Do you have to have bad thyroid blood tests results to have thyroid issues?

[t4me]

I'm sorry but I have to give some background on my condition before I get to the thyroid part--please bear with me. I have been having some horrible things going on lately.  About 2 months ago I had double vision--like pulling in the eyes--had all kinds of tests--everything ok---I have been very irritable for the last 6 months or so, i am having terrible heart palpitations and several episodes of psvt.  The cardio docs say my heart is fine, however I feel sick all the time.  Every time I eat I get palpitations or pounding heart, I have a lump under my armpit and I have pressure in my upper chest throat area.  At night when I lay down I get a pounding/pressure feeling in my head/ears.  I have recently lost 20 pounds because I'm afraid to eat.  I feel like I have a fever, but I don't.  My hands and feet are always cold (my palms sometimes are almost white).  I get leg cramps at night also. I really just feel sick all the time and it is really interferring with my life.  I had 3 thyroid blood tests done and they all fall in the normal range.  tsh 1.78, T4 1.37, then tsh 1.23 2 weeks later.  My cholesterol also fluctuated alot Jul. 2nd  196 total, 114 triglycerides, 50 hdl, 108 ldl---Jul. 26 246 total,  179 triglycerides, hdl 51, ldl 159---Aug. 2nd  177 total, 151 triglycerides, 50 hdl, and 97 ldl.  I had a carotid artery scan which showed an "incidental left thyroid lobe 1.75 x l.53 x 1.3 cm solid mass with no increased color doppler signal".  From this they did a FNA and the results were "the specimen is moderately cellular consisting of bland appearing follicular epithelial cells with hurthle cell change.  there is scant colloid.  features of papillary thyroid carcinoma are not noted.  follow up is suggested".  Even though my thyroid tests came out in the normal range could I still be having all these issues due to thyroid problems?  Also, can someone help me understand my test results?  I apologize again for the lengthiness, but I am at the end of my rope.  Thanks for any help.

[LazyMoose]

You need to get free T3 tested, the active hormone that should be converted from T4, the storage hormone. Notice I said 'should be'. Not all covert well. It does happen!

T3 is most responsible for thyroid symptoms, many doctors fail to realize this. So get that tested with the others again and post here with RANGES as they very per lab. If you need to change docs to accomplish this, by all means do that.

[t4me]

Thanks for that information.  I have never been tested for T3.  I have absolutely no problem changing doctors--been to 3 cardiologists in the last 3 months!  I would like to see an endocrinologist, but around here you have to give them your name and number and have your pcp send them your records, if they think they need to see you they will, if not, you're out of luck---seems like a crappy system to me.  
Again, thanks for the info.  God bless.

[LazyMoose]

Any General Practitioner doc can order these lab tests, does not have to be an endo. And once (if) your found to have a thyroid problem, endos still are not necessarily the best. An open minded but experienced doc is what you need for treatment. Many endos are T4 only prescribing doctors, not for everyone.

"but around here" ...........- Are you not in the USA?

[t4me]

i live in the Baltimore area...some great docs with Hopkins and U of MD but they are so hard to get to see..

[LazyMoose]

News for you. Good thyroid docs do not learn it in a prestigious med school, they learn it in the real world, from real patients. Most med schools only teach TSH and T4 meds, a shame in the modern world.

I live in Minnesota, home of the world known Mayo clinic. Their thyroid docs are nothing special. I'd rather go to a vet.

[artfemme]

LOL, LazyMoose, LOL. From the studies about thyroid issues I've read online, the best are often about DOGS ! I fear you may be right. Good wishes, t4me...get those Free T3/ Free T4 tests done and get back here !

[t4me]

Hi artfemme & LazyMoose
thanks for your input.  I just got an appointment with an endocrinologist who only treats thyroid disorders.  He is "supposed" to be the best in town (Baltimore) and he is not from Hopkins.  I really hope he can figure out something because I am feeling worse every day.  As far as GP's go, mine thinks if the blood tests are good there are no other issues and i really have a hard time believing that (maybe cuz I want to blame this heart thing on something other than a heart thing!)  Anyway, my appointment is Sept 28th and I will def get back and let you know happens.  Thanks again for your support.  

ps  I am having ovarian surgery on Oct 1st to remove softball sized cysts--this had to be rescheduled due to "cardiac issues"  that the cardio doc says is nothing to worry about---hmmm,,,then why did we cancel the surgery again?  lol--it's all i can do at this point!

[gimel]

For your appointment, keep in mind that the best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever meds are required to relieve symptoms, without being constrained by resultant TSH levels.  FT3 is the most important because it is the most active and it does largely regulate metabolism and many other body functions.  Studies have also shown that FT3 correlates best with hypo symptoms, while FT4 and TSH did not correlate.  Note that FT3 and FT4 are not the same as total T3 and total T4, which are outdated and not very useful.  

I suggest that you request that the doctor test for FT3 and FT4, and if he has a problem with that then just insist on it and don't take no for an answer.  You're the customer.

Another suggestion is to ask the doctor if he is willing to treat you clinically, for your symptoms, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms.  If the answer is no, then you may have to keep looking for a good thyroid doctor.

If you get the testing done, then please get a copy and post results and reference ranges from the report and members will be happy to help interpret and advise further.