# Could I have a thyroid problem?



## tk1018 (Apr 11, 2018)

Hi everyone!

I am a 24 year woman and have been having symptoms of (I think) hypothyroidism. I'm new to all of this so maybe someone on the boards could give me advice!

Since December, I have been feeling very tired. I work in a fast paced dental office where I have never had problems keeping up with the amount of patients, however, I have no energy to want to work and feel exhausted at the end of the day...which I never had before. I'm constantly yawning and I feel like I need to rest. I used to be able to stay up late watching TV but I'm out by 9:00-9:30. I have dry, scaly skin. I use exfoliators and thick lotions but it doesn't seem to work. Recently, my face has started to become very dry. *I don't use anything on my face that would irritate it*. For 6 months now, I've felt my heart skipping and fluttering. In February, my PCP put a heart monitor on for me to wear for 2 weeks and the results came back as PAC (premature atrial contractions.) He told me it's normal to have those. He did check me for TSH in February before the heart monitor and my results came back as *1.95/ulU/mL *on a range of *0.27-4.2 ulU/mL.* When I viewed my results for the Free T4 Reflexive it came back as NOT APPLICABLE. My nails would bend and break, resulting me in getting acrylics so they would keep my natural nails from breaking. I feel like I keep forgetting and lose my train of thought. My hands and feet feel cold to me....not freezing, but cold. My PCP referred me to see a cardiologist because he doesn't believe it's my thyroid. I'm going a week today to see the cardiologist just to go and hear what he will say.

Also, I noticed weight gain. I used to be around 170lbs 3 years ago, and now I'm 200-202. The weight is what surprised me because I usually eat pretty healthy. I feel like I need to constantly eat, and I was never like that. I want to add that I had very heavy periods to the point where I wouldn't be able to walk without think I might have an accident. Has anyone else had these symptoms? I think I have hypothyroidism, but my doctor thinks it's more of a heart issue and wants to put me on a beta blocker. He doesn't think I need further testing. I would rather make sure it's thyroid or not thyroid before starting a beta blocker.

Thanks for your advice and help!


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## Lovlkn (Dec 20, 2009)

Welcome to the board!

The best screening tests are TSH , FT- 4 and FT-3. If you are in the USA in many states you can order them online.

I also suggest testing your vitamin D, Ferritin and B-12 levels.


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## Hopeful (Apr 10, 2018)

Hi tk1018. Your symptoms sound very much all like they could be hypothyroid symptoms and or Hashimoto's symptoms. If you're in the US, your PCP absolutely can and absolutely should order all of the right thyroid panel tests for you, not the wrong ones like he did. You might have to ask for them, but your symptoms alone warrant full thyroid diagnostics. TSH is not exactly a thyroid disease diagnostic because it's not a thyroid hormone. It always has to be used in conjunction with the rest of a thyroid panel to be truly useful, tested along with FT3 and FT4, which measure thyroid hormones. It's also important to test for thyroid antibodies at the same time to see if your hypothyroid symptoms are caused by Hashimoto's. These antibodies are called TPO and TG.

Hypothyroid means slow thyroid, which causes a slow metabolism. Slow metabolism can effect normal heart rhythm, also known as Artial Fibrillation. Another less mentioned problem is an enlarged heart caused by hypothyroidism. I had heart pains and palps that occurred back in college. After graduating, I had "an attack" that didn't stop. I was diagnosed with an enlarged heart at the time. Over the years I had a few pains here and there, had a few new diagnostics and my heart was shown to be normal. 20+ years after the enlarge heart, I was diagnosed with Hashimoto's. Every doctor I've met since, I've made sure to mention that I once had an enlarged heart. Not one of the 40 various doctors I've met as I've chased illness since then have told me about the hypothyroid-enlarged heart connection. Not one! I found it out on my own about 3 weeks ago while researching. Why? Because I've been having some funny heart sensations again and I put two and two together and looked it up.

