# Could this mean hypo even if Dr says no?



## catstlmo

I'm new to this forum and hoping someone can help clear up some of my confusion. 8 years ago I began having a lot of trouble with edema and my doctor put me on a daily diuretic (dyazide). She checked my TSH level at that time and it was 2.51. I still continue to have a lot of swelling, despite taking the diuretic.

I just turned 39. My memory and concentration have been poor for quite some time (5+ years). About a year ago I began gaining weight without any changes in my eating or activity level. I have cut back on calories and increased the amount of exercise I do, but continue to gain weight. I'm tired all the time, feel like I'm always in slow motion, have trouble with constipation, and my hair is dry and brittle (though I attribute this to the fact that my hair has turned almost completly gray and I'm always putting color on it).

A few weeks ago I saw an endocrinologist to find out why I keep gaining weight. He checked some of my thyroid levels and told me everything is fine and that I just need to increase my exercise to one hour 6-7 days/week. Here are my lab results:

TSH - 3.62 (.27 - 4.2)
Free T4 - 1.0 (.9 - 1.7)
Total T3 - 119 (76 - 181) not sure why he didn't do a free T3
TPO Ab <10 (<35) does this mean antibody is negative?

Should I accept this as "normal" and forget about it....or should I look for a doc that might treat for hypothyroid despite being within the normal limits? Any advice would be appreciated!!!


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## HeidiBR

Your labs and symptoms are very similar what mine were; I am being treated for hypo.


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## catstlmo

Thanks for the reply! I'm going to start searching for a new doctor, but from what I've read it's not so easy to find one that will treat someone with "normal" lab results.


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## GD Women

catstlmo said:


> I'm new to this forum and hoping someone can help clear up some of my confusion. 8 years ago I began having a lot of trouble with edema and my doctor put me on a daily diuretic (dyazide). She checked my TSH level at that time and it was 2.51. I still continue to have a lot of swelling, despite taking the diuretic.
> 
> I just turned 39. My memory and concentration have been poor for quite some time (5+ years). About a year ago I began gaining weight without any changes in my eating or activity level. I have cut back on calories and increased the amount of exercise I do, but continue to gain weight. I'm tired all the time, feel like I'm always in slow motion, have trouble with constipation, and my hair is dry and brittle (though I attribute this to the fact that my hair has turned almost completly gray and I'm always putting color on it).
> 
> A few weeks ago I saw an endocrinologist to find out why I keep gaining weight. He checked some of my thyroid levels and told me everything is fine and that I just need to increase my exercise to one hour 6-7 days/week. Here are my lab results:
> 
> TSH - 3.62 (.27 - 4.2)
> Free T4 - 1.0 (.9 - 1.7)
> Total T3 - 119 (76 - 181) not sure why he didn't do a free T3
> TPO Ab <10 (<35) does this mean antibody is negative?
> 
> Should I accept this as "normal" and forget about it....or should I look for a doc that might treat for hypothyroid despite being within the normal limits? Any advice would be appreciated!!!


Going on medications in some cases may not help with symptoms. 
Yes, levels could be better, but going on thyroid medication when really not needing it or even trying to tweak it in, may do more harm than good. I'd keep testing on an annual bases to see if there are any changes, it could go better, or, it could go worse. Thyroid levels have known to change for many different reasons other then thyroid. Some of us find that we need to treat each symptom separately from thyroid when meds. and levels don't do it, which you might think about. Other health issues can have the same symptoms as thyroid.

Good Luck!


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## Andros

catstlmo said:


> I'm new to this forum and hoping someone can help clear up some of my confusion. 8 years ago I began having a lot of trouble with edema and my doctor put me on a daily diuretic (dyazide). She checked my TSH level at that time and it was 2.51. I still continue to have a lot of swelling, despite taking the diuretic.
> 
> I just turned 39. My memory and concentration have been poor for quite some time (5+ years). About a year ago I began gaining weight without any changes in my eating or activity level. I have cut back on calories and increased the amount of exercise I do, but continue to gain weight. I'm tired all the time, feel like I'm always in slow motion, have trouble with constipation, and my hair is dry and brittle (though I attribute this to the fact that my hair has turned almost completly gray and I'm always putting color on it).
> 
> A few weeks ago I saw an endocrinologist to find out why I keep gaining weight. He checked some of my thyroid levels and told me everything is fine and that I just need to increase my exercise to one hour 6-7 days/week. Here are my lab results:
> 
> TSH - 3.62 (.27 - 4.2)
> Free T4 - 1.0 (.9 - 1.7)
> Total T3 - 119 (76 - 181) not sure why he didn't do a free T3
> TPO Ab <10 (<35) does this mean antibody is negative?
> 
> Should I accept this as "normal" and forget about it....or should I look for a doc that might treat for hypothyroid despite being within the normal limits? Any advice would be appreciated!!!


Welcome aboard!!! Results of TPO means you have a smattering. It is below the range.

In general, their presence suggests that there is autoimmune thyroid involvement and the higher the level, the more likely that is. So, you do have autoimmune.

