We would need to see actual figures for TSH, fT3 and fT4. It's not just a question of each hormone being in their reference interval but also how they interrelate. Also, endocrine disrupting chemicals (EDCs) can affect thyroid hormone action without affecting the pituitary so blood tests are normal. The Great Lakes area is noted for having high levels of EDCs.
Estrogen - 33 (Post Menopausal range <202 littre) Am using bioidentical biest low amount
Progesterone - 2.7 (Post Menopausal <0.7) Am using bioidentical progesterone low amount
Testosterone Free - <20 (<29) - Am using bioidentical testosterone low amount
I am depressed, exhausted all day, want to sleep all day, Hashi face, slight edema in feet, loss of muscle mass, hair loss, outer eyebrows disappearing, no appetite (but do eat ok), sensitive inflammed gums, sleep apnea (use a cpap), osteoporosis - shallow breathing big time!, then anxiety where I want to clench my fists and scream, stomach issues, diarrhea alot, if lean over get a bit light headed, TMJ with major jaw clenching during sleep, dry scalely skin, calf muscle cramps, brain fog, LOUD heart beat much of the time, but not all the time
I am so upset. I have been under major, major stress for past 2 years.
I am wondering why my TSH is on the low side towards hyper but my free T4 is also on the low side - the free T3 barely is above the middle of the range.
These are very good results, almost optimal. I was severely hypothyroid with similar numbers although not so many tests. I think your pituitary and thyroid are working fine leading to good blood hormone levels.
I dislike doctors who peddle the concept of 'optimal' hormone / nutrient levels because patients don't get better if you simply supplement. So time is wasted. Of course hypothyroidism causes various deficiencies and if you correct the hypothyroidism deficiencies self correct. It's easy to get this the wrong way around.
Your signs and symptoms indicate hypothyroidism but your blood of tests show you pituitary and thyroid are working fine. This suggests a form of peripheral resistance to thyroid hormone (RTH). The only cause of peripheral RTH I can think of is endocrine disruption. However, investigating this is not feasible in the near term. I would instead take a pragmatic approach, preferably under medical supervision. The only way to confirm you are hypothyroid is a trial of thyroid hormone. Does it make you better, or do you become thyrotoxic?
With this strategy you would gradually increase the dose but reduce it if you develop any signs of hyperthyroidism. It makes sense to monitor and keep a record of your pulse. You may need above normal thyroid hormone levels to be well.
Resistance to thyroid hormone (RTH) is when thyroid hormone is in the cells but the T3 does not bind to receptors and DNA as well as it should do. There are genetic forms which have characteristics (e.g. high fT3, fT4 and normal or low TSH) that help identify them. Endocrine disruptors inhibit thyroid hormone activity in various ways, including affect the binding of hormone and so causing RTH.
I'm not familar with Dr Lam's ideas. The HPA axis affects adrenal function and has nothing to do with RTH.
The endocrine society has an excellent introduction to EDCs endocrine.org/topics/edc . In terms of eliminating them my view is that PBDEs are the harmful ones, because they hand around in the body for a very long time and are everywhere. PBDEs are flame retardants used in soft furnishings from the 1970s to 2004, especially in polyurethane foam. I would get rid of any furniture from this period and damp dust or HEPA vacuum the house weekly. Opening windows also helps.
Any EDC burden is likely to take years to be eliminated from the body so I would trial thyroid hormone in gradually increasing doses whilst monitoring your pulse. If you find no benefit, or you become hyperthyroid then you are unlikely to have a thyroid problem.
I will read up on this. RTH, this has been on my radar for a while. I suspect, I have this complicated by major life stress - being on high alert all the time.
I am back on dessicated, started this am. Will take it for a while - did 15 mg this am, my pulse is 76!
My thought is that my estrogen is soo very low that it is also impacting my well being.
My house is new, new furnishings, hardwood everywhere and my windows are open alot (not right now it is 37C and humid here in Ottawa right now).
Blesssings to you in aiding a complete strangers .
There is an old saying I grew up with on the farm - "many hands make light work" - you and this board are evidence of this.
I will respond back to this thread in the next while to provide feedback.
Imo, yes. And there seems to be great debate about what is ‘normal’. I’ve been following a doctor in the US named Westin Childs and he posts interesting info about what he believes to be the ‘optimal’ range for people to actually feel good.
I’ve also always had normal labs but have responded well to a T3 T4 med, Armour thyroid. I had every Hypothyroid symptom there is- all with normal labs.
I have tried dessicated thyroid at 15 mg but felt it made me a bit hyper or so.
Was thinking of doing just a little bit of only T3.
What I did notice is that when on the dessicated, a good portion of the body edema on the feet, fingers was significantly reduced - so that tells me that the thyroid is not working properly despite the "regular" blood work.
Hmm, how long were you on dessicated? Did you give it time? I recall starting T4 only and having some rough days and then things smoothed out. I moved to AT and that’s when I started to feel better.
