# Zugora's Endo Results...(your input please)



## Zugora (Feb 14, 2010)

I've had "hypothyroid"-like symptoms for YEARS and I've been getting progressively worse (actually, it has been debilitating lately). I FINALLY had my appointment with the fancy pants endo that I've been waiting months to see. I'm wondering if you could help interpret these NEW results:

TSH: 2.97 (.450 - 4.5) - slowly creeping up every time I get blood drawn
FT4: 1.13 (.82 - 1.77)
FT3: 1.25 (71 - 180)
Anti-TPO: <10 (<35)
TGAB: <20 (<40)

LH: 17.5 (no range provided)
FSH: 4.2 (no range provided)
Testosterone: 38 (8-48)

I do have PCOS and I am positive for ANA antibodies. Also, every woman on my mom's side has thyroid problems or Hashimoto's.

Am I right in thinking that my TSH is just a hair below the new standards? Thx!


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## Andros (Aug 26, 2009)

Zugora said:


> I've had "hypothyroid"-like symptoms for YEARS now that have been getting progressively worse (actually, it has been debilitating lately). I FINALLY had my appointment with the fancy pants endo that I've been waiting months to see. I'm wondering if you could help interpret these NEW results:
> 
> TSH: 2.97 (.450 - 4.5) - slowly creeping up every time I get blood drawn
> FT4: 1.13 (.82 - 1.77)
> ...


If you lived in Canada, you would be above. They top off the range for TSH @ 2.0 and most of us feel best @ 1.0 or less. AACE is 0.3 to 3.0; you are correct.

Also, you should not have any TPO or Thyroglobulin Ab. You have a small amount which is below the range but as I say.....................

TPO Ab should be negative, 0
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

(The normal thyroid has TPO but should not have antibodies to TPO)

Thyroglobulin Ab
A negative test is normal. A negative test means no antibodies to thyroglobulin are found in your blood.
http://www.nlm.nih.gov/medlineplus/ency/article/003557.htm
(The normal thyroid has Thyroglobulin in low titers but should not have Thyroglobulin Ab)

FT4 is below the mid-range of 1.29 of the range given by your lab.

FT3 is smack dab in the middle. Neither is desirable. Ideally they should both be above the mid-range.

My estimation is that you are hypothyroid. It is going in that direction.

What has your doctor had to say?


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## lainey (Aug 26, 2010)

Your thyroid antibodies are very low, and they often exist in the "normal" population. The presence of antibodies is not necessarily a problem in and of itself, just that they present a potential to activate and do damage. Usually they increase substantially when that process is occurring.

The desired ranges for the "normal" population are not the same as for those who are medicated. People taking medication often do so to an extent that their levels are higher for the frees and lower for TSH than those typically found among "normal" individuals.

There really isn't anything glaringly wrong with your TSH, FT4 and FT3 levels. The FT3 is the active hormone, and being in the middle of the range should be fine for anyone.

My guess is that the endo said your results are normal.

They are.


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## Zugora (Feb 14, 2010)

Note: My symptoms are as follows:

- Cold intolerance, especially in extremities (getting worse over last 10 years). Freezing all of the time.
- Muscle aches in legs and rear-end (getting worse). 
- Terrible, chronic dry eyes
- Extremely fatigued, no energy, limbs feel very heavy. Feel like I am functioning at 30-50%.
- Very foggy, concentration problems. Feel spaced out.
- Front of throat pain/discomfort/fullness. 
- Eustachian tube fullness (clogged/crackling feeling)
- Low blood pressure (85/50 at times)
- Low basal body temp (average: 96.5 - armpit, 97.3 - oral)
- Depression for no reason 
- Anxiety/jittery
- Heart palpitations/racing at times (for no reason)
- Extremely emotional at times (crying jags for no reason)
- Trouble sleeping 
- Dizzy feeling at times
- Arm/hand/feet tingling at times (also, itchy/prickly sensations)
- Dry hair, thinning
- Excessive sweating (hands, feet, under-arms)
- Chronic post-nasal drip
- Light, irregular periods/PCOS (but since low carb/low sugar, gluten free diet, I have regulated it somewhat (still very light and short)
- Can't handle much sugar (get shake-y easily, especially in the morning)
- Pale in the face (have to wear darker foundation to match rest of body color)


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## Zugora (Feb 14, 2010)

lainey said:


> There really isn't anything glaringly wrong with your TSH, FT4 and FT3 levels. The FT3 is the active hormone, and being in the middle of the range should be fine for anyone. My guess is that the endo said your results are normal. They are.


