What is normal?

[Tra2000]

I was wondering what "normal" may be with regards to symptoms associated with hypo/Hashimoto's.  I have some symptoms of hypo (hair loss, intorelence to cold and feeling cold in temperatures that I would assume would be comfortable, dry skin, and inability to loss weight despite diet changes and exercise).  However, I have had some of these symptoms for a long time (such as feeling cold) that I no longer know what normal is.  My doc has recently done blood work for thyroid which showed a TSH of 3.9 and thyroid peroxidase in the upper 200.  She put my on some meds, but hasn't directly stated I have Hashi or hypo.  However, I don't know what normal is to tell her whether or not I'm getting better or even what other symtpoms I should be on the lookout for because it could be normal for me living with it so long.  I can't make a judgement.  The symptoms I know I have, I have always chalked up to single occurences (until recently), and not as a whole to some disorder.  Though I may be uncomfortable, it doesn't mean that it is abnormal.  But I don't have a scale to judge by.  Can you all give me some suggestions as to what normal, or even abnormal would be with regards to hypo?

[gimel]

Yes, it is different.  The T3 uptake test is somewhat outdated and not real useful.  The FT3 test checks the level of the most important thyroid hormone.  Many doctors don't bother running it because they say that if T4 is okay, then T3 is also okay, assuming the body converts T4 adequately.  My opinion is that with its importance, why guess?  Just run the test.  But, you may have to insist on it.

Sorry I didn't get back to you in time to have it done today, while already there.

[Tra2000]

Thanks for your reassurance.  I will ask about the FT3 when my doc calls about the test results from today.  Is this test different from the T3 uptake?  

[gimel]

Also insist on FT3 along with the FT4 and TSH and antibodies.  FT3 is the most important test.  FT3 is four times as active as FT4 and studies show that FT3 levels correlate best with hypo symptoms.  I'd say you have hypo symptoms for sure.

[Tra2000]

Thank you both for answering to my post.  The test I mentioned is not my first test, just the most recent.  A couple years ago I went to another doc, who after much convincing, tested TSH, T-4, T-3 uptake, and free thyroxine index plus antibodies.  I was put on Cytomel (?), the lowest dose, but was never adjusted.  Did evidentually see an Endo who take me off of the meds, and sent me on my way without any further follow-up.  That was over a year and a half ago.  So with this past experience, I began questioning my symptoms and my own concerns.  That is why I'm asking what is "normal".  I just moved to a different state six months ago, and went to see a new doc who asked me about thyroid in a routine check-up and first patient visit.  I told her of my past experience, and that I didn't know to pursue it or just drop it.  She tested and then she gave me the results for TSH and the antibodies, so I don't remember if free T-3 or free T-4 were tested.  She put me on Levothyoxin at 100mcg.  I'm actually retesting my TSH, Free T-4, and antibodies today, a three month followup.  So, I'm really confused because no one has come out and said I have Hashi or hypo, or what to expect, or even what may be going on.  I know I'm feeling cold in what I think should be a comfortable temp. (71 degrees but I'm wrapped up a blanket, in a sweatshirt and turtle neck).  BUT, it is Dec. 1  :)  Same thing with the hair.  I think alot of hair is coming out in my brush and the shower, BUT I have long, thick hair (alot of hair would come out).  I don't know what normal is so I can't judge if my symptoms are actually symptoms or if even warrant any concern.  Thanks in advance for any advice you can give.

[gimel]

Sounds to me like you most likely have Hashi's and are having hypo symptoms due to your thyroid glands being destroyed by the antibodies being produced by your autoimmune system.  This will proceed until your thyroid glands are destroyed, which may take an extended time.

In the meantime, it's good that your doctor has started you on meds.  Getting your thyroid hormones up to an adequate level will greatly help your symptoms.  The best way to accomplish this is to continually test and adjust FT3 and FT4 levels, rather than dosing you based on TSH.  The "Frees" are the biologically active thyroid hormones that largely regulate metabolism and many other body functions.  So I suggest that you discuss with your doctor your desire to be treated for your symptoms, by testing and adjusting FT3 and FT4 levels.  Note that these are not the same as total T3 and total T4.  

[6hashi]

hello ,
how long have you been on meds and on what dose ?
I have been through the same scenario  ,
I don't know how I am supposed to feel ,
I can tell you that with each improvement you will be more aware to the symptoms you have
and that they are not normal,
also read symptoms list

feel well,