I went to my endo appointment

[jena64]

He said he was very sure I'm not hypo, he said my July results are perfect.

Thyroxine (T4) Free            1.08               0.61 – 1.76
TSH                        1.150           0.450 – 4.500
Triiodothyronine (T3)          123                   85 - 205

Notice, no results for FT3.  My symptoms are, hairloss, fatigue, depression, very hard to lose weight, can't sleep very long, puffy face, double chin, brain fog, horseness, high cholesterol, dizzy, hungry all the time, muscle aches, can't concentrate, achy, digestive problems and allergies (mold, pollen, ragweed corn stalks, and trees.)  

He said, my Supraclavecular is swollen.  He said this could be caused by the allergy meds I'm taking especially symbicort.  He said I might have fibromyalgia.  He had me drink water while he examined my neck.

He said I might have to see a neuroligist or a rheumatolgist.  I'm not sure why the neuroligist.  He was at the computer the whole time I was there and I had a hard time understanding his strong accent.

The tests he ordered are

Vitamin B12
25-Hydroxy Vitamin D
Thyroid Peroxidase AB
Thyroglobulin AB
TSH
T4 Free
T3 Free (finally)
Sedimentation Rate
CBC
Compr Metab Panel
Cortisol
Cortisol 24 Hr Free
Creatinine 24 Hr UR
Testosterone Free
DHEAS-Sulfate
Methylmalonic
Hemoglobin AIC
Insulin

He said I should stay away from carbs and exercise.   He said my sleep problems may be due to sleep apnea or restless leg syndrome.  I don't think I have either.  My blood pressuse is fine 120/70.

Thanks for any feedback.

[jena64]

Thanks again gimel,  All of your feedback and information has been so apprecitated and helpful.  I have printed out the letter you wrote to the doctor and many other posts you have made.  I have all the information that I have accumulated from this forum in a folder so I can present it to the doctor if needed.

I will post my test results when I receive them.  I'm having the blood work done tomorrow morning August 27, so it will be about a week until my lab will send me the results.  

[gimel]

Yes, it was TT3, not FT3, and the doctor has ordered tests for thyroid antibodies.  After you get a copy of the results, please post them, along with reference ranges, so that members can comment.  If there is an apparent need for meds, then I think the doctor will either go ahead and prescribe, or you may have to influence his decision by phone.  Either way you shouldn't have to wait for 2 months after the test results.  

[jena64]

This was my first visit.  I'm getting the blood tests done tomorrow Thursday Aug 27.  I did tell the doctor that I wanted to be treated for my symptoms not my lab results, and I didn't want him to just go by my TSH.   I didn't want to push too much on my first visit and he did order my FT3 which wasn't done before.  I was told from this forum that my results from June did not include FT3 it was just T3.  Am I correct?  This is the only doctor I can see because I can't find anyone else that takes my medical card.

At least he was willing to prescribe all of those tests.  Do these tests include the Anti-body tests?   After I get my results I will give him articles that I have received from this forum.  

The only problem is I could still me feeling very ill for a long time, because I was told they won't see me for another 2 months unless something shows up on my test results.

[gimel]

So both your regular doctor and the Endo can look at lab reports and conclude that your test results fall somewhere within the "normal" ranges.  So what?  How do they explain your multitude of hypo symptoms?  They don't.  I think "Dr." goolarra did a better job in a prior post to you saying that your hypo symptoms were consistent with having both of the actual thyroid hormones in the low end of their ranges.  

In my opinion, the ranges for both FT3 and FT4 are far too broad and incorrectly determined.  Neither of these ranges has ever been adjusted like was done for TSH, to exclude suspect hypo and hyper patients from the data base.  As a result, test results for many patients with hypo symptoms fall within the limits and they are told they are "normal" --see you later.  In actuality, the lower you are in the ranges, the higher the probability that you are truly hypo.

So, where does that leave you?  You can keep looking for a good thyroid doctor that will listen to your symptoms and test and adjust your FT3 and FT4 levels with meds, as required to alleviate those symptoms.  This may take a while to find and get an appt.  Another alternative is to try to get the first doctor to reconsider by giving him more info and start a discussion with info such as the following.  I put this together to try and help a Forum member, with basically the same problems, get her doctor's attention and try and change his approach.









Judi, I hate to see you stop after all this effort.  I would give it one more try.  Since the new doctor is at least willing to read your letter and call you, I would not give up quite yet.  I think I would go in and get them to run new tests for FT3 and FT4 and of course they always run TSH.  After you get a copy of the results, then post them here and let members comment.  

Then I would make copies of this checklist of hypo symptoms and mark the ones you have.       http://www.altsupportthyroid.org/tsh/tshmedrefs2.php

Then I would also make copies of these.
http://www.altsupportthyroid.org/tsh/tshmedrefs2.php

http://www.hormonerestoration.com/Thyroid.html

Then I would send  copies to the doctor, along with the following:

Dear Dr.  ____,  
I thank you for your time and interest to date.  You may be my last resort to getting some of my problems fixed and having a more enjoyable life.  I understand your reaction to my lab results.  My symptoms and my TSH don't seem to match; however, I have learned that TSH is a pituitary hormone that is affected by many variables and does not correlate very well at all with hypo symptoms.  I am also aware that the old range for TSH (.5-5.0) was recommended to be changed over 6 years ago to .3-3.0.  This change was due to screening out suspect hypo and hyper patients from the data base, and recalculating the limits.  I also know that TSH is not a good diagnostic.   At best it is only an indicator of thyroid state. From what I have read, hypothyroidism correlates best with FT3 and slightly with FT4.    
The data bases for FT3 and FT4 have never been adjusted like TSH and still include lots of suspect hypo and hyper patients.  If the data bases for FT3 and FT4 were adjusted like the TSH range, it would result in  much higher ranges for these actual thyroid hormones that regulate metabolism and many other body functions.  I'm sure that is the reason so many of us suffer with hypo symptoms even when we are slightly within the lower limits of the reference ranges for FT3 and FT4.  If the range for FT3 were adjusted comparable to TSH, for example, it would probably change from 2.3-4.2, up to 3.2-4.3   And if the range for FT4 were adjusted similarly, it would probably go from .60-1.50, up to 1.0-1.55.  With the currently unadjusted ranges, the lower you are in the range, the greater the probability of being hypo.  I strongly believe this is the main reason that I have all these hypo symptoms.

To me, test results within the low limit of the current reference ranges for the "Frees" should not be considered as a reason to do nothing further.  Instead, the ranges should be used as a guide, within which to adjust the levels as required to alleviate symptoms.   If being within the low limit is acceptable, then why isn't it just as acceptable to take medication and move up within the range, in order to alleviate symptoms?  


As you can tell I am quite determined to improve my quality of life, by ridding myself of what I think are clearly hypo symptoms.  I would appreciate it very much if you would find some time to read through the articles I have given you and consider what I have said above, and consider putting me on a therapeutic dosage of thyroid meds and monitor the effects very closely with me.  I think it would be of great possible benefit to me, without any significant concern..

Thank you very much,