Lainey, I really wish doctors would rely more on symptoms. Here are accounts of many people with "normal" levels with crushing hypothyroid symptoms and how they felt better once treated....: Google ("Anyone with hypo have normal TSH levels? Healthboards") For some reason the link doesn't work here. Their stories break my heart!! I know that I have been symptomatic since age 16 with a TSH of 1.2 back then. I'm now 35 and things have been getting progressively worse.

Yes, my endo said, "results are normal". Well, he's fired. I'm seeing an integrative doctor Dec 6 who is known for treating thyroid/hormonal cases based on both symptoms and bloodwork. I'm crossing fingers...


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## Andros (Aug 26, 2009)

Zugora said:


> Lainey, I really wish doctors would rely more on symptoms. Here are accounts of many people with "normal" levels with crushing hypothyroid symptoms and how they felt better once treated....http://www.healthboards.com/boards/archive/index.php/t-105457.html Their stories break my heart!! I know that I have been symptomatic since age 16 with a TSH of 1.2 back then. I'm now 35 and things have been getting progressively worse.
> 
> Yes, my endo said, "results are normal". Well, he's fired. I'm seeing an integrative doctor Dec 6 who is known for treating thyroid/hormonal cases based on both symptoms and bloodwork. I'm crossing fingers...


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## lainey (Aug 26, 2010)

What is your ferritin?

Vitamin D, B and other vitamins?

Glucose?

All of these, plus hormone imbalances to name a few can mimic the symptoms of hypothyroidism.

Doctors are people of numbers, and need concrete reasons to prescribe medication, especially one such as levothyroxine, which can be dangerous to the excess and is taken by the patient for life.

I know plenty of people with and without medication who have "hypothyroid" symptoms. Keep in mind, that even with thyroid treatment people who expect 100% resolution of their symptoms are often disappointed.

That said, go right ahead and keep trying to find a doctor who may trial you on medication. You never know what will work.


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## Zugora (Feb 14, 2010)

lainey said:


> What is your ferritin? Vitamin D, B and other vitamins?
> Glucose?
> 
> All of these, plus hormone imbalances to name a few can mimic the symptoms of hypothyroidism.


Glucose, ferritin, Vit D, B and other vitamins are fine. The only thing that came back "positive" and that I was diagnosed of is PCOS (via ultrasound findings and sxs), and something autoimmune going on. I have positive ANA antibodies, but negative for lupus, sjogren's, RA, and other autoimmune disorders. Thyroid levels are "suspicious" but, "normal". Glaring sxs, plus strong family history of thyroid disorders just tells me something is up.

Btw, my good friend was very symptomatic of thyroid issues for years and all thyroid bloodwork was always "normal", including Hashi's antibodies. Finally, a doctor discovered a lump in her throat and turns out it was cancer. Her biopsy later revealed that she indeed does have Hashimoto's. My mother was also the same way: years of hypothyroid sxs, then finally her doctor treated her because herTSH finally rose to above 5.0. She's doing great now after Synthroid medication. Similar stories in this forum here: Google ("Anyone with hypo have normal TSH levels?", healthboards). Somehow when I post the actual link, it doesn't work here.

I totally agree with you that thyroid medication is tricky business and that other illnesses can mimic thyroid disease. However, these cases should wake doctors up to the fact that numbers can lie.


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## lainey (Aug 26, 2010)

Have you had an ultrasound?

Do you have a goiter?

Sub-clinical is still defined as TSH between 4-5 and 10.0.

