Hypothyroidism, Hoshimotos, or in my mind

[Shelley3297]

I have struggled with extreme fatigue at work for the last few months, weak/dizzy spells for the last 4 months, thinning eyebrows (the outer 1/3 is just about gone), always cold at work in 71 degree office, and recently feel like i need to take deep breaths (or yawning sometimes) often.  I asked my do for a thyroid test, and she of course only did the TSH.  This came back well within the "normal" range at 2.1.  After the nurse tried to tell me that this result proved that my thyroid was completely fine, i insisted that i would not take this one limited test as the be-all, end-all test for thyroid problems.  Doc then ordered 2 more tests, one of which was free T4 which came back at 1.1, again within normal range.  I am still waiting on the 3rd test, which i am not even sure what it was.
I am lactose intolerant, have acid reflux, and am gluten intolerant.  I also have 2 1st cousins with hypothyroidism, and a 2nd cousin with graves.  From what i have read, (regardless of the labs "normal' ranges, my results are not too far outside the optimal ranges.  But i can't shake the feelings i have of absolutely no energy, extreme tiredness, and the chills.  
Is it possible, with my tests in the normal range, to still have something going on with my thyroid?

[Rozii7]

Hi,
Just to let you know, I had these issues with tsh 7 and iron deficiency. So far I fixed the iron part and half of the tiredness gone, hair loss stopped, cold sensitivity and dizzy spells are way less. I suggest to check your iron levels if you haven't as it is very easy to fix it if it is related. Check both serum iron and ferritin at least.

[gimel]

Did you ask for the other tests and they refused to order those?  If so you do need to find a good thyroid doctor.  I have sent you a PM with some doctor info.  To access, just click on your name and then from your personal page, click on messages.  

[Shelley3297]

Lab range on Ft4 is .7-1.9 (mine was at 1.1)
I will post the 3rd test when available.  Whatever it was, it had to be sent out.

[Shelley3297]

Ok, just got the 3rd test back, they tested for antibodies
Thyroperoxidase AB
result 3.8 IU/ml
lab range <9.0 IU/mL
thyroglobulin AB
result <1.8 IU/mL
lab range <4.0 IU/mL
no Ft3 done, no B12, no Vit D, no ferritin
I am thinking i need to find a doc to test for these other things?
Today, i literally felt like i would faint most of the afternoon...
and i had a vision episode today, felt like my eyes were shaking for about 20 seconds

[gimel]

What was the range shown on the lab report for the Free T4 test?  

Could the additional test have been for Free T3.  If so, please post, along with range, when available.  If not you should always make sure they test for both Free T4 and Free T3 every time.  Free T3 is used by every part of your body and it correlates best with hypo symptoms.  

Yes, it is possible that you can be hypothyroid even though your test results fall within the so-called "normal" ranges.  Due to the erroneous method used to establish ranges, they are are too broad to be functional across their entire breadth for everyone. In the words of a good thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

In addition the nurse apparently has never heard of central hypothyroidism, which is a dysfunction of the hypothalamus/pituitary system resulting in relatively low in the range TSH levels that don't adequately stimulate the thyroid gland to produce hormone.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  If your doctor is unwilling to diagnose you as hypothyroid based on symptoms and relatively low Free T4 (and I expect relatively low Free T3), and treat you clinically as described then you will need to find a good thyroid doctor that will do so.  

Also, when you next have the opportunity, I suggest testing for Vitamin D, B12 and ferritin and then supplement as needed to optimize.  Low levels can cause symptoms somewhat like hypothyroidism.  D should be about 50, B12 in the upper end of its range, and ferritin should be about 70.

[Shelley3297]

As i am reading more on here, i think i should add that i have had stomach issues for many years.  When i went gluten free in 2013, i felt really great for about 8 months, stomach pains, gas, headaches, all went away, then slowly started creeping back in.  Doctors always say "well you probably had too much dairy, or accidentally had gluten".  The gas lately, and stomach issues again are starting to become an issue. And headaches again.  After you live with these things for so long, you kind of forget that they might be symptoms, and just try to deal.....

[Shelley3297]

I should mention, my lab has a .5-4.5 normal range for TSH, and my past results over the last 2 years (normal testing at annual appointment) on TSH were 1.32, and 1.46 in 2014, and 2015.  I have never had the free T4 test.