Have hypo symptoms- ALL bloodwork ok

[Crzygirl]

I'm in the US, but still looking for advice. ALL normal thyroid bloodwork, no antibioties present. Every test has been run. Ultrasound shows slight to moderate enlargement of thyroid. Diffuse nodules too small to FNA. I've had 2 docs tell me I have all he symptoms.....only 21 & 1/2 my hair has thinned and is yuck. I'm desperate for answers. Only slightly deficiency in a few vitamins. Exhausted, moody, brain fog...college student & feel terrible!

[bluebug]

"Normal" is just an opinion.

Also "slight deficient" is meaningless. If I'm "slightly deficient" in iron I am completely wiped out there as other people with an iron of the same level will be fine.

Dig out your blood work, edit your post and post them on here with the ranges. The ranges are important as different labs around the world use different ones.

Often people on here while they may not have a thyroid issue have iron (haemoglobin/ferritin), vitamin B12, vitamin D, folate and/or markers for inflammation indicating another autoimmune/immune condition.

Post your results in the form:

test_name test_result (range)

e.g. TSH 3 (0.5- 4.5)

vitamin D 27 (20-40)

[Crzygirl in reply to bluebug]

Iron 51 (30-160)

Vit B12. 284 (211-946) have had 2 vit b injections monthly so far.

ANA screen - negative

Thyroid & anti-TPO antibioties- negative

Free T4 1.06 (0.76-1.70)

T3 125 (65-170)

TSH, 3rd generation 2.08 (0.3-5.50)

Vit D - cannot find paperwork, am taking supplements

Thyroglobulin antibiody <10 (0-115)

Taking adderall 25mg twice daily to stay awake. I am also weaning off of antidepressants as my psychologist also feels there is something else going on. An the antidepressant hasn't seemed to help anyway. Started both meds in April- running in circles since July. Have an appointment with 2nd endocrinologist in a few weeks.

[bluebug in reply to Crzygirl]

As you are having vitamin B12 injections it is worth you going to the pernicious anaemia society on healthunlocked and posting all your results there as well for advice.

In regards to your thyroid - all thyroid hormone tests should take place first thing on the morning and on an empty stomach as that's when you get the highest readings for TSH and Free T4. So it is worth getting these tested again if your test wasn't taken in those conditions. This is because your TSH of 2 while in range indicates your thyroid is failing, however most doctors are taught not to do anything until the TSH is out of range. Also if anyone else you are related to e.g. mother, grandmother, aunt, uncle has had thyroid issues make sure you tell the doctors.

[Crzygirl]

Thanks, I'm sure the 2nd doc will want new bloodwork. My dad became hypothyroid but not until mid 40's. I have told the dr this. Also have a cousin who's been hypo since late 20's. They didn't even have symptoms, it all showed in blooodwork.

[shaws Administrator]

If two doctors have told you that you have all the symptoms, then they should have prescribed levothyroxine for you on a trial basis.

The TSH is only a guide and I believe symptoms are the priority. That's how we were treated before the blood tests and levothyroxine were introduced as the 'perfect' pair.

For most of us on this forum 45,000 + we're here because the 'modern' way of detecting/treating hypothyroidism didn't make us well.

Certain diseases can run in families. Ask your new Endocrinologist if he/she will provide a trial of levo. Depression can also be due to low T3, so you should ask your Endo for a Free T3 test and i'll give you a link and in the one re blood tests read why we need to know Free T4 and Free T3. T3 is the most important as it is the active hormone that runs everything in our body from top to toe. Levo is inactive and it's job is to convert to T3.

thyroiduk.org.uk/tuk/diagno...

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/about_...

Always have the tests on an empty stomach and if you're on thyroid hormones allow 24 hours between the last dose and the test and take it afterwards.

Levothyroxine should be taken early a.m. with one full glass of water and wait about an hour before eating.

[Crzygirl]

Thank you so much for all of the information &!the quick response. I will read those articles for sure. It appears I've had every test but a free T3, which in my case will most likely be normal. But I will not give up until I get a diagnosis. I was also tested negative for celiac & the gastroenterologist told me I have fibromyalgia. My other docs do not agree with this, since it's just a name used when you cannot come up with "proof on paper."

Again, thank you so much.

[Kitten1978]

Dear Crzygirl,

As other HU members have already said a patient may have their TSH, FT3 and FT4 within "normal" reference ranges and yet they feel very hypothyroid and present with multiple symptoms. The so-called norms or ranges are only as good as the data that were used to obtain the them. Especially the TSH norms have been widely criticized: the current TSH ranges are flawed as they were obtained using the data from samples, which included people with undiagnosed hypothyroidism: verywell.com/tsh-thyroid-st...

"When people with positive antithyroid antibodies or family history of autoimmune thyroid disease are excluded from the "reference range" cohort, the normal reference range becomes .4 to 2.5" (!!!)

Wartofsky & Dickey, "Controversy in Clinical Endocrinology: The Evidence for a Narrower Thyrotropin Reference Range is Compelling," Journal of Clinical Endocrinology and Metabolism

90(9);5483-5488

"TSH Reference Ranges Differ For 9 Different Manufacturers Assays (10):

TSH Kit TSH Range

Roche Elecsys 0.27- 4.0

Immulite 2000 0.40- 4.0

Tosoh A1A 0.34- 3.8

Bayer Centaur 0.35- 5.5

Beckman Access 0.35- 3.5

Abbott AxSym 0.49- 4.7

Abbott Architect 0.35- 4.9

Ortho Eci 0.30- 3.1"

From: jeffreydachmd.com/tsh-wars-...

[Crzygirl]

I visited my Endo to go over all of my blooodwork. Because it is all "normal" & I know I'm not myself he is suggesting trying 30mg of Armour and see if I feel better. I'm afraid to do this because I've read hairloss is common, I've already lost 1/2 my hair. I'd like some options, does anyone know if this is worth a try ? I know he does think stress is a component but I'm in my 3rd year of college, not first. I truly feel something is wrong with my body! Adderall helps a bit to relieve the brain fog & exhaustion but only slightly. I've also been on a low dose birth control for 5 months but I've felt ill way before these meds. Any information would be appreciated. I hate feeling 80!