# What more can/should I be doing?



## confused&tiredinNY (Jun 4, 2013)

Good Afternoon!
I'm a 26 year old female from NY who was diagnosed with Hashimotos Disease in 2006 (never medicated). I had been seeing a doctor for many years who insisted on doing a biopsy of my nodes twice a year - I always thought this was excessive but as a naïve 22 year old, I made the mistake of trusting the doctor. My symptoms include fatigue, depression, constipation, bouts of mania, sensitivity to cold and most frustratingly, weight gain. I would constantly mention my frustrations, especially about the weight issue, and was always told "you're being vain, eat less and move more". I have since separated from this doctor and have found someone new - the problem I'm having is I'm being told my levels aren't low enough for levothyroxine. I have made an appointment to have my levels rechecked (last appointment was approximately a year ago) in hopes of a new development. 
I've been following Weight Watchers since 2009 and have lost 50 pounds. The trouble seems to be getting past the initial 50 pounds (this plateau was reached in 2011). I eat incredibly well - I can't tell you the last time I had white bread, regular pasta or butter. I've tried giving up processed foods, soda, dairy, wheat and artificial sugars. I've been on the Cabbage diet, the Atkins diet and the South Beach diet and I've swapped breakfasts for green based smoothies. I eat in 3 hour intervals and don't eat past 8:30pm. I take a multi-vitamin every morning. I jog 2 miles, 3 times a week. I'm 5'8" and weigh 230, there is NO reason I weight what I weight. 
My question, forum, is this: has anyone else experienced this? Is there an additional test I should be asking for? I don't think I've been as proactive as I should be but I think it's because I'm so uneducated in this. I'm getting married next September and would like to feel beautiful at my wedding. At this point, I feel so lost that I just want to cry :sad0049:

Last labs 6/26/12
TSH: 1.48 (reference range: 0.40-4.50)
T4 Free: 1.2 (reference range: 0.8-1.8)
T3 Total: 125 (reference range: 76-181)


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## Andros (Aug 26, 2009)

confused&tiredinNY said:


> Good Afternoon!
> I'm a 26 year old female from NY who was diagnosed with Hashimotos Disease in 2006 (never medicated). I had been seeing a doctor for many years who insisted on doing a biopsy of my nodes twice a year - I always thought this was excessive but as a naïve 22 year old, I made the mistake of trusting the doctor. My symptoms include fatigue, depression, constipation, bouts of mania, sensitivity to cold and most frustratingly, weight gain. I would constantly mention my frustrations, especially about the weight issue, and was always told "you're being vain, eat less and move more". I have since separated from this doctor and have found someone new - the problem I'm having is I'm being told my levels aren't low enough for levothyroxine. I have made an appointment to have my levels rechecked (last appointment was approximately a year ago) in hopes of a new development.
> I've been following Weight Watchers since 2009 and have lost 50 pounds. The trouble seems to be getting past the initial 50 pounds (this plateau was reached in 2011). I eat incredibly well - I can't tell you the last time I had white bread, regular pasta or butter. I've tried giving up processed foods, soda, dairy, wheat and artificial sugars. I've been on the Cabbage diet, the Atkins diet and the South Beach diet and I've swapped breakfasts for green based smoothies. I eat in 3 hour intervals and don't eat past 8:30pm. I take a multi-vitamin every morning. I jog 2 miles, 3 times a week. I'm 5'8" and weigh 230, there is NO reason I weight what I weight.
> My question, forum, is this: has anyone else experienced this? Is there an additional test I should be asking for? I don't think I've been as proactive as I should be but I think it's because I'm so uneducated in this. I'm getting married next September and would like to feel beautiful at my wedding. At this point, I feel so lost that I just want to cry :sad0049:
> ...


 and welcome!

It is my opinion that you need thyroxine replacement because you Total 3 is very low. Really, the most beneficial test would have been the FREE T3.

Here is info on that..............

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

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.

And it would be a good idea to get an ultra-sound given your history of thyroid problems which is quite evident based on your symptoms.

Getting antibodies run would be a good thing as well.

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and 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/

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

Trab because you could be flipping back and forth from hypo to hyper and the numbers won't reflect that a lot of times.


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## confused&tiredinNY (Jun 4, 2013)

Thank you very much! :hugs:

I actually had the office fax my last lab results so I've been looking at them all day. I had my T4 Free tested but not my T3 - that was only T3 total, what's the difference? I had my cortisol level tested as well - that was 10.6 (AM range 4.0-22.0, PM range 3.0-17.0).

I will be having my partner join me in August to see the doctor. Sometimes I get so overwhelmed that I kind of block out whats being said to me. After having such a careless doctor in the past, I've been very afraid of speaking to someone about it because of the rude comments he had made.

I really appreciate the information and hope to come back in August with some great news!


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## bigfoot (May 13, 2011)

Welcome! Andros and lots of other "regulars" here are very in-tune to this stuff, so you've come to the right place!

Yes, your TSH and Free T4 don't look awful. But that's not the whole story. Those tests Andros mentioned would sure be handy. And I would suggest getting a Reverse T3 done, too. (Your Reverse T3 could be high, blocking your body from using the thyroid hormone it is able to generate.) Something I am learning myself is that there is always room for a little "improvement". And a question -- how did they diagnose you with Hashimoto's? Can you share those labs and ranges, too?

