please help me to diagnose Hypothyroidism

[VKD123]

if i have Hypothyroidism please let me know.
please help me to diagnose...so that i can start the treatment regarding this.

Symptoms:
my age is 28 yrs old male single. height 5'7"., weight is 56 kg., waist is 35 c.m.
i am P.G in computer science.
i am taking the stress without any reason.
i have constipation problem from a lot of years.
i have also stammering from a lot of years
i am also weak from physical point of view.

some time feel weakness in leg's (some time i can not fastly run)
some time feel tiredness, stress, weak of memory, confusion, poor concentration etc.
my sleeping duration is 6.30 to 7 hours.
some times feeling of disturb sleeping.

hair fall from 5 years. hair are removed from scalp.
some white hairs are also come from previous some months and having some dandruff too
i have taken multi vitamins for some months. but not get the benefit in hair fall.

psychiatrist diagnosed O.C.D (obsessive compulsive) in year 2003.
i have taken the treatment for lot of years.
one or two symptoms was treated at starting of medicines. but some religious thoughts symptoms are persist. they are not treated. now a days i have stopped all the medicines.
i have discussed with my doctor, they said if we will start new medicines and counseling session.

i am doing computer job. 9 hours sitting on computer
i am doing daily traveling of 120 km by train or bus to reach my office and home.

i do some exercise on week end days.
also having stomach obesity from 12 years.

i am taking homeopathic medicine from one and half year for hair fall but not getting any positive effect.

my E.C.G reports are normal.

please review my blood test including throid which are done in last month.

my blood reports are as follows:

i gave these blood sample at 11.30 A.M.

Normal Blood Test report

HAEMATOLOGY
HB: 11.5 gms% (Normal: M 12-16, F 11-14gms%)
TLC: 9,300 /cu.mm (Normal: 4000-11000 /cu.mm)
POLYMORPHS: 69% (Normal: 40-75%)
LYMPHOCYTES: 23% (Normal: 20-45%)
MONOCYTES: 03% (Normal: 2-10%)
EOSINOPHILS: 05% (Normal: 1-6%)
BASOPHILS: 0% (0-1%)
ESR: 10mm 1st Hours (Normal: 0-20 mm 1st Hours)
PLATELET COUNT: 2.67 Lakh/cmm (Normal: 1.5-4.5 Lakh/cmm)
PBF MP: Not-Seen

BIOCHEMISTRY
BLOOD SUGAR PP/RANDAM: 119 mg/dl (Normal: 70-140 mg/dl)
BLOOD UREA: 34 mg/dl (Normal: 15-45 mg/dl)
S.CREATININE: 1.1 mg/dl (Normal: 0.4-1.4 mg/dl)
S.BILIRUBIN (TOTAL): 0.9 mg/dl (Normal: 0.1-1.0 mg/dl)
S.BILIRUBIN (DIRECT): 0.3 mg/dl (Normal: 0.1-0.3 mg/dl)
S.BILIRUBIN (INDIRECT): 0.6 mg/dl (Normal:0.1-1.0 mg/dl)
S.G.O.T: 28 IU/L (Normal: 0-40 IU/L)
S.G.P.T: 35 IU/L (Normal: 0-40 IU/L)
S.SODIUM: 138 mEq/L (Normal: 136- 142 mEq/L)
S.POTASSIUM: 3.9 mEq/L (Normal: 3.8- 5.0 mEq/L)

=======================================

i have gave blood sample for T3 free, T4 free, TSH, ANTI TPO, ANTI Tg at 9.30 A.M with empty stomach.

Test Name:
T3, Free; FT3:
Result:
3.03
Units:
pg/mL
Ref. Range:
2.30 - 4.20
===================================
Test Name:
T4, Free; FT4:
Result:
1.12
Units:
ng/dL
Ref. Range:
0.70 - 1.51
===================================
Test Name:
TSH, Ultrasensitive:
Result:
2.929
Units:
uIU/mL
Ref. Range:

0.550 - 4.780
=========================================

Test Name:
ANTI THYROID PEROXIDASE ANTIBODY; ANTI TPO (CLIA):

Result
21.00

Units
U/mL

Ref. Range
(<= 60.00)
==============================================
Test Name:
ANTI THYROGLOBULIN ANTIBODY; ANTI Tg
Result
22.30
Units
U/mL
Ref. Range
(< 60.00)

==========================================

i gave these blood sample at 11.30 A.M.

