I am new here and need your opinion!

Hello everyone,

My name is Ricardo I am a 22 year old male and I have had a strong suspicion that I have hypothyroidism. There are days where I suffer from brain fog, I sometimes get fatigued, my extremities are cold, I have a hard time doing exercises and losing any weight on my belly. My skin has been dry ever since I was a teen, my hair comes out in clumps not just from the top but also from the sides, I also have enlarged eyes and my fingernails do not have any moons except for my thumbs ( I hear that if you do not have moons up to your ring finger your thyroid is low). Anyhow, I got tested a year ago by a doctor, however, she only tested my TSH which was 7. She told me she wasn't too worried as if it was true hypothyroidism my TSH would be upwards of 10 or so. After this I went online and researched my butt off. I learned that the cut off for TSH levels are not 0.5 - 5 as she was mentioning but that they have been changed to 0.5 - 2.5 or so. She did say that I had subclinical hypothyroidism and that medication is not necessary so far, she also told me that she had a suspicion that I might have Hashimotos and that I would eventually need medication my entire life. Fast forward to today and I recently did a full panel thyroid test as I have been having more symptoms this year and they vary from day to day. I just received the results and I have to say that I am very confused and was hoping that someone one here can help me explain what is going on? I will post both my test results and lab comments. The lab comments doesn't tell me exactly what I should do, which is why I am asking for your opinion.

My results:

Free T4: 1.6

Free T3: 4.2

TSH: 5.8

TPOab: 61

Lab comments from the lab test:

Free T4 is within normal range but reported symptoms indicate thyroid deficiency. This might suggest that hepatic conversion of T4 to T3 is impaired or T4 is being converted to reverse T3 (both conditions increased under conditions of high stress/cortisol). It would be worthwhile to evaluate steroid hormones by saliva and correct any hormonal imbalances (eg. high estradiol, low progesterone, low testosterone, high or low cortisol) that might impede optimal thyroid function.

Free T3 is within normal range but symptoms indicate thyroid deficiency. A normal T3 does not exclude the possibility of a "functional" thyroid deficiency caused by other hormonal imbalances such as excess estrogen, low progesterone, low testosterone, low or high cortisol, and low growth hormone (IGF-1). Testing for these hormones is recommended.

TSH is high. Although most laboratories have a TSH range of 0.35-5.50, new studies are finding that the mean and median values are 1.0-1.5mU/l . TSH levels >3.0 are now considered abnormal due to changes by the endocrinology association - see aace.com for more information. Some experts believe that TSH should be kept below 2.0 for optimal health. Elevated TSH is often associated with symptoms of hypothyrodism, which include fatigue, decreased stamina, depression, rheumatic pain, sleep disturbances, cold extremities or feeling cold, reduced body temperature, brittle nails, dry coarse hair, hair loss, infertility, low libido, puffy eyes and face, decreased sweating, menorrhagia, and/or constipation. Periodic TSH monitoring is recommended if clinical symptoms of thyroid deficiency persist. Thyroid therapy may be worthwhile considering if T4 and/or T3 are low and symptoms of thyroid deficiency are problematic.

Thyroid peroxidase (TPO) antibodies are low indicating that Hashimoto's autoimmune thyroiditis is unlikely.

Thank you,

23 Replies

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  • You ought to have thyroid replacement therapy with those results which are abnormal and indicate autoimmune thyroiditis. I am not impressed by your doctor’s comments. I would describe them as negligent and uninformed . Can you see someone these?

    I had very short bouts of hyperthyroid (you mention eye involvement) and much longer episodes of hypothyrodism so the numbers can vacílate.

    I hope you get some help soon.

  • Thanks for your reply. Yes, over here in the U.S. physicians in general are very unaware of thyroid conditions. The majority of clinics and hospitals look for TSH when you ask for a thyroid test. It is frustrating and infuriating, especially when people are suffering and yet they are told they are just depressed and need to go to a psychologist. Anyway, I am currently taking Selenium supplements and I have to say I do feel a little better. My brain fog has decreased significantly among other things. A lot of people on this forum have told me they suspect Hashimoto and I am kind of scared that I do have it, just because I read about awful stories where people aren't getting better or their doctors don't listen to them etc. I am thankful that this website exist and other people are going through the same thing.

