More than a thyroid problem?

[nalh]

I'm a 38yo female- extreme difficulty losing extra 35 lbs despite diet and vigorous exercise x4k-5/wk/one year.  Fatigue, body tension, low libido, brain fog (e.g., Yesterday I tried to say "Great minds think alike" but wound up saying "Good taste among friends"; got lost driving my daughter to school); history of very heavy periods, currently don't get period w/ Mirena.  Two pregnancies, one w/ low progesterone, both w/ high BP and borderline gestational diabetes.  Initially dx w/ depression, on meds for 5 yrs (now wellbutrin, 300).  Don't currently feel depressed.  Tested for hypothyroidism for years, TSH usually around 3.5 w/one low reading.  Tested again in Nov, TSH high 7.85, started on 50 mg synthroid.  MD not convinced this is the problem as the symptoms preceded increase in TSH by years.  Work up for PCOS showed FSH:LH of 2-3:1.  Testosterone is low (16, lower end of range 15), % free Testosterone is high (1.8, w/ 1.8 the upper limit of normal).  High CRP (cardiac reactive protein?).  No change in symptoms w/ synthroid.  Feels like there's something MDs are missing.  Any suggestions would be much appreciated.  Thanks.

[MichelleH.]

Hi,

I suffer from both PCOS and Hypothyroid, most often these 2 diagnoses go hand in hand. You can suffer from extreme fatigue, heavy periods, weight problems, and mood swings along with a host of other symptoms.

It could be that your doctor needs to up your dose of thyroid medication(are you taking Synthroid?) and put you on something for the PCOS. Most doctors prescribe birth control pills, Glucophage or Metformin. You may want to discuss treatment options with your doctor. Here are to groups where you can fine valuable information: alt.support.thyroid and alt.support.pco

If you find that your doctor is resistant to treating your symptoms, then it may be time to look for help elsewhere.

[childrenrtreasures]

I have only had abnormal lab values for my thyroid disease once (and they were low not high). I was treated based on symptoms and family history (after 4 months of requesting that my dr to do a trial run of synthroid). I was diagnosed with Hashimoto's thyroiditis due to elevated antibodies four months later(I had to request the testing).

You can feel very poorly even when your TSH is only slightly elevated. Also, symptoms can precede an elevation of TSH (considering I've never had an elevated TSH and yet have many many symptoms that are at times debilitating). It's also possible to have a normal TSH but a low FT4 or FT3 (it can take time for the TSH, a pituitary hormone, to respond to low thyroid hormone levels).

I agree, you seem to need an increase in your thyroid meds.

Have you had your thyroid antibodies tested? Ever had an ultrasound done on your thyroid to check for nodules? Antibodies and/or nodules can make you feel poorly even when your labs appear normal or only slightly out of range (although I don't consider over 7 "slightly" out of range!! The new AACE criteria says anything over 3.0 when considering treatment and then with treatment the TSH should be between 1 and 2).

Kelly

[Forum MD_CM]

I would defintely push synthroid as you MD is doing I assume.that may fix it all. I can't make much out of polycytic ovary that would explain your symptoms.
I think there is a modern syndrome of low grade exhaustion. I see it mostly in mothers who are also professionals, who work hard, are diligent with chilren who almost lose themselves and don't get enough real rest or sleep. Just plain overworked and stressed from too much daily work. I  have no idea if that fits but it made me wonder. I think the brain can just get over loaded and when it does it does not work as well, "befuddled" is a good describer of what I am trying to say.

Where are you in exercise?
Just sitting down and figuring out work loads, etc with spouse. ? last real vacation away from children...just some plain selfish fun? Good luck

[nalh]

Two other symptoms that might be worth mentioning-- frequent urination and loss of memory.  I have a PhD and am usually on the ball, but lately my husband has described me as "befuddled", which sums it up perfectly. Thanks again.

[nalh]

Thanks for your response.  No toxic relationships I can think of, loving husband, two young daughters-- they may be zapping my energy a bit.  By body tension I mean my doctor has commented I am tense, and I feel that way a lot.  I think I was probably more anxious than depressed and concurred with the diagnosis, but emotionally, I feel fine now and have for quite awhile.   The rest of the thyroid tests were normal.  PCOS work up was for polycystic ovarian syndrome, which has a lot of symptoms I have had plus things I don't have (like excess body hair).  One of the blood findings in PCOS is an elevated LH:FSH ratio (they are supposed to be 1:1, in PCOS it's usually above 2:1).  Both the LH and FSH are within normal limits despite the elevated ratio.  I think my problem comes in with all of the slightly abnormal results-- like the testosterone right at the border, for example-- make me wonder if there could be something pituitary going on.  I know the American Endocrinology Association has recommended using a narrower TSH range (under 3.03 as normal); with that range, I've been hypothyroid for years which could explain my symptoms predating the recent increase in TSH.  My endo seems reluctant to perform any other tests, and I have not had my cortisol checked.  Thanks again.