This was just in the NY Times. It does reflect common thinking in clinical practice--even the last sentence.

http://www.nytimes.com/2011/11/22/health/for-some-psychiatric-troubles-may-begin-with-the-thyroid.html

How do you convince doctors to medicate people with normal numbers with a TSH of between 2 and 4 and few antibodies? What reasoning based in research do you use--because after all, they are supposed to make decisions based on good medical practice. Most doctors are empirical, and with good reason, because symptoms are subjective. We have ranges for a reason.

I'm not saying that what you are experiencing isn't real. With your numbers, you're going to have to work hard to convince a doctor that you have a thyroid problem.


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## Zugora (Feb 14, 2010)

Great article, but I noticed that their reference ranges were wrong. The new AACE guidelines for "normal" TSH levels are 0.3 to 3.0. I am 2.97 and slowly increasing.

How do I convince doctors who only rely on reference ranges? I can't. But the "sub-clinicals" out there can give him/her a copy of "Stop the Thyroid Madness", and discuss the fact that they know there are outliers in any given research study and that 10-15% of patients (maybe more) test negative for Hashimoto's when indeed they do have it: (http://emedicine.medscape.com/article/120937-overview#aw2aab6b2b2aa).

Btw, I had a doctor also tell me that it's not necessary to test antibodies when the TSH is normal. Baloney! This is not true. My sister had a TSH of 2.9, but had antibodies. Once she was given the proper dosage of Synthroid, her symptoms went away. My mother was also the same way.

Thanks for asking about the ultrasound. Scan last week was "normal". However my previous ultrasound from a different doctor indicated a few nodules. Don't know the size. He just said that it's normal to have nodules. I see an integrative doctor in 10 days who is supposed to specialize in sub-clinical thyroid and endocrine cases. We'll see what happens. Cross fingers.


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## lainey (Aug 26, 2010)

You will find that a lot of doctors still believe the new "recommended" ranges for TSH are controversial. In clinical research, overt hypothyroidism is still classified as usually a TSH over 10, and sometimes over 20. When about 90% of the normal population falls below 4, you can make all of the arguments you like for earlier treatment at lower levels, but statistically the evidence really isn't there.



> But the "sub-clinicals" out there can give him/her a copy of "Stop the Thyroid Madness"


These sites and their misinformation are the reason people with normal numbers start seeking medications as the answer to their problems. This information, and much of what you find in a lot of books, is not always well based in factual, reliable research.

It is not the type of information you want to use to make a solid "argument" for treatment, to a doctor. Even if you are dealing with "reputable" sites such as pubMed, NIH, or others used by professionals (and in many cases even those) a good many doctors will treat that type of research as a personal affront. Not that you would necessarily want to be treated by a doctor with that closed-minded type of thinking, but all the same, even on patient websites, people can twist the information they give in any way they want--their stories and numbers can shift--and the people who are on the internet don't necessarily represent the "normal" population of people with any particular disease. Once again, not there isn't something to be learned about the experience of others, but a reminder that what you see and read is distorted by the particular position the author wants to take.



> My sister had a TSH of 2.9, but had antibodies.


And you really didn't have any antibodies. The trial of thyroid medication with normal TSH is usually in the presence of antibodies. What you are going to need to do is convince a doctor that trialling the medication will DO NO HARM--because with your labs as they are, most doctors will be difficult to convince that it will help.


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## kimberllee (May 20, 2011)

I'd definitely like to chime in on a few levels... I would be the friend who's levels were normal and turned out that I had advanced papillary thyroid cancer.

In my opinion, tests should be used as a tool, not as the end all, is all by physicians. I'm a glaring example. I was heavily symptomatic but tests were "normal" high side of normal..but still normal. I ended up with 24 lymph nodes involved, a full tt and having my cancer wrapped around my vocal chords. I also tested negative for hashimoto's after my FNA. My pathology after surgery showed glaringly otherwise.

Here's the thing, when your endocrine system is off...your body will compensate..such as you can have a thyroid that is malfunctioning and not producing enough tsh, so the pituitary gland sends a message to the brain saying, houston, we have a problem. Make more tsh. Leaving the levels normal but the patient symptomatic.

And seriously, what is the difference between 2.99 and 3.0. Ridiculous. Like that's the magic tipping point and the 100th of a point is going to make a difference....grrrrrrrr. I loathe stupidity of some physicians. Hang in there Z. Smooch!


