Don't rely upon them to even order the correct tests
DEMAND that as a minimum the following be tested:
2) FREE T4 - NOT total T4 but FREE T4
3) FRETT T3 - Again NOT total T3 but FREE
4) Reverse T3
Can also check TSI as it is I think difinitive for Graves.
If total Thyroid is bound up with a protein. It can still leave a person hypothyroid as there is too little active free thyroid.
SHBG is very high inthe range, so I would not doubt your free sex hormones are also low. But that is a whole different dicussion. SHBG has a high affinity to testosterone, less so with estrogen. But with your testosterone being so low already, basically you have no free testosterone and I suspect you would have symptoms of low Testosterone. Which often times over lap with low thyroid. Another reason why generally a person deals with thryoid first.
This is why getting tested for both FREE T4 and FREE T3 is so important.
With your high total T4 and high total T3 it is unlikely that you have hypothyroidism as a disease. Your doctor should not accept T4 and T3 at top of range to be "normal". Your doctor should be looking for a disease that will give you high total T4 and high total T3 and also give you symptoms that are similar to hypothyroidism.
Graves disease and thyroid nodules can give you high T4 and T3. High T4 and T3 production eventually leads to high Reverse T3, which counteracts the ability of T3 to do its job in your body. If T3 doesn't do its job, you feel hypothyroid.
Your doctor needs to do a complete workup on your thyroid which would include: (1) tests for all the thyroid hormones including reverse T3; (2) tests for common autoimmune thyroid diseases including Graves disease i.e. anti-thyroperoxidase (TPO), anti-thyroglobulin (Tg) and anti-TSH receptor antibodies; and (3) check for thyroid nodules.
I am here for the almost exact same reason. I usually go get thyroid labs and they always come back relatively normal except my T3 is within range but below optimal. This means I have a slight issue converting t4 to t3.
PPI also as well as oral contraceptives known to raise SHBG.
Also in my wife's case, GERD was a symptom of low thyroid. Once she started getting somewhat close to adequate dose of thyroid, she had no more GERD. She was able to stop the PPI medication.
Also my wife asthma symptoms declined significantly when she got thyroid.
Her migraines went away as well. It was a chain reaction caught by a good dr. My wife went in for migraine issues. He noticed her clearing her throat often. Asked if she had problems with acid reflux and she said yes. The Dr said that the migraines are linked to acid reflux. And the PPI stopped or at least significantly reduced the number and severity of migraines. But then once she started thyroid dose, she was able to stop the PPI (acid reflux) medication.
Also i have read that acid reflux is often TOO LITTLE stomach acid. As the valve on the top of the stomach senses acid. too little stomach acid and the valve will not shut tightly allowing the stomach acid to escape up and into the esophagus and thus acid reflux.
Too little stomach acid theory also makes sense as to why ADDING Apple Cider Vinegar (acetic acid) helps to REDUCE acid reflux.
Do you have any other autoimmune conditions? I would test for both thyroid antibodies, in addition you may want to check to see about pernicious anemia (inability to absorb Vitamin B12) if you are low. It too I believe is an autoimmune condition.
A person with one autoimmune condition is at higher likelihood to have additional autoimmune conditions.
Your health is slowly going slowly down the toilet blocking the very thing you need to absorb nutrients and kill off pathogens....stomach acid! The worst is not enough vitamin B12. This takes many years to go down while you suffer a long list of symptoms in "normal" range. My mum almost died from Nexium long term use so PPI's are very dangerous drugs. Beware! She now takes betaine HCL with pepsin and digestive enzymes with great results.
Btw, my mum's Hashimoto's thyroiditis was triggered by nexium. Mine triggered by stress. My TSH has been 1.4 to 1.6 mU/L for decades. The moment that number rose into the 2's Hashimoto's thyroiditis had arrived. I asked for both thyroid antibodies - thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) - and to no surprise both were high.
Excerpts from Gallbladder Attack article Chronic Heartburn...
"Too much stomach acid? Really? I mean, how is it that millions of people on PPIs are making too much HCl? Hyperchlorhydria or too much stomach acid is rather rare. If you're overeating, eating junk food or other food that is hard to digest, eating when stressed, living under stress, chances are much greater that you don't make enough hydrochloric acid or digestive enzymes and your symptoms stem from that.