  • MrWellness94 It can’t be pretty bad here in uk too.! It took me decades to get a diagnosis despite me suggesting it given my grandmother, mother and a sister all had hypothyroidism (and cancer of the thyroid which thankfully I have been spared) I was lucky to survive I was desperately ill by the time I was diagnosed after being offered antidepressants which I point blank refused saying it was far too serious for those things. You don’t want to end up in that state but even with those TSH values (10 and 7) I felt utterly dire I was just a crazy at my worst. I though the guides were better in US ie treatment started at TSH of 3.5+

    If you get thyroid replacement hormone and get everything optimised you should feel fine again. Levo did not get me there but NDT has done. In many ways I feel better - depression completely gone for example - that I did for decades when the thyroid was slowly being destroyed by antibodies.

    Advice here is really excellent - I hope you get on the road to recovery very soon

  • I can't believe it took that long for doctors to diagnose you. I am so sorry that you felt horrible. I do feel bad myself but not too bad? I think I've always been hypothyroid so I don't know how it feels to feel normal, just a theory. You'd think doctors would know about this stuff, they do know some stuff but not the important information like how to treat Hashi. Most of the doctors here put everyone into the same bag and they tend to treat everyone the same way instead of individually which irritates me because my hypothyroid is not the same as someone else's. Can you tell me what NDT is? I am not familiar with it. I am so glad that you feel better. I hope to feel the same soon!

  • @MrWelness94 I think I was so poorly all I could do was lurch from moment to moment as best I could - time was speeding like an express train and I was like a tortoise - so slow! Then I’d get a sudden burst of hyper - I’d start running 10 miles with no effort at all, I’d loose my temper in a nanosecond and go berserk over the slightest thing - it felt very unpleasant as my moods just chopped and changed like I had gone completely mad. I had very low starting dose of Levo due to really bad heart pains (for over 20 years - was investigated after 10 years and there was a problem but I was told it was just a thing some women got and was nothing to worry about 😳 so I just ignored it). As I improved I became more acutely aware of just how ill I was. The worst bit was when I was close to being ok but was not ok - where you are now I’d guess - it totally did my head in plus the disappointment of the Levo not really resolving things after9 months of titrating up to supposed optimisation under care of endo. If I took more I felt awful, if I took what they said I felt awful. I stick it for two years and in the meantime started to educate myself via stop the thyroid madness, thyroid uk and the thyroid patient advocacy. NDT was the first treatment for hypothyroid c 1898 it is the ground up thyroid of pigs (sheeps thyroid were used initially) it is the closes thing you can get to what our Own thyroid makes/made naturally with T4, T3, T2 and T1 plus calcitonin. Levo is just synthetic T4. T3 is the most active thyroid hormone - T4 has to be converted to T3 before it does anything, no one seems to know what T2 and T1 do and calcitonin is good for bone health. I seem to have a problem getting enough T3 on Levothyroxine. Oddly my mother and sister felt/feels really well on Levo, I was just unlucky. You can get NDT prescribed in the states we have to buy it on line here and that is being made more and more difficult although it is not illegal if it is for personal use. Conventional medicine abhors NDT but I find it much better than Levo. I was a vegetarian for many years so imagine how desperate I was to take NDT.

    Your vacillation in symptoms indicates it is hashis but still best to nip it in the bud with thyroid medication. I’m gluten free and take vit D3 and good quality multivitamin and an occasional magnesium malate, as it can affect ability to get minerals and vits from food.

    You should try for a functional medicine doctor if you can seems big in the US.

    You might find A series of talks really helpful. They were on a while ago I think it’s the thyroid secret and are being rerun as of tomorrow. They are very interesting i’ll Try and find the link and post it for you. 😉

    This is where you sign up

    thethyroidsecret.com/trailer/

    It Is a bit marketing heavy (for uk types like me!) but you never actually need to buy anything whilst Isabella Wenz opens it up to everyone gratis. She is very good. It starts tomorrow 20 Oct at 9pm (eastern time?)

    I hope you get to see some of the talks.

