testing for hypothyroidism

[artistdiva]

I am becoming frustrated with the state of my health and wondering, once again, if hypothyroidism might play a part in my feeling so lousy. I am a 48 y o female with Ulcerative Colitis (dx 5/03) but not currently on any medication for it and am in remission. Mother had lupus ereth. and sister has Hashimoto's. Other issues I have are chronic psoraisis and severe allergies to dust.  I am very active - used to jog/walk 5 miles every morning but am down to 2/3 miles and that is mostly walking.  Joints ache, hips hurt, my scalp has suddenly become covered in psoraisis plaques. Hands and feet are cold, especially at night.  Last night I couldn't get to sleep for my feet being so cold. And even when I get  (though at times interrupted) 8 hours of sleep, I wake up feeling so tired and I hurt all over.  Even the exercise is no fun anymore, and it's always been my therapy. Usually by mid afternoon I'm starting to feel better with more energy. But I have gained about 10 pounds in the last six months, which for my frame is too much. I went to the fam prac. in 3/08 and thyroid testing showed: T4Free Direct 1.50, T3 uptake 33, TSH 0.968, which all fall into the normal range. Others who have been to an endo say that those tests mean nothing, and I need to go to a specialist, especially since the thyroid and autoimmune run in my family.   I am reluctant to begin the rollercoaster ride of "what is wrong with me?", especially after having been diagnosed with Wegener's Granulomatosis in '93, and fighting tooth and nail for 5 years to have it disproved, which it was.  I truly believe that my UC was partly brought about from 4 years of high doses of SeptraDS therapy for a disease that I did not have.  I realize that my thyroid tests could be completely different at this point, but even so, should I think about seeing an endo?

[artistdiva]

Very good advice from both of you. Yes, I have been tested many times for lupus. Not recently though.  Certainly my Ulcerative Colitis is autoimmune, and so many of the AI disorders go hand in hand.  The FT4 normal range on the lab report is .61-1.76.  I'm afraid that I do not feel comfortable going to the PCP since she's fresh out of med school and looked at me as if I had three heads when I counted off the reasons I thought I might be hypo.  I pretty much felt she was placating me by doing the bloodwork and never had a follow-up from/with her.  And because of my other autoimmune issues I think an internist or specialist might be best.   The psoraisis is also autoimmune, of course, and I have had it since I was 14.  But the scalp issues were horrible after the birth of both my sons, and now it is back again with a vengeance.  I really appreciate the help - did not realize that there was a specific test for Hashi's and that other tests could present as normal.  I will try to keep up with posts and details.  Getting myself to actually GO to the doc is another matter.  I am way behind on many "maintenance" visits and must change my way of thinking. Just too many bad experiences in the past, but then we all have our horror stories, don't we?  :-)

[TamraW]

You do seem to have the symptoms of hypothyroidism, which can be brought on by Hashimoto's. Because auto-immune diseases run in the family, I suggest you ask for the Hashi antibodies tests (TGab and Anti-TPO) . I have Hashi. My TSH, FT3, FT4 labs were normal, too. They fluctuate from normal to abnormal during the first few years as the thyroid and the antibodies duke it out.  

Also, maybe ask for other auto-immune tests. Sometimes various auto-immune diseases run in the family. I do have the scabs thing on the head, cold hands, joint aches, feet, weight, decreased exercise level and lack of energy, etc. My docs tried to diagnose me with shingles last year, but I said, "Shingles shouldn't come back each month!"

:) Tamra

[Barb135]

You might try going back to your pcp and ask to  have the thyroid panel done again - things can change considerably in just a few weeks/months.  Make sure it includes FT4, FT3 and TSH.  I'd also recommend testing for antibodies: TPOab and TGab, which will help confirm/rule out Hashimoto's.  Would also recommend an ultra sound which will tell if you have a swollen thyroid and/or nodules.  Simply having Hashimoto's can cause hypo like symptoms even if your thyroid levels are normal and since you have autoimmune issues in your family, it's a good idea to get tested.  Oh, if you get on a roll with the testing, I'd also suggest that you get your vitamin b12 tested, if you haven't already, to rule out pernicious anemia, which will cause the extreme fatigue.  I have that, as well as Hashi's so I'm currently taking a b12 shot every 2 weeks.  Helps immensely...........

Also wondering if you've been tested for lupus?  My daughter has that also and she has a lot of the same symptoms you do.  

A specialist (usually an endo) is not absolutely necessary, unless you don't feel confident with your primary doctor. Not all specialists treat thyroid issues any differently than some primaries or internists, etc, so I think you will find a lot of people just as dissatisfied with an endo.  I happened to luck out and got one who works very well with me, but that's kind of rare...

Would like to know the reference range of the FT4 that was done - different labs use different reference ranges and/or units of measurement - that info should be on your lab report beside the result.  Also, it's hard to tell what might be happening without an FT3, which is the actual active thyroid hormone; however, most doctors don't run it for some reason...........

It certainly sounds like your plate is full, so I hope you are able to get some answers soon.