# Tests in range, must be all in my head...



## glasswings (Jun 27, 2013)

...and the frustrating part is I don't know what's causing my fatigue yet, so maybe it's time to look elsewhere.

23 years old, male, Hashi's on mother's side of the family. Short (65"), rather skinny (130 lbs for years), often fatigued and occasionally depressed.

But, being skinny, didn't really think that thyroid stuff applied to me.

So, one weekend in late June, I stress myself severely - fly cross country for a wedding, big change in diet (so. much. pasta.), fly back home, hey presto severe acute depression, barely leave bed for five days.

At this point I decide to take a look at what may be causing changes in energy. Read that Hashi's isn't just hypo, especially if you're young, gluten connection, etc.

So, I schedule an appointment start some reasonable vitamin supplements, plus 200mcg/day of selenium, and take the gluten out of my diet.

My body likes this. My body likes this a _lot_. My mood and energy suddenly improve, can't sleep, diarrhea, and I drop about 7 pounds in a week. Pulse rate is up and palpitations make me beg to see someone early. Blood draw.

anti-TPO - 31 IU / mL (0-35)
anti-TG - <20 IU / mL (<20)
TSH - 0.43 mIU/L (0.40-4.50)
free-T3 - 3.2 pg/mL (2.3-4.2)
total-T4 - 9.2 mcg/dL (4.5-12.0)

I asked for free T4 and got total. Beh.

I am really, really tempted to try a gluten challenge and see if I can't get that TPO number up to where a doctor will listen to me. Because the sense I got today was basically that I could get an antidepressant prescription if I begged hard enough and by the way I'd benefit from more exercise.

Never mind exercise making me feel sick in the past.

Will do that, sure, but arghbbl! My understanding is that bloodwork can't rule out Hashi's, can I just get an FNA biopsy then?

Not feeling happy with this practice - was not comfortable talking with anyone - so certainly time for a new doctor.

Any advice appreciated.


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## Lovlkn (Dec 20, 2009)

Quit the selenium and re-test your thyroid hormones if you are convinced it's your thyroid.

Selenium can skew your hormones.

Have you been allergy tested? I wonder if your issue is gluten related and possibly food allergy related.


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## Andros (Aug 26, 2009)

glasswings said:


> ...and the frustrating part is I don't know what's causing my fatigue yet, so maybe it's time to look elsewhere.
> 
> 23 years old, male, Hashi's on mother's side of the family. Short (65"), rather skinny (130 lbs for years), often fatigued and occasionally depressed.
> 
> ...


You could be hyper and the energy challenge arises because your metabolism is racing even when you think you are resting thus leaving you in a very tired and depressed state.

These tests would confirm or disconfirm.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

And in your case, it would be very wise to get an ultra-sound of the thyroid.


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## confused&tiredinNY (Jun 4, 2013)

It's my understanding that you don't need an FNA unless you have questionable nodules. Have you had a sonogram? My doctor looked at my thyroid and without blood work told me I had Hashi. A "normal" thyroid will appear on a screen as light, clear gray. Mine is dark gray, almost black (from years of inflammation) and you could see scar bands.

I've worked on eliminating gluten from my diet and I've absolutely seen a change. I don't know what kind of diet you follow but I've followed the Paleo diet for a while (not by the book but as closely as I could) and I feel better. Sometimes gluten acts as a "fog" in your brain which would absolutely explain your mood and energy. I also work on cutting dairy which helps with my intestinal issues. If you have a good relationship with your primary, I would go back to them and explain your concerns. Being honest about what's happening is the best thing you can do. I was embarrassed by some of my symptoms and I didn't mention them initially because I didn't think they were related.


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## glasswings (Jun 27, 2013)

Thanks, everyone.

<minor rant follows>

I'm between doctors, trying to find a PCP for myself. Tried one, fired one so far.

Entire practice was hostile to the idea of me ordering my own tests and would not release test results. How am I supposed to know what to talk about? And, yeah, I don't have the years of schooling but you'd think my opinion about my body would

Pretty sure my thyroid is the _damn itchy thing low in my neck_, most noticeable between trachea and carotid arteries either side, and I've only had my larynx felt up twice by two separate morons who couldn't find the thyroid gland on a male with two hands and a neck map.

Also, I showed up complaining about depressed mood with obvious first-and-second degree burns on my arms. The two aren't related - burns are from a new job I'm learning at work, fairly small, and healing cleanly - but my new physician _didn't say a word,_* and was generally not interested in my psychiatric history. I felt like I was being treated as "that hypochondriac kid who just needs a little cardio and to enjoy how healthy he is now."

(*I only realized how suspicious it looks after the fact.)

I have no respect for any of these people. Even if I'm mistaken and just being an ass of a patient, the chemistry of the doctor/patient relationship is not working. Dumped.

My ideal doctor will answer questions by e-mail, won't mind me educating myself, and in general would be more like the car or computer gurus I know.

<venting complete, now to the point>

Stopped selenium, gluten's back in my diet after about a month without.

Already had my first stomachache since removing gluten (doesn't prove anything but still...). I'm planning on two weeks and testing for celiac at the same time. (anti-tTG? Need to do some more reading.)

Haven't been to an ENT or endocrinologist. No sonogram yet, but yeah, that's less invasive than FNA.


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## Andros (Aug 26, 2009)

glasswings said:


> Thanks, everyone.
> 
> <minor rant follows>
> 
> ...


I would hope that FNA would not be done unless a sonogram was done first. And we all hope that you find a doctor that has your best interest and good health uppermost in his/her mind.

Many here are very very pleased with their Naturopathic doctors. Some have good luck with a DO or PCP.

Put some "feelers" out there and see what turns up!


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## iroczinoz (Aug 15, 2011)

Well to be honest your thyroid numbers do not look that bad.

I think if you are really feeling fatigued you may need to look at your other hormones.

You may also want to check for mono.

some tests I would ask to be done

Cortisol
Cholesterol
Testosterone
E2
Shbg
Free testosterone
Lh
Fsh
Prolactin
Vitamin d
Vitamin b12
CBC
ferritin
Iron
IGF
Glucose

Look at the symptoms of low testosterone and se if you have many of them. They no doubt overlap with other conditions but maybe your endo will be kind enough to run a complete panel like above.


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## BlindMag (May 17, 2013)

I was diagnosed with Hashi's and have never had an FNA, since my thyroid is a normal size without nodules. With family history, they should do a sonogram to check for nodules. I agree with iroczinoz - I'd try to find a doc who will give you a decent blood work up - rule out things like mono, Lyme, vitamin deficiencies, and other hormone imbalances. If cutting out gluten helps, that's awesome! That's at least one thing you can do yourself without a doctor to feel better. If you can't find a doc soon, an elimination and challenge diet might be something to try since often one food intolerance joins another. Hope you can get to the bottom of things!!
-Maggie


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## hypocrazy (Jun 30, 2013)

Oh


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## Desertrose (Jul 30, 2013)

Just a thought which may have occurred to you already, but it's common to have low iron and low vitamin D with Hashimoto's, both of which can cause fatigue.


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## Ana78 (Aug 8, 2013)

when my tsh went to 0.4 i felt ok. my endo told me to continue with same dosage of Armour and next thing I know I feel like dying and 15 days after that test my lab were TSH 0.02. When thyroid is "within the range" but that low it could drop very rapidly


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