Hashimoto's symptoms not improving

[Krystinamarie]

I am 22 and I was diagnosed with Hashimoto's this last December and placed on 25mcg of Synthroid. I was told I wouldn't notice any improvement for 6-8 weeks but by the 8th week I felt just as bad as I did before starting medication. I spoke with my endocrinologist who ordered labs to make sure the dose was keeping my levels normal but he said the results all came back within normal range and to continue taking the medication. I have been tested for allergies and food intolerances, although I did not test positive for gluten or wheat I do avoid products containing them. I take the medication exactly as instructed. I feel like "continue to do what you're doing" is not a good enough option when I'm feeling so terrible.

Symptoms: Exhausted, unable to sleep, throat visibly swollen from the outside, nausea, unprovoked episodes where I have a hard time breathing, chest pain and heart flutters, moody, unable to concentrate, memory problems, dry skin, hair and nails, always cold with exception of hot flashes, very sore joints (wrists, fingers, hips).

Has anyone experienced this? Any suggestions as to what I should do now?

[Barb135]

Yes, thyroid can cause irregular periods.  

Just tell your doctor that you've read that AACE and ATA recommended that the reference range for TSH be changed, quite a few years ago and you're curious as to why old ranges are still being used.

Were you able to verify the range for your FT4?  Is what you posted the same as is on your lab report?  If so, I'd ask about that, as well.

[Krystinamarie]

Thanks for the info I'll definitely be taking these questions to the doctor next week. I just turned 22 so no menopause, but my periods are very irregular (I assumed due to the thyroid issues?)

Do you have any suggestions for how to bring up to this doctor that the ranges are out dated?

[Barb135]

Everything looks good... I'm most interested in the thyroid blood work, which is the TSH and the FT4 and those tell me right off the bat that, even though they are in the "normal" ranges, you're under medicated.

First off your lab is using are REALLY old range for TSH.  About 12 yrs ago, the AACE and ATA recommended that the range for TSH be adjusted to 0.3-3.0, so you can see how far out the range is that your lab is using.  If we switch over the "new" range, you can see that your TSH of 2.5 is pushing the top.

Also, please check the range for the FT4... the one you posted is very narrow; typically an FT4 range will be something like 0.8-1.8 or 0.6-1.7 or something like that.  

Most important is that your doctor is neglecting to test the most important hormone, of all, which is FT3.  FT3 is the active hormone that's used by every cell of the body and correlates best with symptoms.  

Are you at the age where you could be starting menopause also? I ask because of the hot flashes.  Have you had reproductive hormones tested?

[Krystinamarie]

Thank you for your reply! Below is all the info I have.

STAT WBC 10.3  (4.5-11.0)      10(3)/uL
RBC CNT  4.72  (3.8-5.2)    10(6)/uL
Hemoglobin 14.5  (12.0/16.0)
HCT  43.4  (35-47)
MCV 92.1   (80-100)
MCH  30.8  (26-34)
MCHC  33.5  (32.0-36.0)
RDW 12.4  (11.5-14.5)
PLATELETS 245  (150-400)
*PMV 10.4 (6.5-10.0)
*NEUTRO # 6.6  ((1.4-6.5)
NEUTRO % 64  (40-85)
LYMPH # 2.6  (1.0-3.4)
LYMPH % 25.4  (15-45)
*MONO#  0.8  (0.11-0.59)
MONO% 7.8  (4-11)
EOS# 0.2 (0-0.5)
EOSIN% 2.4 (0-8)
BASO# 0.0 (0.0-0.2
BASO% 0.4

STAT GLUCOSE 92  (74-106)
NA+ 137  (136-145)
CL- 104  (98-107)
CO2 26 (22-32)
ANION GAB 10.5 (10-20)
BUN 8 (8-26)
CREAT <0.6  (0.6-1.1)
ALBUMIN 4.6 (3.5-5.0)
CA+TOTAL  9.2  (8.9-10.3)
MG 2.1  (1.8-2.5)
PHOSPHORUS  3.2  (2.5-4.6)

LDH  135  (100-190)
AST  37  (15-41)
ALT  48  (14-54)
ALK PHOS 126  (38-126)
TBILI 1.0  (0.3-1.2)
PROTEIN TOTAL 7.5  (6.4-8.3)
ALBUMIN 4.6. (3.5-5.0)
GLOBULIN calc 2.9
A/G RATIO 1.59 (1.5-2.5)

ASAP TSH SENSITIVE 2.50  (0.34-5.60)
FT4  0.81 (0.61-1.12)

[Barb135]

I'm sorry to hear you're going through this. "Has anyone experienced this?"  Most of us have experienced this, at once time or another.  From your list of symptoms, it sounds like you may be under medicated.

Why don't we start off by having you post those "normal" test results, so we can see what your thyroid hormone levels actually are?  Be sure to include reference ranges, since those vary lab to lab and have to come from own report.

If you're in the U.S and your doctor didn't give you copies of your lab reports, you should ask for them.  Your doctor is required, by law, to provide them, free of charge, upon request.