A GP and 2 Endocs refused medication! Would you agree I have central hypo, should I self-medicate?

[Ecmy]

Hi All! I will appreciate your helps and opinions. I have most of the hypothyroidism symptoms. Weight management became a nightmare for last 2 years despite the very careful diet and exercise. I have low ferritin and vit D deficiency, which as far as I know may be an indirect result of hypothyroidism. I easily feel cold and I have mood swings. I became even more depressed recently because of chasing after the reason why I am experiencing all these problems. My father and my grandmother/her sister too, have tyroid diseases. We have checked everything else that might cause my problems, everything seemed okay. The last endoc told me I have an anorexic mind and I should go to a psychiatrist and get medicated for that!! Seriously, I am a 175 cm, and 63 kgs woman! I am not overweight for sure but I am not eating properly to maintain this normal weight, and it has affected my social life deeply. I am gaining weight (I was 5 kgs less 2 years ago), slowly just because I am fighting with it so strictly. Imagine being always on diet. I was totally normal until last 2 years.I have read many articles on secondary/central hypothyroidisim, I guess I found out my problem. So frustring that doctors don't even know it! Here are my results;

FT3: 3.70 (3.10 - 6.80 range)

FT4: 12.20 (12.00 - 22.00 range)

TSH: 1.65 (0.30 - 4.00 range)

What do you think? I know some seconday/central hypo patients have lower results, and mine don't seem like the worst, but I think my results explain my sympotms and I should get medicated for secondary hypo. I will take all the articles I found and highlighted to another doctor. But if he doesn't give me medication, do you think I should self medicate with T4 - 25 mcg to start with and then get blood tests every once in 6 weeks, increase it step by step until I get my FT4 and FT3 to the mid range.

And do I need to check my TRH level too?

Thank you so much in advance!

[Clutter]

Ecmy,

I think either central hypothyroidism or isolated TSH deficiency may be likely as TSH is low-normal but FT4 is bottom of range.

Have any of the doctors done a pituitary function blood test?

[Ecmy in reply to Clutter]

Hi Clutter, thank you for your reply! What is this pituitary function test? They asked for ultrasound, tsh, ft3 and ft4 for my thyroid functions but nothing else about my pituitary as far as I know. We don't speak in English in Turkey, so if there is a common shortcut that I can scan in my blood test results, I can see if they asked for it but I didn't know it is this pituitary function test.

[Clutter in reply to Ecmy]

Ecmy,

TSH, FT4 and FT3 are thyroid function blood tests.

In the UK if central hypothyroidism is suspected pituitary function is usually checked to ensure there aren't also sex and growth hormone deficiencies. patient.co.uk/doctor/pituit...

[Ecmy in reply to Clutter]

- oh so sorry, I just saw that TRH is included to pituitary function test.

[Ecmy]

Clutter,

Thank you so much! Then I have to go and get this test done by myself. Do you think I should know my TRH as well? What is the relationship between TRH and central hypothyroidism?

[SimonA87]

I've heard about something called euthyroid sick syndrome which can be related to starvation:

msdmanuals.com/en-gb/profes...

Sorry, I don't know anything more.

[Ecmy in reply to SimonA87]

Hi SimonA87

Thank you for your interest. I have been looking up for sick euthyroid, and the differences between secondary hypo and sick euthyroid. I see that the blood test results and symptoms of both are very similar, but the causes and the treatments are different. It says the cause of the euthyroid may be an illness that cause high stress (like cancer, diabetes), and it would also elevate cortisol levels. My morning cortisol level was normal but I guess I should ask for a more detailed test. I believe the stress amount I have ever experienced is not much higher than an average person, but still I will research more to find out if sick euthyroid may be my problem. Thank you for introducing me an alternative. I will discuss this with my next doctor - if he has any idea about these rare thyroid problems!