When I was first diagnosed with Hashimoto's, I had a complete thyroid panel done. I had all your symptoms and more. My TSH was even lower than yours. My FT3 and FT4 were "in range and normal". In reality they were in the low part of the range, which is not normal and is not good. It was part of the cause of my many hypo symptoms. If your thyroid is functioning as it should be, levels will be over or a bit above half range. It was my thyroid antibodies that told the tale. My TPO was over 1000 (0-60). My thyroid was also enlarge and I had an ultrasound that found nodules (very common). My PCP gave me the worst advice for someone with Hashimoto's. He said I didn't need medication. If you have Hashimoto's, that is completely not true, but his bad recommendation is not unheard of either. Studies have shown that a low dose of thyroid medication can keep thyroid antibodies from getting too high. Well, that's exactly what happened to me. No meds and my antibodies that increased into the multiple thousands. Very bad.

The FT4 Reflex is not a FT4 test. What it means is that if your TSH would have been abnormal, then your FT4 would have been tested. So, since your TSH came back as "perfect" (which can be such an incredibly incorrect assumption), then your FT4 was not tested. Your PCP is missing the boat. As a patient, you have every right to tell him that you want a complete thyroid panel, TSH, FT3 and FT4, plus antibodies TG and TPO. He may or may not have ever heard of these tests. Mine hadn't. I told him I was probably wrong, but wanted to make sure. So he ordered the tests and I finally got the diagnosis I'd been trying to get for almost 10 years.


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## Hopeful (Apr 10, 2018)

If you're in the US, iron is usually tested by running a complete iron panel. Iron, % saturation, TIBC -total iron binding capacity, ferritin, for the full picture.


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## tk1018 (Apr 11, 2018)

Thanks for the replies! I did have B12 tested. That result was 550 pg/ml on a range from 232-1245 pg/ml. CK was 43 U/L on a range of 26-192 U/L. Ferritin was 36.0ng/mL on a range from 13-150 ng/ml. I don't see that iron or Vitamin D was tested. I was also really sick with tonsillitis when this blood work was done and I never had it rechecked when I got over being sick.

I also want to add that I've noticed I've been very moody lately. I did start taking a birth control pill to help with my periods because of the heaviness. Not sure if all of this is from the pill? If my PCP won't test more on thyroid, I wonder if the cardiologist will look more into it?


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## Lovlkn (Dec 20, 2009)

Heavy periods come from low ferritin - sounds crazy but that's what I was told.

You could stand to supplement iron - Floridix is a good one - easily absorbed and easier on your system as it's liquid.

Your B-12 s also a bit low.

Many thyroid patients are low in all 3, B-12, D and Ferritin.


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## tk1018 (Apr 11, 2018)

So even though my B12 wasn't flagged, it's still considered low? I appreciate everyone's advice!


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## Hopeful (Apr 10, 2018)

Heavy periods can cause low storage of iron. Testing ferritin measures the protein that stores iron. In other words, heavy periods can cause low ferritin. If a person has iron overload, one of the main treatments is bloodletting or phlebotomy. This lowers iron levels, and also ferritin.


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## tk1018 (Apr 11, 2018)

Not to be annoying lol but was anyone's body temp. low? I checked mine today, twice, because I didn't believe my thermometer! I've read where your body temp. can be low. First time was 97.1, second was 96.9.


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## Hopeful (Apr 10, 2018)

Low body temperature is a very common symptom of being hypothyroid. If you also have autoimmune problems, such as Hashimoto's, that can also effect your temperature because your immune system is constantly fighting your thyroid and any other thing it encounters. During the few months after I was diagnosed with Hashimoto's and not given medication, I quickly went down hill in all my bodily functions. My temperature was as low as 95.6 and rarely got to 97. Every fiber in my body ached. I felt so incredibly ill! After starting medication, my temperature slowly increased. Winters are still challenging. This winter my temperature was a big problem. I was also sick with other things, so my body was fighting hard. My temperature was warmest when I'd wake up. I'd take it in bed and it would be 98. From there it would drop within about a 1/2 hour of rising and would be 96.5. Then up and down all day long. Highest was lower 97.

I also have something called Raynaud's Phenomenon or Syndrome, a circulatory condition commonly related to autoimmune disease (Hashimoto's). It mainly effects my toes but has also effected my fingers and ears. They easily get numb, turn white, blue and then red when the circulation comes back, and which is painful. You can get Reynaud's in just about any body part, but toes and fingers are probably the most common. It also occurs more often in winter months, but can also occur in the heat of the summer. About 1-2 years so before I was diagnosed with Hashimoto's, I had blotchy pink and white skin all the way down the front of my quads. I was seeing an internist at the time, trying to figure out what was the cause of all the strange symptoms witinh my body. She told me it was called Raynauds. She got that part right, but she completely missed diagnosing any autoimmune disease, let alone thyroid disease. She never even ran any thyroid diagnostics and she was my PCP at the time.


