# Help - tsh 0.02



## kanishma

I got my labs:

TSH - 0.02 (0.35-4.00)
Free T4 - 1.01 (0.81-1.48)

These are the only 2 test done along with my lipid profile, iron, B12 and Hemoglobin. And I requested this tests because my family has history of thyroid disorders.

I have been feeling extremely tired, breathlessness, excessive hunger (but no weight loss), insomnia, irritability.

I went to see doctor last week and doctor said you do NOT have any classic symptoms of hyperT so she said we don't need to anything. She said we will repeat test in about 2 months :-((( She diagnosed me as clinical hyperthyroidism.

What do you all think ??????

I do need help because i feel so tired all the time - to the point that I don't even want to go to work - can not do anything at home :-((((

Any advice ??????


----------



## jackson2348

I'm sure someone more knowledgeable than I will chime in with additional information, but I just wanted to point out that you *are* having classic symptoms. Tired but can't sleep, irratibility, increased appetite, are all symptoms. It sounds like you need a Doctor who will not be dismissive of subjective symptoms. Ugh. I'm sorry you're going through this.


----------



## Andros

kanishma said:


> I got my labs:
> 
> TSH - 0.02 (0.35-4.00)
> Free T4 - 1.01 (0.81-1.48)
> 
> These are the only 2 test done along with my lipid profile, iron, B12 and Hemoglobin. And I requested this tests because my family has history of thyroid disorders.
> 
> I have been feeling extremely tired, breathlessness, excessive hunger (but no weight loss), insomnia, irritability.
> 
> I went to see doctor last week and doctor said you do NOT have any classic symptoms of hyperT so she said we don't need to anything. She said we will repeat test in about 2 months :-((( She diagnosed me as clinical hyperthyroidism.
> 
> What do you all think ??????
> 
> I do need help because i feel so tired all the time - to the point that I don't even want to go to work - can not do anything at home :-((((
> 
> Any advice ??????


Hi there and welcome to the board. Well.......this is interesting because your FREE T4 is below the mid-range (1.14) and ideally, we like to see that mid-range or higher.

It is a shame that she did not run the Free T3 and here is why. THAT is your active hormone and when we see TSH down that low (that's okay under some circumstances) and the Free T4 below mid-range, that makes us think that the FT4 is converting to FT3 very very fast. So fast, that the pituitary keeps on sending messages to the thyroid to put out more. Hence, hyperthyroid.

So, is there any way you can get a FREE T3 test? Free T3 is your "active" hormone. T4 converts to T3 so that you have energy.

Also, some antibodies' tests would be in order. I personally recommend these and the TSI would be especially important for if you have any at all, even a smidgeon, the TSI is responsible for hyperthyroid.

TSH, FREE T3, FREE T4, TPO (antimicrosomal antibodies), ANA (antinuclear antibodies), TSI (thyroid stimulating immunoglobulin) and Thyroglobulin Ab as well as thyroid binding inhibitory immunoglobulins (TBII.)

You can look all of the above up here so you know what they are for........
http://www.labtestsonline.org/

Not all of us lose weight when hyper. I gained weight and so did many others so the symptoms can and do cross over.

Lastly, I know you had your iron checked and I will be interested in that but the bottom line would be the Ferritin which is the protein that stores your iron for cellular uptake. Many have had their hemoglobulin tests come back fine and have been horrified to find the ferritin in the basement.

Some of the symptoms you describe could be attributable to low ferritin which by the way happens to be common amongst those of us who have thyroid disease.

Here is info on that...............
http://www.thewayup.com/newsletters/081504.htm

Let us know how you are doing and whether or not you can get these 2 tests.


----------



## kanishma

Thank you both for your responses.

