting FT4 and FT3 levels as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results when taking thyroid med.  

[Red_Star]

I had to wait 4 years for my TSH to rise to 6 before any doctor would treat me! Sad state of affairs. At the time I didn't know about the integrative doctor working at the beach, perhaps at the time he wasn't..not sure, but there is a good reason there is a three month wait as this doctor does treat what conventional doctor don't or won't. I would also have started at 25 mcg at the beginning as 50mcg was to much for me at the start.

[gimel]

Doctors like to believe that hypothyroidism is just related to thyroid levels and that they can assess your status by just testing TSH, and sometimes a Free T4 test.  In reality hypothyroidism is insufficient T3 effect in tissue throughout the body due to inadequate levels of, or response to, thyroid hormone.  So there is a lot more involved than just thyroid hormone levels, that doctors erroneously believe are accurately sensed by the hypothalamus/pituitary system, with resultant secretion of TSH.

Except at extreme levels, (TSH> 10) it is totally inadequate as the primary diagnostic for possible hypothyroidism.  TSH has only a weak correlation with thyroid hormone levels, and a negligible correlation with Tissue T3 Effect, which determine a person's thyroid status as either hypothyroid, euthyroid, or hyperthyroid.    

The best way to diagnose a potential thyroid patient's thyroid status is with an integrated approach, with a full medical history, an evaluation for signs/symptoms that  occur more frequently with hypothyroidism, and comprehensive biochemical testing.  That testing should include Free T4, Free T3, Reverse T3, TSH, TPO ab if TSH is high, TG ab if TSH is high but TPO ab is negative, cortisol, Vitamin D, B12 and ferritin.  You can read about this in the following link.  I highly recommend reading at least the first two pages, and more, if you want to get into the discussion and scientific evidence for all that is recommended.

http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf

I was going to say that I could not believe that you have not been tested for the actual biologically active thyroid hormones, Free T4 and Free T3.  But then I noted you were from Canada, and under the dictates of national health care.   Even if you get tested for FT4 and FT3, the chances are that they will still be within the so-called "normal" range and the doctor will do nothing.  By contrast a good thyroid doctor will pay most attention to the presence of symptoms that occur more frequently with hypothyroidism and support that evaluation with tests.  When diagnosed you would be given thyroid med as needed to relieve signs/symptoms of hypothyroidism without creating signs/symptoms of hyperthyroidism.  This "sweet spot" is called euthyroidism.  

I have no idea if you could find a good thyroid doctor within the national health service there, but i have the name of a doctor that was recommended by another thyroid patient in your area.  I will send you a PM with info.  To access, just click on your name and then from your personal page, click on messages.