Hashimotos or Cushings my labs say one thing, symptoms say another Please Help!

[carolinamp]

I have been reading the threads on this site in hopes of finding answers to my issues. I have changed endo's more than 5  times and still feel that I'm not being properly diagnosed. I have been diagnosed with Cushings, then Hypothyroid, then Hashimoto's. I'm just tired of not knowing whats going on. Please help if you can, Thank you.

Below are my labs
TSH: 0.789           (0.270-4.2) ****2 Months ago it was at 2.180
FT4: 1.13              (0.93-1.70) ****2 Months ago it was at 1.05
FT3: 3.05              (2.0-4.4)
T3 TOTAL: 128.2 (80.0-200)
T3 UPTAKE: 30   (22-35%)
ACTH: 19              (6-50 pg/ml)

Thyroid Peroxidase Antibodies <1
Thyroglobulin Antibodies 65 mg/dl)
LDL Cholesterol: 83      (65-160 mg/dl)

Symptoms:
Weight Gain
Unable to lose weight with diet and exercise
Fatigue
Hot Flashes (Sometime)
Intolerance to Cold (Sometimes)
Puffy Face
Buffalo Hump
Joint and muscle pain
Constipation

[Tiredsleepymama]

From my researching I have read that adrenal problems, such as crushing, can go along with also having thyroid problems.  You will need more testing to be diagnose with adrenal problems.  I'm still leaning about adrenal problems so can't say much more.  

Your thyroid labs look to me to be low in range and would be why you are having hypo symptoms.  FT4 should be 50% of range and FT3 should be in the upper 1/3 of range.  Both your's need improvement.

[Tiredsleepymama]

One more thing I noticed, your thyroglobulin antibodies look to be high which would tell me you have Hashimoto's which is why you are hypo.  What was the range for that?

You should also be tested for vitamin D, B12, and ferritin.  Hypo people can also be low in these.

There are other people on here that are a lot more knowable then I am and I'm sure they will pop on and help too.  I am still learning and have just been diagnosed with hypo.

Best of luck to you on getting your problems sorted out.

[carolinamp]

Thank you for taking the time to respond any help is greatly appreciated. I have been diagnosed with so many different things that I just want to feel better and get my symptoms under control.

Below is the range per lab report

Thyroglobulin Antibodies <1   (< or = 1 IU/ml)
Thyroid Peroxidase Antibodies <1    (< 9 IU/ml)

Thank you again

[Red_Star]

I had many symptoms of Cushing's disease from a very prominent buffalo hump to a moon face. I had various tests to rule out cushings although I thought I might have cyclical cushings for a while which is harder to diagnose.

But I researched further and found there are two reasons why fat will deposit to the back of the neck - high cortisol and high insulin. My reason was severe insulin resistance.  My moon face was one of my many symptoms of hypothyroidism. I have reversed my insulin resistance but it clearly is going to take a long time for the buffalo hump to go away.

[carolinamp]

No one has ever mentioned insulin resistance in all the years that I have been trying to find out whats going on with me. In searching for more information on it I see that I do have symptoms of insulin resistance. including the dark patches, dark rings around my neck, abdominal obesity, and low levels of HDL cholesterol.

Below I have included all lab results done on the same day. Maybe it will help in getting a better picture of whats going on.

Thyroid Stimulating Immunoglobulin 47   (<140% baseline)
Somatomedin (IGF-I) 299   (53-331 ng/ml)
DHEA-Sulfate, LCMS 463  (102-1185 ng/dl)
Magnesium 1.9  (1.6-2.6 mg/dl)
Creatine Kinase 75  (26-192 U/L)

***Lipid Panel***
Cholesterol, Total 166 (0-200 mg/dl)
Triglycerides 182 (60   (mL/min/1.73m2)
GFR MDRD Af Amer >60   (mL/min/1.73m2)

Testosterone, Total 23 (2-45 ng/dl)
Testosterone, Free 3.3 (0.1-6.4 pg/ml)

Progesterone <0.5
Ranges:
Follicular Phase <1.0
Luteal Phase 2.6-21.5
Post Menopausal <0.5

Thank you again guys. I don't know what most of would do without communities like this. Its disappointing that most doctors just brush off their patients and don't take the time to find out whats really going on.

