5 Thyroid Patterns That Won’t Show Up On Standard Lab Tests

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This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.

In medicine, the key to choosing the best treatment is an accurate diagnosis. If the diagnosis isn’t correct, the treatment will be ineffective – or even cause harm.

Unfortunately misdiagnosis is common in the management of hypothyroidism. If you go to a doctor with hypothyroid symptoms, you’ll simply be given replacement hormones without any further inquiry into the cause of your condition.

Even worse, if you have hypothyroid symptoms but your lab tests are normal, you’ll be told you’re “fine”. If you insist you’re not, you might be sent home with an antidepressant, but no further clue about the cause of your symptoms.

The problem with this approach is that thyroid physiology is complex. The production, conversion and uptake of thyroid hormone in the body involves several steps. A malfunction in any of these steps can cause hypothyroid symptoms, but may not show up on standard lab tests. It’s incorrect and even negligent to assume that all cases of hypothyroidism share the same cause and require the same treatment. Yet that’s exactly what the standard of care for hypothyroidism delivers.

In this article I’ll present five patterns of thyroid dysfunction that won’t show up on standard lab tests. If you have one of these patterns, your thyroid isn’t functioning properly and you will have symptoms. But if you go to your conventional doctor, you’ll be told there’s nothing wrong with your thyroid.

A standard thyroid panel usually includes TSH and T4 only. The ranges for these markers vary from lab to lab, which is one of two main problems with standard lab ranges. The other problem is that lab ranges are not based on research that tells us what a healthy range might be, but on a bell curve of values obtained from people who come to the labs for testing.

Now, follow me on this. Who goes to labs to get tested? Sick people. If a lab creates its “normal” range based on test results from sick people, is that really a normal range? Does that tell us anything about what the range should be for health? (For more on the problems with standard lab ranges, watch this great presentation by Dr. Bryan Walsh)

The five thyroid patterns

  1. Hypothyroidism caused by pituitary dysfunction

This pattern is caused by elevated cortisol, which is in turn caused by active infection, blood sugar imbalances, chronic stress, pregnancy, hypoglycemia or insulin resistance. These stressors fatigue the pituitary gland at the base of the brain so that it can no longer signal the thyroid to release enough thyroid hormone. There may be nothing wrong with the thyroid gland itself. The pituitary isn’t sending it the right messages.

With this pattern, you’ll have hypothyroid symptoms and a TSH below the functional range (1.8 – 3.0) but within the standard range (0.5 – 5.0). The T4 will be low in the functional range (and possibly the lab range too).

  1. Under-conversion of T4 to T3

T4 is the inactive form of thyroid hormone. It must be converted to T3 before the body can use it. More than 90% of thyroid hormone produced is T4.

This common pattern is caused by inflammation and elevated cortisol levels. T4 to T3 conversion happens in cell membranes. Inflammatory cytokines damage cell membranes and impair the body’s ability to convert T4 to T3. High cortisol also suppresses the conversion of T4 to T3.

With this pattern you’ll have hypothyroid symptoms, but your TSH and T4 will be normal. If you have your T3 tested, which it rarely is in conventional settings, it will be low.

  1. Hypothyroidism caused by elevated TBG

Thyroid binding globulin (TBG) is the protein that transports thyroid hormone through the blood. When thyroid hormone is bound to TBG, it is inactive and unavailable to the tissues. When TBG levels are high, levels of unbound (free) thyroid hormone will be low, leading to hypothyroid symptoms.

With this pattern, TSH and T4 will be normal. If tested, T3 will be low, and T3 uptake and TBG will be high.

Elevated TBG is caused by high estrogen levels, which are often often associated with birth control pills or estrogen replacement (i.e. Premarin or estrogen creams). To treat this pattern, excess estrogen must be cleared from the body.

  1. Hypothyroidism caused by decreased TBG

This is the mirror image of the pattern above. When TBG levels are low, levels of free thyroid hormone will be high. You might think this would cause hyperthyroid symptoms. But too much free thyroid hormone in the bloodstream causes the cells to develop resistance to it. So, even though there’s more than enough thyroid hormone, the cells can’t use it and you’ll have hypothyroid – not hyperthyroid – symptoms.

With this pattern, TSH and T4 will be normal. If tested, T3 will be high, and T3 uptake and TBG will be low.

Decreased TBG is caused by high testosterone levels. In women, it is commonly associated with PCOS and insulin resistance. Reversing insulin resistance and restoring blood sugar balance is the key to treating this pattern.

  1. Thyroid resistance

In this pattern, both the thyroid and pituitary glands are functioning normally, but the hormones aren’t getting into the cells where they’re needed. This causes hypothyroid symptoms.

Note that all lab test markers will be normal in this pattern, because we don’t have a way to test the function of cellular receptors directly.

Thyroid resistance is usually caused by chronic stress and high cortisol levels. It can also be caused by high homocysteine and genetic factors.

Conclusion

The five patterns above are only a partial list. Several others also cause hypothyroid symptoms and don’t show up on standard lab tests. If you have hypothyroid symptoms, but your lab tests are normal, it’s likely you have one of them.

Not only do these patterns fail to show up on standard lab work, they don’t respond well to conventional thyroid hormone replacement. If your body can’t convert T4 to T3, or you have too much thyroid binding protein, or your cells are resistant, it doesn’t matter how much T4 you take; you won’t be able to use it.

Unfortunately, if you have one of these patterns and tell your doctor your medication isn’t working, all too often the doctor’s response is to simply increase the dose. When that doesn’t work, the doctor increases it yet again.

As I said at the beginning of this article, the key to a successful treatment is an accurate diagnosis. The reason the conventional approach fails is that it skips this step and gives the same treatment to everyone, regardless of the cause of their problem.

The good news is that, once the correct diagnosis is made, patients respond very well to treatment.

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Comments Join the Conversation

  1. AndreaMN says

    Hello,

    My eldest daughter (now 11) has been diagnosed with ADHD and mood disorders. In August of last year, I had her T4 tested by her pediatrician. Her results>
    Component Standard Range Your Value
    T4, FREE m 0.8 – 2.5 ng/dl 1.2

    Her paternal grandmother has been treated for thyroid disorders for many years. Unfortunately, she lives in Peru and we can’t be certain of an accurate diagnosis for this reason. Anyway, I feel my daughter has something wrong with her thyroid despite her above normal result. Without seeming too pushy and like I’m trying to find something wrong where there isn’t, what can I do to get additional testing that is more accurate?

    Also, my soon to be 7 year old daughter was just recently diagnosed with ADHD, has low muscle tone, only just reached 40 pounds and frequently has hand tremors, outbursts, mood swings (many of the symptoms of thyroid issues). I haven’t even asked yet for testing for her because I’d like to figure out what a more accurate test is before I bother.

    Any advise or suggestions, please respond. Thank you!!

  2. Jamie child says

    I’m reading these comments and you all sounds like you have gone through or are going through exactly what I went through almost 2 years ago. I went to a doctor and told him all about my symptoms and he told me that my thyroid was normal. I was suffering from swollen hands, swollen ankles, severe muscle fatigue, extreme exhaustion, anxiety,depression, my hair is falling out, weight gain and insomnia. My fatigue was so severe I had to crawl up my two flights of stairs. I could sleep 12 hours and wake up and crawl right back into bed. I was told my vitamin D was low. I finally went to a place called Bio Restoration in Draper, Utah and was able to get help. They read my lab results that my GP had drawn and concluded that my thyroid panels that they looked at were borderline low and all my symptoms were hypothyroid and they immediately treated me with Armour Thyroid. Once we got me on a therapeutic dose which was 90 milligrams I started to feel completely better and my symptoms slowly disappeared. the weight started to come off slowly over 2 years my fatigue has gotten better and I feel like me again. you have to find a doctor that will treat the symptoms and not always look at the numbers.

  3. Sherri Chesney says

    I don’t understand why doctors won’t listen to their patients. I have known something was wrong with my thyroid for a very long time. I always got a “normal” reading when having blood tests.
    This last week I went to the doctor got a 3.6 level on the TSH and was given an Rx for levithroxine. That’s it.
    After coming home and doing some research, I’ve found that I have to become the expert myself. I’ve even found a place online that I can order my own blood test. (walkinlabs.com) I have to figure out exactly which ones to take and then take these results to a new doctor that cares. Probably going to try to find someone that will Rx some Armour thyroid.
    I get so very tired researching online that I usually have to stop and take a nap before continuing. Ugh!

  4. Rita says

    i have hypothyroidism due to pituitary adenoma – have tried t4, t3 and NDT but none of these have really helped me feel better so not sure why??? and what to do to feel better

  5. Ml says

    Ok. Maybe this is the correct place to post my situation as I cannot seem to get any answers form searching.

    Always been hypo. Not a big deal, currently taking synthroid.

    My primary dr had me do labs 90 days ago and all labs were normal and fine.

    Primary dr had me do labs again a week ago. All normal labs and t3 and t4 came back normal but tsh was 11.76!! So dr felt around and said the left side felt enlarged. So went for ultra sound. That day.

    Found .6 and 1.0 cm nodules. One on each side.

    Went to ent, scheduled biopsy of nodules. Dr said he wanted to redo the tsh, t3 and t4 test to make sure it wasn’t a lab mess up. This time TSH came back at 14.92!!

    Ent dr is telling me that the ‘out of this world levels’ in my tsh are not related to the nodules. I find this VERY hard to agree with.

    To me it is like saying that your left knee has no correlation to your left bump foot with which you walk awkwardly. One had a result on another in some way. They are in line in the same system within the body.

    Anyway the ent told me to follow up with a endocrinologist about the tsh levels.

    So at this point I am totally confused.

    I can feel things being different. Can’t remember anything short term (‘wait what was I writing about? ;P) my temper is as short as it has ever been. I am sleeping every few hours no matter how I try to stay awake. I just don’t feel right at all.

    Anyone have any experiences or head of anything like this?