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## Alicia123 (Oct 7, 2011)

Zugora,

Please keep searching. I hope you find relief soon. Keep us posted.
Something is definately off.

God bless,

Alicia


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## Shell1370 (Nov 28, 2011)

lainey said:


> Have you had an ultrasound?
> 
> Do you have a goiter?
> 
> ...


What reasoning based on research? When did people become lab mice? I'm not a lab value, I'm a human being with physical, social, emotional and pyschological needs. Just because my labs don't reflect how I feel or how someone else feels does not mean that I or they don't have symptoms of hypo. And believe me, only I know how I feel, not you, not my doctor, not my family, nor my husband.

For an example. I am a RN of 17 years. I have heard all complaint of pain. Pain is subjective. If you are saying you have pain..I have to believe you because it can't be seen, felt, or heard by the person assessing the pain, me. Now with chronic pain, people have lived with this pain 6 or more months. These chronic pain sufferers may not exhibit s/s of increased pulse, respirations, and blood pressure. Those things that indicate a person is indeed in pain. But, if they say they are in pain, they indeed are. I have never heard a doctor say, .."Well, no elevated vital signs, so that person is not in pain." That would be absurd.

Now, just because lab values don't reflect a person having s/s of hypo, doen't mean that they aren't and have to prove anything with research that they are based on "norm" lab values.

I don't need research to base how I feel. Yes, we have lab value ranges, but, not everyone is cookie cutter treatment. We are all different and unique individuals. What works for one, may not work for another when it comes to Thyroid issues. What s/s one experiences at a certain lab value, someone else may not experience.

A good doctor WILL listen and treat accordingly to symptoms and yes, they are out there but hard to find. A good doctor will be educated with all the new research coming out, and I highly doubt, that will be the NY Times.


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## lainey (Aug 26, 2010)

> A good doctor will be educated with all the new research coming out, and I highly doubt, that will be the NY Times.


I'm sorry, the article uses information from a doctor at Boston University doing NEW research through the National Institutes of Health. This is supposed to reflect cutting edge thinking--and note the ranges. The new ACCE ranges are still a source of debate--people with ever lower TSH values, however, seem to be seeking treatment on the basis of them, even though the oh-so-famous Mayo Clinic doesn't use them, and in research they generally don't.



> Now, just because lab values don't reflect a person having s/s of hypo, doen't mean that they aren't and have to prove anything with research that they are based on "norm" lab values.


Okay, so following that line, you could say that you are anemic, because you say that you have the symptoms of it, even though your blood tests for iron are normal? And then you would expect a doctor to agree with you that they should treat your normal results? Suppose your fasting blood glucose comes in twice at 127. Do you tell your doctor you don't want to be treated for diabetes because your lab values are just a little bit over the cut off and you don't have any symptoms? Maybe it's really all about what a patient WANTS to be treated for.

Symptoms that mimic hypothyroidism come from so many different sources and many are subjective and are not measurable on a clinical basis. Thyroid medication, when given to patients with normal thyroid function as measured by standard tests, can be dangerous and cause life threatening complications. Because physicians are trained to do no harm, they are not naturally inclined to prescribe medications that can do harm in a situation where it is not clear that they will do any good.

You can find doctors that will prescribe thyroid medication to patients that don't need it. They do that for pain too--in fact several in my area were just arrested for over-prescribing narcotics. So yes, if a patient thinks they need something, they can seek someone who will give it to them.

We have lab values and standards of clinical practice for a reason, and it is exactly because symptoms are subjective. How would you make a diagnosis and a treatment plan otherwise? You need a concrete basis to start with. A good doctor is not just going to listen to you and use the latest information to evaluate you, but will also not start you on a course of lifetime treatment that could potentially harm you.


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## Octavia (Aug 1, 2011)

Well said, Lainey.


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## HeidiBR (Apr 4, 2010)

Excellent advise Lainey.


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## Zugora (Feb 14, 2010)

lainey said:


> Maybe it's really all about what a patient WANTS to be treated for.


