Help!

[mh22888]

I am looking for advice as I'm at my wit's end. I have been struggling with hypothyroid symptoms for over 2.5 years and they've gotten more severe over time. I recently switched doctors as I felt like I was not genuinely being listened to and treated. My main symptoms are chronic fatigue (despite regularly 8 hours of sleep), joint stiffness and pain (some days even in my knuckles) and inability to lose weight, most recently weight gain. I have gained 55 pounds since October 2014. I am a vegetarian and eat under 1500 calories a day, making sure to get a good amount of protein and stay hydrated. I also have been working out 3x/week (cardio & strength training). These symptoms have also caused greater anxiety and depression. I am 27 years old and am genuinely afraid that I feel the way I do and it's not being taken seriously.

My TSH has been climbing from a 2.33 over the past few years. My most recent was 3.55 and in June it was 3.94. I just spoke to a nurse as my doctor is out of the office and while still deemed within the "normal range" I requested I be put on a low dose hormone as the Dr. had agreed my symptoms sounded very hypothyroid. I said that my numbers have been increasing over the years and while I understand the labs I would like to be treated based on my symptoms and not have to continue on like this until I "pop normal". She said that she will follow up with the doctor but that is unlikely. I'm rather upset because the new lab ranges are 1 point higher than my previous doctor also. I also went to an endocrinologist a few years ago as well as in June. She said that she suspected that my TSH was a fluke and my thyroid is fine. My cortisol, adrenals, etc all checked out fine as well. I listed my most recent labs (8/24) below. I really don't know what to do. I feel like everyone is acting as though I'm crazy. I can tell that this is not right for my body.

Component Standard Range Your Value
T4 FREE         0.82 - 1.77 ng/dL 0.90
TSH                0.450 - 4.500 uIU/mL 3.550

[flyingfool]

The thing that has me scratching my head. Is that the one Dr you had was able to "dismiss" the blood lab TSH as being a "FLUKE", and also dismissed your symptoms.  When BOTH of them were consistent with being Hypo!!!!

Your FT4 as states above is dismally low. Again would be consistent with Hypo.

So lets see here.  Three things all align, your sylmptoms, and two separate blood tests all indicate low in range or hypo.

Hummmm

Maybe we need a rocket scientist to figure out this trend!!!!!!

Be insistent and without results, find another Dr.  you would not be the first person here who has had to fire and hire MULTIPLE Dr's before finding one who actually had a clue and helped the patient feel better.

[goolarra]

Yes, if your result was 0.9 with a reference range of 0-4.0, it was negative.  However, there are two antibodies that are markers for Hashi's, TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies).  You only have to be positive for one to confirm Hashi's, but you can't rule it out unless both are negative.  Furthermore, many more of us who have Hashi's are positive for TPOab than TGab.  So, if your doctor was only going to test one, he really tested the wrong one.  The reason I think this is important is that doctors tend to want to see a test "out of range" before they will treat.  If you are positive for antibodies, it might help your cause.  You might have to find a new doctor.

Also, your doctor didn't test FT3, and FT3 is the test that correlates best with symptoms.  Good thyroid doctors test FT3 and know that an FT4 result at 8% of range is insufficient.  

Don't give up; it's worth the effort to find someone who will treat you.  

[mh22888]

Yes- I'm in the USA.

Those are the Thyroglobulin Antibody (TGaB). My understanding is that that means the test was negative?

[goolarra]

Were those TPO antibodies or TG antibodies?   I don't understand the result and reference range...result of 0.9 with a reference range of less-than 4.0???

Are you in the States?

[mh22888]

My antibodies were tested at the end of May -
< 0.9 _IUnits/mL (Normal)
CDT Reference Range:_IUnits/mL - 4.0 _IUnits/mL

It sounds doubtful that they're going to put me on meds. I'll wait to hear back from the doctor though to be sure.

Thanks!

[goolarra]

Your FT4 is way, way too low.  It's at 8% of range, and many of us have found that hypo symptoms persist until FT4 is around 50% of range.  AACE recommended many years ago (as you can see it's been largely ignored by doctors and labs) that TSH range be changed to 0.3-3.0.  Even though that's a more reasonable range, many people still don't feel well at the top end of that range (3.0).

I bet you'd feel a whole lot better on meds.  

Has anyone tested antibodies?