Thyroid Disorders Community
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Avatar universal

What should I do next?

I'm 54.

Symptoms: cold my whole life, muscle cramps, very low BP esp when young 80/40.  During my last labor is dropped to 53/35, orthostatic hypotension, lifelong depression, very low libido, thin hair, extreme fatigue, inability to sleep without a pill.

Saliva test done:  Low free T4, lower end of normal free T3, 3rd gen TSH OK.  Low vit D, A1C creeping up, very high good and bad cholesterol, crazy high estradiol and high estrone, (was on oral estradial) low cortisol 7-9am and 10-12pm, high melatonin 3-5 pm and 2:30 to 3:30.

I stopped the estradiol, have been taking many supplements for a year since these tests to support adrenals and thyroid support complex, plus prometrium to balance out the high estrogen.  I still have extreme fatigue, fibromyalgia, cold and heat intolerance, depression, very low libdo and sleeplessness without a pill.

What do you suggest I do next?
2 Responses
Avatar universal
Just because your thyroid tests were within the so-called "normal" range does not mean they are adequate for you.  The ranges are far too broad, having been established erroneously.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  Free T3 and Free T4 in the low end of their ranges is frequently associated with being hypothyroid.  Many of our members, myself included, say that symptom relief required Free T3 in the upper third of its range and Free T4 around the middle of its range.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not just TSH results.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance, after initial tests and evaluation.  The letter is then sent to the participating PCP of the patient to help guide treatment.  Please note the statement that, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."


So the first thing I suggest is to get your doctor to test for Free T3 and Free T4 each time you go in for tests.  You should also test for Vitamin D, B12 and ferritin as well.  While at the doctor's you should also find out if the doctor is wiling to treat clinically as described in the letter.  If not, then you will need to find a good thyroid doctor that will do so.
Avatar universal
I agree with gimel.

Actually get your lab results and the ranges. In the USA it is required by law that the Dr's give you the results if you ask for them.  many people have to be well up into the ranges to feel well. Yet many Dr.s won't want to prescribe medication if they are anywhere within the range.

Your symptoms seem consistent with Thyroid problems.  Specifically I think Hypo (low) thyroid.
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