Lainey, I'm just curious. How would you explain the following cases where symptoms got better after treatment despite "normal" lab results?

- My mother: hypothyroid symptoms for YEARS, labwork always in the "normal" range. It wasn't until her TSH finally rose to 5 that a doctor finally treated her. Lo and behold, her sxs went away and she's doing great.

-My good friend: hypothyroid symptoms for YEARS, labwork always "normal", including thyroid antibodies (hashimoto's). It wasn't until a doctor found a mass in her neck, diagnosed thyroid cancer, had surgery, and the biopsy after surgery revealed Hashimoto's.

-Cases similar to the ones listed above on Healthboards where sxs got better with treatment despite "normal" labwork". Google: "Anyone with hypo have normal TSH levels?" for the thread. (link doesn't work here). I understand this link is just a random forum and not "scientific" evidence. But I highly doubt that these people are reporting false events.


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## lainey (Aug 26, 2010)

Sure thing there can be exceptions.

So what then, everyone is going to walk in and claim that they are an "exception" too?

The problem with the internet is that you don't see the thousands of people who are not "exceptions"--they have no reason to be seeking anything--so there is a distorted perception of how common certain situations are--because of the forum, you may see more reports of an event than truly exist in real life. Patient testimonials on the internet are subjective in the same way, and hardly a good way to make an argument to a doctor for treatment when their perspective is that none is necessary.

TSH testing has been around for 40 years or so, with highly sensitive TSH testing available for about 20 years. Combining that with antibodies testing is also a recent development, as hypothyroidism has a longer known history due to iodine deficiency than it does due to autoimmunity. Treatment before that was actually more symptom based, as patients typically showed a goiter and myxedema to merit testing--outward signs of thyroid disfunction. Doctors almost always say your labs are "normal" if they fall in range, and most labs still have ranges that run up to 5. There is a certain number of people with subclinical hypothyroidism that do progress to overt, but a much larger percentage who never do. Maybe your mother never asked for the actual numbers. Maybe the doctor wouldn't have treated her anyway until she was out of range, because there was not a clinical reason in their mind to do so.

As for your friend, keep in mind that the Hurthle cells that are indigenous to Hashimotos are, pathologically, very similar to those that cause cancer. "Found a mass in her neck" is a key difference here, making your situation an apples to oranges comparison. The Hashimoto's diagnosis, post surgery, really doesn't matter. Without a thyroid, that person gets treatment regardless.

Part of the problem for thyroid patients is that their symptoms cause quality of life issues that they find important, but these do not share the same classification in a doctor's mind as other symptoms which may result in a medical disfunction of the body. Unfortunately, sub-clinical hypothyroidism has not been closely tied with any truly life threatening disease, with the exception of perhaps heart disease, so being tired and having dry skin and depression and constipation and hair loss get short shrift.

Have you found this position paper yet:

http://www.thyrochek.com/pdf/publications/What-is-a-Normal-TSH.pdf

It gives the scientific reasons behind why the ranges are what they are, and the rationale for keeping them there. Once again, if you think you need treatment, you are going to need to formulate an argument that makes sense to a doctor from their perspective of clinical evidence.


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## Zugora (Feb 14, 2010)

lainey said:


> Sure thing there can be exceptions.


I'm glad we agree on this.



lainey said:


> So what then, everyone is going to walk in and claim that they are an "exception" too?


When strong family history, glaring symptoms, crushing fatigue, suspicious bloodwork, and all other medical issues ruled out, YES, they should demand it!


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## Shell1370 (Nov 28, 2011)

Zugora said:


> I'm glad we agree on this.
> 
> When strong family history, glaring symptoms, crushing fatigue, suspicious bloodwork, and all other medical issues ruled out, YES, they should demand it!


I agree Zugora, my point..be your own patient advocate. Only you know your symptoms. If lab does not reflect with how you are feeling. Keep searching. I'm sorry lab can be wrong. I have seen it too many times. If I'm feeling poorly, I'm not going to lie down and die because a doctor says my lab is fine. Doctors are not God, and way too many of them have that complex. I want to know why, and do everything in my power to see that I am treated correctly.

