# under medicated?



## Cella6150 (Feb 10, 2015)

Am I under medicated?

February thyroid panel

TSH - 3.1 (0.2-4.2)
Free T4 - 13.7 (12-22)
Free T3 - 3.9 (3.9-6.7)

Symptoms - puffy eyes, dry skin, dry eyes, fatigue, constipation, heavy period, arm weakness, feeling dizzy, headaches, dark circles under eyes.

If my endo has written to the doctor saying my TSH should be brought down to around 1, why has the doctor not noted this? The endo even sent me a letter saying my TSH ought to be 1 and my dose increased until that happens and I requested my doctor to refer to this letter when looking at thyroid tests... But it looks like they haven't acted on this.

Thank you!


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## joplin1975 (Jul 21, 2011)

Yes, you are under medicated.

Your TSH is high, but the real concern is your free t4 and free t3, both of which are painfully low.

No one can tell you why your doctor is not acting on this, but....

1) Why isn't your endo managing your medication?

2) If your doctors (both of them) are focusing on TSH, you'll probably never feel 100%


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## Cella6150 (Feb 10, 2015)

joplin1975 said:


> Yes, you are under medicated.
> 
> Your TSH is high, but the real concern is your free t4 and free t3, both of which are painfully low.
> 
> ...


Thank you.

My endo is no longer managing my medication because she's discharged me as my case can be managed in primary care. Is a request to see a different endo unreasonable?


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## joplin1975 (Jul 21, 2011)

No, I don't think it is unreasonable at all.

You could also seek the opinion of an ENT.


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## Cella6150 (Feb 10, 2015)

joplin1975 said:


> No, I don't think it is unreasonable at all.
> 
> You could also seek the opinion of an ENT.


Thanks for this.

I see my new doctor in 2 weeks about my medications and symptoms so I'll ask about seeing an ENT.

I have had an upper gastroscopy carried out and that was normal but I'm guessing there'll be limitations with that. Biopsy was carried out on 4 samples of my gut and they were negative for celiac. Stool biopsy was done for h. Pylori and that was negative for that.

Do ENTs use barium x rays? I have terrible problems swallowing and certain foods make this problem worse so I seem like I'm a picky eater!


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## joplin1975 (Jul 21, 2011)

I don't know. I've never been to an ENT before.  But, x-rays are generally not used when assessing thyroid conditions so I wouldn't put that at the top of my list of concerns.


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

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.

Hi there and welcome. Yes you are under medicated.

It would appear that they are doing all the tests but the right tests. With those high antibodies you should be getting an ultra-sound. Have you had one or are you scheduled for one?

Info on the FREE T3 test above.


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## Cella6150 (Feb 10, 2015)

Andros said:


> Understanding the Thyroid: Why You Should Check Your Free T3
> http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
> (Copy and paste into your browser)
> 
> ...


Thank you Andros for the reply.

I had 3 ultrasounds on the thyroid.

1st one said thyroid was enlarged and vascular.
2nd one said thyroid was normal. 
3rd one said thyroid was normal but there was sialosis - something to do with the salivary glands?

I think my doctor checks for FT3 and FT4 anyway but my endo has said for these to be checked regardless of TSH. So far this is being done.

Is there anything missing that should be checked?


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## Cella6150 (Feb 10, 2015)

Is it possible for thyroid ultrasounds to be normal but for me to have pain in the front of my neck in between my collar bones? I've had a cough for about 25 years but the doctor says it's not cardiac related because my ECG was normal. The cough is worse and is dry and tickly but I haven't long gotten over a week long cold.

Other symptoms that aren't thyroid related but worrying me:

Hot feeling in hands, fingers and in the fingertips. The fingers go very red as well
Reynauds Phenomenon in fingers and toes but worse in fingers because they go white, cold, numb and stiff at the slightest dip in temperature. 
Red dry rash on my face under my eyes
Dry skin crusted over my eyes in the morning upon waking

when I next see my doctor I'm wondering if they should be looking at Sjogrens. My last doctor suggested repeating my ANAs but I've read that ANAs are only present in 50% or 60% of people with Sjogrens.


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