You will see it mentioned around here, but ideally a good starting point (more like a long-term goal) is to get your TSH to 1.0 or less, and your Free T3 and Free T4 to around 75% of their respective ranges. When it comes to thyroid medications, and hopefully they start you on some, there are all sorts of brands and varieties. The simple version is they will either be brand-name or generic, synthetic or natural/desiccated, and either contain T4-only, T3-only, or a mix of T4/T3. Another key point is to go low 'n' slow with titration, with frequent ongoing lab tests to make sure your levels are improving, and you aren't being over- or under-medicated.

You listed all sorts of diets and regimens; have you ever been tested for Celiac disease and gluten sensitivity? They are not one in the same. I was negative for Celiac but had a scorching case of gluten sensitivity that turned up on testing. Went totally gluten free and within 3-4 weeks things were improving. The catch is that they put gluten in darn near everything; you really have to be diligent with the labels and research. Needless to say, gluten does different things to different people -- some folks get heart palps, others get anxiety, brain fog, etc. It probably wouldn't be the end-all, be-all answer here, but it might be a piece of the puzzle worth looking into.

Another suggestion is to have your doc look into other hormones. Things like thorough Cortisol testing (ideally need a 24-hr. urine or saliva collection, broken into different time periods), DHEA, Estrogen, Testosterone, SHBG, and so on. These hormones are very intricately tied into the endocrine system, and one single thing being off can tip a lot of dominos. Same goes for Vitamin D-25, Vitamin B-12, and iron/anemia. Heck, even having something like sleep apnea can do a number on you.

With how young you are, and the fact that you have been successfully dieting and exercising, but still have signs & symptoms, your doc should be turning over every stone in sight. There is more than likely something amiss behind the scenes that is driving much, if not all, of what you are experiencing. The fact that you hit a plateau with your weight loss is a _big red flag_ to me that hormones are wonky. Short of walking in with a neon sign to your doctor's office, I'm not sure how else you could be more blunt.

Edit: To answer your question, Total T3 is near-useless lab information. You need to have a Free T3 run, which is the amount of active thyroid hormone available for your body to use.

hugs6


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## confused&tiredinNY (Jun 4, 2013)

I was diagnosed in 2006 by a dim wit at a children's hospital. As it turns out, I was really diagnosed in 2004 but the doctor didn't tell me because the levels weren't "significant enough". I will never forget the hell storm that followed that mess. The doctor actually said "it really isn't a big deal!" which set off my momma & poppa bear parents. I had been struggling with fatigue and had bouts of what we thought was mono, it turned out to be Hashimoto's. I don't believe I have access to that information because it wasn't something I was proactive about. I will certainly look into it.

I'm actually well versed in long term medication. I was diagnosed borderline personality and bipolar at 16 (technically they won't give a formal diagnosis until 18 but that was the case). I was on a litany of medication from 16 to 22 when I eventually was stable enough to begin weaning off everything with doctor supervision. Finding the right combination was probably the most hellacious thing I've ever done. I can only assume this is part of my illogical reasoning and inevitable avoidance of all things endo.

I have not been tested for Celiac or gluten sensitivity. The reasoning behind my limiting the intake was a combination of reading "Wheat Belly" and working with autistic children who were gluten free (seeing the mental change was fantastic). I figured if it worked for them, maybe it'd work for me. I do notice when I monitor my gluten, I have a great sense of clarity.

I really appreciate your help and hope to be able to get some of this under control. I've been dieting for more than half my life and eventually get to a point where I give in and binge eat because I'm literally busting my ass to thin out and nothing happens. As a female, it's the worst mind game you can play. I've honestly hidden a lot of the symptoms from friends/family because I'm afraid of being called a hypochondriac (which is what one of the doctors called me).


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## Danniswirl (Feb 23, 2013)

I feel your pain! I have always been called an hypochondriac from family and friends. After going on armour thyroid and increasing slowly I am down to a size 6 again. I lost about 20 lbs. You won't be able to loose all the weight until your thyroid is properly treated. Follow their advice, get that T3 checked! I also follow a gluten free diet. I still have bad days though.


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## bigfoot (May 13, 2011)

confused&tiredinNY said:


> I don't believe I have access to that information because it wasn't something I was proactive about. I will certainly look into it.


I would be very, very surprised if they simply tossed your old medical records after a few years. You should be able to request a copy of them (hopefully lab work results would be there, too) for your own information and reference.


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## confused&tiredinNY (Jun 4, 2013)

I called the hospital where the initial testing took place, they are sending the records to my current doctor who will send me copies (they charge $.75 a page if it goes directly to me). Once I have them, I'll post what those show too.

I really can't thank this forum enough. Even though this is my first post, I've read some of the other users struggles and feel more normal. No one in my family has thyroid issues so it's not like anyone can relate. It's so great to know that I'm not alone in this and that with enough fight I can win this.

THANK YOU :hugs:


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## Lovlkn (Dec 20, 2009)

> My symptoms include fatigue, depression, constipation, bouts of mania, sensitivity to cold and most frustratingly, weight gain. I would constantly mention my frustrations, especially about the weight issue,


Find a doctor to treat your symptoms. I know a small dose of replacement would probably cure all your symptoms.

Find another doctor and keep asking until someone gives you some replacement


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## bigfoot (May 13, 2011)

Amen.

And look into going Paleo, too. More of a lifestyle than a diet plan. What is interesting is that all these years they have been telling folks to eat more grains and carbs, and less fats, eggs, and so forth. Anyway, I didn't know if you had completely eliminated fats from your menu, so it might be worth looking into.


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## bigfoot (May 13, 2011)

Edit... nevermind... just saw in another post you are Paleo, so scratch that one off!


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