possible hypo?

[lys70]

I am a woman in my early 30's and recently experienced a weight gain of 20 lbs on a diet of 1500 to 2000 cals per day and exercising 5 to 6 days a week. I eat very healthy and few carbs etc. I was sent to an endrocinologist to find out what was going on as I have had symptoms including intolerance to cold, very dry cracked skin (especially on my hands around my nails), brain fog, insomnia, no menstral cycle in 1.5 years, and fatigue. My TSH was 2.85 and free T4 0.71. Doctor said I was "fine" and had no idea why I didn't have my menstral cycle and to see a gyno. Wondering what others think about this being possibly hypothyroid? If so, how can I get my doctor to take me seriously that something is wrong because I feel awful and now am terrified to eat more than 1000 cals as I keep gaining (also edema particularly in my midsection). Its awful and I can barely get through a day with the exhaustion.
Thanks for any advice or suggestions!

[Barb135]

I agree that you should get checked for PCOS.  

What was the reference range for that FT4?  Your seems below most of the ranges we see.  Agree that you need FT3 test as well.

[Red_Star]

Check for PCOS as well.

"What are the symptoms of polycystic ovarian syndrome (PCOS)?

The principal signs and symptoms of PCOS are related to menstrual disturbances and elevated levels of male hormones (androgens). Menstrual disturbances can include delay of normal menstruation (primary amenorrhea), the presence of fewer than normal menstrual periods (oligomenorrhea), or the absence of menstruation for more than three months (secondary amenorrhea). Menstrual cycles may not be associated with ovulation (anovulatory cycles) and may result in heavy bleeding.

Symptoms related to elevated androgen levels include acne, excess hair growth on the body (hirsutism), and male-pattern hair loss.

Other signs and symptoms of PCOS include:

obesity and weight gain,
elevated insulin levels and insulin resistance,
oily skin,
dandruff,
infertility,
skin discolorations,
high cholesterol levels,
elevated blood pressure, and
multiple, small cysts in the ovaries.

Any of the above symptoms and signs may be absent in PCOS, with the exception of irregular or no menstrual periods. All women with PCOS will have irregular or no menstrual periods. Women who have PCOS do not regularly ovulate; that is, they do not release an egg every month. This is why they do not have regular periods and typically have difficulty conceiving."

Excerpt from MedicineNet - "Polycystic Ovarian Syndrome"

[gimel]

Your doctor seems to have the "Immaculate TSH Belief", by which they only want to use TSH to diagnose and treat a potential hypo patient.  that simply doesn't work.  If the doctor tests beyond TSH, it is usually only for Free T4, like yours did.  Then if the Free T4 falls anywhere within the reference range, the doctor will tell you that it is adequate and your symptoms cannot be thyroid related.  That practice is called :Reference Range Endocrinology".  That too does not work for many patients.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by TSH levels.  symptom relief should be all important, not just test results.  Many members here myself included say that symptom relief required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the middle of its range.  

So the first thing I suggest is to get the doctor to test for Free T3 and Free T4 (not the same as Total T3 and T4) each time you go in for tests.  Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have also shown that Free T3 correlated best with hypo symptoms while Free T4 and TSH did not correlate at all.  If the doctor resists, then you will have to insist on it and don't take no for an answer.

While there for those tests, it would also be a good idea to test for Vitamin A, D, B12 and ferritin.  Hypo patients are frequently low in those areas as well.  If you have not been tested for the thyroid antibodies related to Hashimoto's Thyroiditis, that should be done also.  Those tests are TPO ab and TG ab.  If Hashi's shows up as the cause, doctors are usually more accepting of the possibility of being hypothyroid.

When test results are available, please post results and their reference ranges shown on the lab report and members will be glad to help interpret and advise further.