# I'm new here - not sure it's my thyroid...



## wooziemimi

...but I have the symptoms of both over and underactive thyroid:

unexplained weight loss
dizziness
constipation
diarrhea
nausea
heat intolerance
cold intolerance
anxiety
fatigue
chronic headache
tachycardia
sleep disturbances

Plus I've been diagnosed with the following, all of which can be related to thyroid disease:

Pituitary microadenoma
Collagenous Colitis (also called Microscopic Colitis)
Lymphadenopathy
Lymphopenia
Raynaud's
Urinary Urge Incontinence

Yesterday, my TSH blood test came back "normal" at 2.14.

So, every doctor I talk with thinks I'm a hypochondriac and isn't interested in testing me further. I'm not sure what to do next.

Thanks,
Michele


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## Andros

wooziemimi said:


> ...but I have the symptoms of both over and underactive thyroid:
> 
> unexplained weight loss
> dizziness
> constipation
> diarrhea
> nausea
> heat intolerance
> cold intolerance
> anxiety
> fatigue
> chronic headache
> tachycardia
> sleep disturbances
> 
> Plus I've been diagnosed with the following, all of which can be related to thyroid disease:
> 
> Pituitary microadenoma
> Collagenous Colitis (also called Microscopic Colitis)
> Lymphadenopathy
> Lymphopenia
> Raynaud's
> Urinary Urge Incontinence
> 
> Yesterday, my TSH blood test came back "normal" at 2.14.
> 
> So, every doctor I talk with thinks I'm a hypochondriac and isn't interested in testing me further. I'm not sure what to do next.
> 
> Thanks,
> Michele


Hi there, Michele and welcome!

I am with you. No one would know their body better than the owner.

TSH is kind of high; most of us do best @ 1.0 or less.

You need further testing.

Sad, but true.

The FREES need to be done.

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

http://www.drlam.com/articles/hypothyroidism.asp?page=3

And antibodies' tests.............

TSI (thyroid stimulating immunoglobulin)http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html,TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

Symptoms can and do cross over so the above will get to the bottom of it.

If you have been diagnosed w/all you have listed; how can the doctor's possibly think you are a hypochondriac? That is the most ridiculous thing I have ever heard. You have real justifiable concerns and complaints.


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## Octavia

Have various forms of anemia been ruled out? Iron deficiency anemia? Pernicious anemia? Other forms of anemia?

It's not a terrible idea to continue to explore the thyroid route, but I would hate for you to be barking up the wrong tree, and only one tree, when there are other possibilities.


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## wooziemimi

Andros said:


> Hi there, Michele and welcome!
> 
> I am with you. No one would know their body better than the owner.
> 
> TSH is kind of high; most of us do best @ 1.0 or less.
> 
> You need further testing.
> 
> Sad, but true.
> 
> The FREES need to be done.
> 
> Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
> 
> http://www.drlam.com/articles/hypothyroidism.asp?page=3
> 
> And antibodies' tests.............
> 
> TSI (thyroid stimulating immunoglobulin)http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html,TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.
> 
> You can look this stuff up here and more.........
> http://www.labtestsonline.org/
> 
> Symptoms can and do cross over so the above will get to the bottom of it.
> 
> If you have been diagnosed w/all you have listed; how can the doctor's possibly think you are a hypochondriac? That is the most ridiculous thing I have ever heard. You have real justifiable concerns and complaints.


Andros,

Thanks for the detailed reply. I'll read up and contact my doctor. Do you think I should get tested by an endocrinologist instead of just my family physician?

Michele


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## wooziemimi

Octavia said:


> Have various forms of anemia been ruled out? Iron deficiency anemia? Pernicious anemia? Other forms of anemia?
> 
> It's not a terrible idea to continue to explore the thyroid route, but I would hate for you to be barking up the wrong tree, and only one tree, when there are other possibilities.


Octavia,

Yes, I do have anemia. I believe it's iron deficiency anemia because my doctor prescribed iron (ferrous sulfate). I take 27 mg. daily. Even though I'm taking iron, could that be causing my problems?

Michele


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## Octavia

wooziemimi said:


> Octavia,
> 
> Yes, I do have anemia. I believe it's iron deficiency anemia because my doctor prescribed iron (ferrous sulfate). I take 27 mg. daily. Even though I'm taking iron, could that be causing my problems?
> 
> Michele


Possibly. Some sites that describe iron deficiency anemia and pernicious anemia list some of the symptoms you are experiencing. How long have you been treated for anemia, and has there been any follow-up to see if the treatment is working?