    Thanks
    ML

  6. h. gearhart says

    Id like clarification on the “pattern”:

    TSH/low T3free/normal T4free/low

    What may that be indicating, exactly? Im returning to the Dr. soon and want to be armed with information. My mess started with BP that normally ran toward high on a sporadic basis turning into full blown very high BP all the time. Since starting BP medications my weight has gone up 20# in 5 months. I cannot afford that extra weight. One of the Dr.s at my PC office wound up testing my vitamin D level. It was beyond low, and the info Ive seen says thyroid/vit. D issues usually travel together? After reading into the subject further it appears a slew of symptoms for thyroid match many of mine Ive had a long time. Definitely the nonspecific yucky feeling, everything is an effort most days, way too sleepy most of the time, carrying my body around feels like Im lugging a ton vs. my real (increasing) weight, veryevry dry skin worst on my feet (they will crack to where I cant walk), my vision is getting crappy, depression (normally staying in the worse end)… I could go on all day. About 10 years ago I got tested for high cortisol because these symptoms swallowed me again and I had had enough. Dr. said normal. My thyroid has been tested (I don’t think extensively though) and same thing “normal”. Im at wits end feeling like shit and fat and dead all the time. Im 45, heading into menopause, and should be worrying about chasing boys around! I feel crappy enough with the physical issues and the depression/exhaustedness that I wish I would just lay down and not wake up. Upsetting my Mom and orphaning my dogs is the only 2 things reminding me to suck more air. :(

  7. sarah says

    I wish I could kill myself some days. I stand up and forget what I was going to do, open cupboards and wonder why… I’m 35 and I think I have dementia. Last summer, about a third of my hair fell out over the course of a couple months. I sweat profusely, all while FREEZING and burning up at the same time. the heat comes from somewhere in my chest or neck, at the base of my skull, not like menopause hot flashes that are more, um, Vaginacentric, if you will. I can set a clock by my daily fatigue bomb. I have heart palpitations, depression, confusion, exhaustion, anxiety… my taste buds seem “off” as well as my nostrils, and it feels like I can only taste chemicals anymore… in everything. my body temp is never over 97.5. but I”m ‘NORMAL!!!”

    if THIS is normal, I want OUT.

    • alyssa says

      I have never commented on page before, but as i read your comment it was as if I were reading my own journal entry. I completely understand everything you wrote! I’m 30 years old and have had a full hysterectomy due to years of medical issues. I also have RA and several other fun little autoimmune things that go along with it (livido, etc.) I am on HRT and have gone in to have my thyroid checked and have been told that it is low (2.1) and that it will be monitored. In the meantime, all of my hormones were doubled. I’m not sure how this is supposed to help with the very sudden weight gain, hair loss, mood swings, etc…I have a family history of thyroid issues as well. I am getting frustrated quickly and don’t know what do to. I set up an appointment with the rheumatologist, and hope to get quick resolution. I don’t have depression or hormone issues, I have thyroid problems!

    • Olga says

      Hi Sara,

      Im having the SAME symptoms, living just miserable life and don’t have energy to play with my son. These symptoms were developing for 3-4 years and God knows how many doctors, I’ve seen and how many tests I’ve had… In my tests the only abnormality is low alkaline phosphatase and TPO antibody on the low level but within “normal range”… :(
      I wish my doctors read this article:(((

      • Ruth says

        Oh I wish so too. I had lots of symptoms and am now on antidepressants. They worked to make part of me feel better but not the whole me. Feeling very depressed again. I also have an eating disorder. The worse I feel the more I binge. Then I binge more because I’m upset with myself. Hard to exercise because all my joints ache and I have no energy. I work with clients who have dementia and really feel like I need to move in and be taken care of too. My memory is so bad some days

    • Skye says

      I completely agree with you. Recently lost almost all my appetite, but when I do try to eat I start intense cramping. I’ve told my mom (i’m 17) that it might by related to hypothyroidism and she ignore it because my tests (PLURAL) were normal and to stop being a drama queen. My patience is also decreasing from whatever was left from it, and I pretty much want to kill everyone. :)
      Hoped that uhm, showed that some people are on the same boat as you?

    • Eileen says

      I feel the same as many of you,there are many days I just esnt to give up!! I just dont understand why these doctors dont get it?? As@result of being so tired I cant get up and do much,I am forgetfull,I have lost my homes,my cars and so much more….but I have been labled “MENTALLY ILL”.ALL I HAVE LEFT IS MY FAMILY,BUT THAT TO MAY JUST BE A MATTER OF TIME,I DONT GO ANYWHERE,I STAY AT HOME MY CHILDREN THINK IM LAZY AND JUST DONT CARE,THEY DONT TRUST ME AS I HAVE DONE SOME CRAZY THINGS….AND I JUST WANT TO BE NORMAL AND NOT ONE DOCTOR GIVES ME ANY HOPE OF THAT!!!! SO WHAT DO YOU DO WHEN YOU KNOW YOUR RIGHT AND THE DOCTORs need to discover Google??I think the hardest part is no one really understands no one helps and your left on your own,it gets real lonely at times…..But please dont give up!!!ive hah several friends whom I am sure had thyroid issues and they did give up,it just leaves many with broken hearts that dont understand still…write any time….I to have said if this is it I want out…but against doctors advice I am thinking of trying something called Bodylogic they deal with hormones,I would rather have 10 good years then 20 more like this,the only ones making me crazy are the doctors that refuse to treat me.Perhaps a lawsuit would give them a different perspective????

  8. Karen says

    i had many tests for my symptoms and no answers. Finally I said to my Psychiatrist “what causes weight gain, losing over 1/3 of my hair in a couple of months…and make me feel like I am freezing to death from the inside out”? She said thyroid. She review all my previous blood work reports and only one showed I was low. She started me on synthoid which was slow to help. When we discussed causes of thyroid problems I learned about iodine deficiency. I come from a long line of diabetic, hypertensive overweight people. At 17 I changed how I ate and all but eliminated table salt (the easier way to get iodine as it is “iodized”) from my diet. It seems I was one of the few North Americans NOT getting enough salt. I better and warmer now (yay menopause! NOT!). So there are insidious ways to get this problem. I seen an r endocrinologist after I was better and she says I never had a thyroid issue. A degree does not make you God. Be your own Heath care advocate! Good luck!

  9. Maribeth says

    I am having the worst problems in my life!! my thyroid levels are in what “the doctor says” seem to be NORMAL range yet im having horrifying symptoms. the doctor put me on levothyroxine years ago I still had issues 8 months later he put me on armour thyroid it was like night and day! it helped so much I felt liberated and like life had meaning purpose and joy again. I felt my 30 yrs of age not 80! (80 as in tired run down fatigued hair loss, lack of ambition, weight gain with out eating even for days! ) when my levels got too low (well below normal range) two years later on one t test they took the armour thyroid away and wanted to go back to levothyroxine which then got taken away completely overnight to where im now medication free and symptom overload again with no joy and no desire or ambition. im severely depressed and the doctor put me on an antidepressant for a second time now. the first made me worse. they keep testing it and its getting lower on the scale of “normal” ill explain. my tsh 3rd generation is at 3.589 which is more on the high range almost too high. my thyroxine free e/h/n is .79 just barely above the LOW normal range leaving it very low. they don’t do normal t4 testings on me I have asked them to do so and he agreed to do so in a month. but the problem is now they are no longer treating my issues and symptoms with anything but an antidepressant and I am seriously feeling the joy of living and desire to keep fighting go away daily to a trickle. I wish nay PRAY they find a better way to test. my doctor said indeed my gland is swollen. but those alone he wont put me back on any med for hypothyroidism!! he wants to do more tests including an ultrasound to see if its growing nodes or some type of issue with in the gland itself that is causing it to behave in such a way. but technically since he sees it in “normal” ranges his hands are tied to do anything more until my ranges go haywire again. my niece who is actually a year older then me “my mom had me in her 40s” was just diagnosed with thyroid CANCER. my sister who died last fall had thyroid issues as well!! this is not something NEW to my family heredicy line. I really don’t know what to do. the more I try to ask for help it seems the more I am given some mood altering drug rather then HELP with the main problem and to get rid of the symptoms!

    • Michelle says

      Find another doctor – he’s not listening. And Armour thyroid is much better than Synthroid, which didn’t work for me.

      Sounds like thyroid issues! Find a good endocrinologist and ask him/her to run full blood panels – tsh, t3, t4, tgb, t3 uptake and cortisol levels. Insist!!!! And make sure your levels are compared against the functional range of 1.8 to 3.0. Anything outside of that isn’t normal. Do ur homework!

  10. Mary says

    My Grandmother had thyroid problems also my mother, my sister and 2 nieces, but I do not. I have ALL the symptoms (fatigue, weight gain, hair loss) to just name a few. The doctor wont go tye extra mile to check further on these tests. What do I do!?

  11. Patricia Solinger says

    I am a 68 yr old female and have had the T3 T4 tests but my Dr. tells me my thyroid is fine……..I’m always cold,I wear extra clothes so I don’t get cold, A/C is not my friend. I don’t know what to tell my Dr. as to not offend him about the tests I need to check my thyroid. Any suggestions would be appreciated,

    Signed
    Really tired of being COLD all the time :(

  12. Sadie says

    I’m 46 and I’m taking hrt for an early menopause, I’ve been feeling unwell for sometime and putting it down to symptoms of that. But over the past 6 months I have experienced fatigue, weight gain, muscle aches the list goes on, I’ve been to the doctors and they have tested my thyriod and said it,s normal!!! Yet I have all the symptoms, they said I was depressed and wanted to prescribe me for that, I’m not just desperate to get a diagnosis. I have now in desperation booked an appointment at a private clinic to hopefully get some answers, as I have read that estrogen can effect results and mask the fact there is a problem with my thyriod!! Can anyone advise?

  13. Morgan says

    I am 23 years old, struggling to figure out whats wrong with me. I have every single sign of hypothyroidism, yet all tests have come back normal. I have seen countless doctors, with no answer. They say if the tests are normal, then i cannot be treated. I’m at my wits end, with no other help to be found. My father also has hypo & has told me this is exactly how he felt before he was diagnosed, but he was lucky & it immediately showed up on his tests. I have no idea what else to do, If i have to be asked again if i’m “depressed”, i really will be depressed! I just had to cut 10 inches off of my hair due to most of it falling out & the rest just turning dry & brittle. I have gained 12 lbs in the past 2 months (very hard for me to gain weight), I’m so fatigued & exhausted, i can barely function, yet somehow i’m considered “Normal”. If anyone finds an answer or finds correct help, please share!

    • Mary says

      could you have fibromyalgia? Many symptoms of thyroid issues mimics that of fibromyalgia and there really isn’t anything to test it.

