Gained 10 lbs without changing diet

[Jenn1302]

I’ve gained 10 lbs over the past year even though I eat the same and work out a lot. My clothes fit the same but I’m a bit concerned. I've had Hashimotos antibodies for years now and I was borderline hypo 3 years ago. 4-5 years ago when I was hyperthyroid I lost 10 lbs. Now I gained 10 lbs without changing anything and I suspect that I may be hypo.

This weight is not normal for me and some of my other conditions have been flaring to the point where they’re worse than they’ve ever been. My heart PVCs and stomach symptoms have gotten worse than ever as of late. Last time my thyroid was checked my TSH was over 3 but no one seemed to care because it was under 4. I’m not sure what to do.

[gimel]

Jenn, that list of  symptoms is for low cortisol.   Also, looking at your saliva cortisol results, even though within range, that does not mean adequacy.   The ranges are far too broad.  Just logically does it make any sense that the high limit is 4 times the low limit?  I expect that the range includes basically the test results for everyone tested.  I have seen limits used by an outstanding thyroid doctor that were far narrower than those you show.  According to his ranges,  the morning result should be in the upper half of the range, before and after lunch results should be in the middle third of its range,  and his night range is just slightly inside the lab range.   Overlooking the result when you were so stressed, your cortisol results seem to be below or at low end of functional ranges.   In addition, that doctor has stated that diagnosis for possible low cortisol should alway take into account symptoms that may be related.   Following is a link to info on cortisol, written by the doctor.

http://www.hormonerestoration.com/Cortisol.html

[Jenn1302]

Is there a way to fix this? btw, my PVCs are getting worse. Way worse. I had another episode in class today. It was so bad. I had one every 5-10 seconds and it went on for a good 20-30 minutes.  I have an appointment with the cardiologist in a few days but at this rate it's going to be a lot worse by then.

[gimel]

Fixing your symptoms is going to require at least thyroid med.   This is not a normal situation where you can wait to see the cardio first, then get in to see your PCP, and then get the needed tests done, then wait for results, and then hope that the doctor will diagnose as hypothyroid and prescribe thyroid med.  That is a long road.  

I think you might just take the desperate approach and go to the PCP now and tell them you are having these horrible PVC's along with many other symptoms that are related to hypothyroidism, and that you just can't wait any longer to be tested as needed to confirm hypothyroidism and get started on thyroid med.   If they resist, tell them you have already been tested and found to have the autoimmune antibodies of Hashi's several years ago and that it is clear it has progressed to the point that you have many symptoms of being hypothyroid now and that there is just no reason to wait any longer for the necessary tests to be done to confirm the need for thyroid med.   That should work when they see how desperate you are, especially due to the ongoing problems with severe PVC's.  Also ask for something to help with the PCV's while waiting for test results and prescribed thyroid med to kick in.  

So, in preparation for whenever you go to the PCP, please look at this link on typical symptoms of hypothyroidism and tell us which ones you have.  

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

[Jenn1302]

Thank you so much for your response. My PVCs finally went away around 5-6 am (I literally had them all night). Something is definitely wrong. These palpitations are definitely much more frequent and bothersome than the ones I had a few years ago. We're talking orders of magnitude here.

I bought one of those home thyroid test kits to check if it's because of my thyroid (TSH, FT3, FT4). Hopefully this will shed some light on what's going on. What's good about having my own kit is that I can draw blood as the palpitations are happening (hormones fluctuate throughout the day right?). I don't have to wait for the clinic to open or try to convince my doctor to order these tests.

Symptoms (based on your list)
Weight gain (10 lbs in a few months, no change in diet)
Increased sensitivity to cold (had it yesterday - I generally don't. It was 66 degrees out and I was freezing to the point where I was shivering. Everyone around me was wearing shorts. I had no flu/cold symptoms)
Puffy face (Hashimoto's face)
Swelling around the eyes
Joint and muscle pain, aches, and stiffness (over the past few days. I usually don't have this symptom)
Pale, dry, rough, and thick skin
Dry, thinning, or coarse hair
Decreased hearing (I didn't realize this was a thyroid symptom, but I definitely have it)

[gimel]

Looking back at our prior messages, have you ever had any thyroid related tests besides TSH?  And when were you tested?   Also, you said you were hesitant to take T4?  Was that previously offered to you by the doctor?  

[Jenn1302]

Yes. My antibodies have been checked plenty of times. I was officially diagnosed with Hashimoto's in 2013.

I saw 3-4 endocrinologists in 2014-2015. One of them told me I was hypo and wanted to put my on thyroid medication . Then he took it back a week later when my levels went back to normal (hypo: TSH: 3.8+, FT4: 1.0, normal - TSH:1.7, FT4: 1.2).