Take a look at some of the symptoms caused by low stomach acid –
Signs of Deficient Stomach Acid:
Gas, bloating and burping shortly after a meal
Feeling of fullness or food not digesting
Heartburn and/or gastric reflux (sometimes too much HCl but most often not enough)
Foul smelling stools
Loose stools in the early morning
Dialated blood vessels on the cheeks and nose - Rosacea
Pernicious anemia or iron deficiency
Nausea especially after taking vitamins and minerals
Weak or cracked nails
Parasites - or at least increased susceptibility to parasitic infections
Chronic yeast infections
Acne in adults - especially if you have other symptoms from the list
Since low levels of stomach acid result in poor absorption of nutrients, many symptoms that accompany a deficiency of that vitamin or mineral makes this list much longer. The nutrients most affected are calcium, iron, folic acid, vitamin K and many B vitamins.
If you're nervous about trying supplemental hydrochloric acid, you can do a trial with 1-2 TBSP of organic apple cider vinegar mixed with 1/8 to 1/4 cup of water after a meal. If it makes you feel better and does not hurt, you most likely would benefit from taking 300 - 500 mg of Betaine HCl with your meals. Start slowly and work up to this.
Risk Factors And Causes Of Low Stomach Acid:
Irritable Bowel Syndrome
Candida & Other Yeast
Bacterial Dysbiosis or infections in the gut
H. pylori infection
Stress, even in children
HCl production decreases with age
Diseases Associated With Low Stomach Acid:
Your testosterone is extremely low. Maybe this is common after child birth or if you are nursing. But less than 20 is all they can report as at that low of levels it is essentially "unmeasurable". Meaning you have NOTHING.
Testosterone is vital to sex drive. Even in women.
In fact by VOLUME, women have 10 TIMES more testosterone than they do estrogen! (still 10 times less than a man, but still) This should indicate just how important testosterone is to women. AND shows just how powerful that estrogen is!
Your SHBG is high, and that is binding what little to nothing you have of testosterone.
All of the sex hormones are dependent upon what part of your cycle you were in when the blood was drawn.
Anti anxiety and antidepressants are known to kill libido. As stated oral contraceptives are also known to kill libido. That is in part why they are effective at preventing pregnancy. when the women doesn't feel like having sex, chances are pretty good that pregnancy is prevented. LOL!
Even IF your sex hormones are messed up. It is best to FIRST get your thyroid levels in line.
As stated you REALLY need to get your Free T4 and Free T3 levels tested. Your symptoms are 100% consistent with low thyroid. I would also strongly recommend getting the Reverse T3 level tested. Given that both your total T4 and Total T3 are high in the range, but you have all the symptoms of low thyroid, the stress you have had from child birth and a major surgery (C-section) is extremely stressful, as is taking care of a newborn. All of which can raise cortisol and also increase revers T3 production.
high Reverse T3 can hinder the metabolism of thyroid and while levels of both thyroid hormones may appear adequate. The blocking effect at the cellular level can leave you hypo (low) thyroid at the tissue cellular level!
You may want to test all the sex hormones, including Estradiol and progesterone in addition to testosterone.
Your symptoms typically relate to inadequate levels of Free T4 and Free T3, which are the biologically active thyroid hormones, along with deficiencies in any of the other tests I suggested you try to get done. I am sending you a PM with info. To access, click on your name and then from your personal page, click on messages.
I see nothing in all those tests to be concerned with other than your Total T4 is above range, and your Total T3 is right at the top of its range. This is not what I would expect to see from a patient with so many symptoms that are typical of hypothyroidism. It could be that your Totals are high, but your Free T4 and Free T3 are too low. This could be due to excessive levels of Sex Hormone Binding Globulin SHBG which can bind excess amounts of T4 and T3, leaving too little Free T4 and Free T3. Taking birth control pills can cause excess SHBG. Note the following:
"They found that SHBG levels were four times higher in the women taking oral contraceptives than in those who had never used birth control pills. ... "Despite discontinuation of oral contraceptive use, SHBG levels remained continuously elevated for up to one year," researchers write.
I realize your SHBG was within the range, but that is not conclusive. To find out more about what is going on you need to get tested for Free T4, Free T3, Reverse T3, cortisol, Vitamin D, B12 and ferritin. Due to the weight gain I would also suggest a test for leptin. Is it possible for you to get all those done?
Even hypochondriacs get sick. LOL In order to assess test results, they must always be compared to reference ranges shown on the lab report. So please add the reference ranges to those test results. Also, for thyroid testing, in the future you should always make sure they test for Free T4 and Free T3, not Total T4 and Total T3. Most all of the Totals is bound to protein and thus rendered inactive. Only the relatively small portion not bound to protein, thus referred to as "Free" is active. Would it be possible to get tested for Free T4 and Free T3, along with very important tests for cortisol, Vitamin D, B12 and ferritin. Since weight gain is one of your concerns I would even ask to be tested for leptin.