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Thyroid concerns
I am at a total loss. I am so frustrated and depressed about the symptoms I am having and no one seems to be able to figure out what is going on. Here is my story.
My mother had thyroid cancer when she was about 35 and had surgery to have it removed. She currently takes thyroid medication. Given my prolonged symptoms, it is obviously a concern since it is hereditary. Everyone I have gone to tells me my levels are completely in the normal range, but, so were my Mom's and she has thyroid disease. She has hypothyroidism. She always says "What is normal for one person is not normal for another person." I am a 42 year old white female and here are my symptoms: Constantly exhausted, extreme intolerance to heat, dry/itchy skin that almost drives me insane and for which I have to always be taking Benadryl to get any relief, depression, muscle aches throughout my body, constant pounding headaches from the moment I wake up to the moment I go to bed and I wake up in the middle of the night with a headache and am then up for anywhere from 2-3 hours, forgetfulness and serious problem concentrating. I have also gained about 15 lbs in the last couple years. I'm just so sick of it all.
My TSH in 2006 was a 2.46. In 2007, it dropped to .85 and has stayed there ever since. Because I was also concerned about the possibility of pre-menopause, I had so much lab work done in July 2013 that I don't know if there was anything I wasn't tested for. My results related to thyroid were as follows:
T3 Free: 4.2 (normal: 2.8-5.2)
T4 Free: 1.1 (normal: .80-2.2)
TSH: .85 (normal .30-5.0)
TSI: <89 (normal ?)
Thyroperoxidose AB: 4 (normal 0-8)
I have a slew of other blood test results I can provide as well. Others that concerned me, but may have nothing to do with this, are:
TIBC: 265 (normal 240-430)
Glucose: 81 (normal 70-180)
Ferritin: 30 (normal 10-120)
EOS: 1 (normal 0-8)
EOS Absolute: .1 (normal .0-.5)
I take multiple medications, including:
Lamictal: Seizures
Sertaline: Depression (though it doesn't seem to be doing anything for me - I am going to a psych to have checked)
Adderall: to try and address my forgetfulness and difficulty concentrating
Trazadone: otherwise I have complete insomnia (lately I have had insomnia despite taking this)
Hydrocodone: the ONLY thing that gives me even a brief period of relief from my headaches
Propranolol: just started as another option for addressing headaches
My headaches and exhaustion have been over the top this last 1-2 weeks, where the Hydrocodone is providing relief for shorter and shorter periods of time. Despite this, I am not taking any more than prescribed because that's not a road I want to go down; I don't want to be taking it at all. So, I am just having to suffer through them.
I feel like I am a mess and just don't know where to turn. I have asked my PCP and another nurse specialist if we could at least TRY a thyroid medication to rule it out but no one will.
My mother had thyroid cancer when she was about 35 and had surgery to have it removed. She currently takes thyroid medication. Given my prolonged symptoms, it is obviously a concern since it is hereditary. Everyone I have gone to tells me my levels are completely in the normal range, but, so were my Mom's and she has thyroid disease. She has hypothyroidism. She always says "What is normal for one person is not normal for another person." I am a 42 year old white female and here are my symptoms: Constantly exhausted, extreme intolerance to heat, dry/itchy skin that almost drives me insane and for which I have to always be taking Benadryl to get any relief, depression, muscle aches throughout my body, constant pounding headaches from the moment I wake up to the moment I go to bed and I wake up in the middle of the night with a headache and am then up for anywhere from 2-3 hours, forgetfulness and serious problem concentrating. I have also gained about 15 lbs in the last couple years. I'm just so sick of it all.
My TSH in 2006 was a 2.46. In 2007, it dropped to .85 and has stayed there ever since. Because I was also concerned about the possibility of pre-menopause, I had so much lab work done in July 2013 that I don't know if there was anything I wasn't tested for. My results related to thyroid were as follows:
T3 Free: 4.2 (normal: 2.8-5.2)
T4 Free: 1.1 (normal: .80-2.2)
TSH: .85 (normal .30-5.0)
TSI: <89 (normal ?)
Thyroperoxidose AB: 4 (normal 0-8)
I have a slew of other blood test results I can provide as well. Others that concerned me, but may have nothing to do with this, are:
TIBC: 265 (normal 240-430)
Glucose: 81 (normal 70-180)
Ferritin: 30 (normal 10-120)
EOS: 1 (normal 0-8)
EOS Absolute: .1 (normal .0-.5)
I take multiple medications, including:
Lamictal: Seizures
Sertaline: Depression (though it doesn't seem to be doing anything for me - I am going to a psych to have checked)
Adderall: to try and address my forgetfulness and difficulty concentrating
Trazadone: otherwise I have complete insomnia (lately I have had insomnia despite taking this)
Hydrocodone: the ONLY thing that gives me even a brief period of relief from my headaches
Propranolol: just started as another option for addressing headaches
My headaches and exhaustion have been over the top this last 1-2 weeks, where the Hydrocodone is providing relief for shorter and shorter periods of time. Despite this, I am not taking any more than prescribed because that's not a road I want to go down; I don't want to be taking it at all. So, I am just having to suffer through them.