Andros: I e-mailed the doctor but she refuses to do further tests. According to her (I will quote here exact words):

As I explained to you on our last visit, you did have an abnormal TSH level however since you DO NOT have any symptoms of HYPERTHYROIDISM then you have what we called SUBCLINICAL HYPERTHYROID disease. Please read the thyroid booklet that was given to you. If you develop any HYPERTHYROID disease symptoms such as:

These include:
- Being nauseated, vomiting, and having diarrhea.
- Sweating a lot.
- Feeling extremely restless and confused.
- Having a high fever.
- Having a fast heartbeat.
- You have sudden vision changes or eye pain.
- You have a fever or severe sore throat and are taking antithyroid medicines, such as PTU or methimazole.

Watch closely for changes in your health, and be sure to contact your doctor if:

- You have a sore throat or have problems swallowing.
- You have swollen, itchy, or red eyes or your other eye symptoms get worse, or you have new vision problems.
- You have signs of a low thyroid level (hypothyroidism). You may feel very tired, confused, or weak.

Contact me
Otherwise, you are schedule to have a repeat TSH thyroid hormone level the end of MARCH.
Drink lots of water and get plenty of rest.

Here are my Iron test results:

Iron - 69 ( 37-145)
TIBC - 388 (250-420)
Iron Sat - 18 ( 20-50%)

Please tell me what can I do. THANKS A LOT.


----------



## Andros

kanishma said:


> Thank you both for your responses.
> 
> Andros: I e-mailed the doctor but she refuses to do further tests. According to her (I will quote here exact words):
> 
> As I explained to you on our last visit, you did have an abnormal TSH level however since you DO NOT have any symptoms of HYPERTHYROIDISM then you have what we called SUBCLINICAL HYPERTHYROID disease. Please read the thyroid booklet that was given to you. If you develop any HYPERTHYROID disease symptoms such as:
> 
> These include:
> - Being nauseated, vomiting, and having diarrhea.
> - Sweating a lot.
> - Feeling extremely restless and confused.
> - Having a high fever.
> - Having a fast heartbeat.
> - You have sudden vision changes or eye pain.
> - You have a fever or severe sore throat and are taking antithyroid medicines, such as PTU or methimazole.
> 
> Watch closely for changes in your health, and be sure to contact your doctor if:
> 
> - You have a sore throat or have problems swallowing.
> - You have swollen, itchy, or red eyes or your other eye symptoms get worse, or you have new vision problems.
> - You have signs of a low thyroid level (hypothyroidism). You may feel very tired, confused, or weak.
> 
> Contact me
> Otherwise, you are schedule to have a repeat TSH thyroid hormone level the end of MARCH.
> Drink lots of water and get plenty of rest.
> 
> Here are my Iron test results:
> 
> Iron - 69 ( 37-145)
> TIBC - 388 (250-420)
> Iron Sat - 18 ( 20-50%)
> 
> Please tell me what can I do. THANKS A LOT.


The most important thing is she did not run a FREE T3 test so she could be way wrong. That said..............; please read the following. The patient should be placed on anti-thyroid meds on a temporary basis to see if they feel better and respond favorably.

Here is an excerpt and I hope you take the time to read the whole article.......

Cardiac Abnormalities and Bone Loss

Patients with subclinical hyperthyroidism are at increased risk for cardiac abnormalities and bone loss, and strong consideration should be given to initiating treatment and restoring the TSH level to within the normal range.3,17,24,26,28 The risk of atrial fibrillation is increased three to fivefold in persons older than age 60 studied for about a decade, compared with those with normal TSH values.3 One study evaluated cardiac function and exercise tolerance in 10 dyspneic subjects with symptoms of adrenergic overactivity on l-thyroxine therapy (for five to nine years' duration) sufficient to suppress serum TSH level.29 Resting baseline left ventricular diastolic filling was impaired and, during submaximal physical exercise, a decrease in left ventricular ejection fraction was observed in the l-thyroxine treated group, compared with a normal increase observed in the control group. Exercise capacity in duration and peak workload was reduced in the l-thyroxine-treated group, and cardiac parameters improved with administration of a beta blocker for four months.

http://www.aafp.org/afp/2002/0201/p431.html (This is a credible source)

You may need to find another doctor. This one sounds condescending to me.


----------

