Not Sure Whether to Pursue the Thyroid Angle

[Chocominto]

About a year and a half ago I went to my GP at the time and had him test my thyroid levels to see what might be going on with my body.  I've always had symptoms that, when described to medical professionals, "sounded like a thyroid problem."  What finally caused me to ask for a test was that I gained a significant amount of weight in a short period of time, on top of all my other problems.  I'm talking 20 pounds in 6 weeks, when I was previously about 5'2" and 120.  

My GP was, to say the least, unconcerned.  His attitude was very much that I must have caused it somehow, but he ran the tests anyway.  The results were:

TSH of 1.64 (range = 0.40 - 4.50)
Free T4 of 1.1 (range = 0.8 - 1.8)

And that was the end of it.  He declared that there was nothing wrong with me, even though I was still fatigued, still cold, and so on.

18 months later and I'm still suffering, and the weight hasn't budged.  I've tried just about everything, but I can't lose it.  I exercise and I only seem to get bigger, not smaller.  I cut out dairy or desserts for months and see no change whatsoever.   I'm already on a special diet for celiac, so it's not a case of "you just don't know how many calories are in a donut."  For most of this period, I didn't have a car and was walking considerable amounts every day in addition to the extra exercise.  It's baffling.  And expensive, since I had to buy all new pants and may have to buy more soon.  

So I'm not sure where to go from here.  Both levels are in the normal range, and I guess hypothyroidism would require a much higher TSH level?  But the T4 is on the lower end of the range, so I'm kind of confused.  I want to go see a doctor and broach the subject of being exhausted all the time, the weight thing, my flaking and peeling skin and recent bout with hair loss, but I'm not sure if the thyroid angle is one to even pursue.  Sure, it might have changed in the last 18 months, but whatever was wrong then is still wrong now.  My last doctor considered those numbers not even worth thinking about.  If I go see a new doctor I just want to know if my previous labs are even worth bringing up.  I keep hoping that one day I'll mention my symptoms to a doctor and they'll know exactly what it is and give me the magic cure, but I may as well wish for my very own unicorn.    

Any advice would be appreciated.  Thanks in advance!

[Red_Star]

"It has been shown in studies that the prevalence of celiac disease in patients with autoimmune thyroid disease is 4-15 times greater than that in the general population. Various findings for the prevalence of celiac disease in Hashimoto's thyroiditis have been reported, between 3.3% and 4.8% in adults. According to a 2007 study published in the World Journal of Gastroenterology, patients with Hashimoto's thyroiditis should be screened for celiac disease and patients with known celiac disease should be screened for Hashimoto's thyroiditis." - Celiac Central - Thyroid Disease.

Tests include TSH, free T4, free T3 and thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb).

[gimel]

Your doctor did not do you any favors.  He basically ignored your symptoms and your low in the range Free T4 test and decided that your TSH showed that you were not hypothyroid.  Obviously he doesn't think about the possibility of central hypothyroidism, which is a dysfunction in the hypothalamus/pituitary system that results in TSH levels that are too low to stimulate the thyroid gland to produce adequate thyroid hormone.  It is too bad that your doctor did not bother to test you for Free T3.   It is an important test for potential hypothyroid patients.  

Note the following.  In the words of a good thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve hypo symptoms.   So that is the type of doctor you need.  You can get some good insight from this link written by a good thyroid doctor.  Also, you might try to give your doctor a copy of the link and request further testing and consideration of the possibility of central hypothyroidism, and the need for thyroid med to  increase your Free T4 and Free T3 levels adequate to relieve symptoms.

http://www.hormonerestoration.com/Thyroid.html

If you are successful with that you should also request to be tested for Vitamin D, B12 and ferritin.  Hypo patients are frequently too low in the ranges for those, with resultant symptoms that can mimic hypothyroidism.  D needs to be about 55-60, B12 in the upper end of its range, and ferritin should be about 70 minimum.  Low ferritin can also contribute to hair loss.

If you are unsuccessful with your doctor, we may be able to suggest a doctor for you, if you will tell us your location.