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Old 01-30-2012, 02:10 PM   #1
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High TSH - Normal T4 - Lot of Hypo Symptoms


My Dr. and I have been watching my Thyroid for a few months now. My TSH has been slightly high (over 3 readings: 6.24, 5.80, 6.46) over a baseline high of 5.0. My T4 has been "normal" (.88, .96, .80). The Dr. asked me if I wanted to be referred to an Endo for further consult.

My main gripe is that a severe inability to lose weight. I am meeting with a nutritionist and exercising at least 5 days a week. I am about 70lbs overweight but workout along side ex military (a navy seal and army) guys and actually seem more committed to my fitness than they are. In addition my nutritionist is scratching her head saying "there's something else going on here" when looking at my food choices as they are very good.

After looking on the boards I see most people with a TSH much higher than mine. I am trying to find some kind of idea about what to expect from this point. Do I have a glaring Thyroid issue?

In addition to the thyroid I have been diagnosed with NAFLD (Non Alcaholic Fatty Liver Disease) and wonder if my Thyroid might have something to do with this?

Other Symptoms:

• A lot of stress and Anxiety for no reason. I've got a bit of a short temper which seems to have only come on in the past year or two.

• Serious Inability to lose weight.

• I wake up early and can't go back to sleep (Sleep 10-4:30 usually) but not tired.

• Slight heart racing / heart skip at times for no real reason (had the ticker checked out and it all looks good)

• Some constipation issues.

I'm sure there are a few other things I can't recall right now but essentially wanted to see if anyone else had the weight loss issues with such a sleight elevation of TSH because I am losing my mind by working so hard and not getting results. Only benefit is that my blood glucose and blood pressure seem to be hanging in good shape due to my consistent efforts.

Any comments are appreciated.

Thank You

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Old 01-30-2012, 05:16 PM   #2
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Re: High TSH - Normal T4 - Lot of Hypo Symptoms

Welcome to the thyroid board!

Sorry for the reason you're here but, glad you found us.

If I didn't see this happen time and time again on thyroid forums, I'd be incredulous at the thought that you haven't been started on meds a l-o-n-g time ago. So, yes, you have a glaring thyroid issue.

If your doctor knew anything about thyroid, he would know that TSH > 2.0 indicates hypothyroidism.

Then, he would look at your actual thyroid hormone levels - FreeT4 being one of them. And, if that level was below mid-range, he would start you on some thyroid hormone replacement.

I honestly don't know if an endo would be any better at seeing what is obvious to me....many endos don't recognize hypothyroidism if it slaps them in the face.

Unfortunately, once the TSH test was invented in the 70's, doctors weren't taught the clinical skills to recognize hypothyroidism.

Throw in the advent of thyroid hormone level testing and doctors focused on numbers miss even more cases.

Thyroid textbooks clearly indicate that each of us has his/her own optimal thyroid hormone levels called "setpoints". And, most healthy people have FreeT4/T3 levels in the upper half/upper third of the range.

While your weight issues are common for someone dealing with hypothyroidism, I wouldn't be inclined to focus on that with a new doctor. Unfortunately, doctors seem to think people are looking for thyroid hormone has a quick fix for weight loss.

Instead, a comprehensive symptoms list should help. You might want to review the symptoms list on the following thread just in case you are dealing with more than you realize.


You might want to read "What Your Doctor May Not Tell You About Hypothyroidism". It was written by an endo who discusses people having "normal" (aka in-range) thyroid labs while dealing with raging hypothyroidism. There's even a section with suggestions for a meaningful conversation with a potential doctor.

It does sound like you need to see another doctor. Maybe the endo will work. If not, you might want to try calling local pharmacists (including compounding pharmacists) to get contact info for doctors that Rx Armour and/or Cytomel. These are two types of meds that thyroid-savvy doctors Rx.

Don't give up until you find an appropriate doctor. It might take a few tries (I'm on doctor #5 myself and this isn't uncommon). It will be worth every effort.
Graves' 2007...remission 2009....hypo 2010

Old 01-30-2012, 05:21 PM   #3
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Re: High TSH - Normal T4 - Lot of Hypo Symptoms

Sammy - thanks for your enthusiastic response. My doctor thought from day one my levels indicated a real issue and was prepared to do something about it. Between the first and second test the levels dropped just a bit so she asked me whether or not to do meds or go to an endo. I opted to wait for one more test which was done this morning. Now I'm here.

I've been relatively healthy up until the past few years so thank god for that but hopefully I can get this under control quickly.

Old 01-30-2012, 05:28 PM   #4
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Re: High TSH - Normal T4 - Lot of Hypo Symptoms

I'm so happy to hear that you have a receptive doctor.

If your current doctor is willing to Rx meds, you just might want to let her care for you.

After 3 clueless endos and a now-former clueless GP, I found a thyroid-savvy doctor in the form of an internist.

It sounds like you have a keeper - yay!!!

Now, I don't know what you mean by "get under control quickly" but, please know it usually takes at least 6 months if not closer to a year to optimize our dose/levels.

Still, it's worth it.
Graves' 2007...remission 2009....hypo 2010

Last edited by sammy64; 01-30-2012 at 05:30 PM.

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