I would google and see if you can find Dr Westin Childs optimal levels and compare your labs to them. It might give you an idea of what to increase.
Thanks. I was not on the dessicated very long at all - I guess I should get back on it and record changes.
It is the crushing fatigue, air hunger/shallow breathing and the loud heart beat.
I did check Dr. Childs optimal levels and I am ok (I posted all my blood work above).
When you say AT - what is that? I have read the Dessicated can be an issue for some Hashi patients, apparently the body recognizes it in its converted form as an intruder and attacks it, creating more issues.
I’m not at all an expert on blood work but I’d wait for some responses on here bc there are some people on here that seem to know far more than the doctors
you have high antibodies this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
Are you on strictly gluten free diet?
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
A wonderful good day SlowDragon! Thank you for your great response to me and many others. You and the other administers here should become a Sir or Dame of the Empire. If Elton John can be a sir, you folks deserve it WAY more! The help you provide others, the improvements you gift to people is worth so much more than Elton ( I love him) . So there!
I am almost on a gluten free diet - occasionally I slip, sigh. I do not have celiac confirmed 3 years ago after colonoscopy where they took a sample and also confirmed by blood work. I will work on this.
My stomach does have issues to be sure.
Yes, my nathropath doctor noted the low morning cortisol. I had a saliva test done 8 months ago and indeed my morning cortisol was low. Not sure why. I have bad sleep and have to use a cpap so I wonder if that is it.
My DHEA is high, I never supplement. It has been above the normal for over 8 years I think. I read that menopause can impact this as well as high stress.
I am very interested in the RTH angle, because my blood work (2nd post in this thread) appears ok, but my thyroid symptoms are huge.
I am scared about my health because my beloved momma died last September at 89 from congestive heart failure and her thyroid was mismanaged for ever. Thyroid is the main reason for CHF. Mom had Hashi's cause I fought her doctor to have her get a full thyroid panel. Sure enough Hashi, grrrrrr.
So I have inherited this and I refuse to meet the same fate as my dearest and beloved momma.
Sir/Dame Slow Dragon - I thank you very much for your assistance.
Thank you for the info regarding T and DHEA. Appears to be a link. My T is quite low and I have osteoporosis, so T levels are important to me.
The stress thing, I fully support the impacts on the body. I know it impacts the thyroid.
I have started 15 mg of dessicated as a trial, thanks to my nathropath, already I see the edema in my fingers and lower foot decline. Better breathing already.
Couple of things I forgot. With all your symptoms it has probably changed your appearance. Take some photos of yourself now, close ups and full body, also photos of any skin problems. You don’t have to show them to anybody. I took photos a couple of days after I was diagnosed, they are really scary. Now they are strong evidence that I was hypo With perfect hormone levels.
I would also take a magnesium supplement if you don’t already as it may reduce stress and pain, especially TMJ. Use a good source of magnesium such as magnesium citrate, oxide and hydroxide are no use. Magnesium blood tests are no use as most magnesium is intracellular and not in blood. Hypothyroidism lowers intracellular magnesium. If you take too much it will cause diarrhoea. You already have diarrhoea and it will lower mineral levels, especially magnesium.
Indeed I have the Hashi face, bags under eyes, jowls, fat patches above the elbows, tummy fat, skin darkening on front/sides of calf's, yep!
I take magnesium, too much in fact, having chronic diarrhea, so stopped the magnesium and diarrhea stopped.
On day 2 of 15 mg of dessicated, no ill effects yet. Each week I will raise it to see the consequences. But the size of my fingers has shrunk and the slight swelling in my lower feet near the toes is less, so something good is happening.
Take magnesium but back off if you start to show signs of diarrhoea. Keep photographic and diary evidence because idiots will deny you were hypothyroid.
I will do. In Canada we have only the public system (there are no private doctors or medical services other than dental) and there are very few family doctors - about 25% of taxpayers in Ontario have no doctor. There are few specialists and the wait can be over 1 year. Since they are all public servants, there is little interest in good customer service or going the extra mile - it really shows. Client reviews are not relevant.
I am considering going to the US, the Holtorf Group in Atlanta, to get thyroid care. I am 62 and I will not put up with my health and useless medical care any longer. I have to get living and make the most of the rest of my life.
A very personal opinion but I do not rate Holtorf, at least from an academic viewpoint.
If you can't find someone in Canada you may have the option of buying thyroid hormone over the internet. I'm not familiar with the law in Canada, it's legal in the UK but may not be where you are.
You might also look into seeing Dr. Theodore Friedman in LA. Due to Corona he is now taking telephone appointments and his reviews are really good - he is supposed to be one of the best hormone specialists in the US.
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weird symptoms (or normal?) for underactive thyroid
Symptoms of thyroid issues but tests normal
Symptoms but blood test normal ranges 
Large Goitre/ Thyroid symptoms / TSH normal. 
