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Old 07-29-2012, 01:52 PM   #1
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Can anyone Help?

Hi everyone, i'm new here and wonder if someone can help?

Over the years I've suffered from bouts of fatigue, depression, loss of motivation etc. I'd say i'm heat intolerant, infact I very rarely touch hot drinks preffering cold drinks. Bone growth was 2 years ahead of me at school, size 14 feet. I reached puberty quite early on and my hair started thinning quite early on, although I’m covered in body hair!

I wake up in the morning not feeling like I’ve had a decent nights sleep. Patches of Psoriasis, struggle to lose weight, carry most of it around the mid section, I put on muscle quite easily, achey legs, joints etc. I have quite an active job but come home absolutely shattered and can’t do anything else, takes so much effort a lot of the time to do things.

Have had various tests over the years but have never got down to the bottom of it.

In August 2010:

My Serum free T4 level was 13.2 pmol/L (11.0 - 22.0) Reference range

Serum TSH level was 2.54 mu/L (0.27 – 4.20) Reference range


Around 5 weeks ago I had a series of blood tests:

My Serum Free triiodothyronine Level was 5.8 pmol/L (3.5 - 8.1) Reference range - Euthyroid at present

Serum Free T4 level was 9.7 pmol/L (11.0 – 22.0) Below Low Reference Limit

Serum TSH level was 0.46 mu/L (0.27 – 4.2) Reference range


The doctor then retested me a week ago:

Serum Free T4 level is now 11.5 pmol/L (11.0 – 22.0) Reference range

Serum TSH level is now 2.45 mu/L (0.27 – 4.2) Reference range

Also did a cortisol test

Serum Cortisol level 332 nmol/L (170 – 540 nmol/L) Reference range


Both tests were taken virtually a month apart, both were carried out in the morning!

I'm told by my docotor everything is normal, but I feel anything but! Any suggestions as to where to go from here and can anyone explain the change of results?

I've been on Sertraline since the end of last year!

 
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Old 07-29-2012, 11:38 PM   #2
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Re: Can anyone Help?

Welcome to the board although I'm sorry for the reason you're here.

I don't agree with your doctor that everything is within ranges and consequently normal and all is fine.

Your doctor probably mainly focusses on TSH. Standard scenario: TSH will rise when free levels (FT4 and FT3) drop too low for the body's needs, yet as you will notice on the board that does not happen with everything.
TSH is thyroid stimulating hormone, produced by the pituitary gland and not an actual thyroid hormone. FT4 and FT3 on the other hand are actual thyrodi hormones and when those drop too low for the body's needs, will cause symptoms.

Most healthy people will have those (FT4 and FT3) at least midrange (or higher) in the ranges. Taking that in account, your FT4 has been
9.7 pmol/L (11.0 – 22.0)
11.5 pmol/L (11.0 – 22.0) Reference range


Although your doctor probably focusses on TSH and consequently did not recognize it as such, they point at hypoT (one below ranges and the other near bottom). Where you ever tested for thyroid antibodies? if those are elevated it might help in receiving treatment.

hope you get to feel better soon

 
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Old 07-30-2012, 12:35 PM   #3
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Re: Can anyone Help?

Thanks for the welcome and reply, is much appreciated. As far as I know I haven’t been tested for thyroid antibodies, I’ve got an appointment with the doctor next week, will ask if I can be tested for them.

From those results can you ascertain whether my pituitary gland is functioning correctly? Is it usual for TSH to fluctuate quite a bit within such a short space of time?

Thanks again!

 
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Old 08-02-2012, 11:33 AM   #4
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Re: Can anyone Help?

Does humidity effect levels at all? I seem to feel far worse when the weathers very humid, feel very fatigued!

 
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Old 08-03-2012, 04:52 PM   #5
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Re: Can anyone Help?

A belated welcome to you!

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

TSH is a pituitary hormone and fluctuates in the body's attempts to maintain stable thyroid hormone levels. There are other reasons why TSH fluctuates but, suffice it to say that your TSH levels indicate that your pituitary gland is working just fine.

Please know that TSH > 2.0 is suspect for hypothyroidism. The fact that you've had two tests show TSH > 2.0 should be telling your doctor something.

Thyroid status is always confirmed by looking at the actual thyroid hormone levels: FreeT4 and FreeT3.

As Lisa789 mentioned, healthy people have FreeT4/T3 levels above mid-range and often closer to the high end of the range.