      • Mia says

        I’ve been diagnosed with fibromyalgia, which recently go much worse, my tests for thyroid came back normal so it must be the fybromyalgia? But I can’t cope with feeling so awful all the time

    • Will says

      Same thing here, I’m looking into methylation a lot at the moment. And beg your doctor to refer you somewhere!

      • Eka says

        Maybe it is time to get out of Dodge (as they say) and find some “real” help…I can recommend Bumrungrad Hospital in Bangkok, Thailand…You will be directed to the specialist of your area of need, they are professional and experts in every field of medicine & health… They are half the price or less compared to many countries. My husband & I have been there and I can recommend it 1st hand….Go to their website http://www.bumrungrad.com You can contact them by email and tell them your need, if you already have some test reports from your doctor even better. Also go to youtube and watch a few video clips of the place and people who have gone there…youtube.com bumrungrad International Hospital Tour and youtube bumrungrad hospital featured on 60 minutes… There is help and you don’t have to pay through the nose to get it you just have to be willing to step out of the box & have a few bucks to travel… Accommodation & food are also very cheap in Thailand.. May your prayers for wellness be answered.

  14. Samantha says

    I’m 15 years old and in the last 3 years, I’ve been to the doctors and hospital 6 times because i have had all the symptoms for hypothyroidism. Every time I’ve gone to visit my doctor, she sends me in for a lab test and it always comes back “negative”. I want to go in again and get tested because I strongly strongly believe that this is the reason to why I struggle more and more in my everyday life. I should also include that my mother and many more of my family members have thyroidism.

  15. Jonna S. says

    I pray all of you find help. I found out just recently that Premature Ovarian Failure, such as what I went thru at 19, ( 22 years ago) can cause thyroid trouble, and as with all of you, I have had ALL the symptoms. I’ve been sent to several Endos, went to endless numbers of doctors, and they always want to blame it on the Ovarian Failure, problem is, when they put me on the Hormones, the weight Gain gets worse and I don’t feel any better. In fact, some times, I just feel worse. They have tested my thyroid so many times that I’ve contemplated naming it so they can address it by a name. I’m sick, tired, and fed up!! This last doctor has decided to do an ultrasound on my thyroid after he felt my throat and said that it felt “full.” I hardly know what good it will do, my labs are always negative, regardless, and MOST doctors won’t treat it without positive test results. GO FIGURE! They treat all kinds of “SYMPTOMS,” but won’t treat your thyroid based on “SYMPTOMS.” I thought I had found a good doctor, but he was no longer taking any patients. All the good doctors are taken!!
    My heart goes out to those suffering from Thyroid “Symptoms.” I wish you all the luck in finding a doctor who can help you.

  16. Mihaela says

    I was asking this because I don’t know if here I can get an answer at my question. Thank you very much!

  17. Chris C. says

    My recent labs showed low TSH (0.130) and high T4 Free (2.16). I have been taking Synthroid for 20 years. Doctor reduced the dosage. But I’m confused: most reports don’t address low TSH and elevated free T4. What’s my diagnosis?

  18. sarah terry says

    I am losing my hair gaining weight and I am tired all the time lab tests say I don’t have a thyroid problem I think the doctors are wrong

    • says

      I am in the same boat. I was even sent to an endocrinologist and they tell me my labs are fine so I am fine. I’m frustrated bc I have horrible symptoms, know my body, and feel like crap.

  19. Sally Hensen says

    I have all symptoms of hyperthyroidism, i lose so
    much weight while I have a good meal plan with about 2500 Calories a day. Each blood yeat, it comes oit nornal for hyperthyroid. I know these aren’t accurate. There is no othwr possible explination to why I match each symptom, I remember mh doctor saying something about a thyroid protien thing, the lab results for that came out abnormal. She said it doesn’t have to do with thyroid problems. I don’t know what to do, these lab results aren’t quit accurate.

  20. Lisa R says

    Well maybe your advisors just want you to de stress. Forget about what hurts. Get away from negative people, the house, and all thoughts of work and finances. Just for two days. Take a break. Go watch a creek, water seems to a calming element.

    Second, write a list of your ailments, initial manifestations’, your age, puberty onset, and school involvements. work. Maintain a list of these. and be honest about. where you lived, exposure to salt and fresh water climates, exposure to sunlight, sporting activities, basicially stress relievers. If you have always had a dry mouth, but it did not manifest itself until you were older, then it was affected by your changes and stresses. Check with other family members of the same gender for similar affects. Also, you may have been prescribed synthetic medication where natural may be needed. Do you yearn for specific foods. i.e. Sweet Potato Pie… (its because of the IODINE contained within) Also sea food. many other foods urges indicate other changes or needs for your dietary needs. Listen to your self.

    Then start looking for a new doctor. I learn of my condition from a concerned friend,, then after taking medication upon medication…I found out from a free clinic doctor who voluntary went to third world countries that I was taking the wrong medication. go figures.

    But take a walk, be around positive people, lay down the law as it were upon those whose unrequited desire is to point out your issues and think positive. Laugh.

    Then go to an open minded General Practioner, provide a copy of your list and listen to what they say. Do not provide copies of test results. you need a new set. I even went above and beyond and bought two additional tests online. for hair and 4 stage saliva test. Those ended up being the indicators. Go to your minister and ask for a doctor recommendation. They have more clout and contact. Ask your more influential friends for their input as well. Best of luck.. don’t forget to check your water and air quality in and around your house and work place. Have your HVAC professional cleaned, use HEPA filters, sterilize the pool, and avoid open water, avoid power lines. old microwave ovens, check for RADON, lead and asbestos, mouse and bats droppings and urine need to be abated as well. Due Diligence.

  21. Stephany sasson says

    I have many symptoms of thyroid issues, fatigue, memory problems, problems concentrating, always cold, sleepy… Where can I find a dr who test all these things and is knowledgable in this subject?

    • sheri r fehr says

      You have to keep going to doctors! I’m in SC and have had a terrible time with docs! I have sjorgrens and lupus and bunch of problems! I today was told by my doc (gp) that my blood work showed my thyroid was a little low. And is not going to do anything I should see physiatrist! I asked doc if she could refer me to a endocrinologist and they waited and called me back and said No. So I called until I found one that would take me without a referral. Nobody knows your body better than you! Imso tired nails and hair thinning. Cold all the time! Something is wrong! I pray I can figure more out. Before I do give up!

      • martha hancock says

        I have had a thyroidectomy, but during my journey to find out what was wrong with me, I had one endocrinologist tell me that he could do nothing for me because my labs were all “normal”. I had tears in my eyes as I asked what I was supposed to do, because there was SOMETHING wrong with me. He looked at me and asked if I had ever seen a psychiatrist. I could have punched him in the nose. Keep searching, keeping changing doctors, until you get a proper diagnoses and treatment. Normal labs do not necessarily mean there is not a problem. Symptoms play as much of a role as labs. It took two years and 5 doctors to find a 7 cm nodule on my left thyroid. I had classic hypothyroid symptoms.

        • Lauren Coppela says

          Interesting! I have the opposite problem, labs come back saying I have hypothyroidism but I feel 100% fine, while the doctors want me to take the replacement hormone. I agree symptons should be more important than lab results…

        • dngrs2003 says

          that is what I’m going through. Labs and ultra sound are normal! I know something is wrong. Neck visibly swollen and I can feel the swelling. My doctor even felt it. She just tells me everything is normal and have a nice weekend.

          • Tammy says

            This happened to me a year ago. My history, 11 years ago I had my right part of my thyroid removed due to a nodule. I am now left with just the left side. I have never been offered meds because they the docs say that the blood tests are fine. But all of my symptoms say otherwise and there is not one doc to help me on this. I have seen an endo, my family doc, a surgeon, an ENT and back to my family doc that wanted to give me nerve pills for all this. My blood tests the endo doc says are in the medium range…What does that mean?? So they the docs will not do nothing for me. I have had a partial hysterectomy, leaving just 1 ovary and tube, 2 years ago. I thought since this is happening with me if the hysterectomy and the thyroid have something to do with each other. So Im going to request hormone blood testing from my OB doc. I have an appointment next month. I am hoping to find something out. My symptoms are getting real bad. I think sometimes is it in my head am I crazy???

      • Allison says

        In San Diego there is a hormone specialist doctor named Dr. Melinda Silva in Chula Vista. I plan to see her and my breast implants totally screwed with my hormones, thyroid, and adrenal glands. She has great reviews. Check her out.

  22. Anne Mcnelis says

    I have fatigue, migraines, nausea & vomiting, thin nails & hair, unexplained random body pains, blurry vision that comes & goes, POTS diagnosis, and thyroid problems run in my family. My TSH level was 1.4 & the Free T4 was .8 so the DR says I’m normal & I’m so sick all the time that it’s hard to function. Any thoughts?

    • Jennifer Richardson says

      Anne, I am the same way. My lists of issues are a mile long, but the most significant things are minute by minute mood swings, fatigue, migraines, nausea, nausea and more nausea. Thin, brittle nails and thining hair. Nummular excezma, unexplained random body pains, blurry vision that comes and goes (especially when going down stairs and brushing my teeth – it’s almost like my eyeballs are bouncing). Thyroid runs in my family too. My fasting TSH on Friday was 1.8, my T4, Free was 1.02 and my T3, Total was 127. My PCP basically told me I’m crazy and need an antidepressant. I’d like to punch her in the throat at this point.

      • Lois says

        Hi Jennifer – I have very similar labs to yours, although I don’t know my Total T3, just my Free T3. Have you made any headway? I’ve been on NDT for 3 weeks and feel absolutely horrible. Considering stopping it and reevaluating after my adrenal test.

      • Lori says

        I thought I was crazy because my thyroid was bad and my RA was bad, and I was doing everything the doctors said, and I wasn’t feeling any better. This went on for several years. I went to a psychologist, thinking maybe I secretly didn’t want to get better. She came to the conclusion that I was not depressed or sabotaging myself, and that I needed to push back harder on my doctors (which I did, and got improvement). Currently, I’m facing yet another thyroid issue that isn’t improving despite the doctor changing my treatment. I’m waiting for her to tell me to go see a psychologist or psychiatrist at which point I will tell her I have and I’m not depressed, and she (the endo) needs to figure this out.

