Hashimoto's? Doctor not concerned, but lab results abnormal

[dakota1235]

I recently asked my doctor for a set of tests because I have had symptoms of Hashimoto's thyroiditis for the last 11 or so years. I have been trying to get pregnant and am concerned about the effect of untreated Hashimoto's on my fertility as well as health of any babies. Both my mother and aunt have Hashimoto's. My symptoms include:

Major depressive disorder , recurrent (currently in remission, d/t lots of exercise, stress reduction, therapy,and happy thoughts. =0p)

hair loss

brachycardia (resting pulse is from 46-68)

High cholesterol (204)

cold hands & feet

miscarriage & infertility

Heavy painful menstrual periods
(lasting 7 days) (losing approximately 6oz of blood per cycle)

FATIGUE (I routinely sleep 9+ hours per night , and still need a day time nap)

My lab results are as follows:
TSH                                         4.00 uIU/mL    Reference 0.28- 3.89
Free T4                                     0.88 ng/dL     Reference 0.58-1.64
thyroglobulin antibody               274 IU/mL       Reference <40
Thyroid Peroxidase antibody     932 IU/mL        Reference <35

I am not a pest, I go to my yearly physical, ask questions, and really don't bother my doc much. I exercise 7 days a week 25-45 minutes. I do not smoke, drink alcohol or caffeine. I work hard to control my stress levels, and am a generally happy person. I figured I was someone who needed more sleep than others and arrange my schedule so I can sleep more when I need it, but lately it has become excessive. My doctor is not concerned about these levels, and I must admit I am. I am wondering if they indicate Hashimoto's and if I should push for treatment or find a new doc who has some knowledge of thyroid disorders?

[TamraW]

Dakota, I strongly advise you find a new doctor, one who knows how to treat thyroid.

I started my Synthroid at 50 mcg. What you're taking, 25 is the lowest possible dose. My endo called it a child's dose. I didn't start feeling better until at 75, and even now, I still feel I need to be bumped higher.

Although it's good she started you on something, I fear she will leave you at 25 and not bump you in two months.

Bad idea.

Your antibodies are very high. Your FT4 is low, about the same as mine was when I started on 50. Your TSH is higher than mine ever was, and SHAME on the doctor for not testing FT3.

Take care...
:) Tamra

[dakota1235]

Thanks for the replies. I called my doctor, and we discussed it. She told me I should not have any concerns about getting pregnant (really?), and that most doctors and endo's would not treat me because my TSH is only a little high and my T4 is normal. I pushed a little and she agreed to start me on levothyroxine 25mcg, but told me "YOU have to take the weight off, the medicines don't do that for you". The frustrating thing is I am not seeking treatment because of my weight gain. I exercise daily, and I eat healthy, my major complaint is I am tired of being TIRED! I really felt she was saying I'm looking for an excuse to be fat, which I am not... It's disconcerting to be blown off, and reminds me why I gave up complaining about my symptoms after a few years, there was no point, no one listened and I felt like maybe I was just nuts.

However now that I am older I trust myself more, and I am glad I pushed for the tests I wanted. At least now I have some validation, and an explanation of my symptoms besides being told they are "psychological".

At any rate, hopefully I am at the beginning of solving my fatigue issues. In addition I started taking selenium 200mcg/daily, at the recommendation of a naturopathic doctor who I consult with occasionally.

[TamraW]

Here's a list of recommended endocrinologists state-by-state. Find an endo who treats your FT3/FT4 levels and your hypo symptoms! Not just a doc who looks at TSH in the OUTDATED lab range and sends you home. TSH is a pituitary hormone anyway, and doesn't always paint the full thyroid picture.

I have Hashi. My endo said she'd like to see my FT4 in the 1.6 range. Most Hashis feel better with frees on the higher end of normal. She doesn't like treating my FT3 levels. She doesn't believe in FT3, so I'm going to a new endo next week. Shop around. It's your body!!!

:) Tamra

Here's the link to recommended doctors:

http://www.thyroid-info.com/topdrs/

[Barb135]

Your TSH is higher than the currently recommended 0.3-3.0; even though your FT4 is in the range, it's most likely too low for you; your antibody counts are both high, indicating that you have Hashimoto's.  The  only thing I see missing is a Free T3 test, which I would ask for.  Free T3 is the active thyroid hormone that the body actually uses, so it's important to know that those levels are right for you also.  

Yes you should push for treatment.  I would go back to the doctor and ask for a low dose of thyroid T4 med - most likely synthroid, unless your doctor is okay with generic, to see if that would bring down your TSH and raise your FT4 levels.  Nothing will reduce the antibody counts, but med will most likely reduce the symptoms so you will feel better.  If you start med now and get tested regularly, you may be able to get by without some of the grief that some of us have gone through.  

Good luck and let us know how you do.