# symptoms of hyper, but TSH in normal range. Doc thinks I'm just "crazy"



## wevie (Nov 27, 2010)

So, I visited my GP recently due to a long struggle with anxiety, sleeplessness and mild depression. Also, have been losing my hair and having hand tremors. I asked for some thyroid blood work, but Doc assured me I am just struggling with garden variety anxiety, but humored me and ran a few tests. TSH is the only thyroid test I can see on my blood work, and Doc never called me back to "go over" the results with me. The levels read 1.02 with reference range of .4-4.5 Could I still have thyroid issues, or do I need to face facts and just get on anti anxiety meds? I'm almost certain this is something more than garden variety anxiety, but my doc is less than supportive. Advice?


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## lainey (Aug 26, 2010)

It's hard to say definitively that you "don't" have a thyroid issue with out the full slate of lab tests---Free T4, Free T3 and antibodies. Your TSH is presently at a very good place, but this can change fairly easily.

These are the tests in a good thyroid panel:
http://www.labtestsonline.org/understanding/analytes/thyroid_panel/glance.html

and the antibodies: http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/glance.html

Do you have a goiter--swelling in your neck area where the thyroid is?

Many physicians attribute a lot of symptoms to anxiety without doing a full exam.


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## wevie (Nov 27, 2010)

Thanks. So, I should see another physician and request a full thyroid panel, correct? Should I try to go to an endo, or just find a more supportive GP? I've had issues with my GP in the past, and am ready to move on after this visit. 
Also, I didn't mention before, but I'm having memory loss and heart palpitations, too. I exercise very regularly and eat well. This all came on suddenly roughly 4 months ago. I feel like I'm losing my mind, and am really looking for answers. Can those of you with diagnoses of hyper/hypo remember being in these shoes? It's awful!


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## GD Women (Mar 5, 2007)

wevie said:


> So, I visited my GP recently due to a long struggle with anxiety, sleeplessness and mild depression. Also, have been losing my hair and having hand tremors. I asked for some thyroid blood work, but Doc assured me I am just struggling with garden variety anxiety, but humored me and ran a few tests. TSH is the only thyroid test I can see on my blood work, and Doc never called me back to "go over" the results with me. The levels read 1.02 with reference range of .4-4.5 Could I still have thyroid issues, or do I need to face facts and just get on anti anxiety meds? I'm almost certain this is something more than garden variety anxiety, but my doc is less than supportive. Advice?


Your TSH is in a very good place and does not suggest your symptoms are thyroid related. Thyroid symptoms do not come with normal thyroid levels, they are usually seen in overt thyroidism - TSH over 10 or under 0.1.

There are a lot of other health issues that mimic thyroid symptoms and need to be checked out before any type diagnose and treatment. Symptoms need to correlate with thyroid levels for it could be something else. Symptoms of both hyperthyroidism and hypothyroidism are non-specific and can be mimicked by other conditions and to prescribe thyroid treatment on a clinical basis alone without biochemical confirmation carries potential risks.

Serum TSH measurement is the most diagnostically sensitive test for detecting mild (subclinical), as well as overt, primary hypo-or hyperthyroidism.

A lot of doctors use the Thyroid Cascade Testing method which the basis for the cascade is the TSH. If the TSH result is abnormal then the other thyroid test would be ordered accordingly as warranted. This test cascade allows clinicians to use reflex ordering of thyroid function tests in order to provide more timely and cost effective laboratory diagnosis of common thyroid function disorders.

An F/T3 test is usually ordered in cases of an overactive gland. Otherwise it's usually not done routinely because it adds little information compared to the combo of a TSH, T4 and Free T4 that you get when you get a thyroid panel.

However, testing all three, TSH and both FTs, can relate to a few other nonthyroid health issues that might be going on. Such as pituitary or hypothalamic etiologies is suspected then TSH and free T4 should be ordered.

Regardless if thyroid or not, you might consider taking anti anxiety meds. or antidepressants to help you though it all. And it doesn't have to be forever but just until you get over this part of your health issue(s).

I hope you get an answer and solution soon but don't be surprised if thyroid is not an health issue......Good luck!


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## lainey (Aug 26, 2010)

I would say that unfortunately, because they symptoms you describe are really quite general, and not necessarily specifically thyroid, that what you want is someone who will give you a complete physical, with the idea of finding a source of those issues.

Blood sugar issues, vitamin deficiencies, low iron, hormone issues are just a few of the reasons that you could be having these symptoms. What else was part of the blood work that was run? Can you get a copy of the results? Without them, it's hard to know if the doctor was even looking for any of these.

The first place to likely start is a different internist or general practitioner if you don't like your current one and want to change. Most endo's are very busy and their offices have long waiting times for new patients--they also may not necessarily examine all of the possibilities for your symptoms, as they only deal with the endocrine system.


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## anmora4 (Oct 19, 2010)

I say try to find an endo who will take you without a referral. It can't hurt and your paying. I have heart palps off and on for 10 years now. I had a GP who ran my thyroid and TSH came back 0.17. Endo has run my blood twice and everything blood was normal. But when the endo did the physical they found a nodule. My nodule is over 2cm in size and will be biopsied on the 16th. My palps are still there but now I am have some nerve problems. Sometimes only an endo can recognize a goiter by physical exam. If they say your find move on the another possible diagnoses.


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## Andros (Aug 26, 2009)

wevie said:


> So, I visited my GP recently due to a long struggle with anxiety, sleeplessness and mild depression. Also, have been losing my hair and having hand tremors. I asked for some thyroid blood work, but Doc assured me I am just struggling with garden variety anxiety, but humored me and ran a few tests. TSH is the only thyroid test I can see on my blood work, and Doc never called me back to "go over" the results with me. The levels read 1.02 with reference range of .4-4.5 Could I still have thyroid issues, or do I need to face facts and just get on anti anxiety meds? I'm almost certain this is something more than garden variety anxiety, but my doc is less than supportive. Advice?


Hi there and welcome. Can't say I agree w/your doctor and that was not a thorough thyroid check-up. I feel like you have been patronized.

Here are tests that I suggest and may I suggest that you find a doctor who takes you serioulsly?

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), 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/unders...s/thyroid.html

TSI will settle the question of hyper or not for sure as will some of the other tests. On your behalf, please use the link and learn what this stuff is about. You must learn to advocate for yourself.

Your TSH does not have to be in the basement for you to be hyper; the antibodies skew that test because there are blocking, binding and stimulating antibodies and autoantibodies.


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## jumpinjiminy (Nov 27, 2010)

I've not been diagnosed with thyroid problems yet, but had a neurological episode come on suddenly that was associated with a long-standing fever of unknown origin. Through months of testing (which included TSH - 3.74), it was finally discovered my TPO antibodies were way out of range, which points to Hashimoto's. I've had symptoms of hyper and hypo for many, many years. I always passed the TSH screening tests.

I second the opinion to find a doc who will take you seriously. The one that finally discovered the Ab turned out to be the neurologist. Prior to this, I think I had been tested for everything under the sun.


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## midgetmaid (Jul 22, 2010)

When my TSH was in range, I had symptoms. They got worse as TSH dropped.

My husband has hypothyroidism and had symptoms while in range, also.


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