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Hypothyroidism?
For the past few months I've been experiencing hypothyroidism symptoms: chronic fatigue, hair loss, joint pain, constant coldness, memory loss/foggy-ness, lack of concentration, irritability, heavier menstration, constipation. The symptoms hav worsened the past 3 weeks. I especially feel exhausted all the time, no matter how much sleep I get. My mother was diagnosed with hypothyroidism 2 years ago. It's been very frustrated and scary for me because I feel my health has changed drastically. I met with an NP to explain this and was told I should just eat healthy and exercise more. I had the TSH test done and the results came back as normal. She also tested for total t3 and t4 which came back normal. When I explained I had seen research that the TSH is not always reliable she said its very sensitive and accurate so I clearly do not have a thyroid problem. However, the symptoms are very overwhelming. She screened me for depression and anxiety and I explained that I'm anxious because of these physical health concerns. I'm not really sure how to proceed and I feel a bit trapped by my insurance coverage as well. Any advice would be very welcomed!
COMMUNITY LEADER
Not all endos are good thyroid doctors and many don't believe in testing both FT3 and FT4. We have quite a few members whose endos are still stuck on TSH. Sad, but true.
You can insist upon seeing an endocrinologist. They would order the correct labs.
Thank you so much!!! That is what I thought but by the NP's responses I felt like maybe I had heard incorrectly. I did request testing for B12 and D in case there are deficiencies there and I should know those results in the next few days. The results are as follows:
TSH 2.30 reference range .27-3.5 miu/l
T3 total 101 ref range 80-200 ng/dl
T4. 6.0 ref range 5.1 -14.1 ug/dl
TSH 2.30 reference range .27-3.5 miu/l
T3 total 101 ref range 80-200 ng/dl
T4. 6.0 ref range 5.1 -14.1 ug/dl
COMMUNITY LEADER
You are correct that TSH is not a good indicator of thyroid status. Find a different doctor and get tested for Free T3 and Free T4. Total T3/T4 are considered obsolete and of little value, but since that's all you have, please post the results, along with the reference ranges from your lab report. That will give us something of an idea where you stand.
You should get antibody testing to see if you have Hashimoto's Thyroiditis. With Hashimoto's, it's not unusual for symptoms to appear long before labs indicate a problem. The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). With Hashimoto's, the destruction of the thyroid is continuous and eventually, this will show up in your blood tests. Hopefully, though you might be able to find a doctor willing to treat sooner, rather than later.
There are also some vitamin/mineral deficiencies that can cause hypo-like symptoms that you might want to have checked, as well. Those include Vitamins B12 and D.
You should get antibody testing to see if you have Hashimoto's Thyroiditis. With Hashimoto's, it's not unusual for symptoms to appear long before labs indicate a problem. The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). With Hashimoto's, the destruction of the thyroid is continuous and eventually, this will show up in your blood tests. Hopefully, though you might be able to find a doctor willing to treat sooner, rather than later.
There are also some vitamin/mineral deficiencies that can cause hypo-like symptoms that you might want to have checked, as well. Those include Vitamins B12 and D.
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Both your Total T3 and T4 are quite low in their ranges. Considering that some of each will be bound by protein and unusable, it's safe to assume that your frees would be low enough in their ranges to cause hypo symptoms.
Your T4 is only 10% of its range, indicating that your thyroid output is definitely lacking. Your T3 is only 17.5% of its range.
Thyroid 101: The pituitary senses that there's not enough thyroid hormones, so it puts out TSH to stimulate the thyroid. The thyroid produces T4 hormone and a very little T3. T4 is converted, mostly by the liver, but also some by other organs, into T3.
Some of the T4 will be bound by proteins and will be unavailable for conversion. That's where the "free" T4 comes in; the free is what can actually be converted to T3. Once converted to T3, again, some of the T3 will be bound by protein and unusable; the portion not bound by protein (free) is what's actually used by the individual cells.
You can try going back to the NP and requesting the FT3 and FT4 tests, but I'm guessing you won't get real far. If you can't get her to test them, you can either try a different doctor or you can order them online and once you have the results in hand, go back to the NP and show her. Sometimes, doctors will listen if you have labs in hand. Healthcheckusa is an online sight that I, and others, have used successfully, but there are others. You order the tests, they e-mail you a lab order and tell you what lab to go to in your area, you get the blood draw, then a couple of days later, they e-mail the results directly to you, with a hard copy followed up in the mail.