What to do about normal labs with hypo symptoms?

[Kris0721]

I have almost all symptoms for hypothyroidism but my labs come back normal according to the dr. They checked tsh/t3/t4 and antibodies. I have a nodule and they said my thyroid felt full.
Can I still be hypo with normal labs?
There HAS to be an answer for all of this misery. Thanks in advance for your input. I'm at the end of my rope trying to figure out how to get some relief

[gimel]

The best I can offer is a doctor in Ventura, recommended by a fellow member.  Would that be of interest to you?

[JSS1736]

I live in north Orange County CA.  I'm hypo and my incredibly bright/compassionate Dr. died suddenly 15 months ago.  I have yet to find an endocrinologist who is knowledgeable and has a good rapport with patients.  I'm a former ER/OR RN so my standards are high.  Can someone Please suggest a endocrinologist in my area?  Thank you so much!  I'm very glad I found this community.

[gimel]

Well, you can insist on testing for Free T3 and free T4 (not the same as Total T3 and T4).  If the doctor resists, explain that TSH is a pituitary hormone that is supposed to accurately reflect levels of the actual thyroid hormones, but in actuality cannot be shown to correlate well with either Free T3 or free T4, much less with symptoms, which should be the most important consideration.

Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  If the doctor still resists, then you should again insist and don't take no for an answer.  

If that fails, then you might as well find a good thyroid doctor.  A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

[Conn333]

I too am really suffering and believe it to be thyroid related. My result on my tests
TSH 1.10
not sure what T3 and T4 is.
I am having such a hard time getting anywhere with my doctor. Not sure what to do. Any suggestions would be appreciated.

[gimel]

The best I have for you right now is this link to the Top Thyroid doctors site for Kentucky.  Have a look through it and be sure to read all the patients' reviews  and see if there is a doctor that seems to be a prospect for you.   If not, then let me know and I'll look further.

http://www.thyroid-info.com/topdrs/kentucky.htm

[Kris0721]

Central ky

[gimel]

Big state.  Please narrow it down a bit.  

[Kris0721]

I'm in ky

[gimel]

As stated previously, just because your thyroid test results are within the so-called "normal" ranges does not mean they are adequate for you.  First the ranges are far too broad, due to the way they are established.  Second, everyone is different and has their own optimal levels at which they feel best.  A patient with test results in the high end of the ranges has over twice as much serum thyroid hormone, yet according to "Reference range endocrinology", both are considered as "normal", nothing further required.  Where is the logic to that ?

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf  

So you really need to find a good thyroid doctor that will treat clinically, as described.  If you will please give us your location, perhaps a member can recommend a good thyroid doctor near you.  

Also, when you go in for tests again, you should also request to be tested for Vitamin D, B12 and ferritin.  Hypo patients often find they are too low in the ranges for these three, which can cause symptoms as well.

[Kris0721]

Thanks

[Kris0721]

TSH .450-4.500
T3 2.0-4.4
T4 0.82-1.77
Antibodies 0-34

[gimel]

You certainly have lots of typical symptoms of being hypothyroid.  Before commenting further, please post the reference ranges for those Free T3 and Free T4 test results.  Since results and associated reference ranges vary from lab to lab, it is always best to compare results to the ranges shown on the lab report.

[Karli143]

That sounds like me
my latest labs:
Tsh .44(.45-4.5)
Ft4 1.09(.89-1.78)
Ft3 3.1(2.0-4.4)
I am in remission from graves, my Tsh has bounced around from .40 - .71.

My endo won't prescribe replacement cause of my Tsh.
Biggest symptom I have is ache and numbness in my legs

[Kris0721]

Thanks for the reply. Here are my results
TSH:1.62
T3:3.3
T4:1.15
Antibodies:9

My symptoms:
Weight Gain(11#'s in 3 months)
Hair Loss
Pain
Fatigue
Insomnia
Depression
Anxiety
No Energy
Cold Weather makes everything worse
Very sensitive to everything, especially smells.
Hand and Foot swelling
Arthritis (Worse in hands)
Very Weak
Dizzy/Lightheaded(Vertigo)
Migraines
Constipation
numbness in hands and feet
fibromyalgia
Hot Flashes, straight into freezing
Low Basal Body Temp
Irritibility
memory loss

[Kris0721]

Thanks for the feedback.  I had an ultrasound after they saw a nodule on x-ray.

[nicolelm]

Lee*  and Nolin

Sorry....Gena Lee Nolin..lol.

[nicolelm]

If your thyroid feels full, you should get an ultrasound. Gena Leen Nollins ( an actress with Hashimoto's) said that her antibodies came back negative, but they were able to diagnose her hashi's with an ultrasound. Have them take a look, see what's going on in there.

That's something I want to try.

[gimel]

Just because lab results are in the so-called "normal' range does not mean they are adequate for you.  The ranges are far too broad to be functional for many people.  If you will please post your lab results and reference ranges shown on the lab report, along with symptoms you have, members will be better able to assess your status.