Labs:
Two months ago:
TSH: slightly over 3 (checked because my PVCs were flaring)
My doctor didn't order FT3 and FT4
Gained 10 lbs

Late 2016-early 2018
I felt fine so I didn’t get my thyroid levels checked
My PVCs were nearly gone

Mid 2016:
TSH, FT3 and FT4 were completely normal (TSH~.5, FT3 & FT4: upper half of the range)
PVCs were nearly gone

March 2016:
TSH: 1.6
FT4: 1.2
TPO: 600
Unexplained eosinophilia (high EOS)

Early 2016:
TSH, FT3 and FT4 were more stable than before

August 2015:
TSH: .88
FT4: 1.3
Anti Tg: <20 (<20)
Anti TPO: 580 H

March 2015:
TSH: 2.6 (.35-4.9)
Free T4 0.95 (.89-1.89)
T3, total: 96 (60-181)
Anti TPO AB: 1118 (<5)

Sep 2014:
T4 serum free: 0.97 ng/dL (0.7-1.48)
TSH: 2.16 u[iU]/mL (.4-3.98)
T3 free serum: 2.4 pg/mL 2-3.9
Thyroid peroxide ab: 781iu/ml (<5) H
TSI: 44% (<140) August 2014

April 2014:
TSH 1.7
Free T4 1.2
Thyroglobulin Ab: 83.9 IU/mL (<19.0) H
TPO ab: 420 IU/mL (<34) H

Nov 2013 - Mar 2014:
TSH 3.8-4.2 mIU/L
free T4 1.0-1.2  (range: 0.9-1.7)
(had lots of hypo symptoms)

mid 2013:
borderline low TSH
normal free T4
positive TPO
negative THYROGLOBULIN Ab

2012:
PVCs started

2011:
hyperthyroid
Lost 10 lbs

[gimel]

So you tested positive for the autoimmune antibodies of Hashimoto's Thyroiditis about 5 years ago.  Since that time you have had several thyroid related tests that showed that your Free T4 was bouncing around in the bottom part of its range.   Although you should be tested for the biologically active thyroid hormones FT4 and FT3 every time you go in for tests, the one test you listed for FT3 showed it to be only at 21% of its range.  The ranges are far too broad to be functional in the lower part of the ranges due to the erroneous assumptions used to establish them.  Your doctor ignores your Hashi's background, ignores your many symptoms, most of which relate to being hypothyroid, and some possibly indicating hypocortisolism, and does nothing but continue to test and refer you to other doctors.   That is a clear indication that the doctor is only paying attention to TSH and using "Reference Range Endocrinology", by which a test that falls anywhere within range is considered "normal' and does not require treatment.  That is very  wrong.  

I have no confidence in your  doctor  correctly diagnosing and treating you: however, in the interest of getting something done quickly, I suggest that you take the copy of the symptoms of hypothyroidism, and hypo-cortisolism and circle the ones you have and then give a copy to the doctor ASAP and remind her of you being diagnosed with Hashi's 5 years ago and that apparently over that time your thyroid gland function is deteriorated, resulting in the hypothyroid symptoms, and that you need to start on thyroid med.  Also give the doctor a copy of the one page overview I mentioned that is in my Journal.  If she is the right kind of doctor she may be open to reading the material and considering the possibility of needing to change her protocol for hypothyroidism.  Be very insistent in talking about your history and all the typical hypo symptoms you have, likely including  the PVC's.   Suggest starting on 1/2 grain of  a desiccated type containing both T4 and T3, like NatureThroid, or Armour Thyroid and don't take no for an answer.  Since your cortisol seemed to be borderline low, it may be that adequate thyroid med could help relieve stress on the adrenals and your cortisol level could get better.  You will have to monitor that and see.   Insist on getting all those tests that we discussed done because they are frequently deficient for hypothyroid patients and are very important.  

Anyway, short term you are going to have to be your own advocate for getting the testing, diagnosis and treatment needed.   Longer term, if you will tell us your location, perhaps we can suggest a good thyroid doctor that has been recommended by other thyroid patients.

[Jenn1302]

I've changed PCPs a lot over the past 5 years. The tests I listed about were done by 10+ different doctors (internal medicine doctors, functional medicine doctors and endocrinologists). My symptoms and thyroid hormones got significantly better 2.5 years ago so I stopped thinking about my thyroid. I was finally healthier and had no reason to see my doctors. My insurance and doctors have changed a lot since then and now that everything is flaring again my current doctors don't know much about my history. I made sure to tell them I have Hashimoto's but they're currently more concerned about my heart. They don't seem to think my palpitations have anything to do with my thyroid (even though I'm pretty sure this is the cause for all of this madness).

Thank you for offering to help me find a doctor. The thing is that my current insurance plan doesn't cover nearly as much as my old plan did. I don't think I can pick and choose the doctors I want to see and I can't afford to pay out of pocket. I also need a referral to see a specialist so I can't even see an endocrinologist at this point.

The doctor I saw a few days ago said he would consider checking my FT3 and FT4 after my cardiology appointment. I'm going to go back to to him after my appointment with the cardiologist and we'll see what he says. My thyroid home test kit should be here in a few days. I just hope those annoying PVCs don't flare again before then. I really need sleep.