Hypothyroid symptoms, low t4 free, normal TSH and T3 free

[Danikeyser222]

Hi everyone,
I am new to the forum so please bare with me if this question has been asked before. Since I had my son, about 2.5 years ago (2nd child), I have the following symptoms (which have been in overdrive for the last 6-8 months):

- weight gain- Ive gained 10 lbs over the last couple of months (after running 25 miles per week and dieting) I have always been thin and usually could lose weight just thinking about it

- extreme fatigue - so hard to get out of bed in the am but I thought it was because I had a hard time falling asleep and staying asleep

- dry skin

- swelling- face and hands, water retention and bloating in belly

- foggy and memory loss. I couldn't remember parts of conversation that I had just the night before and just felt like I was on a cloud throughout the day

- anxiety because of all of the symptoms

- very low libido

I'm sure there is more that I just can't remember right now :/

I've been to a GI Dr. for my chronic constipation, weight gain despite exercise and diet, and water retention and bloating - NOTHING

I was diagnosed with PCOS about 3.5 years ago while having difficulty trying to conceive my son. It took 2 IUI's before we became pregnant.

I went to ENT for dizziness and foggy feeling thinking it was related to sinus issues. NOTHING

My primary sent me for an ultrasound of my gall bladder (because of the GI issues) and said to have them look at my thyroid too because he felt it looked larger than usual. Gall bladder was fine but the found 2 complex cysts. Followed w/ u/s 3 months later and the one shrunk and the other grew so I had a biopsy 2 days ago. Waiting for those results.

I am just seeking treatment now because I am a nursing student and thought that my symptoms were due to stress but they have worsened and the weight gain is very rapid and unexplainable.

Anyway, after they found the cysts I scheduled with the first endo I could find. He took the blood work results from my primary and said my tsh and t3 levels were normal. I demanded (nicely) that he run them again (3 months later) and include the t4free, t3 free and tsh. these were the results (including glucose and isulin to ck for insulin resistance with the weight gain and PCOS:

TSH - 1.25
T4 free  1.0
T3 free  3.1

fasting glucose 94
insulin < 2
c - peptide  0.94

Now I am waiting for my biopsy results to go in and discuss all of my symptoms and lab results with him. In the meantime I called and asked for a lab slip to check my cortisol levels and for the thyroid antibodies. I read that a normal tsh and low t4 could indicate a pituitary issue.

So my questions are, am I requesting the correct tests and is there any thing else I should request?

If he is willing to do so, do you think I could benefit from hypo meds?

I absolutely hate taking any medication at all. I fractured my femur a few years ago and couldn't stand to take the pain meds because of how they made me feel.

But my current symptoms are almost debilitating some days and I have developed such anxiety in trying to learn what it is. There is definitely something wrong and I am desperate to find answers.

I apologize for the length of this. Your suggestions and opinions are much appreciated. I just want to feel better... especially before I am 100 lbs over weight!

Thank you,
Danielle

[Croman]

I have a similar problem. We have a history of hypothyroidism in female members of my family.

I did a blood test in my home country, while I was on vacation, and it flagged TSH as high.

When I got back in the US I did more thorough test for thyroid and he results were
In October 2014 these were my tests results:
TSH 0.50-4.50 mcIU/mL 3.96
Free T4 (Thyroxine, Free) 0.8-1.8 ng/dL 1.0
T3 free they didn't do.
Ferritin 13-150 ng/mL 11
Glucose  90
Insulin they didn't do.

My doctor said it is all normal and gave me some iron that has gone up to 22 in 4 months.

I have a lot of symptoms of hypothyroidism:
depression
fatigue
very low libido
dry skin (my psoriasis if getting wild)
weight gain
lack of physical activity due to general tiredness and fatigue

Do you think I should repeat my test now after 4 months?
Which test should I look for?

Thanks for the help

[Mugski]

I swear I was reading a letter that I wrote when I read your post!!
I have hypothyroidism,PCOS & had fertility issues too. Your symptom list made my jaw drop because they're my symptoms too. The foggy feeling is hard for everyone to understand unless you've experienced it. I swear if it weren't for having to get my kids to school,I wouldn't even get out of bed somedays because of the way my head feels & the fatigue.

[Danikeyser222]

Oh ok, now I understand. My thyroid ultrasound said the size of my thyroid is normal but I had the two nodules. I'm awaiting the biopsy results now.

[Barb135]

TSH and FT3/FT4 aren't indicators of Hashimoto's.  They only indicate how well the thyroid is functioning, as in hyper or hypothyroidism.

Antibodies and a thyroid ultra sound are what diagnoses the autoimmune aspect.

I've read that about 10% of people with Hashimoto's don't have positive antibodies.  An ultra sound could also diagnose it, if there is swelling and inflammation present, along with nodules.

There are also other types of hypothyroidism, as well, though Hashi's is much more common.  

[Danikeyser222]

I had the blood work done yesterday to check for the antibodies. If the results don't show the antibodies, is there still I chance I may have it then? Or are u just referring to the t3, t4, and tsh not showing Hashimoto's just yet?

[Barb135]

The pituitary is what drives the endocrine system, including thyroid, adrenals, reproductive system, etc.  TSH is actually a pituitary hormone, produced to stimulate the thyroid into producing hormones.  

I'm not saying there's nothing wrong with your pituitary; just that pituitary issues are relatively rare, whereas Hashimoto's is very common and it's not unusual for symptoms to show up, long before blood tests indicate a problem.