Should I pursue the possibility of a thyroid condition even if my TSH/TT4 is normal?

[MarySunshine1983]

Hi Everyone,
I recently started researching thyroid conditions since a practitioner who I sought help from for depression suggested I look into it. I do seem to have about 60% of the symptoms of hypothyroidism. Namely depression, anxiety, irritability, fatigue, cold-intolerance, cold hands and feet, difficulty concentrating, low sex drive, acne, and a recent miscarriage.

I asked my PCP to run tests. Ahem:
TSH 2.6
Total t4 8
Total t3 33

I understand that even thought my t3 was low, that is ignored since the other two levels are okay. Through research I am wondering if he should have run a couple more tests (namely, free t4/t3 levels and thyroid antibodies) and if he should have considered the possibility that I am hypothyroid based on clinical symptoms despite lab results. I have made an appointment with an endocrinologist. Will they laugh at me? Should I just drop this since my TSH is okay?

I just want to feel normal. I also want to have a baby someone later this year and I need to feel good and know that I am at my healthiest and won't be at risk for miscarrying again.

[stella5349]

Let's see... first your TSH is 4.6 and that is your most recent test right? If you take the current reference ranges which are .3 to 3.0 ( max 5.5) You "could be subclinical hypo thyroid

I never use that 5.5 - but some physicians and endo do??? That is where you may have a problem.

Not really -- TSH (if not on any replacement meds) will change like that. Especially if your hormones are out of whack from the miscarriage.

If the endo you see follows the "old " range of .5 - 5.5 he may look at you and put you on a bus home. This is where the doctor / patient/ problems come in. and it is awful. SOme / MOST endos do not have a "great bed side manner" so a reference number to them IS WHO YOU ARE  and your symptoms won't matter.

My advice is to call - and ask what reference range your physician follows for TSH. SOme patients (even in the current range) still experience hypo or hyper symptoms depending on where you are in levels. Optimally- 1.0 - 1.5 is the best area to be in and most feel really good shooting around those levels for themselves.

Listen to your body - keep accurate records (ask for everything)_ always.

DOn't get too ahead of yourself on the PG thing right now. Many... many complications may happen if you are hypo thyroid and you just do not want to have anything happen. Your situations sounds very promising and I believe you will get pregnant and have a healthy family - right now concentrate on that sub clinical Hypo thing first. Remember 1.0-1.5. You have a way to get there.

[MarySunshine1983]

I forgot to ask -- is that really weird that my TSH went from 2.6 to 4.6 in just about 2 weeks?

[MarySunshine1983]

So, here were my results:

Negative antibodies
Free t4 1.1
TSH 4.6

The NP said she wanted to wait four weeks and then retest. She would be in favor of starting synthroid if the TSH doesn't come down.

I'm totally confused. I can find very little information in the medical literature that believes that my thyroid would explain my symptoms with such a borderline TSH. However, I have found some literature indicating that I SHOULD be getting thyroid replacement therapy if I plan to become pregnant (which I do). So....huh. I would just love to feel better and have a healthy pregnancy.

[helen1207]

if no issue with thyroid, perhaps you want to ask to have adrenaline checked out. that's what my doctor is suggesting. lack of adrenaline will have some similar symptoms.

[fibro_fog]

If I were you I would definitely pursue it!!!  Though there are other conditions that could cause some of that it sounds likely that you are on the right track.  You are correct that you need to run the other tests.  Hashi's runs in my family (sister, father, nieces) and none of us were diagnosed by those tests you mentioned.  We all had high antibodies and all of us respond well to the thyroid replacement hormones.  Hashi's causes inflammation of the thyroid.  When I had mine out the surgeon was surprised at how large it was - this is classic Hashi's.

Hope you find your answers soon,

Blessings,

Valerie

[Letterer]

I don't have any personal experience with that, but there are many stories on here of women who have had trouble conceiving and/or maintaining pregnancy. You need to get yourself optimized before you try again, if Hypo is the culprit.

I'm not a medical pro, just a patient, but I can tell you from my own experience - my TSH was only 2.48, but with positive antibodies and symptoms and family history I began treatment.

Keep posting and reading, let us know how things go.

[MarySunshine1983]

Thanks SO much letterer. Yes, I have had one miscarriage (no living children). While miscarriage is really common, I couldn't help but wonder, in light of all my other symptoms, if there wasn't a thyroid situation I should nip in the bud now.

[Letterer]

It's difficult to say based on your numbers above, because those are totals and not frees, but I'd agree that your TSH with symptoms (gray hair at 25!) warrants looking deeper, especially if you're planning on getting pregnant. You need to have the TSH, FT4, FT3 and antibodies (TPO & TG) run and see how they relate to each other. Post those results along with your ranges and you'll be able to get some better feedback.

You'll also want to check into adrenal function, iron/ferritin, vit D, B12, etc. to rule out deficiencies there as well.

Do you have any family history of thyroid problems that you know of? Autoimmune (Hashimoto's) is the most common cause of hypothyroidism. From your post it seems you have miscarried before? Google Hashimoto's/thyroid/pregnancy, you'll see where dysfuncttion may cause problems. If Hashi's is your problem, know that there are many who have successfully optimized their levels and have gone on to have healthy babies.

You may need to go through a doc or two if you feel they don't or won't look beyond just the TSH. I wish you luck - learn all you can so you can discuss with your doc what might be best for you!

[MarySunshine1983]

I forgot to add one more (possible) symptom: I'm 25 years old and my hair is about 30% grey.