You will want to read this..............

http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/test.html

Also, AACE recommends that the range for TSH be 0.3 - 3.0 and many doctors here in the U.S. and abroad think that the top of the range should be a 2. I happen to agree w/ that as most of us feel best w/ the TSH @ 1 or less and the "FREES" @ at least mid-range or higher.

You are right; it would have been most helpful if your doc had run the Free T3.

I am going to suggest some other antibodies' tests. I hope you can get them.

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/understanding/conditions/thyroid.html

Mid-range for your FT4 is 1.3 so that is low and even though that is a Total 3, something is afoot as that is really low, mid-range being 1.28. When you think that that is bound and unbound hormone plus possibly rT3 (reverse); you have to wonder.

Sounds like you have myxedema too. http://www.wrongdiagnosis.com/m/myxedema/basics.htm


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## catstlmo

Andros said:


> Welcome aboard!!! Results of TPO means you have a smattering. It is below the range.
> 
> In general, their presence suggests that there is autoimmune thyroid involvement and the higher the level, the more likely that is. So, you do have autoimmune.
> 
> You will want to read this..............
> 
> http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/test.html
> 
> Also, AACE recommends that the range for TSH be 0.3 - 3.0 and many doctors here in the U.S. and abroad think that the top of the range should be a 2. I happen to agree w/ that as most of us feel best w/ the TSH @ 1 or less and the "FREES" @ at least mid-range or higher.
> 
> You are right; it would have been most helpful if your doc had run the Free T3.
> 
> I am going to suggest some other antibodies' tests. I hope you can get them.
> 
> 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/understanding/conditions/thyroid.html
> 
> Mid-range for your FT4 is 1.3 so that is low and even though that is a Total 3, something is afoot as that is really low, mid-range being 1.28. When you think that that is bound and unbound hormone plus possibly rT3 (reverse); you have to wonder.
> 
> Sounds like you have myxedema too. http://www.wrongdiagnosis.com/m/myxedema/basics.htm


Andros,

Thank you so much for the reply - very helpful! I certainly do not want to take thyroid meds if I don't need them, but at the same time I don't want to continue feeling like this if I don't have to. I'm a single parent working full time and It's been getting harder and harder to keep up.

I'm not sure about myxedema - I thought that meant swelling of the face - mine is all over, but mostly lower extremities. The diuretic helps somewhat, but even with that I haven't seen my ankles in years. I have been to a vascular surgeon, nephrologist, cardiologist, and endocrinologist trying to figure out why I have so much edema. I have had doppler studies on my legs to check circulation, an echocardiogram, and a renal ultrasound - everything was okay. The docs just end up telling me that it's normal "female fluid retention." A few months ago I had to stop the diuretic because my potassium level was way too low - I was off it for 5 days and gained 12 pounds - that doesn't seem very "normal" to me. I have no idea if it could be related to thyroid stuff though.

I'm still waiting on the 24hr urine cortisol results. He also checked my testosterone levels:
Total = 17 (2 - 45)
Free = 1.3 (.1 - 6.4)
% Free = .75 (.5 - 2)

I guess they are in normal range, but do you know why he would check this? Is testosterone related to the thyroid? I have a follow up appointment on Monday, but I already know he's not going to offer any treatment because he doesn't think anything is wrong with me.


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## Andros

catstlmo said:


> Andros,
> 
> Thank you so much for the reply - very helpful! I certainly do not want to take thyroid meds if I don't need them, but at the same time I don't want to continue feeling like this if I don't have to. I'm a single parent working full time and It's been getting harder and harder to keep up.
> 
> I'm not sure about myxedema - I thought that meant swelling of the face - mine is all over, but mostly lower extremities. The diuretic helps somewhat, but even with that I haven't seen my ankles in years. I have been to a vascular surgeon, nephrologist, cardiologist, and endocrinologist trying to figure out why I have so much edema. I have had doppler studies on my legs to check circulation, an echocardiogram, and a renal ultrasound - everything was okay. The docs just end up telling me that it's normal "female fluid retention." A few months ago I had to stop the diuretic because my potassium level was way too low - I was off it for 5 days and gained 12 pounds - that doesn't seem very "normal" to me. I have no idea if it could be related to thyroid stuff though.
> 
> I'm still waiting on the 24hr urine cortisol results. He also checked my testosterone levels:
> Total = 17 (2 - 45)
> Free = 1.3 (.1 - 6.4)
> % Free = .75 (.5 - 2)
> 
> I guess they are in normal range, but do you know why he would check this? Is testosterone related to the thyroid? I have a follow up appointment on Monday, but I already know he's not going to offer any treatment because he doesn't think anything is wrong with me.


For one thing, there are potassium sparing diuretics such as Maxide. For another, it sounds like you do have thyroid induced myxedema.

Hope you get those tests I have suggested for you. You could have perfect labs but "if" you have antibodies indigenous to the thyroid, that does mean you have autoimmune thyroid disease.


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