  23. Kelly says

    My husband has “hypothyroidism on paper” – or rather, his lab results show high TSH levels, however he has none of the symptoms of hypothyroidism- in fact, he demonstrates the opposite of almost all of the classic symptoms. His skin is not dry- but instead quite oily. His hair is smooth, strong, not falling out. He is indeed quite overweight but VERY active- in addition to work he referees multiple sports several nights per week, and plays sports himself as well. He is always moving. He is NEVER constipated, to the contrary, he has around 5 to 6 BMs daily (which he claims is “normal for him”). He does not seem to respond at all to levothyroxine, he has gone up to 50 MCG with no observed differences, and the labs still show an elevated TSH. It seems that he is not the “run of the mill” thyroid case- any ideas? Any help or insight is appreciated.

  24. Jack says

    Could I get more info on Functional Ranges for TSH and other tests as opposed to Standard Ranges?

    References I could show my doctor would be great.

    “1. Hypothyroidism caused by pituitary dysfunction”
    “With this pattern, you’ll have hypothyroid symptoms and a TSH below the functional range (1.8 – 3.0) but within the standard range (0.5 – 5.0).”

  25. John says

    Hello, a first time poster here, and posting from the UK.
    I have a number of symptoms that have worsened over a period of 9 years, mostly the feeling of being incredibly cold.
    The first time I noticed was in the middle of the night when my flesh seemed unusually cold. I have now come to accept this as its become a permanent condition. My hands, legs and face get unbelievably cold!
    In addition tests have shown a number of times that my white blood-cell count is very low but TSH levels are normal.
    Other symptoms include extreme fatigue – I literally have to sleep there and then sometimes – Joint pains, and itching, similar to those symptoms listed as candida overgrowth, is there any link? And does anybody else feel so cold that they can feel the warmth of another person from 4 or 5 inches away! And have to sleep with four layers of clothes on, and have to have the heating on so high that everyone else finds it unbearable?
    I would like to hear if anyone has similar symptoms or know of a UK based doctor that might know

    • Rachael says

      Hi john,

      Not sure if it’s related but I also experience cold hands feet and nose etc. I have people comment when I shake their hands that I’m freezing. Doesn’t matter if I rug up or not. I seem to have an intolerance to the cold & really love the heat. I don’t sweat much at all either. When I exercise nor if I’m in a car with no air con on a 35 degree day.
      I am 26 and I had the right side of my thyroid removed at 20 due to a mass that continued to grow. I am not on any medication and my thyroid levels always come back fine. However over the years I havd suffered depression and anxiety, incredible mood swings at times and am increasingly irritable and emotional at times. NOT FUN! I have gone back to the doctors who are of no help. I am increasingly stressed, am finding it hard to sleep yet am extremely tired ALL the time. I struggle to want to get out of bed in the mornings etc. I’m at all of what to do now. I feel like I’m
      Starting to go crazy and there are no suggestions or help from the doctors. I have also had low white count on numerous occasions but nothing alarming apparently. I am also apparently a little low on iron as of the last few months. (Def doesn’t help). Any suggestions as to what I can walk into the doctors and ask for in the way of testing?

  26. JBoss says

    25 year old female, is lethargy and fatigue. She was small in
    stature and had previously been diagnosed with attention-deficit disorder. On physical examination she was found to have an enlarged thyroid gland (goiter). Blood tests revealed elevated levels of T3, free T4, and TSH, yet she did not exhibit symptoms of hyperthyroidism. What could explain her symptoms?

  27. Pete says

    What would cause Free T4 and FT3 to be elevated? TSH is 2.7. Have been checked for hypo antibodies, but not hyper. What causes the hormone in blood to be high?

    FT4 1.98 (.73-1.95)
    FT3 4.1 (2.3-4.2)
    TSH 2.7

  28. Katgirl says

    my recent lab results

    i have hashimoto, taking armour, alternating between 60 mg one day, 90 mg the next. my endo will only see me once a year when i get close to my appt they call and cancel, lab worked done twice a year. My issues are not a priority to her but i am at wits end…

    Triiodothyronine, free serum 5.4
    t4, free (direct) 1.11
    tsh .578

    brittle nails/hair, massive hair loss, tired all of the time, depressed, moody, 51 year female. surgical menopause, I gain almost 15 lbs in 5 months, have gone to Paleo eating but slipped back.

    • Lisa Gregory says

      I have just started the steps and phases to figuring out my problems. So far I have gotten a lot of eat more often and increase my protein intake. However my protein level was 7.4 which is normal. My TSH was a 1.4. I’m 29 years old. Trying to lose weight but I am tired a lot constantly feeling sick. I get lots of headaches primarily in the back of my head the occipital region primarily. I feel like they are just saying well I don’t see anything wrong so do xyz and come back in so many months.

    • says

      I am 50 in surgical menopause ovaries removed have numerous symtoms related to thyroid issues however blood not showing it I can’t take antidepressants tried various ones only to feel dopey and out of it how do I get someone to listen to me???

  29. Jennifer says

    Hi, been having some issues for awhile now. Had an ultra sound done on my neck which revealed nodules on my thyroid. Went and got my levels tested and they came back with my TSH=3.45 (considered normal) and my Free T4=1.14 (no idea what is considered “normal”) and I asked to have my Free T3 tested but guess they didn’t do that. I don’t feel good and haven’t for awhile now but am being told I’m “NORMAL” any advice??? Thanks in advance.

  30. Reanna says

    I’ve been dealing with hair loss by the fistful, fatigue, and constipation as my main “hypothyroid” symptoms. TSH has been normal however. Recently saw a new doctor and he ordered an anti-thyroid antibody level which was way high (254, normal <9). But…my TSH and T4 are still normal. Any thoughts?

  31. says

    This has been happening to me for over 2 years. My symptoms are: weigh gain and the inability to lose weight,fatigued,exhausted,lethargic(all during the day), moody,irritable, achy body,sleeping problems,thinning hair and my periods are now heavier and lasting longer than usual with continuous cramping. I’ve had 2 full panel blood tests done in 2 years by different doctors. All results come out normal. Yet I know theres something wrong. It’s a nagging feeling that it’s my thyroid. My grandmother had a slow thyroid. My doctor acknowledges that I look tired and my weight is not changing, but wont do anything. What can I do???

    • ALYSE says

      Christina, this is so very similar to what has been happening to me for years! I have changed doctors a few times, and each one, despite me listing off all of my symptoms, and having many people willing to vouche for my low energy, moodiness, and unfortunate weight gain, keep telling me that my tests are normal. I contacted the endocrynology department at the hospital in my area, and they will not see me unless my tests from my primary indicate there is a problem.. I feel like I have hit a brick wall. Why is it so hard to get the care we KNOW we need? Have you had any sucess with this since you have posted on here?

      • Cher says

        I’ve had the same issues plus constantly feeling cold..even my fingers turn purple..Dr’s answer was to lump it as Fibromyalgia with no treatment. .I know it’s my thyroid but they will not run the extra test which is the one that caught my mom’s. .it’s hard not being listened to!

    • Mary says

      Hi All…

      When I was diagnosed with Hashimoto’s syndrome (autoimmune hypothyroidism) all my thyroid tests were normal EXCEPT a test called “thyroid antibodies” . This test was extremely out of range and high. Not all doctors test for the thyroid antibodies. Maybe your doctor needs to check this test. If that’s normal and your B12 and Iron levels are fine, I would look into a diet centering on vegetables/fruits/protein.
      hope this helps.

      • ADM says

        Hi Mary. Did they treat you for Hashimotos even tho all other levels were fine? Because I had thyroid antibodies but normal thyroid levels and nothing was done about it. I have so many symptoms I don’t know where to begin. Weight gain (20 lbs) yet I work out 3x a week….minimum. Hair falling out. Can’t sleep. Memory problems. Extreme cold intolerance or heat intolerance, irregular periods, dry skin, can’t get out of bed,mood swings…went thru a period of time where all of my exercise and dieting actually worked and then it stopped working and I started to gain and no matter what I do I can’t lose weight. My body stopped responding and I know his isn’t because I’m 40….which is what I’m told a lot. My face is puffy and my eyes are swollen too. Any suggestions are helpful. I’m frustrated. In tears because of it. Thanks! I need consistency and I’ve been suffering from inconsistency with my system my entire adult life.

  32. jsc says

    Just exhausted every afternoon and sleeping whenever I’m not working. I had recent blood work results: Free T3 Automated .382 (range 222-383); Free T4 Automated at .9 (Range: .8-1.6 and TSH at .19

    Please, any advice is welcome on this. Very low TSH. Should I be taking kelp? I am on Naturethroid, taking 1 to 2 per day.

  33. Melody says

    I just got covered under medicaid in Ohio – I had been without insurance for 25 years. I went for an initial visit to establish a relationship with a PCP, who is a nurse practitioner. I had been taking a number of supplements for about 2 months on a regular basis prior to the visit ( I had been taking them sporadically prior to that). I had also begun a mild exercise routine at the same time. At the time of my visit, I felt great. The PCP and her techs were so amazed at how young I looked (I’m 63, with a BMI of 18.5), that they couldn’t stop talking about it. She ran a blood panel to establish baseline levels for me. My TSH came back 13.48! She wanted to put me on synthroid. I don’t do well on pharmaceuticals as I have MCS due to a chemical injury that caused me to lose my career 25 years ago. I got better through nutrition (26 years vegan), yoga, supplements and B.E.S.T. Chiropractic). I thought the test was wrong. We tested again after 6 weeks (I stopped taking the kelp supplement) and my TSH came down to 9.3. I had requested testing for T4 and T3…they were both right in the middle of normal. She still says I’m Hypo and should take the drug. I had a number of toxic exposures earlier in the fall and lost a dear friend to cancer (this is when I stepped up my health routine as I was depressed and having headaches and nausea from the exposures). Can you help me figure out what’s going on? I’ve been feeling terrible since the results of the first test, but I think it’s due to the stress of not knowing what’s happening.
    Thanks

    • Jeanine Pate says

      Good that you stopped the kelp; if you happen to have Hashimoto’s the kelp would make things worse. Request the TPO antibodies next time you have bloodwork to see if you may have Hashimotos or not. Also, I would encourage you to hold off on the synthroid until you can better understand your options. Look into NatureThroid, Armour type meds that are natural and supply BOTH T4 and T3; as the synthroid type options only supply one of these. Lastly, if you could go off gluten, that may bring your TSH down even further. I learned alot through Dr Datis Kharrazian’s book, “Why do I still have thyroid symptoms…”. If you do write again, I wonder if you might share about what your “toxic exposures” were. I wish you well!

