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Thyroid issues - any insight is appreciated

Family Dr has referred me to an endocrinologist, but I cannot get an appt for 2 mos and I am confused.  Labs show hyperthyroid but my symptoms are mostly hypo and have been for years.

54yo F (5'0" 130 lbs) in late menopause. Mostly vegetarian for 5 yrs but with plenty of egg, dairy and collagen supplement.  Was taking supplements for last 2 years including B vit (and 3000mcg of Biotin for nail & hair), high zinc & D since CV19, but went off all supplements when sick in March, so no vitamins taken prior to labs for 60 days.

I had a physical since it had been 3 years since going to Dr. and had 2 bouts of non-CV19 sickness this year (Jan & Mar). I had not had a resp. infection in over 5 years - I am rarely sick. Following bronchitis in March, I had tenderness in neck near thyroid.  New PCP felt thickness and ordered ultrasound and thyroid labs. I have had typical symptoms of hypo for years, although former PCP would not order tests and told me I was getting older and should eat less, work on sleep habits and exercise to not gain weight.
Symptoms:
Fatigue and insomnia
Increased sensitivity to cold - can be extreme
Constipation  and digestive issues
Dry skin  
Weight gain (difficulty losing weight) even on 1100 cal/day
Hoarseness
Blood cholesterol level - higher than past years, but only slightly elevated
Pain, stiffness or swelling in your joints
Heavier than normal or irregular menstrual periods - hemorrhaged 2x - 5 yrs ago and had ablation
Thinning hair - nails splitting before growing to finger tip
Slowed heart rate & BP on low side - now normal, previously low
Depression
Impaired memory

Images:
IMPRESSION: Diffuse heterogeneity of the thyroid without definitive isolated nodule.

RECOMMENDATION: No features requiring follow-up.
FINDINGS: Thyroid Dimensions (cc length x transverse width x AP):

Right Lobe: 3.5 x 1.4 x 1.7 cm.
Left Lobe: 3.7 x 1.4 x 1.5 cm.
Isthmus: 0.4 cm.
Vascularity: Normal
Overall echotexture of the gland: Moderately heterogeneous bilateral.
No abnormal lymph nodes identified.
Nodule Assessment*:  No nodules.

Labs:
TSH <0.01 mcIU/mL 0.30 - 5.00 mcIU/mL L
Free T4 1.7 ng/dL         0.6 - 1.6 ng/dL                H
Excess biotin may interfere with this test. Please contact the clinical laboratory if more information is needed.
No T3 was done

Total Protein 6.1 gm/dL    6.4 - 8.9 gm/dL L
Albumin 3.6 gm/dL     3.5 - 5.7 gm/dL
Iron 86 mcg/dL             32 - 192 mcg/dL
Iron Saturation 30 %    15 - 58 %
Transferrin       206.2 mg/dL 205.0 - 400.0 mg/dL
All other labs were in normal level
B12 and D were not done.
Why is my only symptom of hyperthyroid insomnia (perhaps the occasional hot flash) and the rest of the symptoms are aligned with hypo?
What recommendations can you provide moving forward?
Lab tests, diet, etc - my endocrine appt is not until early August, do I need to worry that it is so far out?
Thank you for any insight or advice!

1 Responses
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Avatar universal
You have multiple symptoms of being hypothyroid, with test results that do not correlate.  Even the sleep problem mentioned can also be related to being hypo.  

Taking biotin will definitely affect your thyroid related test results , similar to what you show.  If possible, after being off biotin for at least two weeks, I suggest that you make sure to get tested for Free T4, Free T3, TSH, Vitamin D, B12 and ferritin.   Do you think you can get those done?

Beyond having all those symptoms, I see nothing to worry about while getting this figured out.  
Helpful - 1
1 Comments
Thank you,  I will stop all supplements and then see about getting the blood tests prior to my Dr visit and re-post results.  I appreciate your extensive knowledge and contributions on this forum.
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