Not a new hypo question, but seeking advice

[bmwM4me]

I've been reading this forum for about a month now, trying to absorb the information from the many helpful posters. Many of my symptoms are very similar to others:  heart palpitations, fatigue, dry skin, hair loss (like almost half!), weight gain (>30lb) , eyebrow hair loss, avg 97.8 waking temp, brain fog, memory loss, panic attacks, joint and muscle pains.  This has been happening for 3 years - I still drag myself through workouts and walking my dogs.  The primary care and gynecologist all said "welcome to menopause and getting older". deal with it.

I finally convinced my gyno to test my vitD after a papsmear came up at a grade 4 from being absolutely clear along with my other complaints. That was a 16 in late 2012. Supplementation helped a little, but did not resolve symptoms. During that time, I also broke my ankle - which looking back, should have been a sign to someone.

My primary care dr has been very unhelpful and spent more time telling me about her similar problems.  She agreed to some blood tests this past December:  vitD= 29. VitB12=471  (200-1100 pg/ML) and iron tested normal and the gluten intolerance test was negative.

I had my own hormones tested April 2013 after the VitD supplementation was not very helpful. those results:
estradiol        .5    1.3-3.3 range
prog               7    75-270
testosterone   15   16-55
DHEAS          2.2      2-23
The gyn was shocked at these values  (I wasn't) and am now on estrogen and progesterone from a compounding pharmacy.  My last 2 papsmears are now back to normal.  My periods have returned.

I've had my own thyroid tests done last month:
Thyroxine (T4) 7.1 4.5-12.0 ug/dL
T3 Uptake          25 24-39 %
Free Thyroxine Index 1.8 1.2-4.9
TSH                 1.93 0.450-4.500 uIU/mL
Triiodothyronine,Free,Serum 3.1 2.0-4.4 pg/mL
T4,Free(Direct) 1.14 0.82-1.77 ng/dL
Thyroglobulin, Antibody <1.0 0.0-0.9 IU/mL
Thyroid Peroxidase (TPO) <6 0-34 IU/mL


They appear to be "normal" - but symptoms persist. Will the estrogen/prog supplementation impact these tests? I am taking VitD, calcium and vitB12 supplements as well.  The fatigue is not as bad and the panic attacks have completed disappeared, so some things are getting better.  I am alarmed by my ever increasing weight as diabetes runs very strongly in my family and I have been so vigilant the past 25 years.

At 51, I don't think I should feel like an 80+ year old woman.  I have spent an enormous amount of money out-of-pocket on blood tests, even acupuncture (that guy told me something was wrong with my liver???) Somehow, it appears that a lot of things got out of whack - not sure what started it, maybe the VitD being so low.
I'd appreciate any feedback.  At this point, I'm not sure who to go see - the gyn or find another primary care dr.
Thank you -  reading these posts have confirmed that I am not nuts, that alone has been a relief.  My apologies for such a long post.

[Barb135]

Adequate iron is necessary for metabolism/production of thyroid hormones, so it's important to keep levels high enough.  You gained weight like I did - I put on > 30 pounds in < 3 months!!  

You don't have to have the Glucose Tolerance Test (GTT - the one with the nasty drink).  You can request an A1c test which will give you an average of your blood sugar levels over the past 3 months.  That will tell you whether or not your blood sugar levels are running too high sometimes.

Yes, it would be a good idea to have the reproductive hormones retested to make sure they're in the normal ranges.

No, doctors will not request a an ultrasound if there's no evidence to support need, but you can ask for one, based on your symptoms.  It's  not unusual for symptoms to appear long before labs indicate an issue.  An ultrasound, on the other hand, can tell whether or not there's swelling/inflammation in your thyroid or if you have nodules.  If you have any of those, the chance that you do have Hashimoto's is even greater.  Some people have been diagnosed with Hashimoto's, simply based on swelling/inflammation and/or thyroid nodules.

[bmwM4me]

Hi Barb-
thanks for the reply.  I will check on the iron level value - don't know the specific count. The weight gain pushed me to a 28.5 BMI and 2-3 clothing size changes. Glucose was 87 in Dec, but have not had blood sugar testing (with the nasty drink 1st thing in the morning) for many years.  My cholesterol was 160 a year ago with chol/hdlc ratio at 2.9.
I have considered  having the hormones tested again, because I wonder if I still need them.  Since all drs have said the thyroid is "normal", there has been no suggestion for ultra sound.  Will a dr typically request this procedure with little evidence to support?
thanks

[Barb135]

No, you're not nuts.... Rule of thumb for FT4 is about mid range; yours is at 33%.  Rule of thumb for FT3 is 50+% of its range; yours is 45%.  Your levels aren't "horrible", so it will probably be difficult to get anyone to treat you for thyroid, but a trial dose of thyroid hormone replacement wouldn't hurt and could very well help.  

Just to make it less expensive, next time you have thyroid blood work, all you really need to get is Free T3 (Triiodothyronine, Free), Free T4 and TSH.  Thyroxine (Total T4), T3 uptake and Free thyroxine index are considered outdated and of very little value, so you can save your money on those.

Vitamin D deficiency can cause a lot of hypo like symptoms, so that could be part of your problems.  In addition, even though your B-12 was "in range", it's quite low.  Anything below about 500 can cause symptoms of deficiency.  I, personally, have to keep my levels at the very top of the range, or even over in order to feel well.

What was the exact iron level, with reference range?

Have you had reproductive hormones tested again, since you've been on the compounded hormones?

Have you had any blood sugar testing done?  What are your current cholesterol and triglyceride levels?  Did gaining > 30 pounds cause you to be overweight?  

Have you had a thyroid ultra sound done to determine if you have nodules or swelling/inflammation of your thyroid?