Thyroid Disorders Community
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My Thyoid

Hi, I am a 19 year old female. I can't lose weight even though I mostly only eat fruits and vegetables. I am frequently constipated, don't want to move around and I have a lot of rashes, dry skin, and allergies. My TSH:1.49 (0.40-4.00) , FT4 0.9( 0.6-1.6 ), T3 88 (70-180 ). Could it be that my Thyoid is cause of my problems? Do I need to see a doctor? Thanks.  
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Avatar universal
The answers to your questions are yes and yes.  When it comes to diagnosing potential hypothyroidism, symptoms are the most important, followed by the biologically active thyroid hormones, Free T4 and Free T3.  You should make sure they always test for those, instead of Total T4 or Total T3 as reported above.  

From your test results your Free T4 is at only 30% of its range, which is lower than the 50% level that seems to work for most people.  Along with that Free T3 needs to be in the upper part of its range, and adjusted as needed to relieve hypo symptoms.  If your Free T3 is comparable to your Total T3, which is only at 16 % of its range, then that is far too low.  Most doctors would only pay attention to your TSH level and tell you that you don't have a thyroid problem.  In reality your relatively low TSH along with relatively low T4 and T3 is indicative of the possibility of central hypothyroidism.  Central hypothyroidism is a dysfunction of the hypothalamus/pituitary system that results in TSH levels that are too low to adequately stimulate the thyroid gland, resulting in insufficient T4 and T3.

Keep in mind that a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  So you need to find a doctor that will recognize central hypothyroidism and will also treat clinically, as described.  
Could anybody recommend a good doctor who can increase my Free T4 to 50% range and T3 to the upper part of the range? Thanks a lot.
Avatar universal
Avatar universal
Where are you located?
California and New York
Avatar universal
I don't mind to see doctor out of CA and NY if she /he is great. Thanks.
Avatar universal
I sent you a PM with info.  To access, just click on your name and then from your personal page, click on messages.
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Thanks for your email.

I know that central hypothyroidism is rare, but that mean that doctors rarely diagnose patients with it. Do you know which doctors are the top in country?

Avatar universal
The occurrence of central hypothyroidism is not rare at all, just the diagnosis it seems.  Since Doctors erroneously rely so heavily on TSH, they usually overlook central hypothyroidism.  A good thyroid doctor that treats for symptoms is obviously the best bet to get diagnosed and treated.  The doctor I gave you based on recommendations from thyroid patients should have no problem diagnosing and treating you.  
Avatar universal
Central hypothyroidism is not a rare disorder at all, just a rarely diagnosed disorder due to existing erroneous beliefs such as thinking that having a Free T4 at 30% of the range and a Total T4 at 16% of the range is fine, and not indicative of a thyroid issue.  Due to the erroneous assumptions used to establish reference ranges, test results in the lower end of the ranges should be suspect for hypothyroidism.  In addition, the symptoms of fatigue, constipation and dry skin are very frequently related to hypothyroidism.  
Avatar universal
Those symptoms are experienced nearly as frequently in healthy people as they are in people with hypothyroidism, as has been shown on scientific studies.  When combined with her very low levels of Free T4 and Total T3, that is strong evidence of hypothyroidism.  And no, I don't diagnose everyone as having central hypothyroidism, only those with such symptoms and test results, along with a relatively low TSH.  Even at that, you should note that I said "indicative of the possibility of central hypothyroidism".  The best way to be sure of a diagnosis of hypothyroidism is a therapeutic trial of thyroid med to adequately raise her Free T4 and Free T3 levels.

In addition, since hypo patients are so frequently too low in the ranges for Vitamin D, B12 and ferritin, Mission 2015 also needs to test for those and supplement as needed to optimize.  D should be about 50 min. B12 in the upper part of its range, and ferritin should be 70 min.  

And you are really off base in the last paragraph.  
Avatar universal
First sentence should read, "Those symptoms are experienced NOT nearly as frequently in healthy people as they are in people with hypothyroidism, as has been shown in scientific studies."
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