  • That is quite an experience, I can't believe you felt like that for years! I am just glad that you found a solution. I have read research articles that pretty much say that some people do better with T4 or T3 or a combination and it also depends on the synthetic or natural sources. I have also read about the natural thyroid medication apparently it was the only and most effective way to treat thyroid disorders back in the 19th century. I just don't understand why they changed the thyroid medication to synthetic? Yes functional medicine is definitely big here and I have heard good things about it too. I will be sure to check my vitamin levels as well as get started on levo. It sounds like it is very difficult for people in the U.K. to get appropriate medication? Especially when it comes to T3. Thank you so much for the information it has been really helpful and I feel less scared about getting treatment. Also, thanks for sharing your experience, it has helped me understand this condition better as well. I will be sure to inquire about NDT options if levo doesn't workout.

  • MrWellness94

    Thanks for your kind reply - I even managed to carry on working throughout 😱 - the last two years were not my best!

    I felt very alone with it all till chatting to someone in the park who had a much worse time than me with Graves’ disease and understood what I gone gone through (and a lot more on top of that) then I joined here and things got a lot better.

  • Go and see another GP in the surgery and ask for treatment.

    You will have to have two tests 3 months apart first and both need to come back with TSH around 6. Stress to the doctor you are aware of the NICE guidelines (look them up), your test results and you want to be treated not left to get worse.

    Btw subclinical hypothyroidism is just an excuse to make people suffer.

  • Yes, I was thinking about going to another doctor and getting another full panel thyroid test to rule out or confirm hashi. I will also test for vitamins such as B12 and Vitamin D3 and Ferritin. I agree with you, people with subclinical hypothyroidism are told that it is just in their head and they are "fine". I am NOT fine I know my body, I haven't been fine since I was a kid. It is disheartening that doctors just don't listen, this is especially true here in the U.S.

  • Welcome to our forum,

    I noticed you were in the USA. One of our Advisers, now deceased, was in the USA. He detested how people were diagnosed and treated these days. He was also a scientists and logistician .

    I will give you some links which may be helpful. He also invented a product for hypothyroidism which doesn't need a licence and his wife, Tammy, now runs this side of their website. He hated the modern way we are now diagnosed/treated/untreated. He also stated it was due to corruption, i.e. doctors being paid to prescribe levo/blood tests instead of prescribing what was best for patients. Because the site is now archived some llnks within may not work. There are other topics at the top of the pages (usually).

    web.archive.org/web/2010103...

    naturalthyroidsolutions.com...

    naturalthyroidsolutions.com...

  • You have hypothyroidism it’s not even boarderline, it’s evident and you should receive medication. I agree with the previous poster about your doctors comments. I don’t know where you are in the world but uk will only diagnose you when tsh is very low at 5.0, most countries diagnose on a tsh of3.0, you are over both bottom limits. I know I felt very unwell with tsh of 3.6, at 7.0 or even 5.8 I’d be crawling on the floor! You need to put the ranges for T4 and T3 up too in order to properly assess but your T4 looks very low to me, could you put up the ranges? You should be aiming for top of range for these. I also think you should try and see a different gp as the one you gave spoken to is clueless.

    Keep in mind that you should take blood tests first thing in the morning before medication (when you do get some), but the earlier the better. TSH isn’t the best measure of a thyroid problem as it is changeable throughout the day yet it seems to be the measure all GPs use. That being said, it is a measure and yours definitely indicates a thyroid problem. You should probably get your vitamin b12 and vitamin d levels checked too as these can cause similar symptoms and contribute to difficulty absorbing thyroid medication. Also check you thyroid antibodies.

  • Yes I also believe I have hypothyroidism, and it is a bit frustrating since there will be weeks where I feel fine, just fine, and then like a couple days where I feel like a train ran over me. I will post the results with the ranges here, sorry about that.

    Free T4: 1.6 Range: 0.7-2.5 ng/dL

    Free T3: 4.2 Range: 2.4 - 4.2 ng/dL

    TSH: 5.8 Range: 0.5 - 3.0 U/mL

    TPOab: 61 Range: 0 - 150 IU/ML (70 - 150 borderline)

    I believe that I the blood test at around 10:00 A.M. and that was when I wasn't even supplementing with Selenium at the time. I just started Selenium this week and I do feel a little better actually. So far I am supplementing with Selenium, Zinc, Magnesium, and sometimes I take Vitamin D3 + K. I believe it has made some difference in my energy levels and mood. Still, I do not feel like a 22 year old which stinks but I am happy that I am getting opinions from people who know this stuff.