THYROID PROFILE, TOTAL (CLIA)

T3, Total: 0.79 ng/mL (0.60 - 1.81)
T4, Total: 6.80 ug/dL (5.01 - 12.45)
TSH: 3.93 uIU/mL (0.35 - 5.50)

Note: TSH levels are subject to circadian variation, reaching peak levels between 2 - 4 a.m and at a minimum between 6-10 pm. The variation is of the order of 50%, hence time of the day has influence on the measured serum TSH concentrations.
2. Recommended test for T3 and T4 is unbound fraction on free levels as it is metabolically active.
==========================================

please suggest me to take a better decision so that i can resolve my problems.
thanks.

[VKD123]

Thanks gimel for your response.

[gimel]

First, let me make sure you understand that this is the patient Forum on Thyroid, and that I am not a doctor, just a patient like yourself.  

As for treatment I suppose it should be allopathy, although many conventional doctors have the "Immaculate TSH Belief" and only want to diagnose and medicate based on TSH.  Others mistakenly think that if a FT3 and fT4 test result falls even within the very low limit of the so-called "normal" reference ranges, then everything is okay and you need nothing further.  Neither of these beliefs works for a hypo patient.  What you need is a good thyroid doctor that will treat you clinically as I described in my prior post.

Loss of hair is a frequent symptom of hypothyroidism, so clinical treatment for being hypo should take care of that.  As for OCD, that is totally different and I think would be best treated separately by a psychiatrist.  

[VKD123]

Dear Sir,

Thank you for your response.

some questions are raising in my mind.

- which treatment will be the best for me allopathy or homeopathy or both for thyroid?

- should we start the treatment for O.C.D from psychaitry and hairfall treatment from a skin doctor with starting thyroid treatment or only thyroid treatment is sufficient for now?

please suggest.

[gimel]

Sorry, made a typo in last paragraph.  First sentence should have read that the med needed will be a desiccated, T4/T3 combo type, or as an alternative, a synthetic T3 type.

[gimel]

From those symptoms and your FT3 test, I'd say that you are hypothyroid and in need of medication, mainly to increase your FT3 level as necessary to relieve symptoms.  Symptom relief should be all important to you, not test results.  Test results are valuable mainly as indicators during diagnosis and then afterward to track FT3 and FT4 levels, as meds are increased to relieve symptoms.    

FT3 is the most revealing thyroid hormone test because FT3 is the biologically active portion of Total T3, and it largely regulates metabolism and many other body functions.  Scientific studies have shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not correlate very well at all.  The main value of T4 is as a storage hormone, available for conversion to T3 as needed.  Conversion does not always happen as needed, resulting in relatively low FT3, like yours.

Just because your FT3 and FT4 levels are within the so-called "normal" ranges does not mean that they are okay for YOU.  The ranges are far too broad for that to be the case.  The ranges should be considered as guidelines within which to adjust levels as necessary to relieve symptoms.  Many of our members report that symptom relief for them required that FT3 was adjusted into the upper third of the range and FT4 adjusted to at least the midpoint of its range.  A good thyroid doctor understands this and is willing to treat a hypo patient clinically, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms without being constrained by resultant TSH levels.  Again symptom relief should be all important.


You can get some good insight into clinical treatment of hypo patients by reading the letter in this link.  It was written by a good thyroid doctor for patients that he is consulting with from a distance.  The letter is sent to the Primary Physician of the patient to help guide treatment.  

http://hormonerestoration.com/files/ThyroidPMD.pdf

With your test results, the med needed will be a desiccated, T4/T3 combo type or as an alternative, a synthetic T4 type.  Either can be used to raise your FT3 level as necessary to relieve symptoms.  I know from past experience with another member from India that T3 meds are not so readily available.  In fact he was told they were not prescribed in India.  I found this was not true by looking at the listing of Top Thyroid doctors in India and finding mention of prescribing T3 for a patient.  So you may have to do so searching for a doctor that will prescribe.