      • Melody says

        Hi Jeanine,
        Thanks for your comments. My original MCS came from working in Photo Engineering for the government back before digital. I worked with many sensitizing agents including formaldehyde. I became sensitive to all petroleum products and could not tolerate fragrances, etc.
        At that time I was advised to avoid all exposures to petroleum products and spent thousands of dollars on removing synthetic products from my home including the carpets, furniture, cabinets, etc. I lived as a virtual hermit. It took many years to be able to rejoin the modern world and I still had problems with fragrances and fumes from exhaust, lawn chemicals in the neighborhood, etc.
        As I recovered, I (and my husband) became tired of the isolation and since I was better, we became more cavalier about what I let myself be exposed to. Our finances forced us to replace brokens items with less safe products.
        My husband, a musician, asked me to work with him and I became his percussionist and back-up singer 9 years ago and did ok as long as I kept exposures to “incidental” and not constant. After the financial crisis, the music business dropped off drastically and I was forced to return to working a part time job in 2011. I ended up working in sales at a health food store. The daily exposure to fragrances and being required to work with bleach and other cleaning products took it’s toll, but when the owner put in new carpeting, the spring of 2013, I became very ill and I was fired. I do remember at the time, that the last week I worked there I could not stand wearing a turtleneck sweater as it hurt my throat. I did some detoxing and was well enough to continue working as a musician.
        This August I experienced a number of emotional blows, including learning of my dear friend’s diagnosis of stage 4 cancer. We had attended photo school together and she worked for a short while at the same research lab as I had back in the day. She passed in September and I became very depressed. About that time my only sister developed heart problems and as her only sib, she leaned on me for support and advice. She had heart surgery in November and thankfully is recovering.
        In October we found ourselves without a working furnace. We had no option but to heat with space heaters – we had 2 “safe” ones – all metal and they were several years old. At the end of October, I “shrink – wrapped” our house (covered all the windows with the plastic storm windows that you install using a blow dryer). Immediately after this, I experienced slow brain function and slurring of speech (my husband also experienced these same symptoms, but to a lesser degree). The symptoms eased in a few days.
        Winter became harsh (zero at night) early and we had to add 2 new space heaters. This time my husband thought the “Eden pure” infrared style heaters would be more efficient and bought the cheap ones made by Duraflame. This was early November. Soon I started having severe headaches and when I sat near them, became nauseous.
        Still, with all this going on, I tried to feel better and began taking my supplements regularly. I took the following (most of which I have taken for years, but not always every day) starting around mid October: Nutrex spirulina, Luminous by Vitanica for hair, skin and nails, Planetary Herbals Women’s Dong Quai Treasure, Ceramides from Lipowheat, Pau’d Arco Extract, Multidophilus powder, a kelp tablet and one we started using earlier in the year – Enzymatic Therapy Coleus Forskohlii.
        A month later, I was doing well and had no problem carrying PA and instruments and performing 4 sets in an evening. Since we work less in the winter, I resumed a mild exercise routine.
        As I said before, I was doing well when I had my blood drawn, but when I got the totally unexpected results and was told I must take the Synthroid for the rest of my life and have blood work regularly and carry a medical alert card, etc. – All with no indication that anyone at that office had any understanding of my pre existing MCS, I freaked out! Reading that kelp could cause a high TSH, I suggested I stop the kelp and recheck in 6 weeks.
        I know if it’s Hashimotos, the kelp is bad, but I use non iodized sea salt (have for several years – started while working at the health food store) and live in the “goiter belt”, so have few sources of iodine in my diet. There appears to be none listed in the supplements I take either. I was feeling better and my symptoms from the poor air quality in my house were improving when I was on the kelp.
        About 3 weeks into the no kelp, I began to feel really awful. No energy, worse headaches, more sensitive to fragrance and the heaters, brain fog…all the MCS symptoms. I added Ashwaganda and a vegan vitamin D tablet to my supplements at that time.
        I felt a little better (probably the vit. d), but about a week before I was to get my second blood test, I became so nervous and cranked up that my husband couldn’t stand being around me – I couldn’t stand being around me. The night before the test, I couldn’t sleep at all and had to get up and shower in a 52 degree house (the space heaters do not keep temps level, just about 40 or 50 degrees warmer than outside). I was a wreck at my PCP’s office and it got even worse when they took my BP and it was 158 over 82! I have had normal to low BP all my life (110 over 72 my first visit there) and this got me even more upset. They said not to worry as my blood gasses were 99% and a second reading after my blood was drawn showed my BP going down.
        I was told all my symptoms were due to hypo thyroid and my nurse practitioner went so far as to say that that was probably my problem all along, re-diagnosing my MCS as hypo thyroid.
        I told her thyroid issues were ruled out by all the doctors involved back then (I was subjected to endless tests for months and seen by many, many doctors), and since the diagnosing doctors had been hired by the company I worked for, if they could have found a problem that would have relieved my company from liability, they would have not given the diagnosis of MCS and workers comp and my disability insurer would not have certified my claim.
        I was so ill and upset by the time I got home from her office, that I was afraid I’d end up in the emergency room.
        I was weak and nervous for days and felt like I was convalescing from a bad case of the flu. I was weepy and depressed and so worried about my BP that I probably made it worse. I couldn’t stand the Duraflame heater at all. My headache was back with a vengeance. We moved the heater to the basement and put the safe one back in the living area the next day and for 2 days I took kelp again because I had felt so bad after stopping it, then stopped because I wasn’t sure what to do, Now I’m taking one 125 mg kelp once a week because I know you need iodine to make thyroid hormones.
        I started taking echinacea extract and detoxing with red clover tea and lemon water. I started on homeopathic platinum 30X for my nerves twice a day. The headaches are gone and only return if I go into the basement to do laundry. I am calmer and feeling better, but had another bad day when the med tech called and said they still wanted me on the synthroid despite the latest results (TSH 30% lower, T4 & T3 mid normal).
        The resumption of the MCS symptoms along with the deja vu of weird blood work has me feeling as if I have PTSD. I considered asking for a referral to an endocrinologist, but I don’t think I could stand another trip to any doctor. I really never want to go back and almost wish I had never gone in to start with. BTW – my husband has been having many of these same symptoms and he also has muscle and joint pains, but he’s doing much better than I (he never stopped the kelp). We both eat the same diet and take the same supps (except he takes saw palmetto extract and not the Women’s treasure.
        Sorry to bury you with info….any advice would be a blessing. Thanks

        • Hailey says

          Melody,
          Wondering if you have a carbon monoxide alarm. The headaches and nausea getting worse around heaters make me wonder if that may be one of the issues you are experiencing. May be worth checking out the levels in your home.

          • Melody says

            Hi Hailey,
            My space heaters are all electric, so no CO2 is generated. The ones I’m having a problem with are infrared heat with a blower. I’m pretty sure it’s the material they are constructed from that’s causing the headaches – some kind of fake wood cabinet. I can’t get any specific info from the manufacturer, but I’m sure they are loaded with flame retardants and a ton of VOC’s.

            My electric heaters with quartz heating elements and all metal housing don’t bother me at all…of course they don’t make them anymore, which is how I ended up with the toxic ones…Thank God spring is nearly here!

            BTW – Some flame retardants – Polybrominated diphenyl ethers (PBDEs), have been linked to hyperthyroidism in cats. PBDS have been mostly phased out in this country, but my space heaters were manufactured in China, so there’s no telling what may be in them…I’m praying it’s not PBDE, I’ve had 3 cats with hyperthyroidism over the years and while surgery, radiation and Tapazol (we’ve tried all 3 methods) extend their lives, it’s never easy and ultimately not a good end. I’m really worried about my cat babies that have been exposed to these heaters this winter…

            • Bruce Arnold says

              Fake wood often has formaldehyde in it, in operation it will give this off. Replace with solid wood if possible.

      • Susan says

        Hi, I have Hashimotos. I was taking 120 of Armour and my TSH was way too high (which means not getting enough) and I felt like crud my free t3 was low. So he upped to 180 and my free t4 was a little bit above low normal and free t3 mid range which is perfect. when he tested me TSH was too low (which supposedly means it’s hyper) had no symptoms. Nails were growing again, energy etc. Now, TSH is climbing up to normal range, and free t3 is starting to lower but still in normal range but hair is falling out, nails are gone, weight is coming on because it’s all fluid, and not regular bm’s anymore either. I say to my doc forget about TSH let’s look at the free t3 and free t4 that’s the hormones that’s available for use. Will they listen? nope. I can’t take just synthroid because it doesn’t convert and my free t4 gets way high, tsh too high and t3 too low. going on for 20+ years now.

      • Melody says

        I checked back with my PCP about possible iodine deficiency. She said I should try going back on kelp and use iodized salt and we can retest in a couple of months to see what effect that has on my TSH. I’ve been back on kelp – 225 mcg a day – for a week and feel really good despite the poor air quality in my house.

        This article from the website of a respected throat surgeon in my area may be of interest: http://www.daytonent.com/articles/iodine.asp

        As far as Armour and other “natural” thyroid meds go…they are made from factory farmed animals that are pumped full of antibiotics and fed GMO corn…

        Melody

    • Chris says

      Melody,
      In case you’re still reading this, you don’t have to take a synthetic thyroid replacement like Synthroid or Levothyroxin. Armor Thyroid and Nature Throid are naturally dessicated thyroid hormones. Because it is animal based, this might be a problem if you are vegetarian, but worth looking into if you are concerned about synthetic drugs. Many people find them to work better than synthetic replacements.

