Is my enlarged thyroid causing these issues? Treatment or diagnosis tips?

[Victoria3719]

I'm a 21 year old female college student, and since I hit puberty when I around 12 years old, I have had trouble losing weight... I'm about 6 foot 1, 250 lbs but I'm very active and I workout 5 days a week, resistance training for an hour and sometimes cardio. I play basketball once a week as well. I found out 5 years ago that I had an enlarged thyroid, which I blame for the massive weight gain and extreme hair loss. However, after going to the doctor numerous times, all my tests came out "normal". I know something's wrong... I still have hair loss, I can't lose any  weight, I'm always fatigued, and I get this weird burning, achy sensation in my throat every once and a while. Sometimes I have heavy periods, have random nausea, and my voice is deep. Nevertheless, I really need to lose weight; I have almost every genetic factor leading to CVD, diabetes, HBP, etc in my family history. Weight loss and energy is essential! Please help! What can I do? What could it be?

[Victoria3719]

Thank you so much! I'm not sure when I'll get the tests done but I will post them for sure. I know one thing that my doctor has said (the one I see while I'm in college) is that my ferritin levels are low. I couldn't find the paper but I think it was in the low twenties last month.


When I do test, should I test for anything else other than Free T3 and Free T4?

[gimel]

Make sure they test for Free T3 and Free T4, not Total T3 and Total T4.  Also test for Vitamin D, B12 and ferritin.  Since you recall being low on ferritin in the past, I would also request a test for Reverse T3.  That might be difficult to get them to do the Reverse T3 test, but worth a try.  

[Victoria3719]

Ferritin = 25
TSH = 1.86
T3 Uptake = 32
T4 Total = 6.0
Free T4 = 1.9

They said my Ferritin was kind of low, but other than that, they said everything is normal. They didn't give me the Free T3 or the Reverse T3 test.

[gimel]

I expect that your doctor is as outdated as some of those tests.  The T3 uptake and Total T4 are no longer recommended.  Free T4 and Free T3 should be done every time you go for tests.  If they resist, you should insist and don't take no for an answer.  

Before commenting further, what was the reference ranges for those tests, as shown on the lab report?  Test results and associated reference ranges vary from lab to lab so results must always be compared to ranges from the same lab.  

[Victoria3719]

Sorry! Forgot to post the reference ranges.

T3 Uptake is 22-35%
T4 Total is 4.5-12 mcg/dL
Free T4 is 1.4-3.8

[gimel]

I have never seen a Free T4 range that broad.  Is that shown on the lab report, or did someone tell you by phone?