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## tk1018 (Apr 11, 2018)

I finally got the T3, T4, 25-Hydroxy Vitamin D, and Thyroid AB Group blood work done! Here are my results. Like I have previously mentioned above, I am new to all of this and have no clue what these results mean. I didn't get TSH because when I visited the cardiologist today (he actually ordered all the tests because my PCP wouldn't, he saw I had it done in February of this year.)

TSH (from February 14, 2018) 1.95 *Standard Range: 0.27-4.2 ulU/mL*

T3, Free - 3.2 pg/mL *Standard Range: 2.5-4.3 pg/mL*

T4, Free - 1.44 ng/dL *Standard Range: 0.9-1.7 ng/dL*

Thyroid Peroxidase AB - 12.2 IU/mL *Standard Range: <34IU/mL*

AB to Thyroglobulin - <10.0 IU/mL *Standard Range: <115 IU/mL*

25OH Vitamin D Total - 26ng/mL *Standard Range: >19ng/mL *(*It then said *Insufficient: 20-29 ng/mL *

Is there anything I should be concerned about with these results? I appreciate your answers!


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## Lovlkn (Dec 20, 2009)

> 3, Free - 3.2 pg/mL *Standard Range: 2.5-4.3 pg/mL*
> 
> T4, Free - 1.44 ng/dL *Standard Range: 0.9-1.7 ng/dL*
> 
> ...


((3.4-3.85)) is 1/2 - 3/4 for your Free T-3. Your lab of 3.2 reflects that a low dose of Cytomel or lilothyronine(generic) would benefit you. Goal is to be pushing 3/4 of the range

((1.3-1.5)) is 1/2 - 3/4 range for your Free T-4. Your lab is smack in the middle so you would need a slight reduction of your T4 hormone then add the 5mcg of T3 hormone split and taken 6 hours apart daily.

You will benefit from Vitamin D supplementation. I personally take 5K IU daily and struggle to get to 3/4 range, 3/4 the range is your goal. Doctors used to prescribe 50K IU pills to be taken 1x daily to force up D levels. Once you atop that - you will go right back down. Finding your Vit D dose takes a few labs. If your doctor won't prescribe you could can pick a dose you are comfortable taking and re-test in 6 months. Being in the sun does not appear to impact my levels at all.

I'm not a doctor - I'm just a thyroid patient with alot of dosing experience.


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## tk1018 (Apr 11, 2018)

I do have a referral to see an endocrinologist.Should I make an appt. to see them? Would I be considered hypo looking at my results?

Also the antibodies to the thyroglobulin is very low at 10.0. Is that bad?


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## Lovlkn (Dec 20, 2009)

Have you ever had an ultrasound? If you have thyroglobulin then you need to have an ultrasound of your thyroid.

Be prepared - many Endo's tend to rely heavily on TSH only.


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## tk1018 (Apr 11, 2018)

No I have not had an ultrasound done yet. So if my TSH looks fine, an endo Dr. wouldn't think there is anything wrong? Does it look to be (looking at my results, in everyone's opinion) if I'm hypo? Or could it be very early signs?


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## Lovlkn (Dec 20, 2009)

Thyroglobulin can be a cancer tumor marker. It’s best to have an ultrasound to rule out any suspicious modules on your thyroid which can indeed impact thyroid function


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## joplin1975 (Jul 21, 2011)

Tehran thyroglobulin (Tg) and thyroglobulin antibodies (TgAB). You can't have TgAB without having Tg...TgAB is a "reaction" to Tg and it usually indicates an elevated level of Tg.

So, yes, you need to follow up with an ultrasound.


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## tk1018 (Apr 11, 2018)

Hello everyone! It's been a while since I posted however, I wanted to bring something up to see if it related to thyroid. So for about a month or so I've noticed numbness on the side and middle of my big toe. No matter how hard I push it, I have no feeling. I told my PCP and he told me it was my shoes I wear. I wear sneakers that fit me fine and I have plenty of room. Then he told me it was an ingrown toenail. I have no pain, just numbness. I thought I'd ask here! *Also I cant get in to see an endo Dr until September -_-*


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