As for pain vs. overmedicated drug seekers that's a different story.

Sorry but, I am going to disagree with you when it comes to symptoms vs lab. So we will just have to agree to disagree.

HAGD.


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## Octavia (Aug 1, 2011)

I think the risk with this is that some patients get themselves into a mindset of "my symptoms are this, so it must be this" when often, symptoms of different diseases/disorders overlap. So "settling" on one issue with labs say otherwise may mean not treating some other underlying cause of the symptoms.

I do agree that "universal" lab ranges for some disorders don't always work for everyone...as a general rule, though, I would just advocate for any patient and doctor to take a more thorough approach to finding out the underlying cause of the symptoms, rather than plowing forward with only one option in mind.


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## lainey (Aug 26, 2010)

> When strong family history, glaring symptoms, crushing fatigue, suspicious bloodwork, and all other medical issues ruled out, YES, they should demand it!


As someone who also likely went untreated for years in spite of an obvious goiter, I can validate your feelings. But I will not lie to you about your numbers. Right now, they are normal, and the frees are spot on in the ranges. Maybe in 6 months time things will change, but that is how it is right now. Most endos and gp's are going to tell you that.

A naturopath or DO is more likely to go along with your symptoms.


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## joplin1975 (Jul 21, 2011)

My husband frequently (heck, almost daily) says "There's a reason we all say we are 'practicing' medicine."

Are there doctors with "god complexes?" Of course. Are there doctors who disregard patient reports of symptoms? Absolutely. But I'd like to believe most are trying to understand what are often times very complex problems. However, they, like all of us, are human and have limits to their knowledge, training and discipline-specific perspectives. It's difficult and frustrating for all involved -- certainly -- but I don't think it is always purposeful negligence.


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## kimberllee (May 20, 2011)

[quote name='lainey']Sure thing there can be exceptions.

So what then, everyone is going to walk in and claim that they are an "exception" too?

Well, I'll take it this is aimed at me.
I spent from 2002 until 2011 with CANCER undiagnosed. All because my tsh was in normal range. 1/100th of a point of being out of range. Accompanied by severe symptoms. That worsened with each passing year. Im not just a random, rare exception, cases like this happen every single day.

Oh, and I had surgery July 9. 4.5 hour surgery. With 24 lymph nodes taken out..that's how far my cancer spread. Additionally, today I found out my cancer has most likely returned and I'll need another surgery and radiation. good thing my endo didn't just rely on numbers... It showed up on ultrasound...not in my blood work.

I'm the friend..btw. And no doctor even checked my thyroid..it was all based on bloodwork. Had a doctor say listened to my page long list of symptoms instead of blaming my issues on weight or a woman's malaise or "normal tsh" I saw 5 drs. FIVE. And it isn't the fact that I was diagnosed "post op" with hashimotos. It's the fact that I had an autoimmune disease that went unchecked and undiagnosed. I sat in dr after drs office begging them to help. Handfuls of hair falling out, weight gain, fatigue, puffy eyes and face..hmmmmmmmmmm sound familiar?

Please understand my frustration. It's the blind eye of normal ranges or there isn't anything wrong ; is ignorant, offensive and insulting. People aren't symptomatic for zero reason. It's your opinion that it's just a quality of life issue not shared by doctors...it was super fun to be drenched in sweat, also equally amazing to be so exaughsted I couldn't go to work. Or gain 50 pounds while working out 3 days a week, working with a trainer, a nutritionist..

Did I mention, my miscarriage at 3.5 months? Attributed now to both undiagnosed pcos and undiagnosed thyroid cancer???

Yep. Just an inconvienance.

I read the paper... In it's entirety. It also discusses the pluses and minuses to both sides of lowering the ranges and keeping them the same. This is just the data part of the puzzle. 
That's just it..it's a piece of the puzzle, not the end all is all. Tsh ranges were derived from a sample study. Done 40 years ago.. And just like everything else, especially medicine. We tend to learn more and revise things. It's how we do things better and not become archaic. I'd take some time and think before you post again ranting about numbers only. I was deeply offended and I don't believe for one second I'm just an exception to the rule. I've met dozens in the short few months I've become pretty active locally.