  • Can you add the ranges to these results

    Is TPO Ab range <34

    If so, you definitely have Hashimoto's

    What time of day was test done? TSH, which is all most GP's look at, is highest first thing in morning

    Definitely get your vitamin D, folate, ferritin and B12 checked these are very often low because of thyroid issues and then also affect thyroid.

    Consider changing to gluten free diet

    thyroidpharmacist.com/artic...

    thyroidpharmacist.com/artic...

    amymyersmd.com/2017/02/3-im...

    chriskresser.com/the-gluten...

    scdlifestyle.com/2014/08/th...

    If you email Louise at Thyroid Uk for list of recommended thyroid specialists, but I would get vitamins checked first, come back here with new post with results and members can advise

    Louise.roberts@thyroiduk.org.uk

    If you can't get full thyroid and vitamin testing from GP

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

    Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw or

    All thyroid tests should be done as early as possible in morning and fasting

  • I completely forgot to add the ranges, sorry. Here are the ranges for me, I live in the U.S.

    Free T4: 1.6 Range: 0.7-2.5 ng/dL

    Free T3: 4.2 Range: 2.4 - 4.2 ng/dL

    TSH: 5.8 Range: 0.5 - 3.0 U/mL

    TPOab: 61 Range: 0 - 150 IU/ML (70 - 150 borderline)

    Currently I am supplementing with Selenium, Zinc, Magnesium and sometimes Vitamin D3. I am going to go see another doctor and get tested for those vitamins as well, especially ferritin.

  • So these are very different ranges from Medichecks or Blue Horizon

    Are you in UK?

    Very confused by the high FT3, with high TSH and fairly low TPO. Though TPO are creeping up

    As SeasideSusie says.......unless you have high TG antibodies.

    I would get TG antibodies tested, plus vitamin D, folate, B12 and ferritin

    Do you have any gut symptoms, e.g. IBS, acid reflux or notice any changes after eating any different foods?

    Brain fog can be candida, SIBO or gluten related too. This often linked to hypo especially Hashimoto's and/or low stomach acid

  • The only thing I believe I an sort of sensitive to is lactose. Little after I eat ice cream I get gassy and bloaty. Compared to when I eat bread I do not feel any intestinal distress. I am only constipated sometimes when I do not eat enough fiber. I do suffer from occasional acid reflux and it is very mild like maybe once every two weeks. If I eat greasy food my energy levels drop substantially and I feel very sleepy and fatigued like pizza and burgers and other high fat foods fries etc. I will look into TG antibodies as well. My tongue was white and I believe I have a yeast infection so I believe it is candida. I have ordered a candida cleanse that contains digestive enzymes, probiotics and anti fungal essential oils. I just started so I will have to see how that works out.

  • Welcome to our forum. When you post results it is helpful for us to comment if you also put the ranges. The reason being that labs use different machines and so are the ranges,

  • Hello,

    I understand, sorry about that. Here are my lab results and ranges:

    Free T4: 1.6 Range: 0.7-2.5 ng/dL

    Free T3: 4.2 Range: 2.4 - 4.2 ng/dL

    TSH: 5.8 Range: 0.5 - 3.0 U/mL

    TPOab: 61 Range: 0 - 150 IU/ML (70 - 150 borderline)

  • Thanks and I will add in the others for comments, otherwise they may not read your response. I am puzzled because FT3 is good but TSH too high.

    SlowDragon

    bluebug Clutter SeasideSusie

  • Thank you! Yes, I am very confused as well, I have researched thyroid issues ever since last year because I wanted to arm myself with knowledge on this issue if I was going to confront doctors about it. However, these test results are confusing and make no sense?

  • I would try and get Thyroglobulin antibodies tested as well. You can be negative for TPO and positive for TG = autoimmune thyroid disease = Hashimoto's = fluctuations in symptoms and test results.

  • I will be sure to get a TG to rule out or confirm Hashimoto. I just do not know what will happen when I go to my doctor and show her these test results as she will probably say it's just in my head or theres nothing wrong with me. If I do have Hashimotos I am worried about how my doctor will go about it. I live in the U.S. and the primary treatment is T4, you have to really beg for T3 treatment. Thankfully though there are some holistic doctors that prescribe T3 and use compounding pharmacies that use natural substances but they are very expensive. I just really want to feel my age again.

  • See another doctor.

    This doctor knows nothing about thyroid disorders.

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