# Now there's muscle fatigue... Thyroid?



## angiedmfan (Jul 12, 2015)

Hello all,

I am trying to decide how hard to push for a thyroid issue. First of all I have had pretty severe asthma and allergies and have my whole life, so my immune system is not the greatest. But thank goodness, these seem to be managed pretty well at the moment.

I am a teacher and have been off for the summer, and I have noticed something new, muscle fatigue. So I went to my Internal Medicine doctor, and she ran a bunch of tests. Most of the results look pretty good. My B12 and Potassium are in the normal range (although on the lower end). I have usually taken B Complex but gave it up when I had urinary issues. I am now taking B Complex again without C, sublingual. But my T4 Free was a little concerning. It was 0.9 with a reference range of .8 - 2.2, Boy that seemed low to me. My TSH was 2.14 with a reference range of .47-4.68. This one is more in the middle. So should I be worried?

I will tell you this is not my first run in with concerns about my thyroid. My mother and her two sisters all had thyroid issues, and my Mom told me that she took medication for it when she was younger (but didn't later in life). I have many of the classic symptoms, cold feet and hands and generally cold (I HATE winters- I am miserable without at least 4 layers.) I am tired a lot and require a lot of sleep. I usually am really groggy by 8pm and can hardly stay awake, so I usually nap for 1/2 hour or so and then get up and do more work. Yes, I get up pretty early 5:45am, but my husband gets up at 5:00, works out, and does a full day of work and is never tired like I am. Now I am seeing something new, muscle weakness. I know I'm getting older (turning 50 next year), but I've never had difficulty climbing stairs or crouching down. (Weight is not an issue - 5'2", 123lbs). Braig fog- oh yeah. I just write everything down, so I don't forget.

I took Synthroid for a short time, when a D.O. said we could try it. I did have some heart palpatations, so I went to an endocrinologist, and they immediately took me off, saying I didn't need it.

I feel like my thyroid has probably not been fully functional most of my life, but my symptoms have always been mild enough I can bear them, and I just put up with being cold and tired all the time. I also attributed it to my asthma and oxygen deprivation.

But I am not ready to feel 80 at 50. Please help. I don't know if I should fight my doctor over this, as I am pretty sure she will say that the results are "within range" and send me on my way.

Thanks everyone. Glad you guys are here to talk to.

Angie


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## angiedmfan (Jul 12, 2015)

Oh, I just found a document on my computer which shows historical values, from the last time I tried to address my potential thyroid issues.

In October 2002, my TSH was 2.044 (.35-5.5), and by T4 free was 1.19. (0.61-1.76)

In Jan 2008 TSH was 1.50, T3free was 294, and T4 free was 1.3 (Can't find original data for

reference ranges)

In May 2009 TSH was 1.30 (.450-4.50) (T4 free was not done)

Thyroglobulin Antibodies in Mar 2008 was less than 20 (Normal is less than 20)

Thyroid peroxidase Antibodies in March 2008 was 15. (Normal less than 35)


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## angiedmfan (Jul 12, 2015)

Sorry for the additional posts, but I see that you often ask for B12, Vitamin D etc. Here's mine:

Vitamin D: 47ng/ml (no reference range given)

B12: 436 pg/ml (ref 239-931)

Potassium: 4.5meq/L (3.5-5.3)

I look pretty healthy on paper, just don't feel real healthy.


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## Lovlkn (Dec 20, 2009)

> I took Synthroid for a short time, when a D.O. said we could try it. I did have some heart palpatations, so I went to an endocrinologist, and they immediately took me off, saying I didn't need it.


There is an EDIT function at the bottom of all your posts if you need to add or change what you have posted. Can you please go edit your lab ranges please.

How long ago was this and do you have any labs, with ranges that you could post when the above event occurred?



> In October 2002, my TSH was 2.044, and by T4 free was 1.19.
> 
> In Jan 2008 TSH was 1.50, T3free was 294, and T4 free was 1.3
> 
> ...





> Vitamin D: 47ng/ml (no reference range given)
> 
> B12: 436 pg/ml (ref 239-931)
> 
> Potassium: 4.5meq/L (3.5-5.3)


How many times have you had thyroid labs run?

Ferritin would be another lab to ask for - if you are perimenopausal and having heavy periods low iron tested as Ferritin could be the cause of your muscle issues. Your TSH is on the higher side of normal which is closer to 1 based on feedback posted on this board.

Your Vitamn D looks low as I believe the top range is 100 and your level should be closer to 70.


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## angiedmfan (Jul 12, 2015)

I have had my Thyroid checked multiple times over the years, I looked through my records and found I also had it checked in 2010 with my current doctor, but the only results they gave me was a little sheet that said "normal", no actual data. But I can probably get that, as it is from the same doctor I am seeing now.

I am on birth control because probably about 5 years ago my periods got heavy and I was feeling anemic. Now they are very light, so I would be surprised if I am low in iron. According to the records I found, my vitamin D has been low before. I think that's when I started taking the calcium and vitamin D. I don't take that anymore as it made my constipation even worse. According to the NIH "Many experts recommend a level between 20 and 40 ng/mL. Others recommend a level between 30 and 50 ng/mL." and I am sitting at 47 ng/mL. So I am not really worried about vitamin D.


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## Andros (Aug 26, 2009)

SUGGESTED TESTS
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/
(Copy and paste into your browser)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

Substances not found in normal serum
http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm
(Copy and paste into your browser)

You do have thyroid issues as evidenced by the presence of those antibodies. I highly recommend an ultra-sound and possibly a new doctor who "gets this!"

Will furnish some info for you.........; and Welcome!


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## angiedmfan (Jul 12, 2015)

Thanks for the information. There is so much to learn. I have gone through the list of symptoms for Hypothyroid and I have 90% of them and have for years. My latest, muscle weakness, is new. I even have been saying "why is my face look fat" in my pictures over the last year or two, and I just learned that facial swelling is part of thyroid illness.

Historically, over the last 5-10 years, it seems my TSH is going up, and my T4free is going down, and I am feeling worse each year. I have left a message with my doctor that I want to further investigate thyroid issues, especially with all three girls on my Mom's side being medicated for thyroid, and all the symptoms I have. I have been doing a lot of reading and it seems that not everyone feels good even if they are within the accepted "reference ranges". I wish I had thyroid results from when I was young and felt great, so I can compare how they have changed.


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## angiedmfan (Jul 12, 2015)

Well, doctor said I was normal, and will not refer me. So I am self-referring (thank goodness my insurance allows that). If anyone has any referrals for an understanding Endo in the Kansas City area, please help.


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