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## Andros

wooziemimi said:


> Andros,
> 
> Thanks for the detailed reply. I'll read up and contact my doctor. Do you think I should get tested by an endocrinologist instead of just my family physician?
> 
> Michele


No need for an endo yet if at all. Your family doc can order the tests.

When you do this, get copies of the results and ranges. We can help you understand the results.

We definitely need the ranges as different labs use different ranges.


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## wooziemimi

Octavia said:


> Possibly. Some sites that describe iron deficiency anemia and pernicious anemia list some of the symptoms you are experiencing. How long have you been treated for anemia, and has there been any follow-up to see if the treatment is working?


I've been taking iron for about six years. No follow-ups.


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## wooziemimi

Andros said:


> Hi there, Michele and welcome!
> 
> I am with you. No one would know their body better than the owner.
> 
> TSH is kind of high; most of us do best @ 1.0 or less.
> 
> You need further testing.
> 
> Sad, but true.
> 
> The FREES need to be done.
> 
> Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
> 
> http://www.drlam.com/articles/hypothyroidism.asp?page=3
> 
> And antibodies' tests.............
> 
> TSI (thyroid stimulating immunoglobulin)http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html,TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.
> 
> You can look this stuff up here and more.........
> http://www.labtestsonline.org/
> 
> Symptoms can and do cross over so the above will get to the bottom of it.
> 
> If you have been diagnosed w/all you have listed; how can the doctor's possibly think you are a hypochondriac? That is the most ridiculous thing I have ever heard. You have real justifiable concerns and complaints.


Andros,

Thanks for your detailed reply. I thought I replied to this yesterday, but the posting is not there.

Michele


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## Andros

wooziemimi said:


> Andros,
> 
> Thanks for your detailed reply. I thought I replied to this yesterday, but the posting is not there.
> 
> Michele


You are very welcome, Michele!! That's okay; I have brain fog, you have brain fog so neither us knows the difference. We are on the same page. LOL!


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## wooziemimi

Andros said:


> You are very welcome, Michele!! That's okay; I have brain fog, you have brain fog so neither us knows the difference. We are on the same page. LOL!


The worst part is, I didn't even think I was having brain-fog! (And yes, I've experienced that wonderful symptom, too). :winking0014:


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## Andros

wooziemimi said:


> I've been taking iron for about six years. No follow-ups.


Goodness. You may have to ask for one!

Ferritin http://www.thewayup.com/newsletters/081504.htm
(should be 50 to 100; the closer to 100, the better)

Octavia is right about this. For one thing, it would seem that low ferritin and thyroid disease go hand in hand. In a way, you could say low ferritin is a good diagnostic tool for various autoimmune diseases as the body either down regulates it or is not able to make full use of it.


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## wooziemimi

Andros said:


> Goodness. You may have to ask for one!
> 
> Ferritin http://www.thewayup.com/newsletters/081504.htm
> (should be 50 to 100; the closer to 100, the better)
> 
> Octavia is right about this. For one thing, it would seem that low ferritin and thyroid disease go hand in hand. In a way, you could say low ferritin is a good diagnostic tool for various autoimmune diseases as the body either down regulates it or is not able to make full use of it.


Andros,

Thanks for the link. Sounds like I have something else to add to my list of possible signs of an autoimmune thyroid disease. Now, if I could just get a doctor to be as interested in "fixing me" as I am. Ugh.

Michele


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## Andros

wooziemimi said:


> Andros,
> 
> Thanks for the link. Sounds like I have something else to add to my list of possible signs of an autoimmune thyroid disease. Now, if I could just get a doctor to be as interested in "fixing me" as I am. Ugh.
> 
> Michele


Hopefully we can help you do that. Knowledge is power; even in the doctor's office!


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## wooziemimi

Well, I found a doctor who listened to me! I went to him yesterday for chronic diarrhea and he thinks I have Collaganeous Colitis again. I told him I thought it was my thyroid causing it (as well as causing tachycardia - did I mention my heart rate went to 270 bpm on an EKG stress test in October?!) and he agreed to test further than the TSH. So yesterday the lab took blood to test T3 and T4. I'll let you know of the results - should get in a few days. Can't believe I'm excited to possibly have thyroid problems, but I am - because that means it's TREATABLE!!


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## Andros

wooziemimi said:


> Well, I found a doctor who listened to me! I went to him yesterday for chronic diarrhea and he thinks I have Collaganeous Colitis again. I told him I thought it was my thyroid causing it (as well as causing tachycardia - did I mention my heart rate went to 270 bpm on an EKG stress test in October?!) and he agreed to test further than the TSH. So yesterday the lab took blood to test T3 and T4. I'll let you know of the results - should get in a few days. Can't believe I'm excited to possibly have thyroid problems, but I am - because that means it's TREATABLE!!