      • Melody says

        Thanks for your comments Chris,
        Right now I’m experiencing no hypothyroid symptoms. I have all my hair and eyebrows, weigh my normal (for me) 99 pounds, have a good energy level, my brain is functioning well (I’m back to working NYT crossword puzzles and have my math skills back) and have no headaches as long as I stay away from the VOC’s that have caused me headaches since my occupational chemical injury.
        I still am sceptical as to the necessity of medication for me. I feel that something else (something in my environment or perhaps one or more of the supplements I take) is giving a false TSH reading. I really feel that medicine by numbers is a big mistake and a product of sloppy medical practice.
        I am relying on natural healing and prayer, as God is in charge of us all. Should my path lead to eventual medication, I will consider my options and ask the Most High for guidance.
        My veganism is a deeply rooted product of my faith and for that reason alone I doubt that Armor or other medications made from the suffering and slaughter of living creatures will be my choice. I spent 5 years living on my ex-father-in-law’s family hog farm 40 years ago and experienced first hand the brutality of animal farming. Modern factory farming of animals is even more horrific.
        Even from a health perspective, I feel these medications are not ultimately good for your overall health, as they are made from animals that are pumped full of antibiotics and fed GMO corn. How much of this ends up concentrated in the endocrine glands of the animals is not revealed by the manufacturer.
        I understand that sometimes there is no choice, as when your thyroid can no longer produce enough hormone, or the thyroid has been removed. If this is what I must ultimately face, then I will have to make peace with God’s plan for me.
        Blessings,
        Melody

      • Deb Bowers says

        I have concern that we continue to use animals for our own health care issues. Women have been using premarin (natural estrogen) for menopausal ax’s. Unfortunately female horses are kept penned and pregnant to harvest this estrogen so that middle-aged women can avoid hot flashes and mood swings. And now we are talking about Armour/dessicated pig thyroid to improve our own condition. On top of all this we are building synthetic medications causing numerous side effects..i.e. viagra and other ED meds to men and now women who just need to improve their general health through diet and exercise in order to improve their sexual health. So I don’t know the answer. But seems we should be relying less on animals and more on our own resources (diet and exercise and clean living).

  34. Sharbel wahbee says

    My wife. Is recently suffering of dizziness ,increased heart beat rate ,numbness and we consulted a doctor and the doctor asked for blood tests and the results came with the a TSH=4.58.
    The doctor then asked for a full thyroid panel and an ultrasound scan
    the results of the tests are : TSH = 4.83 where the upper lab limit is 4.9
    T4 2.64 and T3 is 1.57
    Meanwhile the ultra sound is showing some calcification
    We are completely confused
    Can you please tel us what do these results mean

  35. says

    great info.
    question: i have THE worst insurance (medi-cal) and not a lot of money. i asked my pcp for a full thyroid panel and showed him what i wanted tested and he said yeah yeah yeah and only tested my TSH. which came back normal (1.5). i have just about every symptom of hypothyroidism (cold hands, yellow hands, fatigue, brain fog, depression/anxiety, inability to lose weight no matter what i eat or how i exercise, high cholesterol, achy muscles, neck pain…etc.)
    any advice for how i can get to the root cause of my symptoms and get appropriate medical care with state insurance?
    thanks!

    • Sam says

      I would get a new doctor that doctor sounds like a joke. You need to write down all of your symptoms and that way you can show a good doctor what’s been going on with you. I just got my results back and going to see the endocrinologist this Tuesday and I’ll let u guys know what he says my blood test they say are stable which to me doesn’t mean jack it’s either normal or not. I do have low testostrone which is 332 which is extremely low for a 34-year-old guy the range of 250-1100 is a bunch of bs because it has guys at all age groups which I at the same t as a 80 year old man that’s not good. I think it’s all from the food we eat it’s all full of fillers that the body can’t use that’s why everyone is having thyroid problems. The thyroid is like one big ass computer and if one little thing is off the whole computer doesn’t run right that came straight from my endocrinologist that I am seeing. A lot of this could be your parathyroid check out parathyroid.com and read the testimonies from the people. Keep me filled in as I will too.

    • Maria says

      You need to get the full thyroid panel done. Unfortunately from your doctor’s attitude, you may need to go to a different doctor to get it done. That’s what happened to me. TSH was fine but all the other hormones were way off.

      Sam, the parathyroid site seems like they just want to do surgery to remove your parathyroids without understanding what’s wrong with them before removal. Its very risky to take out an organ because you cannot put it back if it’s discovered to be OK after the surgery.

  36. lacey says

    I am 32 i have 4 kids. I was tested a over a year ago. my results came back normal since then I have be on 4 different antidepressants none of them work. these are my symptoms
    -thinning hair, dry skin, cold all the time, foggy brain, dizziness, i could sleep all day, diagnosed with RLS, everyone gets on my nerves. my doctor said that was anxiety, weight gain, no apatite, and i have what looks like a goiter. my voice is hoarse all day. i am depressed but i think its because i feel like **** i am 5ft. my normal weight is 105 and i now weigh 120. i cant even do the dishes without feeling exhausted. I am going to the doctor tomorrow. i cant afford to go to a specialist without a referral.

    • Linds says

      Same situation, I have had lab work done 3 times and all have been normal, yet I was given antidepressants, stomach mediation for my constipation and heartburn, pain medication for body aches and migraines. I have all the same symptoms you have. I am 34 and have 3 kids. I’m 5′ and my weight ranges between 125lbs to 140lbs. I gain weight extremely quickly and suddenly loose weight. I have been told I was normal and just stressed by doctors. Please post any additional information regarding your diagnosis so I can get help thank you.

  37. Joyce Bushorr says

    I had Graves disease (hyperthyroid) about 12 years ago. I had the radioactive iodine treatment which put me in a hypothyroid state. At that point, I started taking levothyroxime, 110 mcg. I always had trouble with muscular pain and could not climb stairs. My doctor lowered me to 88 mcg about 2 years ago and since then, have severe tendinitis, rotatar cuff tear and carpal tunnel syndrome. I cannot find a doctor to treat me. She just raised my meds to 100 mcg but all the research points to low T3. I cannot get a doctor to listen to me.

  38. Sam says

    Please any of you who are expericening these crazy sypmtoms please post your symptoms. Here are mine any of these sound like any of you? If I find a cure to the problem I will definitely post it here for you others to see. How I feel

    Feel bruning all through my body

    Feel weak and tired

    My body is trembling with hot flashes and cold chills

    Nervousiness out of no where

    Pain in my left chest area down into my stertruim

    Blurr vision and off balance feeling

    Feels like I am out of control of myself not really knowing whats going on around me and can’t focus.

    Pain in my left shoulder area and pain in my mid left side of my back like a knot been there for at least three years.

    Feel my heart racing at times.

    Get heart papalutions at times.

    Weird feelings in my lower jaw bone and in the middle of my chin

    Anexity comes and goes with all of these symptoms.

    Every now and than I’ll get a dull to sharpe pain in my right lower side.

    Get lightheaded and feels like I am going to pass out.

    Feels like my blood sugar is out of wack after I eat feel worst.

    I take a deep breath in and I feel that something is in the left side of my chest at times.

    The whites of my eyes at times get red.

    I gain a lot of weight very fast.

    I change my diet and I lost 8lbs in one and half days.

    Now I am losing weight fast.

    I loss my appetite.

    I get ringing in my ears at times.

    I have high chosteler too.

    I can’t sleep very good now.

    I’ve notice as time goes on whatever is going on is getting worse and after I switch to a healthier diet it really got bad.

    • Katie says

      Hi Sam,

      For a minute there I thought.. ‘Did I post this comment and not remember..?’ Our symptoms are almost identical. With the addition of mental slowing and constipation.

      Even about switching to a healthier diet and getting worse. It is really affecting my life right now. I have had these symptoms for most of my life. I had a naturopath check my levels (and it wasn’t cheap)…she came back saying they were normal and dropped the whole subject, not looking into it at all. My mother has hypo and my father was born with hyper. He now has Hypo…

      So I think definitely have a good chance of having it. I have been dealing with this question of my health for a long time, many years and my symptoms are all spot on with Hypothyroidism. I am sort of hopeful to have it, because this would mean I could have a treatment to sort out my health, finally.

      I am a little nervous about asking my new doctor to look into a different way of diagnosing my hypothyroidism. You know they are a little stubborn when it comes to what we have found on the internet about our sicknesses. Hope it will be well received, I just want to get better.

      I am also having crazy migraines.. but this might be something else. I am not sure that is related.. has anyone heard this?

      I wish you luck with your health. I know exactly how you feel, literally. :)

      • Sam says

        Thanks for your input Katie I don’t know exactly what is going on but I will definitley post here when I find out. I pretty much have found out two things wrong with me in the pass one was gallbladder and the other was tontcelis which I had both removed. What I think I am going through is either thyroid or parathyroid problems. You need to get to a good endocrinolist and have him test you I am waiting on ,my blood test results. My SED Rate is slightly elevated which means that their may be some type of inflamation or infections in my body. Have your doctor test your parathyroid by doing a PTH test which will show if your parathyroid is not working right most of the time. I am being tested for ESR, ANA & RA, IRON/FERR, FOLATE, VIT B12, MAGNESIUM, PSA, CK, PTH INTACT, DHEAS, FSH/LH, THYROGLOB, THYRO ANTI, T3 FREE, T4 FREE, CMP W/GFR and CBC W/DIFF. These test should be ran to see where your at and if you never had them demand them. Because you only have one body and one life don’t let anyone take that from you beside God wants a to have a Good Quality of Life. I am not stopping until I have answers that make me feel better. I’ve had doctors tell me that its in my head and say you have anexity issue but I tell them that this gives me anexity and my body is telling me to fix something which is what there job is. Please let me know what you find out I swear this is from our food in the US with all of the fillers in our food which is a population control this is a sad thing. Also check out the parathyroid.com website its amazing how a tumor in your parathyroid can make you feel like this. I am also getting headaches as well.

        Thanks,
        Sam

        • Katie says

          Sam,

          I had my blood tests on Thursday, and just called today to find out the results. I only spoke to the receptionist, but she read that all my levels look ‘normal’. I have scheduled an appointment with my GP for tomorrow, but with the NHS it is a 10 minute session. When I first went to see him, my main concerns were feeling extreme fatigue and migraines among other things. These have gotten worse over the last 3 weeks since I have seen him, I have had a migraine 6 days a week with the 7th being an achey headache. So no relief whatsoever. And am taking ibuprofen, but too much can hurt my system. I cannot do this forever. This feels like it came out of nowhere. How can my levels be normal… with all this pain? Having heart palpitations, limbs falling asleep, constipation and weakness.

