very low TSH pointing to hyperthyroid but HYPOthyroid symptoms

[weatherweather99999]

A few weeks ago, I had a blood test and have been referred to en endocrinologist but it's a small town and he only visits here and there at an internal medicine office so I am still waiting to see him.  My doctor said my TSH was barely traceable pointing to hyperthyroidism but I am so cold that I am always shivering--cold enough that I never have less than three layers of clothing on and in the summer I wear a light jacket when it's 100 degrees.  I have the chills so bad sometimes that it's unbearable.  People say I have really bad mood swings and I've noticed that about half my hair has fallen out but what hair I "do" have does grow fast..at least 7 inches since March 2009.  I have a lump on my neck but it's been there for a while so I don't really think much of it but apparently I've gotten bad enough on the behavior side of things that my work sent me for a full blown psych eval and it was the psychologist who looked at my chart brought from the physician who gave me the endocrinologist referral.  Everyone around me seems to think I've become a looney toon.  In the midst of always being cold that I run fevers just at random when I'm not sick otherwise and I do notice that when I feel feverish, that's when I'm irritable and cry easy and worry alot more.  I really don't understand why I'd have symptoms of one thing and blood work of the other.  I don't go to the doctor much because I'm not usually sick otherwise but when I do go, every practitioner sees my neck and asks how long this bump has been here.  I work in a DOT sensitive job and have been removed from duty until I get treatment for whatever the problem may be.  Can someone please shed light because some of it I just really don't understand.

[weatherweather99999]

Thank you for the input.  I gave my chart to the psychologist so I dont have the lab to look at.  When the bloodwork was done, I do remember that a full thyroid panel box was checked on the requisition form but the numbers are all jargon to me at this point.  I hope to get this all fixed very soon because I know my kids will appreciate when the heater doesn't have to be set to inferno degrees.   I guess I've not really been aware of the mood swings but people around me say I cry really easy over little things that most people wouldn't cry over.  Thank you again for the info.

[Super_sally888]

See if your GP (or the psych) can order more thorough thyroid testing, even before you get to the endo.  Tests should include FT3, FT4, TSH, AntiTPO.  An  ultrasound of the lump in your neck would also probably be a good idea.  If you go to the endo armed with these results likely the treatment / management can progress more quickly.

Just a TSH and your symptoms don't tell anything much, except that there is a problem.  Defining the problem needs some more testing and investigation.

Hope this helps.

[gimel]

TSH is a pituitary hormone that is affected by many variables.  Metabolism and other body functions are dependent on the levels of the actual, biologically active thyroid hormones, free T3 and free T4 (FT3 and FT4, not total T3 and total T4).  A low TSH doesn't mean you are hyper, unless accompanied by hyper symptoms, which you don't have.  Your hypo symptoms are likely due to low FT3 and FT4 levels.  Whenever that occurs with low TSH, doctors usually start evaluating pituitary function.  Along with that you need to insist that they also test for FT3 and FT4, right away.  

In my opinion the very best way to treat a hypo patient is to test and adjust the levels of FT3 and F4 with whatever type of medication is required to alleviate symptoms, without being constrained by resultant TSH levels.  Frequently this requires that FT3 is adjusted into the upper part of its range and FT4 is adjusted to at least the midpoint of its range.  Ft3 is the most important because it is about four times as active as FT4, plus FT3 correlates best with hypo symptoms.