I feel like I am a mess and just don't know where to turn. I have asked my PCP and another nurse specialist if we could at least TRY a thyroid medication to rule it out but no one will.
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COMMUNITY LEADER
There are a couple of things I'd like to comment on. First off, your thyroid levels are "in range", but your FT4 is very low. Your FT3 is at 58% of its range, which isn't so bad, considering that you aren't on medication.
One thing I noticed was that the only antibody you were tested for was Thyroid Peroxidase Antibodies (TPOab). To diagnose Hashimoto's, which is the most common cause of hypothyroidism in the developed world, you have to also have Thyroglobulin Antibodies (TgAB). Some people with Hashimoto's only have TPOab, some have only TgAB, and still others have both. In order to diagnose Graves Disease (unlikely) you need a Thyroid Stimulating Immunoglobulin (TSI), which is the definitive test.
Hashimoto's is most often associated with hypothyroidism, but in early stages, can be characterized by periods of hyperthyroidism, as well.
Another thing I noticed is that your TIBC is pretty low in the range, as is your ferritin. Ferritin is an iron storage hormone and low levels indicate low levels of iron. Ferritin should be somewhere around 70. Was there an actual iron test done?
You said you had more tests that you could post. Was there a CBC done? If so, was anything out of range? Vitamin B12? Vitamin D? If you have results for Vitamin B12 and D, please post them, with reference ranges.
I'm not real impressed with your Endo Specialty Center; they left a few stones unturned.
That said, you're on quite a cocktail of medications, and some of those (hydrocodone, in particular) can cause extreme fatigue/exhaustion, plus they have other side effects. You might want to research all their side effects and see if they might be part of your problem.
One thing I noticed was that the only antibody you were tested for was Thyroid Peroxidase Antibodies (TPOab). To diagnose Hashimoto's, which is the most common cause of hypothyroidism in the developed world, you have to also have Thyroglobulin Antibodies (TgAB). Some people with Hashimoto's only have TPOab, some have only TgAB, and still others have both. In order to diagnose Graves Disease (unlikely) you need a Thyroid Stimulating Immunoglobulin (TSI), which is the definitive test.
Hashimoto's is most often associated with hypothyroidism, but in early stages, can be characterized by periods of hyperthyroidism, as well.
Another thing I noticed is that your TIBC is pretty low in the range, as is your ferritin. Ferritin is an iron storage hormone and low levels indicate low levels of iron. Ferritin should be somewhere around 70. Was there an actual iron test done?
You said you had more tests that you could post. Was there a CBC done? If so, was anything out of range? Vitamin B12? Vitamin D? If you have results for Vitamin B12 and D, please post them, with reference ranges.
I'm not real impressed with your Endo Specialty Center; they left a few stones unturned.
That said, you're on quite a cocktail of medications, and some of those (hydrocodone, in particular) can cause extreme fatigue/exhaustion, plus they have other side effects. You might want to research all their side effects and see if they might be part of your problem.
Hi Dee,
Thank you so much for the response. I have actually gone to my PCP and to an Endo Specialty Center - which is where they did all the blood work. That's part of why I'm so frustrated because they simply said, well, we don't know what it is but your thyroid is fine. Interesting what you said about not taking meds when your TSH is that low. I guess I figured if it was that low (or really high), that meds were the answer. I am going to look up Haishimotos and Graves. Those do not run in my family, but, you never know.
I really appreciate you taking time out of your life to provide me support. It means a lot...
Thank you so much for the response. I have actually gone to my PCP and to an Endo Specialty Center - which is where they did all the blood work. That's part of why I'm so frustrated because they simply said, well, we don't know what it is but your thyroid is fine. Interesting what you said about not taking meds when your TSH is that low. I guess I figured if it was that low (or really high), that meds were the answer. I am going to look up Haishimotos and Graves. Those do not run in my family, but, you never know.
I really appreciate you taking time out of your life to provide me support. It means a lot...
Hi there, I am so sorry for what you are experiencing. With such a low tsh I can see why they do not want to try medication.
Mine was that low when I was on medication and I was told to reduce the meds.
I do understand all about having symptoms while it it is not showing up on blood work. Blood work is not the only thing they are supposed to go by. They are supposed to go by your symptoms.
I had hypothyroid though instead of being cold I was hot like you.
Have you thought of going to an endocrinologist? Have you been checked for Haishimoto disease? My Aunt was diagnosed with both Haishimoto and Graves disease a very dangerous illness.
I hope you can find some answers.
Mine was that low when I was on medication and I was told to reduce the meds.
I do understand all about having symptoms while it it is not showing up on blood work. Blood work is not the only thing they are supposed to go by. They are supposed to go by your symptoms.
I had hypothyroid though instead of being cold I was hot like you.
Have you thought of going to an endocrinologist? Have you been checked for Haishimoto disease? My Aunt was diagnosed with both Haishimoto and Graves disease a very dangerous illness.
I hope you can find some answers.
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