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Avatar universal

Do I bother going to Endocrinologist and how do I find one?

Symptoms:
40 lbs. weight gain, can not lose
Puffy face
Dry eyes and skin
Exhaustion
Insomnia
Constant Sweating (I know that's typically hyper)
Lost 1/3 of eyebrows

Here are my test results which my doctor said were fine.  She said she's refer me to an Endocrinologist if I insisted.  Should I insist or am I barking up the wrong tree?  Also, I am not peri menopausal yet as that was tested too.

Ferritin     18.7           4.6-204
Vitamin D   29               18-72
B12            394            211-911
TSH           1.12         0.35-4.94
Free T4       0.8             0.7-1.5
Free T3       3.1              1.7-3.7

Thanks!

3 Responses
Avatar universal
You don't really want an Endo, unless the Endo is a good thyroid doctor.  The chances of that are fairly low, since most of them specialize in diabetes, not thyroid.  Also many of them have the "Immaculate TSH Belief", by which they mostly pay attention to TSH, which does not work for many people.  If they go beyond TSH it is usually only to test for Free T4 and then they will use "Reference Range Endocrinology", by which they will tell you that a thyroid test result that falls anywhere within its range is adequate.  That also doesn't work for many people.

For comparison, a good thyroid doctor will diagnose a potential hypothyroid patient primarily based on symptom, and also the biologically active thyroid hormones, Free T4 and Free T3.  Then if the diagnosis is hypothyroidism, the patient will treat a hypothyroid patient clinically, by adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  

In view of your symptoms, there is nothing about your test results that is "fine".  Your Free T4 is only at 12.5% of its range, when it should be at least 50%.  Your Free T3 is at 70%.  Being that much higher than the Free T4 is an indication that your body is converting as much T4 as possible in order to try and maintain body function as well as possible.  So you need thyroid medication to optimize your Free T4 and Free T3 levels.  TSH is a very poor indicator of thyroid status except when very high, as in overt hypothyroidism.  Your relatively low TSH, coupled with inadequate FT4/FT3 is indicative of central hypothyroidism.  With central, there is a dysfunction in the hypothalamus/pituitary system that results in TSH levels that do not adequately stimulate the thyroid gland to produce thyroid hormone.  

In addition, hypothyroid patients are frequently too low in the range for Vitamin D, B12 and ferritin.  Your  D is too low, since it should be at least 50.  B12 should be in the upper end of its range.  Ferritin should be at least 70, so yours is way too low.  You need to supplement all three to optimize.  

So you have two options.  One is if your current doctor is not too arrogant to consider being wrong, then you could give him a copy of the following link and ask him to review the paper, reconsider his diagnosis and consider clinically treatment as described.  If not possible, then the second option would be to give us your location and possibly we know of a doctor that has been recommended by other thyroid patients in your area.

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

I also highly recommend reading at least the first two pages of the paper, so that you are better able to be your own best advocate.  Read further if you want to get into the discussion and scientific evidence supporting all the suggestions on page 2 and recommendations for treatment.  
1 Comments
Please let me know who you would recommend in the Central Indiana area.  I am also willing to travel at this point.  Thank you!
222507 tn?1485911446
The first three lab results appear to be low - you might consider supplementing all three. TSH is ok, FT4 and FT3 are ok. Dr could check TPO ATG antibodies - see if you have Hashimotos. Good luck!!
1 Comments
At only 12.5% of its range, Free T4 is not okay... Recommendation is that Free T4 be about mid range to be optimal.  In this case, it appears the poster is converting all the FT4 to FT3 in order to maintain body functions...

As gimel noted, since there are multiple symptoms of hypothyroidism, a dose of replacement thyroid hormones would bring FT4 up to optimal range and help alleviate many of the symptoms.
Avatar universal
I just sent you a PM with info.  to access, just click on your name and then from your personal page, click on messages.  
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