Thyroid Disorders Community
26k Members
Avatar universal

What should I be asking?

TSH 2.57 (.450 - 4.50) , PTH Intact 29', High cholesterol for many years that does not respond to meds, osteoperosis for 10 years not responding to meds, latest symptom is hair loss of eyebrows, arms, legs and some scalp thinning.  Dr. said thyroid issue is  unlikely.  I am a 55 year old female.  Can you help me understand?
11 Responses
Avatar universal
Your doctor will never know for sure if you have a thyroid problem or not if not tested further.  TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as the sole diagnostic for thyroid.  At best TSH is an indicator to be considered along with more important indicators such as symptoms (which you have), and also levels of the biologically active thyroid hormones, Free T3 and Free T4.  Of these Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have also shown that Free T3 correlated best with Free T3 and Free T4 and TSH did not correlate at all.

You may have secondary hypothyroidism which is due to low output of TSH by the pituitary.  This obviously will result in low levels of Free T3 and Free T4.  To find out, you need to test for Free T3 and Free T4, along with TSH each time you go in for followup.  If the doctor resists, then you should insist on it for the above reasons, and don't take no for an answer.  Since hypothyroid patients are frequently low in other areas as well, I suggest that you should also test for Vitamin A, D, B12 and ferritin.

When test results are available, if you will please post results and their reference ranges shown on the lab report, members will be glad to help interpret and advise further.
1756321 tn?1547098925
"Symptoms of Low Thyroid

Being one of the master regulators of body metabolism, symptoms of low thyroid function generate a global response. Symptoms include:

• Fatigue and low energy, with need for daytime nap.
• Depressed, down, or sad.
• Skin that becomes dry, scaly, rough, and cold.
• Hair becomes coarse, brittle, and grow slow.
• Excessive unexplained hair loss.
• Sensitivity to cold in a room when others are warm.
• Difficulty in sweating despite hot weather.
• Constipation that is resistant to magnesium supplementation.
• Difficulty in loosing weight.
• Unexplained weight gain.
• High cholesterol resistant to cholesterol lowering drugs."

Excerpt from Dr Lam website - Hypothyroidism
Avatar universal
Thank you!  You have empowered me.  The doctor's office just called, and he is agreeing to refer me to an endo because my liver panels are worse (despite being off all cholesterol drugs).  Tomorrow I am going to the derm and I am going to insist on the thyroid tests that you suggested.  I have lived with the high cholesterol, the osteoperosis, but the hair loss is just too much!  Can a thyroid issue effect liver panels?  Thanks again!
Avatar universal
There is definite relationship between hypothyroidism and liver function.  If you search for that subject on line you will see numerous articles about it.  

As I thought about your osteoporosis, I happened to think that you might like to read this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance after the initial diagnosis and testing.  The letter is then sent to the participating PCP of the patient to help guide treatment.


In the letter, please note the directive about clinical treatment.  Also, note this statement.  

"Thyroid hormone does not cause bone loss, it simply increases metabolism and therefore the rate of the current bone formation or loss. Most older women are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies. The solution is not (to live with) life-long hypothyroidism, but the correction of their other deficiencies."  
Avatar universal
I don't know who you are, or how you know so much, but I really appreciate your kindness.  It is really good of you to reach out to others.  I cannot wait to get the endo.  In the meantime, is there anything I can do by myself with diet?  My B12, iron and hemoglobin levels are all good.  I think it may take weeks before I can get an appointment, and the hair loss is tough to take (I am so vain!)


Avatar universal
We have many experienced and knowledgeable members who spend lots of their time learning about thyroid problems and trying to help other members.  That is what happened for me, so I am just passing whatever I can to others.

Please make sure you get all those tests I suggested done tomorrow and then post results and reference ranges.  I can't think of anything further to recommend while waiting for test results.  

I don't want to rain on your parade, but just because a doctor is an Endo does not mean a good thyroid doctor.  Many of them have the "Immaculate TSH Belief" by which they only use TSH to diagnose and medicate a thyroid patient.   That doesn't work.  Others only use "Reference Range Endocrinology", by which they will tell you that a thyroid test that falls anywhere within the so-called "normal" range is adequate.  That doesn't work for many thyroid patients.   The clinical approach, described above is the best for effective treatment.  Based on all our experiences,  the probability that the Endo will treat clinically is very low.

So, if you will tell us where you are located, perhaps a member can recommend a good thyroid doctor in your area.    
Have an Answer?
Top Thyroid Answerers
649848 tn?1534637300
Avatar universal
1756321 tn?1547098925
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Here’s how your baby’s growing in your body each week.
These common ADD/ADHD myths could already be hurting your child
This article will tell you more about strength training at home, giving you some options that require little to no equipment.