High-normal TSH with symptoms of HYPERthyroidism

[Novah]

Hello everyone,

I'd really like Dr. Lupo to help me out but I can't post today because his daily limit of submitted questions has reached its maximum :(

I'm a 21 year old female, 5'1" and 103lbs. I have literally every symptom of Hyperthyroidism beginning with sudden onset tachycardia (180bpm) in Jan 2007. I do *not* have any Graves' eye or skin signs/symptoms, but my heart rate is always between 100 and 120 when I'm resting or calm, and it goes beyond 150 if I'm doing activities or am stressed.

In addition to the constant tachycardia, my menstrual periods have ceased (amenorrhea, it's been over 6 months since my last period), I developed cystic acne, I also developed "panic disorder" where I have panic attacks for no obvious reason, I have an increased need to eat every few hours otherwise I feel very weak, and I seem to go to the bathroom a few times a day where before I had any of these symptoms I only went once every other day.

When I was in the ER last December (Dec 2007) because my heart rate went beyond 180bpm for no known cause, they did a complete workup and ruled many things out, determined my tachycardia was "harmless" and originating from the sinus node,  however in the way of testing my thyroid they only tested my TSH.

My TSH level was 3.48, and their labs' ref ranges were 0.34 - 4.82, so they said my thyroid was normal based on this TSH test alone.

Many doctors have looked at my neck and thought that I may have a goiter, while other doctors tell me I just simply have a thin neck which makes my thyroid "appear" larger. I am 5'1" and 103lbs, and I was even thinner (93lbs) before I began eating so much.

Please help me with any insight as my symptoms have caused me to have to quit college classes and my job.

[Novah]

Thanks to you both. I am learning that a lot of people can have hyper symptoms with hypothyroidism, although I'm kind of scared to treat a hypo problem considering my heart rate is already through the roof, and I can't take beta blockers because of asthma. eeek.

I intend on requesting those labs.

I wonder if it is possible to have a high TSH with high T3 or T4. I just seem to be th classic case of hyper.....yet my bloodwrok is such a contradiction.

[kitty9309]

I had hyper symptoms- extreme insomnia and anxiety when my TSH went from 3.5-4.7 (too high anyway) to 5.96.
Most doctors said I was fine- thyroid wise. I was rx'd antidepressant and sleep meds instead of thyroid meds!
I took myself to an endo and was diagnosed with Hashimoto's Hypothyroidism due to the elevated TSH and positive thyroid antibodies.
Those symptoms went away as my TSH dropped below 2 for the first time that I know of.

I also agree with Peggy and AR above.

[peggy64]

Many of the symptoms are the same for hypo as they are for hyper. According to new lab values, which not all have updated, the range is 0.3-3.0

Do you have an GP that you see and trust? If so, that would be a good place to start.

[AR-10]

Pick ONE of those doctors, preferably one of the ones that don't think you're crazy, and ask for the following tests;

TSH
Free T4
Free T3
Thyroid peroxidase antibodies (TPOab)
Antithyroglobulin antibodies  (TGab)
TSI antibodies
TBII antibodies

Get those tests run and then talk to the doctor about results. Your TSH should be between 1.0 and 2.0 Your Free Ts should be a little above midrange on the scale the lab uses. If you test positive for any antibodies, then that will lead to a diagnosis of thyroid disease and you will either get close monitoring or medication, depending on the hormone levels and the doctor.  

[Novah]

will someone please have any insight? I'm new to thyroid as my doctors keep making me believe I just have a psychological problem or Polcystic ovariy syndrome...