I'll be at mayo in February. Since they are the ones who wrote the paper... I'll definitely ask the endocrine department how they see numbers in relation to symptoms and get back to you. I think you'll be in for a rude awakening.

I hope you never find yourself in the position that zugora or myself is in. It's devastating and debilitating.


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## Koof (Nov 9, 2011)

Zugora, I just wanted to let you know I'm in the same boat. I'm all normal and no one will do anything. I'm pushing for as much as a I can, including antibody tests and an ultrasound. I have found some things, but nothing my PCP or endo is willing to treat... yet. still working on it!

Good luck!!!hugs3


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## Andros (Aug 26, 2009)

kimberllee said:


> lainey said:
> 
> 
> > Sure thing there can be exceptions.
> ...


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## HeidiBR (Apr 4, 2010)

"The problem with the internet is that you don't see the thousands of people who are not "exceptions"--they have no reason to be seeking anything--so there is a distorted perception of how common certain situations are--because of the forum, you may see more reports of an event than truly exist in real life. Patient testimonials on the internet are subjective in the same way, and hardly a good way to make an argument to a doctor for treatment when their perspective is that none is necessary."

Lainey you are dead right.

Zugora, Lainey is correct that your bloodwork does not show any sign of hypothyroidism. Forget about your TSH - your Free T3 and your free T4 are almost perfect and you are negative for the antibodies. You do not have suspect bloodwork - you have symptoms. Of something. That may or may not be thyroid.

I had similar bloodwork and symptoms to yours - but I was positive for the antibodies. Hence my treatment and the doctors being willing to treat me.

I would bet that you do not have a thyroid problem. If I were you I would be looking at food allergies/sensitivities, lifestyle, etc...

The other option is to pay for a naturopath and try to get a a trial prescription for thyroid meds. You will probably feel great with the T3 coursing through your veins. But at what price? If you really don't have a thyroid problem, being treated may cause you more trouble down the road.


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## kimberllee (May 20, 2011)

Thank you andros! I really appreciate it. I think cases like yours and mine go undiagnosed because of drs relying solely on numbers. Which is why I get incredibly crabby when I see posts directed to people I know personally and seeing things like, your bloodwork is normal, so your not sick, or you don't have thyroid issues. It's really infuriating. No one should have to suffer. Thanks again for all of your support and insight. You're a wealth of credible information!

-k



Andros said:


> kimberllee said:
> 
> 
> > This should have never happened; I am so so sorry. I went 20 years ever ever so sick. Fluffed off by so many doctors, I can't even remember. I almost died from a thyroid storm and by that time my eyes were so bad, I almost lost my sight.
> ...


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## HeidiBR (Apr 4, 2010)

Kimberllee,

I think medicine is an art and a science. You can't treat based on either one exclusively. Doctors have to rely on something and I think bloodwork is a terrific place to start. But is should not be the end all, be all.

Last year my husband had a cough. Just a cough. Turns out he had a freaky, like-from-another-realm tumor in his chest that was made of testicular cells. Does it mean that everyone who has a cough needs to worry about a freak, sci-fi tumor? Obviously, no. The same way that people with symptoms of tiredness, coldness, depression- could it be a bad thyroid disorder? Sure. Could it be just life? Sure.

I think any one of us here who is currently medicated had something - some indication - in the blood work - that something was wrong with the thyroid. Something. Just like my husband's tumor turned a pregnancy test positive (yes, indeed).

Honestly, I am not sure I'd have much faith in a doctor who medicates patients with thyroid med who have not even one bloodwork indicator of a thyroid issue. Not one. I think that might be dangerous. Give too little med and it could slow or possibly kill a healthy thyroid. Give too much med and send the patient into thyroid storm, heart issues, etc...


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## Andros (Aug 26, 2009)

kimberllee said:


> Thank you andros! I really appreciate it. I think cases like yours and mine go undiagnosed because of drs relying solely on numbers. Which is why I get incredibly crabby when I see posts directed to people I know personally and seeing things like, your bloodwork is normal, so your not sick, or you don't have thyroid issues. It's really infuriating. No one should have to suffer. Thanks again for all of your support and insight. You're a wealth of credible information!
> 
> -k
> 
> ...


