Need guidance

[jlocke81]

I'll start with my question first:

What data/information in test results should I request after a blood test for hyperthyroidism?

After not having much luck with doctors over the last 3 years, I really need the help of the veterans on this site! :D

Three years ago I started having problems with dizziness and vertigo. I was diagnosed with everything under the sun pertaining to my ears by many different doctors.  Finally, after 3 whole years of gradually worsening problems, I finally was referred to an ENT specialist, who diagnosed me with TMJ and then suggested I get a blood test for hyperthyroidism and anemia (which I was told by many doctors I did not need even though I had not even requested it).

Not knowing what hyperthyroidism was, I looked up general information on it.  Generally, my symptoms match up.  Here's the list of my symptoms that may or may not be related.  Let me know what you think.

Dizziness, vertigo, ringing in my ear, insomnia, hyper, anxiety/panic attacks, horribly dry skin and chapped lips, thirst, frequent urination, hot flash (my armpits usually hurt and throb when this happens), constipation and then diarrhea, heart palpitations, horrible acne on my back, pale skin, blood-shot eyes regardless of quality of sleep, brain fog, inability to concentrate, hair just recently started to fall out in weird patterns, horrible reaction to alcohol in any amount (sweating, shaking, and convulsing in my sleep the night of drinking). I also am a 27 year-old male, 6'1" and only weigh 125 lbs, but I eat enough in a day to feed a small family as well as drink 3-4 meal replacement drinks. My pulse rate is 70 bpm (SP?) which didn't really seem to match up with the general symptoms of hyperthyroidism and my blood pressure is fine.

I don't know how much of this is relevant to hyperthyroidism, but there it is.  Because there are so many symptoms, I'm afraid I'll just be branded a hypochondriac or be pinned with anxiety or panic disorder considering the way I have been treated by doctors while this has been going on.  I might have believed it was mental if not due to the fact that I now look like a walking corpse and have no stress other than the stress that whatever this is is very slowly ruining every aspect of my life.

So, after my big sob story, I need to know what to specifically ask for in the test results instead of a "no, you're fine" answer because frankly--and sadly--my faith in doctors and medical science has been gravely shaken.

My blood test is this Tuesday and I have nobody else to turn too. Any help would be appreciated! :)

[AR-10]

What test results to ask about...

You should request a TSH test, a Free T4 test, and a Free T3 test.

The TSH test should come back somewhere between 0.8 and 1.8 if it is normal. If it is below 0.2, that indicates hyperthyroidism.

TSH is not the most reliable indicator.

Your Free T4 should be anywhere from a few points above the lower lab limit to several points below the upper lab limit. Below midrange is not unusual. Two points from the top indicates you might have too much T4 floating around.

Your Free T3 should be above midrange. If it is two points below upper limit, you might have too much T3 floating around.

Tell the doctor you want a Free T4 and a Free T3.
Some doctors order a Total T4 and a total T3, which are old tests, less acurate, and will not tell you anything.

You list a lot of symptoms. Many of them sound like either hyperthyroid or hypothyroid. Some of the symptoms are shared by the two conditions.

Many of them can be attributed to other conditions. They can also point to thyroid trouble. Anxiety and depression are common in both hypo and hyperthyroidism.

Don't let anyone shove antidepressants and cholesterol meds on you just because they can't come up with a diagnosis. Some doctors will try to treat six different symptoms instead of digging for the root cause.

If your tests come back hinting at hyperthyroidism, ask for antibody testing for ALL thyroid antibodies. You'll get three instead of ALL, but the three common ones are a start.

TSI (Thyroid Stimulating Immunoglobulin), the antibody that causes Grave's disease (autoimmune hyperthyroidism).

TPOab (Thyroid Peroxidase antibodies)

TGab ( antiThyroglobulin antibodies)  

[jlocke81]

Thanks for the speedy reply!

I'll be sure to ask for the copies of the results.

I'm drinking Ensure Plus and, thinking retrospectively, I believe that I do feel worse in periods while taking them.  I don't feel well enough to go shopping to get more at that point (whirlwind panic attacks and anxiety). I'll slowly get better and try to get back on the "healthy" horse and go buy more. It appears there might be something to that for me.  I'll take your advice and avoid iodine.

Thanks again!

[AR-10]

I scanned your post quickly, and have two thoughts.

1) Get copies of all your test results. Make it a habit. The doctor will get used to it. They are your property, and they do you more good at home than in a file at the clinic. The clinic can still keep their copy.

2) Check your meal replacement drink. If it has iodine in it, find a different brand. Ensure has 1/2 the day's MDR of Iodine, and if you are drinking three or four a day, you are making your hyperthyroidism worse, if that is your problem. I found that out the hard way.

IF you are hyperthyroid, you want to avoid iodine as much as is practical.

When you get your test results, post them here. From the copy you asked for. You are not wrong in doubts about a doctor looking at test results and giving you the "all is good" just because the report is not smoldering.

Thyroid test results are notorious for coming back "normal" while at the same time showing a problem that the doctor is not trained to notice.