Yep; sounds like another hyper symptom.

Wish you could get these tests run.

TSI (thyroid stimulating immunoglobulin)http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html,TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin, http://www.ncbi.nlm.nih.gov/pubmed/1969138 ), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/


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## wooziemimi

Andros,

Your first link goes to a site, but there is no article showing. Yes, I agree, I need further testing. I told this doctor that I wanted the antibody tests done and he just wanted to start with the T3 & T4. That's OK, I'm keeping copies of all the lab results because no matter what the test results, I think I need to see an endocrinologist and will go armed with recent lab test results. I definitely have enough symptoms and diagnoses that warrant further look at my endocrine system (not only the thyroid, but also the adrenals). Now I just have to figure out where to go, what doctor to see. Any suggestions for the Mobile, Alabama area, anyone?

Michele

P.S. Sounds like it'll be more than the antibody tests - thanks so much for your info - I'll read up on it to become informed.



Andros said:


> Yep; sounds like another hyper symptom.
> 
> Wish you could get these tests run.
> 
> TSI (thyroid stimulating immunoglobulin)http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin, http://www.ncbi.nlm.nih.gov/pubmed/1969138 ), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.
> 
> You can look this stuff up here and more.........
> http://www.labtestsonline.org/


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## Andros

wooziemimi said:


> Andros,
> 
> Your first link goes to a site, but there is no article showing. Yes, I agree, I need further testing. I told this doctor that I wanted the antibody tests done and he just wanted to start with the T3 & T4. That's OK, I'm keeping copies of all the lab results because no matter what the test results, I think I need to see an endocrinologist and will go armed with recent lab test results. I definitely have enough symptoms and diagnoses that warrant further look at my endocrine system (not only the thyroid, but also the adrenals). Now I just have to figure out where to go, what doctor to see. Any suggestions for the Mobile, Alabama area, anyone?
> 
> Michele
> 
> P.S. Sounds like it'll be more than the antibody tests - thanks so much for your info - I'll read up on it to become informed.


Thank you for the heads up; guess that site crashed and burned. Wah!

You are welcome; I know that all of us here feel the same way. 
We are happy to help if we can!

This should work now....

http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html


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## wooziemimi

The latest lab tests were "normal":

T3, Total - 1.0
T4, Total - 6.8
Sed Rate - 13
ANA Screen - Negative
CRP - .07
IGA - 232

After spending a few minutes going over these results, and the fact that I felt good at that moment, this doctor gave me the "you're fine look" as well as a wisecrack when I asked him what he thought was causing my collagenous colitis. I then asked to see an endocrinologist and was hesitantly referred to one. I say hesitantly, because I can now add another doctor to my list who thinks I'm a hypochondriac. Yes, it was another heart-wrenching doctor's visit and yes, I will not be seeing this doctor again.

Still, I'm thinking that it might be a waste of time seeing the endocrinologist if he doesn't want to test me further. I had to argue with his nurse about my symptoms and family history in order to get a visit scheduled:

Nurse: "Your labs are normal"
Me: "Maybe I need further testing - something is wrong with my metabolism!" "Plus, I've heard that Free T3 and T4 are more accurate tests (no reply)."

Only after I mentioned the pituitary microadenoma did she schedule a visit. I think I'm going to call her back and ask the following questions:

* Will this doctor test my thyroid further?
* Will this doctor test my adrenal glands?
* Does this doctor believe in adrenal insufficiency or fatigue?
* Will this doctor prescribe treatment based on symptoms and not just lab results?

My husband thinks I should instead look for a more forward thinking doctor as well as one doing current research, perhaps at Oschner in New Orleans. I'm thinking I should get tests done at home first. What do you think? Also, do you think the "ANA Screen" was sufficient to test for autoimmune thyroid disease?

Thanks,
Michele


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## bigfoot

I know Andros will chime in here shortly, but they should be running TPO Antibodies, Thyroglobulin Antibodies, as well as TSI and TBII tests. I'm no expert, but I don't think the ANA test is sufficient enough to diagnose autoimmune thyroid problems. On the other hand, it *is* good that the ANA test came back negative!

Hopefully the endocrinologist appointment will go well. Never know, you might be surprised. I kinda see all of this stuff as pieces of a puzzle. One doctor might lead you towards one direction, then connect that to something else, refer you to another doc, and then discover more there, etc.

