Thyriod issues or chronic fatigue?

[ellie_carbone]

Hi, I am going through the process of seeing if I have hypothyroidism. I spoke with my dr today who suspects that I could have chronic fatigue syndrome. I'm getting blood results, but just curious to see if anyone has been misdiagnosed? I feel like the symptoms overlap a lot. Are there any symptoms that would indicate one over the other? Thank you :)

[Barb135]

A lot of symptoms overlap between hypothyroidism and Chronic Fatigue and it's easy to be misdiagnosed - the main one being fatigue.  Other common symptoms of hypothyroidism include weight gain/inability to lose, constipation, hair loss, puffiness in the face (especially, under the eyes), joint/muscle pain.

Do you know what tests your doctor has ordered to rule out/confirm hypothyroidism?  I hope s/he's not simply relying on a TSH test because you'll need a lot more than that.  In addition to TSH, you should be getting Free T4 and Free T3 (as opposed to Total T4 and Total T3), and antibody tests, Thyroid Peroxidase (TPOab) and Thyroglobulin Antibodies (TgAb).  The antibody tests would confirm Hashimoto's, which can cause symptoms of hypothyroidism before TSH is elevated or FT levels are decreased enough for a diagnosis.  

You should also be getting a thyroid ultrasound to determine whether or not you have thyroid nodules.  An ultrasound can also help to diagnose Hashimoto's since Hashimoto's produces certain characteristics of the thyroid.

In addition, you should ask for Vitamin B-12, Vitamin D and Ferritin tests.  Vitamin B-12 deficiency can cause the most intense fatigue you can imagine, along with some other symptoms.  All 3 are needed to properly produce and utilize thyroid hormones.

[ellie_carbone]

Thank you for the comment. I don't have the muscle/joint pain or weight issues with my symptoms, but I have everything else.

They have requested TFT, TSH & T4 if indicated. Vit D + B12. Also looking at ANA, Mg and zinc.

[Barb135]

“TSH & T4, if indicated” tells me they ordered TSH w/Reflex, meaning that they will only do T4 if TSH is out of range.  That’s an obsolete way of doing thyroid function tests.   You should insist on Free T4 and Free T3, which are the actual thyroid hormones.  FT levels can be too low before TSH gets high enough to indicate a problem.    

ANA can be helpful, but, at this point, actual thyroid antibodies would be a lot more useful.   Can you also get them to include Ferritin?  

[ellie_carbone]

Hi, that is really helpful- thank you. I have been thinking of ordering my tests privately. My ferritin was tested it was 72 (range: 30-160). Would ferritin indicate thyroid dysfunction?