I am new here and was hoping you all could help me. I have been experiencing low functioning thyroid symptoms for about 6 months now. I kept passing it off on something else but the inability to lose weight and the constipation finally frustrated me enough to go to a Dr. He checked my TSH levels. Before getting the results I did some research on my own and thought I had read that a TSH above 3.0 indicated a low functioning thyroid and should be treated with meds. At the time the Dr. would not do further tests unless my TSH came back normal. He called me about 2.5 weeks ago and said my TSH was normal so if I continue to exhibit symptoms to come back. He did not leave the actual TSH number. Since I cont to exhibit symptoms that were getting worse (my eyebrows are now thinning) I went back to see him today. first of all the lady that weighed me was in such a hurry she must be wrong. I have gained 2 lbs by my scale since the last time I saw him but they have a manual scale and she was in such a hurry she didn't wait it out to see if it was in the middle so she showed me losing 6 lbs and I know I didn't. Anyway, in addition as he was talking to me I could tell he was leaning towards telling me I was depressed and I know I am not. I have lots of anxiety (also a symptom I believe of low thyroid). I told him I was not depressed. I asked him what my TSH level was and it was 3.89. Which if what I have read this means I have a low functioning thyroid. His lab shows the normal range of anything above a 5, which I believe this is the old standard. I attempted to explain that they re did this range to anything above a 3 is low functioning and he got defensive with me and said he had been in the medical field for 27 years, blah, blah, blah. And then told me as long as his lab showed me being normal he would not treat me with a low functioning thyroid. So question is what is a normal TSH?
He ordered more tests of my T3 and T4 but said he was sure they would come back normal and he did not think I had a low functioning thyroid. I need some advice on how to handle this. I do think I might switch to a different Dr. b/c of his attitude with me trying to inform him of the new standards. I need help pretty quickly as if I do have a low functioning thyroid I need to get on meds for this. The fatigue is getting worse and worse and I am having a hard time functioning.
Thanks so much for your help.
I don't know if you will get anywhere with this doctor or not. But based on what you have said, I'd be ready to do some doctor shopping if you don't get some better answers when the T3 and T4 tests come back. Yes, a TSH of 3.9"can" be normal, but that would be very unusual. IMO most people feel best with a TSH around "1-2" on the most common lab ranges. Personally, I feel best around "1"ish. The T3 and T4 tests can give more information, but the ones you really want are the "free T" tests. To make a long medical explaination short, those test how much of each thyroid hormone T3 and T4 is "free" or "available" to use by your cells.
Not only do you need a solid diagnosis of what is causing your symptoms, but you need to know why your thyroid is not functioning properly. An antibody test could tell you if you have Hashimoto's disease, an auto-immune disease that is the most common cause of hypothyroidism (underactive thyroid) in modern countries where good nutrition and medical care is not an issue. Perhaps you have a small thyroid nodule (like a little cyst, 90% of the time benign) causing your thyroid not to work properly. IMO just a TSH test does not tell the full story, and you need more info.
Since you are so new to this, you need to get educated, thus YOU can better guide your treatment. YOU are in charge of your medical care, no doctor worth his salt should get defensive when you ask questions about medical tests or your test results individually. The doctor is there to help you understand what is going on in YOUR body. They should LISTEN to your concerns, and then explain in terms that you can understand (not a lot of non-sensical medical jargon) what their opinions are of your condition, what your options for treatment are, and TOGETHER make some decisions about your care and treatment. Most of us here recommend the book "Thyroids for Dummies", as a starting place. When I was first diagnosed a little over 4 years ago, I found my public library to be a wealth of information with many books and medical journals to help me. I am sure you have already done some web research too. My best advise it to wise up about thryoids, get smart, and find the very best doctor for thyroid care in your area. That may be the doctor you already have, but you won't know that until you know enough about thyroids to trust or question his diagnosis.
Best of luck to you. Hope to see you around the board with great news about your health. You have found friends!
Really sounds as though it's time to shop an ENDO. And 'Red Malpe' is right on with the point of a good doctor doesn't get mad when you question his opinion or tests. Also with the read up and get educated. Information is the power to protect and take care of yourself. Good luck!
I had my TSH tested in 2003 and it was 1.62, so I am sure the 3.9 is high for me. I have done some research on the web but haven't read any books. After I got home from the Dr today I made some calls to some Endo's and so far none will make an appt for me unless my Dr. refers me. I have the ability to self refer with my insurance but they said the Dr. has to refer me. And my current Dr. said after he finishes running the tests if he finds nothing he will refer me to an internist but not an Endo b/c he doesn't feel I need it! Since I do have a TSH out of normal range will my T4 and T3 come back out of normal range as well?
I have one more endo to call to see if they will make an appt with me. Hopefully she will.
In addition I think I need to change to a different PCP. But I don't want to go years through dr.s hoping one will take me seriously before I can get on some medication.
Last edited by moderator2; 01-16-2007 at 04:10 PM.
Since I do have a TSH out of normal range will my T4 and T3 come back out of normal range as well?
Your T4 and T3 very possibly could come out normal even with the high TSH. Try to get a doctor, any doctor, to do the "FT3" and "FT4" tests. With a normally functioning thyroid, it produces the hormone T4, with a good supply of T4, your body should convert the T4 into T3 for use at the cell level. In some cases the body does not convert properly and thus you do not have enough FREE T4 and FREE T3 available at the cell level. (again that's a simplified version of a medical explaination, chemically the T's are bound to proteins etc, etc, etc, and not "free" for your body to use). The plain T4 and T3 may show up as normal but not giving your body the supply of FREE or AVAILABLE hormones to use because they are bound to proteins. That's why the frees are so important to measure. All the test results, TSH, T4, and T3 may show up as normal, but there is still not a goodly supply of 'available' thyroid hormones to relieve your symptoms.
There is a poster here by the sign on of Midwest1. She really is the board expert on this stuff and I have learned a lot from her. You should call her for an opinion by using her sign in name in the "title" section of a new post. Her opinions of MD's are pretty strong--to put it mildly she doesn't think to much of them ... and thus she will understand your situation to a "T" (yes, pun intended with the T hormones)
You may want to try a DO or Doctor of Osteopathy, rather than an endo. if you can't get in to one. They often are more willing to treat thyroid conditions than MD's. DO's also are licsenced and must have the same medical training as MD's but have a different view point of medicine by treat the body as a "whole" rather than specializing in just parts. Many thyroid patients prefer DO's for thier care.
Again good luck, and keep us posted!
Last edited by Red Maple; 01-16-2007 at 09:33 AM.
Reason: fix quote
Start MD-shopping, kag. You won't get anywhere with a dolt like that.
Yes, your TSH is too high and likely means you are hypothyroid. I hope the dolt ordered the best T4 and T3... that is, the free T4/T3 and not the "total" ones. If these two hormones are not at least mid-level on their ranges, you should be treated. There are doctors who will treat those levels, but they can take some work to find. Don't give up hope.
Red... I regard compassionate, intelligent, curious, willing-to-learn-from-a-patient MDs extremely highly. It's just that most of them don't fit those exacting criteria... Not, at least, the ones I've been exposed to... and that ain't just a few.