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Old 07-27-2012, 02:48 PM   #1
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Are these tests adequate for diagnosis?

I just picked up my lab report, are these adequate for a diagnosis of thyroid problems, the endocrinologist assures me this isn't my problem.
T4 5.5 reference range 4.7-10.5
TSH 0.838 range 0.470-4.830
Also did a COMP Metabolic Panel, BUN-low B/C ratio-low,Potassium-low
FSH Serum 6.3
TPO Ab 8 range 0-34
I am 45yrs and have gained 25lbs over last year, not changed my eating habits at all-normally weigh 115 now 139. I can and do sleep many days all day with waking only 30 min to an hour before falling back to sleep. I never needed more than 6hrs of sleep before this to function. Now I am so tired all the time i can't seem to function, although it isn't everyday that I sleep all day-probably 4-5 days a week. I can't even seem to get the energy to leave the house or do simple things around the house most days. Do these labs indicate thyroid or should I have other tests done? Thank you for any help!

 
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Old 07-27-2012, 09:38 PM   #2
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Re: Are these tests adequate for diagnosis?

The reason the endo thinks these results are fine is because he was trained to believe that the TSH test is the gold standard of thyroid diagnostics, and your result is unfortunately all too "normal".

But he ordered the least useful of the T4 tests. He should have run the test for free T4, not total. However, your very low-normal total T4 strongly suggests that your free T4 would be every bit as low... too low... and that's what's causing your symptoms. The majority of people do best when their FT4 is at least mid-range or up to 75% of the range.

He also should have run a thyroglobulin antibody test. Some people with autoimmune thyroid disease test negative for TPO Abs but positive for TgAbs.

There are reasons why TSH can remain "normal" in the face of hypothyroidism. Trouble is, endos don't believe that. You may be able to find treatment from a more progressive doctor, not necessarily an endo (most of whom are TSH worshippers.) You may have better luck with an internist, DO, or any doctor willing to prescribe Armour thyroid.

Don't give up. I very much suspect your thyroid likely explains your symptoms.
Good luck going forward.
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Old 07-28-2012, 06:15 AM   #3
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Re: Are these tests adequate for diagnosis?

midwest1, thank you so much for your reply. This is all very confusing to me so I appreciate you writing it out for me. Now I just have to try to find a doctor to do the correct tests, which I don't even know where to look! Thanks again!

 
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Old 07-28-2012, 08:33 AM   #4
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Re: Are these tests adequate for diagnosis?

It can be hard to find a good thyroid doctor, one who understands the right tests to run and how to interpret them. It can be done, though.

Ask everyone you know whom you know to have thyroid disease if they're having good luck with their treatment. I accidently found out that three of the assistants in my dentist's office are hypothyroid, for example. If I needed to find an MD, I'd ask them about theirs.

Ask area pharmacists directly (not their counter help) for names of MDs who prescribe Armour thyroid or Cytomel. These MDs are usually more thyroid savvy than ones who won't prescribe these drugs. Compounding pharmacists might be especially helpful. Make sure you don't ask for a specific doctor recommendation. They can't ethically provide that. But they should be willing to give names of several MDs who write particular scripts.

Find a holistic doctor. They understand that the thyroid is the "Master Gland" that controls the proper function of every system in the body. My own doctor is a licensed MD who treats homeopathically. He's in the best of both worlds; because he's an MD, insurance reimburses him, and he totally "gets" hypothyroidism. Osteopaths (DOs) also practice holistically, and because they are the most mainstream of the "alternative" style of doctors, insurance also usually reimburses them.

Good thyroid doctors are usually not endocrinologists... Although, there was a report by someone here on the board just yesterday of finding a really great one. There are a few good apples in that barrel, but they are generally scarce.

Just don't give up! Let us know what happens.
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Old 07-28-2012, 01:23 PM   #5
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Re: Are these tests adequate for diagnosis?

I agree with Midwest1 on all counts.

For whatever it's worth, networking helped me find a thyroid-savvy doctor but, I have been collecting names as a backup plan (you just never know )

Here are a couple of other suggestions to help find a thyroid-savvy doctor:

- check the Top Thyroid Doctors site for a listing in your area

- contact the Broda Barnes Foundation and pay ~$18 to get an information packet that includes a list of doctors in your state who follow Dr. Barnes' ideology (Dr. Barnes was the author of "Hypothyroidism - An Unsuspected Illness" and was lightyears ahead of his time)
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