Labs, Doctors, Confusion... Help?

[miles837]

Hello. I am new to the world of the Thyroid and would appreciate some guidance!

In May I had some simple blood work done at my gyno's office. She prescribed the nuvaring birth control for me but wanted to generally check things out. My labs came back unusual, so she had me wait about 7 weeks and then tested me again. The labs were still unusual...so I was referred to an endocrinologist.  I understand that BC can alter lab results sometimes - but she prescribed it, fully aware of what it does to women, and was still concerned about my labs. I have also been on this birth control for over two years and have never, ever felt this way.

I finally went to an endo who was actually super mean and patronizing. He claimed that, based on a five minute physical exam, I was fine but he ordered a full work up for me anyway. He didn't even actually listen to how awful I felt.
I am suffering from a whole bunch of the hypothyroid symptoms... Changes in hair, dry skin, extreme and unusual fatigue, extreme sensitivity to light, loss of appetite/gaining of weight, painful joints, and did I mention extreme fatigue?! I feel awful. No matter how much sleep I get, I am still so exhausted I can barely raise my arms. I am a teacher and it is interfering with my work.

These are my lab results:
Cortisol  17.8     (norm. 2.3-19.4)
TSI          76      (norm 0-139)
TSH          2.75  (norm .45-4.5 OR .3-3.0)
T4            15.2   (norm 4.5-12.0)
T3Uptake  19      (norm 24-39)
T3             232   (norm 71-180)

Now, I had a follow up appointment today and, surprise, surprise, the doctor was unkind. He told me that the numbers could be just because my body makes more of a specific thing. He mentioned the birth control (which I already knew about). But he patronized me and danced around my questions. I was trying to self-advocate and ask him for help or other routes to take and he basically said that based on my labs, it wasn't his problem.

Am I making up this hypothyroid thing up? Where might these symptoms be coming from? I am so exhausted that I honestly have no idea where to turn. I made an appointment with my family practitioner to see what he says, but I would love to hear what you have to say.

Thank you.

[miles837]

I don't think it is the BC because I have been on it for years with no issue.

[Totie]

Could the BC be causing your symptoms? Just a thought, I am not sure of the side effects of the BC you are on.

[gimel]

There is very little in those test results that indicate a hypothyroid condition; however, the tests are for Total T3 and Total T4, which are somewhat outdated, and not nearly as revealing as would be tests for Free T3 and Free T4.  Most of Total T3 and Total T4 is bound up with protein and thereby biologically inactive.  Only the small portions not bound to protein,  and designated as "Free" are biologically active.  

Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms while Free T4 and TSH did not correlate at all.  So one of the things i suggest is to ask your family practitioner to test for Free T3 and Free T4.  If he resists, just insist on it and don't take no for an answer.  

By the way, even though the T3 uptake test is also outdated, and not very useful any more, note that yours is below range, which is on the hypo side.  

Since many people find that they are too low in the range for Vitamin D, B12, and ferritin, I also suggest that you request to be tested for those as well.  Deficiencies in those areas can result in symptoms that mimic hypo symptoms.  

If you are able to get the above tests done, when results are available, pleae get a copy of the lab report and post results and their reference ranges shown on the lab report and members will be glad to help interpret and advise further.