You can see that your FreeT4 levels have consistently been below mid-range and even dipped below-range.

You are dealing with hypothyroidism and the cause is most likely the most common one: Hashimoto's thyroiditis.

Comprehensive antibody testing includes:

TPOab (thyroid peroxidase antibody)
TGab (thyroglobulin antibody)
TRab (thyrotropin receptor antibody)

Just as your doctor errs in looking at your "normal" (aka in-range) and is calling you normal re thyroid function, there's a chance you will hear the same about your antibody test results.

Be sure to get the actual value of the result and the reference range to share here for interpretation.

I've been stable at optimal levels for over a year and excessive humidity wears me out. It had been so long since I was "normal" that I asked my doctor about it. She confirmed that "everyone has been complaining" - it seems that, in this case, your humidity-related fatigue is normal.
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Old 08-06-2012, 02:35 PM   #6
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Re: Can anyone Help?

Many thanks for the reply and welcome, pleased you've been stable at optimal levels for a year, hope your progress continues

One thing that I forgot to mention is my grandmother suffers from an overactive thyroid gland, so is it hereditary even though mine sounds like it's the opposite?

What is the thyroid gland supposed to feel like?

Hopefully my doctor will agree to the antibody test and will post the results up in due course!

Thanks again!

 
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Old 08-07-2012, 06:32 AM   #7
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Re: Can anyone Help?

Thanks for your kind words.

Most cases of thyroid disease are autoimmune in nature and there is a genetic component to autoimmune diseases in general.

I really don't know what the thyroid is supposed to feel like. All I do know is that one of my doctors recently told me that she usually can't feel a patient's thyroid and is able to feel the textural changes in mine (that obviously occurred as a result of me having thyroid disease).

Best of luck to you moving forward!
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Old 08-11-2012, 04:25 AM   #8
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Re: Can anyone Help?

Thanks Sammy64, need all the luck I can get right now!

I've seen the doctor as far as he was concerned everything is normal and the levels can fluctuate a lot and the TSH reading is fine! Said there was no optimum levels, as the TSH will fluctuate to compensate the thyroid level hormones. Said it was perfectly acceptable for the FT4 level to drop below range then for the TSH to kick in.

He said he didn't know where I was getting my information from and that the internet is unregulated which causes them problems at times! Said if I wanted to find an answer I was looking for I could find it on the net.

Mentioned they had a patient once who went and saw someone to get some medication for thyroid which completely messed the patient up! So going on a trial to top my levels up would be a no, no in his opinion! He said he's perfectly happy to run the test again in a few months time!

Think the thing is when you've suffered with depression it's hard for them to look beyond that. He said there was no point running the thyroid antibody tests, as everything is "normal"! He suggested I do some excersise, even though I have a physical job.

I'm not sure where to go from here now, my only other avenue is to go private and see an endocrinologist. I don't feel depressed, I just want to get down to the bottom of it all.

Appreciate any feedback?

 
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Old 08-21-2012, 03:56 PM   #9
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Re: Can anyone Help?

With going as far as I can with my doctor, A Naturopath came highly recommended to me. I've been for the first consultation and was extremely impressed with what he had to say. Very interested in my symptoms and what he was saying made total sense. I took my blood results to show him and he was absolutely amazed how my doctor passed my thyroid results as normal particularily my Free T4. He think's it's probably a combination of things that's the cause of my problems. First off he wants to stablise my blood sugar levels, by altering my diet and he's putting me on a natural thyroid supplement which will help my thyroid and hopefully ease the stress on the adrenals!

It was so refreshing to be able to talk to someone who actually wants to get down to the bottom of things who took my symptoms on board and not fob me off with a label like most doctors seem to do. Actually felt like I might finally be getting somewhere, which gives me some hope!

Prior to me making the appointment i'd never even heard of a Naturopath before, it's an alternative type of medicine, from what I can gather it focus's on the causes and gets down to the nitty gritty of energy and cellular metabolism etc. They don't just treat the symptom like traditional medicine seems to do, but find out a reason why!

I'm to go back in a few months time with an update of my thyroid bloods and to see how i'm progressing! Been advised it could take at least 6 months to see an improvement, it's not going to happen over night! There are plenty of other tests and avenues that can be looked at, but for now he's writing a report and seeing how i get on with the diet changes and the natural thyroid supplement and then look what effect it's had on my wellbeing and blood results!

 
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