Could I have thyroid trouble with normal test results?

[JonieMF]

Hi, I used to be on thyroid meds (don't remember what they were called or if it was for hypo or hyper, it was quite some time ago as a teen/young adult) and at one point I was told I 'could' have graves disease. I also have multiple nodules on my thyroid. Due to moving multiple times in a short time period, I didn't have a doctor steady enough to follow up with it all. Now that I do, she does a blood test several times and it says normal. Problem is, I have symptoms that I am wondering is the tyroid malfunction. Nausea - so severe at some points in the day and it is nearly daily. (like being pregnant but not pregnant). My hair is falling out so badly that even my hairdresser is making comments. I have other symptoms but I don't want to bombard this... the point being... could it be that there is something wrong even if the blood test comes back normal? if so, what should I say or do to look deeper into this. To say the least, all the symptoms I am dealing with are rough but the two above are enough to make me crazy. The nausea is starting to affect my job. I need to figure this out and a starting point is needed...

[Barb135]

In the U.S. doctors are required, by  law, to provide a copy of lab or test results, upon request.  I have every one of mine, since about 1999.  I use my thyroid test results as a running record of my disease.  On each report, I mark my med and dosage, along with any symptoms I was having at the time.  If I am symptom free, I know those are the numbers I need to target.

What are the reference ranges for the results?  Ranges vary lab to lab and have to come from your own report.  Without the ranges, the results don't tell us much.

Thyroid Stimulating Immunoglobulin is the definitive test for Graves Disease.  Nodules are common with both Hashimoto's and Graves. They are usually nothing to worry about.  

Lab tests are not always the end-all, be-all - symptoms are the bottom line - however, unfortunately, if there's nothing in the blood work to give a clue, doctors are unlikely to be willing to do anything.

Under what circumstances are you getting the nausea?  That's not, typically, a symptom thyroid malfunction.  Hair loss is typical with hypothyroidism.

What other symptoms do you have?  Some symptoms are shared by hyper and hypo.

[JonieMF]

I live in Ontario, Canada - just north of Toronto. I actually never thought of ever having copies of my tests. This is the first.
I got my results and everything is 'normal' as usual over the last 2 years but used to be hyper and at one ponit told may have graves disease back in 2010. I also am dealing with all those symptoms previously mentioned so that is why I need to know if these results are be-all, end-all?

So my blood work results are as follows:
Free TriIodothyronine - result 4.3
Thyrotropin (sensitive TSH) - result 1.05
Free Thyroxine (FreeT4)-  result 14
Anti-TPO - result 12
Anti-TG - result 23
My ultrasound says
Right Lobe measures 45x18x18
Left lobe measures 46x18x14
Isthmus measures 3mm
Multiple small hypoechoic nodules all measuring 6 mm or less are seen scattered throughout right and left lobe with the largest nodule on the right side at 5mm in lower middle third of right lobe and the largest nodule on left side is 6mm in lower third of left lobe.

[Barb135]

Where are you from?  I'd never walk out of my doctor's office without a copy of my labs in hand.

Will look forward to seeing your labs.

[JonieMF]

Thank you. I see my family doctor on the 12th of April. I will ask for my results then as I do not know them and it isn't common practise here to walk out with the report. Thank you and will get back to you.
FYI I have been tested my iron levels as I know that can cause hair loss and that too is 'normal'.
Stayed tuned. Thanks.

[Barb135]

It's very possible to have thyroid issues with so-called "normal" results.  First off, tell us what tests your doctor is doing to determine your thyroid health. Please post whatever results you have and be sure to include reference ranges, since those vary lab to lab and have to come from your own report.

Since Graves disease is associated with hyperthyroidism and you were told you "could" have that, it might safe to assume you were hyper.  I guess you weren't actually tested for Graves?  There's another autoimmune thyroid disease called Hashimoto's, which is usually associated with hypothyroidism, but is often characterized by periods of hyper in beginning stages.  If I had to bet money, that's what I'd say you have.

What other symptoms do you have?  While hair loss is a common hypo symptom, nausea is not and there are many other conditions that can cause, both it and hair loss.

The starting point is to post whatever thyroid test results you have, so we can better assess your testing/treatment. That combined with your other current symptoms, will give an idea of what's going on, so we can advise you on what to ask your doctor for.