[carolinamp]

***Comprehensive Metabolic Panel***
Glucose 89 (74-106 mg/dl)
Sodium 142 (136-145 mmol/l)
Potassium 3.8 (3.5-5.1 mmol/l)
Chloride 99 (98-107 mmol/l)
CO2 31 (19-34 mmol/l)
Anion Gap 12 (6-22)
BUN 11 (6-20 mg/dl)
Osmolality Calculation 282 (275-295 mOsm/kg)
Creatinine 0.68 (0.40-1.10 mg/dl)
Calcium 10.5 (8.6-10 mg/dl)
Protein, Total 7.2 (6.4-8.3 g/dl)
Albumin 4.5 (3.5-5.2 g/dl)
Bilirubin, Total 0.2 (0.0-1.2 mg/dl)
AST (SGOT) 19 (10-40 U/L)
ALT (SGPT) 22 (0-33 U/L)
Alkaline Phosphatase 90 (35-105 U/L)
GFR MDRD Non Af >60 (mL/min/1.73m2)
GFR MDRD Af >60 (mL/min/1.73m2)

[carolinamp]

hmmm it seems my post was cut short. I'll try this again.

***Lipids Panel***
Cholesterol Total 166 (0-200 mg/dl)
Triglycerides 182 (<200 mg/dl)
HDL Cholesterol 46 (.65 mg/dl)
LDL  Cholesterol 83 (65-160 mg/dl)
VLDL Cholesterol 36
Cholesterol/HDL Ratio 3.6

[Red_Star]

Yes those are symptoms of insulin resistance. My waist to hip ratio was up to 0.96. I'm current down to 0.86.  My labs show basal insulin 39 mU/L (6 - 22) and 2 hours after drinking glucose (glucose tolerance test) insulin was 184 mU/L (15 - 65).  Your calcium is quite high. Might want to get that rechecked along with parathyroid hormone (PTH). I also had magnesium deficiency as the high insulin was excreting excess magnesium through the urine. Magnesium serum isn't accurate since only 1% of magnesium is in the blood.
  

[carolinamp]

May I ask what you're taking for Insulin Resistance. I just want to be a bit more prepared when I go for my next appointment.

Also do you think from my numbers that I have hashimotos/hypo?

[Red_Star]

I was eating too much sugar in my diet. I had a terrible craving for chocolate (magnesium deficiency symptom) so when I corrected my magnesium I was able to stop eating it! I just stopped eating added sugar in my diet.

I have Hashimoto's thyroiditis too and this is why my cholesterol and liver enzymes started to rise. Your would have to look at previous labs to see if they are rising but I have to say it looks like your thyroid gland is fine to me.  

I will add I have cellular thyroid resistance which I have pinpointed to inflammatory cytokines which I believe is due to the visceral fat (from insulin resistance). Not sure if anyone else is suffering this with insulin resistance but I've had symptoms from excessive ear wax to hair loss for decades due to this. I only realised my problem when symptoms I'd suffered with for decades vanished one month into a two month hyperthyroid flare up then returned when the flare up was over. My cellular issues have improved in the past year. :)

This is info from the article: Insulin Resistance: The #1 Surprising Reason You Can't Lose Weight...

"This whole process builds slowly over years. What triggers it in the first place? Experts believe that for many people, the problem stems mainly from a diet overloaded with simple carbohydrates -- bread, pasta, pizza, pastries, crackers, chips and other processed snack foods, sweetened beverages, corn syrup, and other quickly-digested sugars and starches. In other words: the typical modern Western diet. Faced with constant, quick hits of easily digested energy sources, the pancreas keeps pumping out insulin to help the energy get into the cells, but the overwhelmed cells finally say, "Enough!" and stop paying attention."

[carolinamp]

Thank you so much for all your help. I'll read up on insulin resistance and see what changes I need to make.