I have found the input and support from folks on this website to be so very helpful, informative and encouraging! I am hoping someone here can help me interpret my recent self-requested labs and offer some advice on my hair loss issue. I have Hashimoto's hypothyroidism, diagnosed in 2009. Current symptoms that may or may not be related are:
Extreme brain fog and forgetfulness (first noticed in 2010; it gradually has worsened)
Hair Loss (have had since mid 2000s but it has worsened)
Difficulty losing weight (started gaining fast in 2013, only recently have lost some)
Intolerance to both heat and cold (used to be only to cold but started noticing intolerance to heat around 2013)
Hirsutism (ongoing, and I have PCOS)
Irregular cycles (started in 2015 after starting a very stressful job)
Oily scalp and acne on scalp (in past two years)
Poor complexion (since 2013)
Acid reflux (since 2009 after taking an antibiotic)
Inability to handle stress and easily startled (ongoing; possible adrenal issues)
Low energy in afternoons (possible adrenal issues)
Joint stiffness and pain (since 1999, no autoimmune connection found)
I need to clarify that I currently am not under a doctor's care and have been self-medicating on NDT. I admit it's an unwise way to go, but I haven't ever found a doctor who was willing to treat based on symptoms -- every doctor I've seen would treat based on TSH, didn't see a need to order extensive thyroid labs, and thought synthetic T4 was a good fit for everybody. I've had other conditions throughout my life that have worsened under doctors' care and I have avoided doctors for years. I realize that it's time to try again to find a good doctor but I dread trying to find one here in San Antonio who treats clinically on symptoms instead of basing treatment on TSH levels and who routinely orders comprehensive thyroid labs and understands their importance. (The place that diagnosed me with Hashimoto's back in 2009 was a Fibromyalgia clinic located 250 miles away.) Funds also currently are an issue, as I am out of work.
Here are my labs from July 2018, which reflect taking NDT (but I withheld my morning dose until after the lab draw):
TSH: 0.042 "LOW" (Ref range 0.45 to 4.5)
FT4: 1.35 (Ref range 0.82-1.77)
RT3: 28.6 "HIGH" (Ref range 9.2 to 24.1)
FT3: 3.8 (Ref range 2.0 to 4.4)
ATA: <1.0 (Ref range 0.0 to 0.9)
TPO Ab: 103 "HIGH" (Ref range 0 - 34)
Here are my previous labs, done in 2013. I don't remember whether or not I was taking anything for the thyroid at the time:
TSH: 1.39
FT4: 0.84
RT3: 20.6
FT3: 2.3
ATA: <20
TPO Ab: 161
Some recent history: At the end of February, I decided to cut wheat and sugar out of my diet to see if I could improve my hashimoto's, improve my health and lose weight (starting weight was 250lbs, I am female, 50 years old and 5'1"). It led to doing the Keto diet and I currently still am eating low-carb though I don't actually count the carb grams. I still intentionally don't eat wheat but I think that sometimes it may be in seasonings of some restaurant foods. The only grain I have is the occasional corn tortilla. In the past five months, the only sugar or wheat "cheats" I have had was a slice of wedding cake I ate in early July. I started taking NDT (Thyroid-S from Thailand) in February and worked up to taking 2 grains per day. I did notice an increase in hair loss after starting it but it was hard to say at the time whether it was the NDT or a possible deficiency from changing my diet. It was concerning but not extreme. I sometimes would forget to take the NDT. In late May, I realized I was running low so I ordered more. It took much longer to arrive from Thailand than expected and I ended up going a little over 3 weeks without any NDT. During this time, I started gaining back weight I had lost since February (had lost 24 lbs and was at a point of losing 1/2 to 1 pound a week, very slow weight loss, but now was gaining a pound a week instead). Also, I started having chills in the evenings and sometimes had trouble falling asleep at night because I was so cold and couldn’t seem to warm up. When I finally received the NDT about 3 weeks ago, I immediately resumed taking it. Perhaps unwisely, I upped the dose to 3 grains (wasn't feeling any symptom relief on 2 grains) and within a few days of taking it my hair started falling out at an alarming rate. Once I realized the hair loss wasn't stopping, I lowered the NDT dose back down to 2 grains (1 grain upon awakening, the other in the early afternoon), but unfortunately the pronounced hair loss has not improved. In less than a month I have lost 30-40% of my hair with no signs of it stopping. I find it everywhere, it clogs the drains, it falls in my food, it falls on my clothing throughout the day, and my scalp is visible and is very itchy. I have no idea if restarting the NDT without gradually working up to the previous dose suddenly suppressed my thyroid, causing temporarily increased hair loss, or if I'm taking too much. I certainly do not have any hyper symptoms. I am so distressed over the hair loss. If it doesn't let up or start growing back, I will have to wear a cap or wig to hide my baldness by the time my birthday rolls around this month. The only positive I've seen so far since restarting NDT is that my weight has gone back down a couple of pounds.
Can someone help me interpret my labs and offer any advice on where to go from here? Also, any insight as to the sudden excessive hair loss? I think that the stress from the hair loss is causing me to lose even more hair!
I have scheduled more labs for Monday: Female Panel to include hormones; B12 & Folate; Ferritin; Vitamin D, as I know those can affect my thyroid and adrenal functions. I also I believe I need to get my adrenals tested. Can anyone recommend which Adrenal test is most useful? I’m trying not to spend more than I need to as funds are very tight for me. Thanks so much to everyone who takes the time to read this.