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## lainey (Aug 26, 2010)

@Kimberlee



> It showed up on ultrasound...not in my blood work.


And cancer never was never going to show up in your blood work. And while it is more likely in those with Hashimotos, autoimmune disease is hardly causative regarding cancer, and treating the autoimmune disease, provided it merited it, would not have prevented the cancer.

As far as the OP, yours is still an apples to oranges comparison.



> I read the paper... In it's entirety. It also discusses the pluses and minuses to both sides of lowering the ranges and keeping them the same. This is just the data part of the puzzle.
> That's just it..it's a piece of the puzzle, not the end all is all. Tsh ranges were derived from a sample study. Done 40 years ago.. And just like everything else, especially medicine. We tend to learn more and revise things. It's how we do things better and not become archaic.


That 40 year old study was a baseline, confirmed with longitudinal follow-up results 20 years later. How much more "normalization" do TSH test results need? As long as you are studying humans, the baseline for normal shouldn't change significantly for the next 100 years. Sample studies must be done to establish ranges--we must have data or we can't make treatment decisions otherwise.
Any decisions as to the merits of treatment then, based on "normal" levels, will be "guidelines" just like those we have for blood pressure, diabetes and hypertension. By by lowering the ranges, we will likely include a significant percentage of people who truly do not require treatment--obviously counterproductive on a large scale, not "outdated".

As for the rant about "numbers", read your own post. I don't see any purpose to telling people what they want to hear. I prefer to stick to facts, not conjecture, as there is enough of that in the internet.


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## Zugora (Feb 14, 2010)

Just wanted to report that new MD says that my Free T3 and Free T4 are definitely not optimal (too low) and that my TSH should be lower than what it is. He is starting me on a small amount of Armour (30mg/day) and would like to slowly raise the dosage every couple of weeks. He also thinks my cortisol level isn't quite optimal either.

All in all, he thinks I'm an autoimmune conglomeration - perhaps, a little bit of a few different things, but with BIG symptoms - a little hashimoto's, a little insulin resistant, a little celiac, and so on. Hard to diagnose and not falling into any one blood-test category. So, we'll see how Armour goes and in the meantime, he wants me on a non-inflammatory diet. Cross fingers.


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## CP900 (Sep 2, 2011)

*crosses fingers*

I really do hope this works for you!


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## Andros (Aug 26, 2009)

Zugora said:


> Just wanted to report that new MD says that my Free T3 and Free T4 are definitely not optimal (too low) and that my TSH should be lower than what it is. He is starting me on a small amount of Armour (30mg/day) and would like to slowly raise the dosage every couple of weeks. He also thinks my cortisol level isn't quite optimal either.
> 
> All in all, he thinks I'm an autoimmune conglomeration - perhaps, a little bit of a few different things, but with BIG symptoms - a little hashimoto's, a little insulin resistant, a little celiac, and so on. Hard to diagnose and not falling into any one blood-test category. So, we'll see how Armour goes and in the meantime, he wants me on a non-inflammatory diet. Cross fingers.


Excellent! Once the T3 in Armour kicks in you will feel so much better. When does he want you in for labs for titration of Armour?

You "must" let us know how you feel. Did you get the Armour yet?


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## Zugora (Feb 14, 2010)

Andros said:


> You "must" let us know how you feel. Did you get the Armour yet?


Yep. Took first dose this morning (30 mg) - 1/2 hr before breakfast. I think that's only a 1/2 grain. I felt pretty wired/anxious (a little bit of racing heart), afterward, but I've been feeling anxious/wired to begin with at times, so it's hard to tell. I'm very sensitive to meds - doc thinks I "hyper-regulate" (?), so I often will get heart palps when I take any medication (even vitamins). That's why he is starting me off at a low dose. He says heart palps like this can happen with thyroid problems, adrenal issues or hormonal changes. When my sister started Synthroid, she had heart palps for a while, then they slowly went away as she settled into the med. So, who knows... I see the doc again in 2 weeks.


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