# Newbie in need of help!



## HeatherM (May 18, 2017)

Hi everyone. Thank you in advance for any help you can give me!

I am a 32 year old woman who is 5'9" and 240 pounds. My last pregnancy really affected my mental health negatively from halfway into the pregnancy to my postpartum time. It's just now that I'm starting to get back to normal and my baby is 18 months! But I finally felt stable enough mentally to start trying to work on my physical health.

I went to my doctor last week because I had been trying to lose weight for two months without success. I logged all of my food intake in an app and stuck to an 1800 calorie diet for a month. After I didn't lose any weight I changed to a 1300 calorie diet for a month. I stuck to my diet fastidiously. The whole time I was exercising 3-5 times a week for an hour each session. I do weight training and cardio. I got a heart rate monitor so I could be sure that I was adding only as much calories to my diet as I'd burned that session. My average calories burnt for each workout session is 400-600. I have gotten measurably stronger, my sleep is better, and I feel happier and more fit. But I haven't lost any weight at all. It has stayed exactly the same. My clothes fit the same and everything.

Something wasn't adding up so I visited my doctor. He is very laid back and didn't seem concerned or really have any advice. He ordered some labs. Here are the results from last week:

Component Your Value Standard Range

TSH 0.79 mcIU/mL 0.35 - 4.00 mcIU/mL
VIT B12 229 pg/mL 200 - 910 pg/mL
HGBA1C % 5.4 % 4.8 - 5.6 %
HGBA1C % 5.4 % 4.8 - 5.6 %
T4 FREE 0.6 ng/dL 0.8 - 1.5 ng/dL 
VITAMIN D, 25-HYDROXY, D3 29 ng/mL 
VITAMIN D, 25-HYDROXY, D2 <4 ng/mL 
25-HYDROXYVITAMIN D 29 ng/mL 30 - 100 ng/mL

He wants me to take vitamin D supplements. When I asked about the sub clinical T4 Free level he was unconcerned. He said that sometimes that's just how some people are and it isn't a big deal. When I pushed he ordered more labs.

Here are my results from the blood tests I took yesterday:

Component Your Value Standard Range

TSH 1.11 mcIU/mL 0.35 - 4.00 mcIU/mL
TPO AB <3.0 IU/mL <=5.5 IU/mL
T4 FREE 0.8 ng/dL  0.8 - 1.5 ng/dL
FSH 3.3 mIU/mL 
LH 2.4 mIU/mL

What do you all make of my results? Should I ask for a trial of thyroid meds? Be persistent? Ask for a second opinion? Or am I looking in the wrong direction? I'm not going to stop exercising and trying to be healthier. But I am so frustrated with the lack of weight loss that I could cry. I am really beginning to despair. Thank you so much in advance if you read all this and can give me any advice!


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## jenny v (May 6, 2012)

You definitely need a starting dose of thyroid meds, as your FT4 is way too low. It would be good if you could get your Free T3 level tested, too, as that one is a good indicator of things (esp. metabolism, for a lot of us). Your D and B12 are way too low, as well, which can exacerbate or mimic thyroid symptoms.


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## HeatherM (May 18, 2017)

jenny v said:


> You definitely need a starting dose of thyroid meds, as your FT4 is way too low. It would be good if you could get your Free T3 level tested, too, as that one is a good indicator of things (esp. metabolism, for a lot of us). Your D and B12 are way too low, as well, which can exacerbate or mimic thyroid symptoms.


Thank you so much for your reply! I like that my doctor is laid back but sometimes I feel like he's not taking my concerns seriously. But with my symptoms, low test result, and family history, I really think I'd like to pursue treatment for my thyroid. At least to see if it helps. I've never had to get a second opinion before but I will seriously consider it if my doctor continues to poo-poo this.


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## HeatherM (May 18, 2017)

Welp. I got a second opinion. He agreed with the first doctor that no treatment or monitoring was necessary. He sent the results to endocronology just because it's so unusual to have a normal tsh but low t4. They said that no treatment or monitoring was necessary too. So I'm back to square one. Doctor suggested trying a month with no dairy because that can commonly cause a negative insulin response even for people who have normal insulin levels. So I guess I'll try that. I'm just feeling really sad and discouraged. I had hoped that maybe this thyroid thing was the missing piece of the puzzle.


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## Lovlkn (Dec 20, 2009)

Yes.. low TSH with low FT-3 is definitely not "normal"

Have you had thyroglobulin antibodies run? Graves disease is usually associated with low TSH, you might want to ask for TSI antibodies.

Has anyone suggested an ultrasound of your thyroid?


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