          Since I have to report 1 problem at a time to the GP, I am trying to focus on the immediate problem – my migraines and extreme fatigue. I am not sure if this is related to the other thyroid-like symptoms or not.

          It was very frustrating getting this ‘normal’ news. They keep making it seem like it is all in my head. But I haven’t done much work the last few weeks and am falling behind. It is definitely affecting my life.

          I don’t think they tested my PTH, I will find out tomorrow, but if this is not hypothyroid, then this would be something I will look into. They say headaches are a symptom. I had a blood tests taken in America before I left to the UK, my blood calcium level was 10.1. For my age of 21, I understand this is normal, but maybe there is still something there. It is still on the high end.

          I will keep at it with my GP. You are right about the american food. I am glad I got out while I could. I could fee it was starting to affect my system.

          Thanks for the reply.. I am trying to keep my head up. I hope you feel well soon.

          Katie

      • Mia says

        Me too, I’ve got all those symptoms thyroid tests normal, been told it’s fybromyalgia but I feel so awful all the time, I’ve had fybromyalgia for years but never felt as bad as this.

    • Rebecca says

      Sam,
      Sounds like scm muscle triggers. Sounds crazy but when you said the weird feeling in your chin I remembered reading about it. Google it and you may have your answer.

    • Julie says

      hi Sam,
      Do you live in the northeast? If nothing turns up with your thyroid, you might want to be checked for lyme disease and other tick-borne illnesses. Definitely go to a better doctor if you are not getting any answers. It could be something else, but your symptoms sound like lyme.

    • leepers says

      Do you take vitamins or other supplements; and, are you taking medication (s)? Have you seen an endochrinologist? You may be experiencing a multi-organ exhaust condition; adrenals, thyroid, and pituitary. What is your diet like? Also, what types of skin/hair/fragrance (latter, if any) care products do you use. Finally, if your diet has been not so good (cookies, cakes, pies, others), you may be experiencing excess parasites and/or candidiasis.

  39. says

    Is there a reason a person would have a low t3-uptake and a low normal t4? And a TSH that ranges from high optimal to 4 and back (basically cycles over the course of a year or two).

  40. says

    I was diagnosed with hypothyroidism about two months ago and was put on medication. However, instead of feeling better, I’m getting headaches, I’m unable to fall sleep even though I’m tired, feel extremely hot and my skin is clammy. When I saw my PG last week after my blood test came back, she told me that I’m displaying both hypo and hyperthyroidism symptoms. How is that even possible? And where do I go from here?

    • Jason says

      One thing which causes both hyper and hypo is Hashimoto Thyroiditis. Another could actually be some form of carcinoma. Unfortunately, having gone through both and still being incorrectly treated, I couldn’t tell you anything other than see an endocrinologist.

  41. JennR says

    I had some labs done and am looking forward to seeing what is going on next week. For reference, I had a nodule on the right side of my thyroid that they determined was benign, however had the presence of some cells that concerned them, so they took the nodule and half of my thyroid out in early 2013. Though there were symptoms here and there of hypothyroid, they were not significant and whatever tests they did (TSH and T4) came back normal. I was diagnosed with Lyme over the summer (damn New England woods) and was treated successfully for that. Now there has been a sudden onslaught of fatigue, headaches and some weight gain, which I thought may be the Lyme returning, though I had reservations because in addition to these symptoms, my hair fall has been ridiculous. What once was a head of beautiful, thick and shiny hair is now limp, dry and thin. My nails break constantly (never happened before), my skin is terribly dry, I am always cold, my libido is gone (not common for someone my age) and though I eat very healthily, weight gain continues. So I went to the doctor yesterday. She is a great doctor, immediately felt it was thyroid related and ordered a FULL thyroid panel, testing not only TSH and T4, But T3, thyroid binding and also ferratin, iron and B12 levels. Interested to hear how they come back…and what can be done to alleviate all of this.

    • Kathy says

      You don’t say your age, but I am turning 60 in a few months. I went to my PCP today to discuss my recent thyroid results and what to do. My TSH and free T4 are OK but total T3 and free T3 are LOW. I asked to try T3 {generic for Cytomel), the lowest dose, added to my 88mcg of levothyroxine (T4) for a month and then retest. My doc finally agreed to let me try. I don’t know if this is the answer for me, but some have said that they feel better on T3 plus T4. My doc does not like Armour or Naturethryroid, etc. I hope it agrees with me and helps to relieve my symptoms which are similar to some of yours. Good luck with your results!

      • Diana says

        I went to doctor after doctor and they kept telling me my numbers were fine. Finally I found an endocrinologist who looked at my blood results for 5 seconds and said my T3 was low. He put me on Cytomel, in addition to my Synthroid and it was an absolute miracle! I feel normal. My symptoms disappeared and all is right with the world! I’ve been taking the combination for about 4 years now with no adverse effects. I hope it works for you! Good luck.

        • Sam says

          Diana can you please share your numbers with us so that we and I can compare it to the numbers that we have this way it may help us to know what path to go down. Also what kind of test that you had done please.

          Thanks,
          Sam

        • loni rossbach says

          Hi! I have been taking Synthroid .075mg 4 days/week and Synthroid.05mg 3 days/week. My t- 4 is testing within the “normal” range and my t-3 is low. I have been seeing an endrocronologist for 10 years now and have always taken Levothyroid . With the advise of my General Practitioner I am just starting to take Liothyronine 5 mg 2 x day and levothyroxine 50 mcg 1 x/day. She feels that since my t-3 is testing below 30 that I should “up” the t-3 and I should feel better. I am having all of the symptoms mentioned in the previous post – the fog, tingling, headaches, exhaustion, blurred vision, nervousness, irregular heart beat/palpitations, etc. I basically feel miserable! Can’t wait to see if adding the t-3 will help!!! I am 60 years old and in generally good health.

    • bobbie says

      Im have the same issues had test run and everything is normal been put on all kinds of antidepressants but massive weight gain my voice is horse my hair is so dry i itch everywhere but still doctor says nothings wrong

  42. Kathy G. says

    Just got my lab results back but haven’t talked to my doc (PCP) yet, with an Rx for Synthroid (levothyroxine) that I have been taking for 18 years since being diagnosed as hypothyroid at age 41 after my second and last child. I have been on 88mcg for a year. My TSH was 1.743, my Free T4 was 1.25, my Free T3 2.4 (range is 2.3-4.2), and my Total T3 was 57.6 (range is 60-161) so it is LOW. Should I ask for an Rx for Cytomel? (Is that T3?) Does this mean that I may not be converting T4 to T3 or that T3 is not being used by my cells? Is this something that will harm my other organs in the future if not addressed? Thanks for any answers. I love reading this forum.

  43. Sara anderson says

    I have recently started having symptoms of some form of thyroid issue. I had blood work done and my levels for my ths levels were “normal” but my doctor said no way he said he is convinced due to my symptoms that I have some form of thyroid issue and has set up for more labs. I am so very thankful for him I was terrified that he would just say everything is fine and leave it at that all the while I would be feeling rather miserable.

    • Katie says

      I so understand Sara. You are lucky you have a doctor like that. I have seen so many doctors, and not one would keep on trying with me.

      I hope you find out and get on what you need in order to feel better. I still hope to find out as well :)

  44. Lauren says

    What about an elevated TSH, but normal T3 and T4? Once I saw that my TSH was high, I expected to see some variation in my other levels. Is this a typical combination?

    • says

      Erika,
      That pattern can be seen in someone who is already taking thyroid hormone but did not take it on the morning of the blood test. It may also be seen in someone who recently started high doses of iodine supplementation, or perhaps just went on an intense Detox program of some kind. I would just re-test it and make sure the patient takes their thyroid hormone the morning of the test.

  45. lexie roe says

    Last year my mother was diagnosed with diabetes. I took her to an endo doctor and asked him to please run tests on her thyroid because she seemed symptomatic to thyroid issues. i.e. weight gain, fatigue, etc. He ran the normal tests and proceeded to treat her for the diabetes. After a year of diabetes meds, she went into the hospital for heart issues. A doctor there ran more extensive testing and, guess what? She had a thyroid problem! They put her on meds and is no longer taking diabetic medication. Now I am going through the same thing! Blood tests show normal, but I know with my other symptoms I have a thyroid issue. They are, instead, checking me for diabetes!

  46. So&So says

    I appreciate finding this site and the info however I notice that there are many many people here who are having similar issues but their doctors seem to be discounting them and or their concerns. This sounds like an epidemic and why isn’t something being done about that? Also, I noticed there weren’t any responses to the many posts made here. Is there a reason for this? It would be just as helpful to hear the responses to the posts. As many of us know, it’s hard to find a good doctor to deal with these concerns. How does one find a good recommendation, within their geographical area? I live in the Minneapolis, Minnesota area.

    • joyelaine says

      I believe – for best results – look for a MD that practices holistic medicine specifically thyroid. This is my next step. My family doc said my labs are normal, my gyn said I was on the hypo side but she doesn’t treat thyroid issues. I have all the symptoms, plus more.

    • Angela says

      I agree 100% this should be looked into further so that people can be properly diagnosed at the onset of symptoms

  47. Rebecca says

    Dr. Chris great Article will be taking it to my Doctor next month.
    Have been on Thyroid medicine for 19 years. Currently taking Cytomel 50 mg and Levoxly 50 mg my blood work shows that I am having too much thyroid medicine, but my symptoms are still the same no energy , cold. Have a feeling my thyroid is not converting the medicine properly what do you suggest?
    thank you.

  48. bo jangles says

    The way to test people who have normal labs is through symptoms, body temperature and heart rate, which are direct consequence of absorbing the hormones.

  49. C says

    Just had my TT removed. My first thyroid panel came back at TSH .78, FreeT4 1.4. And Free T3 at 2.7. These numbers see a little out is sync with your past conversation but I do feel great and no longer have any of the medical symptoms before the surgery.

    Has a multi benign nodule substernal thyroid that was massive and grew to 12.5 cm RT lobe and LT Lobe 8.5 all within 6 months due to subacute thyroidistis.

    I was wondering if the TSH should be higher?
    C

  50. Leona says

    I also am confused. My blood tests are normal, although i have cysts on my thyroid. I have the symptoms of hypothyroidism. The front of my neck will feel swollen then go down. what do I do?

