# Am I off the mark with this?....



## voto23 (Jul 23, 2012)

Hi All,

This is my first post (question) I am leaving on the Hashi board.
I posted my newbie story a few weeks ago. It's titled "Hello. New to thyroid issues and VERY confused". It gives a little background on me.

Long story short....I have 4 nodules, two had fna and came back fine. Endo said I had Hashimotos because of multi nodule goiter, symptoms, ultrasound info etc. But after getting bloodwork back said all levels were in range and I have no problem at all with my thyroid and that all my symptoms are from something else.......done with her.

Here are my labs:
thyroglobulin Ab : <20 range <20
thryroid peroxidase ab <10 range <35

tsh- 1.61 range (0.47 - 4.68)
free t4- 1.0 range (0.8 - 2.2)
free t3- 3.0 range (2.8 - 5.3)

Have been trying to find a new endo for second opinion. In the mean time I thought I would call my pcp and ask if she would think of starting me on a trial, very small dose, of thyroid medication since my levels are so low. She called back and said that my TSH is absolutely perfect and adding medication would only make everything worse.

WOW! I'm so confused. From everything I've been reading, and from the wonderul advice I get here, I thought I was on the mark with asking her that. But then you keep getting the same comebacks from these doctors and it starts to make you second guess everything.

Okay...my questions. Isn't it possible to need medication even with a normal tsh? And can't that be common with Hashi?

Thanks, ahead of time, for any advice!

~Kathy


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## Octavia (Aug 1, 2011)

Even though your TSH is "normal," your Free T3 and Free T4 are at the very, very low end of the range. Some doctors might call you "subclinically hypothyroid" and prescribe meds. It would be nice to see your Frees in the upper ends of their ranges.


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## angel1976 (Nov 15, 2011)

Subclinical hyothyroid means HIGH TSH with normal T4 and T3; normal TSH with low t4 and t3 means lack of feed back between blood hormone levels and pituitary gland in the brain.If T3 is at the low end while T4 closer to the middle indicates T4 to T3 conversion problem. 
Did the biopsy report indicate T-lymphocytes?


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## lainey (Aug 26, 2010)

The free T4 and T3 are in the normal range here, the TSH is below 2 and the antibodies are negligible.

A working thyroid produces very little T3 of its own. As for a conversion problem, that only applies to people on replacement who have high free T4 and low free T3. If your free T4 is low in the range to start with, the T3 will naturally follow.

Feel free to get a second opinion from another doctor, but you will be hard pressed to get one to give you medication based on your labs--even if the frees are "low" in the ranges. Most doctors are not interested in medicating their patients to sub-clinically hyperthyroid, and they are going to see your labs as having an easy potential for that.

There are a lot of conditions with symptoms that are similar to thyroid disease--hormone imbalances, low iron, low levels of certain vitamins are just a few. You might want to rule all of these out.

A DO or naturopath would likely be more sympathetic to a trial of thyroid medication.


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## Keba (Aug 11, 2012)

I have several symptoms with Hashimoto's disease and normal TSH levels.

My Doctor wants to wait and re-check, which I'm ok with but it's very hard when you want your life back.

I agree with others to push for the Free's to be tested. I didn't have this and it seems many find answers in regards to Hashi's based on those results.
I will be asking for this.

At first I started looking at several other auto-immune diseases based on how crappy, I felt. Also it really seems to come and go based on stress, sleep, etc. Now I know better. Hashi's cover's all of my symptoms.

The way my Doctor explained it was, my Thyroid was failing, but hasn't yet. My thinking is why not stop or slow it before it does. I guess this can go either way with Hashi's. Some Doctor's will do a trial with meds during the "watch and wait" period, other's like to wait it out.


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## Andros (Aug 26, 2009)

voto23 said:


> Hi All,
> 
> This is my first post (question) I am leaving on the Hashi board.
> I posted my newbie story a few weeks ago. It's titled "Hello. New to thyroid issues and VERY confused". It gives a little background on me.
> ...


Looks are deceiving (the numbers); your FREES are in the basement.

In any case, any one can see the FREES are waaaaaaaaaaaaaaaaaaaay low and you must feel like poo. No energy, right?

You need to find a doctor who understands this stuff; you are definitely a candidate for some thyroxine replacement.

Here is info on the FREES.

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.
Dr. Mercola (FREES)
http://www.mercola.com/Article/hypothyroid/diagnosis_comp.htm
Dr. Woliner
http://www.thyroid-info.com/articles/freet3woliner.htm

Most of us feel best w/TSH @ 1.0 or less and the FREES at about 75% of the range given by your lab for the FT4 and FT3.


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## voto23 (Jul 23, 2012)

Thank you all for the advice and feedback!

Octavia....I agree, I think I would feel MUCH better with my frees in the upper range. I just need to find a doctor that agrees! 

Angel1976....Very interesting about a possible conversion problem associated with the pituitary gland. I have read some info on that...I think I will read up a little more on it. No, the fna report did not say anything about T-lymphocytes.

Keba....So sorry to hear you are going through a rough time. You are in the right place for support and advice! I completely understand when you said "we just want our life back". It's soooo hard when doctors don't understand or seem willing to help. Stay strong and (as I've learned) keep standing up for yourself, ask questions, keep searching and if that means finding another doctor.....then so be it! Only we know how we feel.

Andros.....YES!!! I feel like poo!...haha. I'm exhausted beyond reasoning. Thank you so much for your advice and guidance....and to the links about the FREES. Interesting articles that only confirm what I'm thinking...thank you. I am in the process of trying to find a "good" endo for a second opinion...fingers crossed. )


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## Andros (Aug 26, 2009)

voto23 said:


> Thank you all for the advice and feedback!
> 
> Octavia....I agree, I think I would feel MUCH better with my frees in the upper range. I just need to find a doctor that agrees!
> 
> ...


You don't really need an endo; try to find a good NP in your area.


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