Desperate for Thyroid help. Low TSH, Low Normal T4 & F T4

[Herself62]

Help, I've been sick for almost 2 years. I can barely function.
It is difficult to get a  doctor to properly test thyroid here in rural SC.
On two occasions of severe trauma/stress I was bedridden for weeks

I asked for thyroid testing
I have 2 thyroid nodules, have been scanned and FNA told they are not cancerous.

I have been told the following tests were "fine" I'm normal. I know I'm not!

On 3/12
TSH .256 uiL/mL         (0.350 - 5.50)
T Uptake 32.0% ng/mL    (27.0-36.0)
Free Thyroxine .87ng/dL  (0.60 - 1.76)
Thyroxine  4.5 ug/dL (4.5 - 12.0)

Antinuclear Antibodies Negative

I asked for Free T4 and Free T3, but the F T3 wasn't ordered this time.

Previously 10/13
TSH .576 uiL/mL         (0.350 - 5.50)
Free Thyroxine 1.17ng/dL  (0.60 - 1.76)
Free T3 2.9pg/mL         (2.0-4.4)
TPO 20 IU/mL      (0-34)
TG 72.6 ng/mL   (1.5 -38.5 )

I can gain 10lbs in a week, and lose it the following week.

I awaken during the night with INTENSE heat in my head

I can have insomnia, then I can go to sleeping on and off thru day and night. Drink strong coffee, and fall asleep in an hour

I crave dairy, salt.

I'm a mental/emotional  mess, have vision disturbances, and have lost much of my physical strength which was superior for a woman of 51. I'm past menopause.

I have joint pains, tendonitis and head aches on and off.

Can anyone PLEASE help me???

[Herself62]

June 17/13

TPO Antibodies <10 IU/mL        ( <35 )
Cortisol 3 specimins
@11:33 am  6.3 mcg/dL
@12:20 pm  26.2 mcg/dL
@12:45 pm 29.0 mcg/dL

because this test was not done at correct timing, I can't give the reference ranges. The reference ranges given are for Adult 7-9 am 4-.0 - 22.0 and Adult  3-5 pm 3.0 - 17.0

Free T3 3.3 pg/mL  (2.3 - 4.2)
Free t4 .82  (0.70 -1.55)
TSH 0.45 (0.25 - 5.0)

I've done a lot of research today. I've read many official endocrine sites, doctors papers, etc. I agree with you Barb, I don't have typical hyper or hypo thyroid blood work, it looks more like a pituitary issue. I've researched for endocrinologists on the AACE site, and www.ratemds.com. I've talked with Mary Shomon as well on facebook.

If anyone else has any suggestions I would still appreciate any feedback. Thank you!

[Herself62]

Menopause was natural, I did have a hyster at age 29. I needed it when I was 21, but doctor said I was too young.

[Herself62]

TY, so much for your response Barb!

I had
Anti-thyroglobulin Ab  <1.0 IU/mL (0.0-.9)
TPO Ab 20 IU/mL  (0-34)
C Reactive Protien  0.30 mg/dL (0.00 - 0.60)
Sed Rate 2 millimeters/hour (0-30)

I did a lymes test in may of 2013
IgM P41 ab - Absent
Igm P39 ab. - Absent
IgM P23 ab - Present. I was told this is normal because I had Mono in my late 20's

I've told my doctor I've had 9 severe blows to my head, and unconscious 3 times. (child hood was violent, accidents as adult)

When I asked for a ACTH stim test the endo I was sent to did it at 11 am, didn't have me fast or stop taking supplements. I was taking adrenal factor for a month at that time. If I didn't take supplements then, I would have been dead I think.

[Barb135]

It's really unfortunate that your doctor is ordering obsolete tests, instead of what you really need, which is the FT3.  The only test that you have that really tells us much is the FT4 and that level is pretty dismal.

At first glance, it would appear that maybe your pituitary is the problem, since both your TSH and FT4 are low.  It looks like your pituitary gland is not recognizing the need for more thyroid hormones, so isn't producing TSH to stimulate your thyroid.  Has your doctor done any pituitary testing?  Was your menopause "natural" or surgically induced?

Did you have any thyroid antibodies tested?  You should ask for Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) to confirm/rule out Hashimoto's Thyroiditis, which is an autoimmune thyroid disease, in which antibodies destroy healthy thyroid tissue, so it eventually produces no hormones.

Have you had any adrenal testing done?  The pituitary gland stimulates all of the endocrine glands to produce various hormones.  Pituitary issues can affect one or all of the endocrine glands.