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Avatar universal

I don't know what to think on my thyroid issues!

September of last year I started to get alot of weird syptoms which I originally thought was low Testosterone. Testosterone blood tests came back almost perfect so I decided to see my Dr. because my symptoms were only getting worse and I also was now getting hyperpigmentatin on my face. My Dr. ordered blood tests on my thyroid because hypothyroidism runs on my moms side of the family. My first blood tests were: TSH .075 (.555 - 4.78) T3 33.4 (22.5 - 37) T4 8.5 (4.5 - 10.9) T3 Total 112.6 (60 - 81) Free T3 3.3 (2.3 - 4.2) Free T4 1.15 (.89 - 1.76) My Dr. immeadietly recomended me to a Endocronoligist. I finally after 6 months was able to see the Endo Dr. because it had been 6 months I had to get new blood tests and an Ultrasound done. The results were: TSH .567 (.550 - 4.78) Free T3 2.9 (2.3 - 4.2) Free T4 1.24 (8.9 - 1.76) My Utrasound result was that my thyroid is slightly enlarged. Because my 2nd round of blood tests were in the normal range he told me there's nothing he could do besides have me come back with new blood tests in 6 months. Normally I would agree with a Dr. but I have a list of about 12 symptoms ( Hyperpigmentation, lost 25 lbs and can't gain weight, shakiness, NO energy, nervous energy, shallow breathing, and more) I feel like I'm going crazy and no one is listening to me!! Did I just go to the wrong Endo? If anyone can even give me advice on what to think or what to do next, it would be greatly appreciated! Also I am a 34 year old Male and was in very good health before all this started a year ago.
6 Responses
Avatar universal
The symptoms you describe are typically hyper symptoms.  However, in both sets of labs, your FT4 is a little low of the 50% of guideline target at 30% in the first set and 40% in the second.  FT3 was in the upper half of range recommended, but has dropped (at 53% and 32%).  So, it seems there is inconsistency between your symptoms and your labs.  

Please list other symptoms.

T3 uptake, which you have listed as T3 33.4 (22.5 - 37), total T3 and total T4 are all considered obsolete.  The free T3 and free T4 are much more useful.  

Did anyone do any antibody tests?
Avatar universal
I should also have asked if your family history includes autoimmune disease, i.e. do your maternal relatives have Hashimoto's thyroiditis (ultimately hypo) or Graves' Disease (hyper)?
Avatar universal
Yes my mother has Hypothyroidism. Nobody did an antibody test. My symptoms are 1. Hyperpigmentation 2. Lost 25 lbs 3. Can't gain weight no matter how much I eat 4. memory loss (I can't think of certain words) 5. Fatigue (feel like I'm wearing a lead suit 6.Sleeping longer 7. Nervous energy (agitated/anxiety) 8.Irritable/frustrated/angry 9. Psoriasis 10.heavy chest/short breaths 11. Shaky hands 12. Sweating under arms for no reason 13. dizzy when I stand up 14. Tired after I eat. 15. strength/muscle loss All of these symptoms came on within 2 months. I was in relativly good shape and going to the gym 4 - 5 days a week before this. thank you for writing back to me
Avatar universal
Hashi's is the most prevalent cause of hypo, so there's a good bet your mom has it, but you can't be certain without antibody tests.  The two antibody markers for Hashi's are TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies).  You only have to be positive for one, so both have to be tested to rule it out.  You should both have those tested.

Hyperpigmentation isn't a symptom we hear often for either hypo or hyper.  Weight loss and inability to gain weight are hyper symptoms usually.  Memory loss is usually hypo.  Fatigue coupled with excess sleep is hypo, coupled with insomnia hyper.  Agitation and anxiety can be either.  Irritability and frustration can be either, but add the anger, and it's usually hyper.  Psoriasis we don't hear often for wither.  Shortness of breath is usually hyper (any changes in HR and BP?).  Hand tremors, sweating - hyper (intolerance to heat, i.e. you're hot when everyone else is comfortable?).  Dizziness upon standing is usually a sign of a drop in BP.  Lower BP is hypo.  Fatigue from thyroid tends to be more or less an all day thing and isn't usually related to a meal.  Strength and muscle loss can be either, too.  

Your FT3 and FT4 are a bit low, but I don't think they're low enough to give you all those symptoms, which are very mixed hypo and hyper.  Although thyroid symptoms can happen quickly, it's much more typical for them to come on very slowly.  As more and more thyroid function is compromised, we start racking up an array of symptoms.  

My suggestion on where to go from here would be to have those two antibody tests mentioned above.  If they're negative, you could still have thyroid disease, but it's a lot less likely.  In addition, since some of your symptoms are hyper, I think it would be a good idea to have TSI (thyroid stimulating immunoglobulin) tested.  TSI is the antibody involved in Graves'.  

What about vitamins and minerals?  Do you know what your iron (ferritin specifically), vitamin D and vitamin B-12 are doing.  Deficiencies of any of those can have symptoms similar to thyroid symptoms.  

Nothing about nodules in your U/S report?  Just a slight enlargement?

        
Avatar universal
Thank you for writing back such a detailed response! I really appreciate it and feel like you have taken more time then the Endo I saw did! I did actually have my TSI tested but do not see it on my results so I will call tomorrow and see if I can get the results Emailed to me. I am also definitely going to get the 2 antibody tests done. I never thought to get a blood test for vitamin deficiency. My symptoms being so mixed is very interesting. I don't know if it makes a difference but the anxiety,shakiness, and shortness of breath came on probably 2 years ago. It's almost a feeling of my "fight or flight" response is broken and I'm in that constant state of "fight or flight" Th other syptoms did come on quickly but about a year later. If I had to pick the top four it would be 1. Anxiety 2. Weight loss 3. Sweating under my arms 4. Fatigue. Would it not be normal if my Mom had Hypo and I have Hyper? Meaning is it thyroid problems that are genetic or usually more focused to hyper or hypo?

Again, thank you so much for the blood test ideas!
Avatar universal
My bill is in the mail!  LOL

Fight or flight is an adrenal response, and adrenals are notorious for trying to "take over" and make up for compromised thyroid function.  It works for a while, then the adrenals become fatigued.

Amazingly enough, it's autoimmune diseases that tend to run in families.  So, it's not unusual for one family member to have Graves' (hyper) and one to have Hashi's (hypo).  Furthermore, the autoimmune diseases are often not that related.  I know of a family in which one member has Hashi's and pernicious anemia, another has type I diabetes and a third has lupus.  So the connection seems to be "autoimmune".

We may inherit the tendency for our immune systems to go slightly whacky, and what it attacks affects each of us differently.  Once we have one autoimmune, we are more likely to get another than the general population is to get their first.  Some of us have all the luck!  
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