Hypothyroid or not?

vamah

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I am wondering if thyroid tests are as unreliable as some other tests (lyme, etc) because I have many symptoms of Hypothyroid, but my tests always come back normal. Is there something else that closely mimics hypothyroidism? The big red flag for me is low basal body temp (96 or lower), extreme sensitivity to cold and reynaud's syndrome. That just screams thyroid dysfundtion to me, but my tests are normal.
 

Ema

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I just wrote about this on Lotus97's thread...normal is a statistical construct that encompasses 95% of the given population. To be out of range on a lab test means that you are in the top or bottom 2.5%. Obviously that is a HUGE range and not all that helpful in terms of catching those who are ill.

Second, if you are using the TSH as the only measure for hypothyroidism, you will miss a great deal of people who are actually hypothyroid. Especially those in our population. You need to look at TSH in concert with the FT3 and FT4 along with RT3 and thyroid antibodies.

The tests aren't unreliable per se...they are just limited in what they can tell you. But doctors don't tell you that and let you think the labs are the holy grail because they are cheap and easy for them to order as opposed to taking the time to sit down and listen to the patient and take a detailed history.

Have you posted your labs here before?

Ema
 

Ema

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These are my most recent test results.

Component Your result Standard range Units
T4 FREE 1.07 0.6-1.7 NG/DL
T3 121.1 60-181 NG/DL
TSH,BLD,QN 1.990 0.320-5.500 MIU/ML
Generally people seem to feel best with a FT4 of about 1.3-1.4 ng/dl. So I would consider your result to be low.

That looks like a total T3 instead of free unfortunately.

Your TSH is still between 1-2...but just barely.

I would bet big bucks that your FT3 would be low as well if you got it tested. I would also bet with your sensitivity to temp and Reynaud's that you also have HPA axis dysfunction causing faltering cortisol production. This may impact your ability to tolerate thyroid hormone so it is important to test and address it first.

Low iron is another cause of inability to tolerate or benefit from thyroid hormone. Optimal serum iron levels are generally considered to be 100-110 with a %sat of 35-45% and TIBC/UIBC well above the bottom of the range which indicates the ability to safely store iron.

It would also be worthwhile to try to figure out if your hypothyroidism is caused by an autoimmune process such as Hashimoto's or if it is a result of chronic illness. The former is often readily responsive to thyroid meds while the latter may not be. Thyroid antibodies (TgAB and anti TPOAb) can help to sort this out.

Either way, if the FT3 is also low, I would ask my open minded progressive doctor for a trial of thyroid meds (most likely a T4/T3 blend rather than simply T4) and see if titrating up to an optimal dose (usually 3-5 grains of natural desiccated thyroid) helps you feel better or not.

If it turns out that pathogens are responsible for your hypothyroidism as opposed to an autoimmune disease, treating those can also go a long way towards resolving the problem.

Ema
 

vamah

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Washington , DC area
Generally people seem to feel best with a FT4 of about 1.3-1.4 ng/dl. So I would consider your result to be low.

That looks like a total T3 instead of free unfortunately.

Your TSH is still between 1-2...but just barely.

I would bet big bucks that your FT3 would be low as well if you got it tested. I would also bet with your sensitivity to temp and Reynaud's that you also have HPA axis dysfunction causing faltering cortisol production. This may impact your ability to tolerate thyroid hormone so it is important to test and address it first.

Low iron is another cause of inability to tolerate or benefit from thyroid hormone. Optimal serum iron levels are generally considered to be 100-110 with a %sat of 35-45% and TIBC/UIBC well above the bottom of the range which indicates the ability to safely store iron.

It would also be worthwhile to try to figure out if your hypothyroidism is caused by an autoimmune process such as Hashimoto's or if it is a result of chronic illness. The former is often readily responsive to thyroid meds while the latter may not be. Thyroid antibodies (TgAB and anti TPOAb) can help to sort this out.

Either way, if the FT3 is also low, I would ask my open minded progressive doctor for a trial of thyroid meds (most likely a T4/T3 blend rather than simply T4) and see if titrating up to an optimal dose (usually 3-5 grains of natural desiccated thyroid) helps you feel better or not.

If it turns out that pathogens are responsible for your hypothyroidism as opposed to an autoimmune disease, treating those can also go a long way towards resolving the problem.

Ema
Thank you for this information. I am currently in the process of switching insurance, so I will bring this up with my new doctor in July, when my visits are covered, and see about getting those other tests.