Doctor thinks I might my thyroid is hyper?

[Cinderellamom456]

Recently went to the doctor for not feeling well.   Body/joints ache, vision change I have to wear glasses now,  heart racing and palpitations,  headache,  dizziness.   Cannot seem to gain weight.  Blood pressure seems to be high.  My menstrual cycle went from  27 days apart to 47+days apart.   Cold hands and feet, hot flashes.  Trouble falling asleep and fatigue all the time.   She is going to do my blood work in six weeks and refer me if needed. What do you think?  Any advice and what should I expect in the future?   What should I watch out for?  Age 35

Blood results related to tyriod
TSH (2013) 1.39

Current
TSH .446  rr .5-4.20
T4,Free =1.2  rr 0.8-1.8
T3 Total =82  rr 60-181

[Cinderellamom456]

I'm also wondering if the mri would show the pituitary gland with the speniod sinus fluid.   It was without contrast.   She didn't seem concerned with the fluid.   Told me to try nasal rinse.   Thank you for researching and giving me feedback!

[Barb135]

Not being able to lose weight is another symptom of hypothyroidism.

I don't know if too much sinus fluid could put enough pressure on the pituitary gland to cause it to misbehave or not; I would think it would have to be a lot of excess fluid to cause that much of an issue, but you're saying "mild spenoid sinus fluid".  I'll have to do some research on that, later.

[Cinderellamom456]

In my original post I said I can't gain weight I ment lose weight.

[Cinderellamom456]

I have a appointment in less than two weeks to discuss diet and medical history.   I also had a mri the same day I had blood work done.   The mri showed mild speniod sinus fluid.   Which I have learned is next to the pituitary gland.   The mri was without contrast.   Do you think it's related?   Thank you

[Barb135]

She thinks it's hyper, because she's only looking at the TSH.  She needs to look at the Free T3 and Free T4; those are much more telling.  Free T3 is the hormone that has been shown to correlate best with symptoms.

Do you think you could get her to re-test prior to the end of 6 weeks and give you that referral sooner, rather than making you suffer that long?  There's no need for you to suffer just because she doesn't really know what she's doing.

[Cinderellamom456]

Thank you she mentioned that it is acting like hyper but is actually hypo.  Hopefully now that we have a clue she will test both the free t 3&4.  

[Barb135]

While some of your symptoms and your TSH indicate hyperthyroidism, the rest of your symptoms and your FT4 and TT3 indicate hypothyroidism, plus, racing heart and palpitations are common with hypothyroidism, as well as hyperthyroidism.  

With FT4 as low as yours, we would expect your TSH to be much higher than yours.  Total T3 is really considered obsolete and doesn't tell a whole lot, but even that's low in its range, which indicates hypo, not hyper.  Everything points more toward Central hypothyroidism, than it does to hyperthyroidism.  With Central hypothyroidism, the problem is in the pituitary/hypothalamus axis, rather with the thyroid, itself.

It would seem that your doctor is looking only at TSH and ignoring the Free T4 and T3 levels. When thyroid levels are low, the pituitary gland produces TSH to stimulate the thyroid to produce more T4 and T3.  Of the total T4 and T3, most is bound by protein and can't be used, which why we look at the frees.  Your pituitary gland is not producing enough TSH to stimulate your thyroid, so your thyroid is not producing adequate amounts of hormones, which is what's causing your symptoms.

In my opinion, what you should watch out for is that your symptoms will continue to get worse, as your thyroid hormone levels continue to drop lower.

When you talk to your doctor, talk to her about the possibility of Central hypothyroidism... many doctors miss this, because they only look at TSH.