Oh, and if possible, can you post the ranges for your lab tests?

hugs3


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## Andros

wooziemimi said:


> The latest lab tests were "normal":
> 
> T3, Total - 1.0
> T4, Total - 6.8
> Sed Rate - 13
> ANA Screen - Negative
> CRP - .07
> IGA - 232
> 
> After spending a few minutes going over these results, and the fact that I felt good at that moment, this doctor gave me the "you're fine look" as well as a wisecrack when I asked him what he thought was causing my collagenous colitis. I then asked to see an endocrinologist and was hesitantly referred to one. I say hesitantly, because I can now add another doctor to my list who thinks I'm a hypochondriac. Yes, it was another heart-wrenching doctor's visit and yes, I will not be seeing this doctor again.
> 
> Still, I'm thinking that it might be a waste of time seeing the endocrinologist if he doesn't want to test me further. I had to argue with his nurse about my symptoms and family history in order to get a visit scheduled:
> 
> Nurse: "Your labs are normal"
> Me: "Maybe I need further testing - something is wrong with my metabolism!" "Plus, I've heard that Free T3 and T4 are more accurate tests (no reply)."
> 
> Only after I mentioned the pituitary microadenoma did she schedule a visit. I think I'm going to call her back and ask the following questions:
> 
> * Will this doctor test my thyroid further?
> * Will this doctor test my adrenal glands?
> * Does this doctor believe in adrenal insufficiency or fatigue?
> * Will this doctor prescribe treatment based on symptoms and not just lab results?
> 
> My husband thinks I should instead look for a more forward thinking doctor as well as one doing current research, perhaps at Oschner in New Orleans. I'm thinking I should get tests done at home first. What do you think? Also, do you think the "ANA Screen" was sufficient to test for autoimmune thyroid disease?
> 
> Thanks,
> Michele


For one thing; when they told you ANA (antinuclear antibodies) was negative, what did that mean? None or that it was in range? You should not have any ANA and interestingly, ANA is hard to catch. It waxes and wanes. Furthermore, the presence of ANA is "suggestive" of a myriad of things and futher testing should be done.

Please read this link.
http://labtestsonline.org/understanding/analytes/ana/tab/test

Also, only the bare minimum of thyroid testing was done as you well know for I provided you a list of tests that would be in your best interest in an effort to get to the bottom of all this.

In the future, I hope you can provide the ranges for any further testing results as different labs use different ranges.

Your husband may be "right on!"


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## wooziemimi

bigfoot & Andros,

Thanks for your replies.

Here are my test results again, with the ranges from this lab:

T3, Total - 1.0 - 0.8-2.0 NG/ML (NRML-RANGE)
T4, Total - 6.8 - 5.1-14.0 ug/dl
Sed Rate - 13 - 0-30 MM/HR
ANA Screen - Negative (no range given)
CRP - .07 - 0.00-0.40 MG/DL
IGA - 232 - 70.0-400.0 mg/dl

Andros - I have no clue what "negative" for the ANA Screen means. When I asked my doctor if there were any other antibody tests that should be done, he said "no - that one is conclusive". So I'm guessing that there were no antibodies present (hmm, probably shouldn't assume, though). I still have to read your link, so I can understand better myself.

Sounds like you both think I should get further testing (I think I should, too - not only based on my symptoms, but also because the tests done were insufficient). I'm leaning more towards cancelling the local endo visit and checking out Oschner.

Thanks,
Michele


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## Andros

wooziemimi said:


> bigfoot & Andros,
> 
> Thanks for your replies.
> 
> Here are my test results again, with the ranges from this lab:
> 
> T3, Total - 1.0 - 0.8-2.0 NG/ML (NRML-RANGE)
> T4, Total - 6.8 - 5.1-14.0 ug/dl
> Sed Rate - 13 - 0-30 MM/HR
> ANA Screen - Negative (no range given)
> CRP - .07 - 0.00-0.40 MG/DL
> IGA - 232 - 70.0-400.0 mg/dl
> 
> Andros - I have no clue what "negative" for the ANA Screen means. When I asked my doctor if there were any other antibody tests that should be done, he said "no - that one is conclusive". So I'm guessing that there were no antibodies present (hmm, probably shouldn't assume, though). I still have to read your link, so I can understand better myself.
> 
> Sounds like you both think I should get further testing (I think I should, too - not only based on my symptoms, but also because the tests done were insufficient). I'm leaning more towards cancelling the local endo visit and checking out Oschner.
> 
> Thanks,
> Michele


That link is very important for you to read. ANA is never conclusive. If you have it, it is at the most "suggestive" of a myriad of things.

Also, while the FREES would have been better, both Total 4 and Total 3 are below the mid-range of the ranges provided by your lab. That should have raised an eyebrow.

Read this, please.....................

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

http://www.drlam.com/articles/hypothyroidism.asp?page=2#diagnosis: standard laboratory test


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