  51. says

    I have all of the symptoms and I’ve been tested, and each time I’m told that I’m okay. My Mother and my grandma had hypothyroidism. What can I do if the doctor can’t see the symptoms? Is there a dr. With a cure? I need help

    • says

      I too have been having similar struggles. I found Dr. Steven F Hotze in the Houston, Texas area and that is who I suggest checking out. I ordered a book called Hypothyroidism, Health & Happiness written by Dr. Hotze and it explains so much. I highly suggest you check it out. Its definitely an interesting read. Hope this helps!

    • Audrey Settje says

      I had symptoms of a thyroid problem for more then 15 years on and off before a doctor caught it on a blood test. My family had a history of high diagnosis of thyroid and diabetes. I went through years and years of hell, and still get told I don’t know what I am talking about from endocrinologist specialists. Yet I know what I have had to deal with symptom wise. Turns out after having a total thyroidectomy during the dissection of my thyroid papillary cancer was found. This had not shown on any of the tests used to diagnose hyperthyroidism. If I hadn’t insisted on having my thyroid out instead put on medication treatment for 3 years the cancer could have spread. Over and over I have had misdiagnosis, doctor’s trying to tell me it was a mental illness, or that I was just over weight. I can not tell you how many doctor’s should be without a license to practice, but I was to ill for such a long time to pursue their incompetence. I will tell you that you should keep a medical diary, always keep track of your symptoms, get copies of your medical records, ask for second opinions, and believe in yourself because if you don’t you can end up dead. Seriously.

  52. Bee says

    I have numerous symptoms of hypothyroidism, I’m losing my hair and eyebrows ,dizziness weight gain , terrible bone pain , exhausted and cold all the time , I having a pain in the front of my neck and swelling comes and goes ,my doctor checked my tsh level which is 3.52 but was 1.6 this time last year , she said that was normal so i paid private for free T3 and free T4 test the results are fT3 4.4 and FT4 15.2 my doctor has now dismissed that my symptoms have anything to do with my thyroid , she hasnt yet felt my neck for any bumps , I’ve had vit d and ferritin blood tests done today but I feel like I’m banging my head off a brick wall can anyone shed some light on these results or has had similar symtoms with similar results

  53. Jm says

    I have a strange thyroid issue – mine swells then goes down. there’s no set pattern to it, but when it does swell up quite a bit, my heart races and I get really tired. When it goes back down, all is good. Been to two different endocs, both did biopsy and told me that I had multi-nodule goiter, all bloodwork (that they did) came back normal. They put me on replacement hormones for my thyroid as they said maybe it was being “overworked” – didn’t help any with the swelling. Anyways, when I told the two endos that it goes up and down, they said it doesn’t do that! Also my GP said the same thing. The biopsies were non cancerous, but the first one said “it was full of blood” they said they could remove it if it’s bothering me, but I don’t want to have to take meds for the rest of life and the whole process of trying to get everything figured out as far as levels. Any idea on what this could be? thanks!

    • Anna says

      I’m 23 and I have had hypothyroidism symptoms for 3 years. I’m not at all a professional, but that sounds like hashimoto’s. It is an autoimmune disease that cause your thyroid to swing back and forth between hyper and hypo. This results in the thyroid swelling and shrinking. I would research that and see if the symptoms fit. Good luck!

  54. Melissa says

    I am 43 and last year started having symptoms of what I would think would be hypothyroidism. Staying cold all the time, lack of concentration, feeling tired, some dizziness and at times anxiety. I went to one doctor and the only test he performed was the TSH. Result came back normal. Finally after the persistent symptoms TSH, free T3 and free T4 was performed. Results are TSH – 1.78, free T4 – 1.00 and free T3 – 2.9. LDL was slightly elevated at 120. Doctor tells me results are normal. Can anyone please help with interpreting results? Thanks

    • Kristin says

      Hi Melissa,

      My thyroid levels are close to yours. TSH = 1.30, T4 = 1.0, T3 = 2.8. I’m so cold so often that my ability to function as a substitute teacher is no longer there. I’ve been at home playing the sleuth and listening to every summit for the past several months! It’s been fascinating and thankfully, I think I’m finally figuring some things out. I love to check my ideas against Chris’ articles because I feel that he is such an authority on so many topics. Also, he explains things well.

      I’d like to pass along a link to some info about functional thyroid levels and what they might indicate presented by Andrea Maxim. She’s a naturopathic doctor in Canada who I also find to be very knowledgeable and a good teacher.

  55. Lisa says

    Dr. Chris my Mom had her thyroid removed a little over a year ago. She is tired, breathing is labor and she at her all time weight. He endo Dr. says here levels are where they were prior to them removing he thyroid. Any advise?

    • Lisa says

      Meant to say her weight is more than she’s ever weighted in her life. Forgot to say she now has hypertension as well. Her blood pressure before surgery was lower than normal.

  56. Lori says

    Wow! I guess I stumbled on the right doctor! I had my first visit with her yesterday and told her I wasn’t sleeping and have zero energy. She ordered labs and will then do a physical. She included the T3 test right off the bat! Sounds like she knows her stuff. She is an internist and not a family doctor.

  57. michelle says

    10 out of my dads 14 siblings and my grandmother all had hypothyroid , alot of my cousins have it, and on my mothers side 2 of her siblings had pituitary tumors ..I have been wrestling with thyroid issues for yrs but always comes back normal..even my doc is surprised ..time to get more into the reason because I can literally check almost all the symptoms off .its so frustrating

    • melinda says

      Me too, it recently took everything out of me and I can’t even keep up with my children. I have some symptoms that I don’t see listed on many pages such as sore soles of feet or can’t stand for a long period of time… I walk across the house and suddenly I’m so tired I want to lay down on the floor and sleep. I just want my life back… I miss my energy and if I scratch my legs anymore they will bleed! My Dr doesn’t even believe me when I tell him all my symptoms.

  58. Rebecca says

    I have a lot of symptoms for a thyroid problem. I went to my Dr he ordered the standard lab test for thyroid. They came back normal. I asked him to order additional thyroid tests to test T3. He said it would be inappropriate to order more tests since the last one came back normal. What can I say to get these tests? It is frustrating to me that he wont just order them. I’m the patient I want them done!

    • Suzanne says

      I just got home from seeing an endocrinologist because my basic thyroid tests came back normal and my primary care provider was stumped. It was great. She listened and agreed that my body wasn’t doing what it was supposed to do and is going to order a series of tests that my PCP wouldn’t be comfortable ordering. General practitioners just kind of throw up their hands and say there’s nothing wrong with you.
      If you can, get in to see an endocrinologist because they’re the people who know what’s appropriate and what isn’t when it comes to your thyroid.

    • Wendy says

      I’m in the same boat, Rebecca. I have asked for a complete panel for months. I told the doctor I still didn’t feel up to par, and would like more than just the TSH done. I get the order in the mail….she only added T4 and free T4. I don’t understand why it is so difficult for a doctor to order complete profiles.
      Or to leave me be on my original thyroid, which I did well on since I was 6 weeks old. Tweaking dosages now and then kept me going till a dr. switched me to Synthroid. Their choice, not mine
      Then I get a phone call from the office manager. Dr. terminates my being a patient there! Right when I’m trying to get help! All she had to do is test, and adjust.
      All I want is to ENJOY my life, hike and bike with my family & friends, and keep up with my grandkids.
      My insurance helped me find a DO. Hopefully now, I can get some help.

    • Maria says

      T3 is the active hormone that T4 is supposed to be converted into. Sometimes for various reasons the conversion doesn’t go the way its supposed to and that’s why you want to check T3 and free T3, and sometimes reverse T3 (RT3) which also reduces the effectiveness of T3. You can find another Dr. and/or report this Dr. to the state medical board for leaving you hanging. I would do both. In my case, I’m having difficulty getting the full thyroid panel from endocrinologist. When family physician found out, she ordered all the proper blood work pronto!

  59. Helena Max says

    Do you know anything about hyperconversion of T4? I have been on block and replace therapy for hyperthyroidism for years now, and my TSH has NEVER been normal. My typical numbers are: TSH: 26, Free T4, .79 (normal .7 to 1.5), T3, 160 (87 – 178 normal). Even when I had a high T3 and was severely hyperthyroid (with low TSH), I never had a high T4. It was always low to low-normal.

    No matter how much synthroid (T4) I take, the T4 numbers don’t go up. They are always in the low to low normal range.

    So my assumption is that my body converts the majority of my T4 to T3, so I have both hypothyroid symptoms (depression, fatigue, body aches, hair loss, weight gain no matter what I do) and hyperthyroid symptoms (heart palpitations (especially when I wait too long to take medicine or when I try to go down on my methimazole thyroid blocker), shakes, etc.

    I now have a thyroid nodule that they want to remove, and the surgeons recommend having the whole thing taken out. However, I am concerned that I will hyperconvert the T4 (synthroid) into T3, and I will still have all of the same problems I am having now. I have gained a lot of weight (for me), and though I am eating a very healthy, low calorie diet and exercising regularly, I can’t lose it.

    Do you know of any doctors who might be able to help with this?

    • Ally says

      I am going crazy I can’t control my weight no matter what I do no matter the amount if physical activity my diet I regulate strictly as I am celiac I am in my 50’s and already went through menopause I pee up to 36 times a day I can’t sleep I am sleep deprived all tests come back normal but there is a history of thyroid disease in my family so I was wondering if I should pursue these other tests and are these symptoms part of that

    • 4juices says

      Did they do a biopsy of the nodule? I have 3 nodules. The biopsy didn’t show anything. But when I lost weight, they became smaller.

  60. Tamsyn says

    This is a fantastic article, I am printing it off to take to my Dr’s tomorrow. Totally sick of the NHS and their pesky lab ref ranges, Dr’s have no idea how to think outside of the box. I was undiagnosed with crohns for 4 years – nearly died – twice and had to pay privately for treatment, now that is in remission I have MS and accepted this speedy diagnosis with grace, now for the last two years I have suffered ‘globus’, extreme anxiety, heart pains, palpitations, hoarse voice, sore glands, hair falling out by the handful and apparently I need anti-depressants because this is all a bad reaction to my last diagnosis and my thyroid markers are fine. I am stressed to the point I am in a constant state of angst all the while working full time with absolutely no recognition for these symptoms, except to be made to feel neurotic for mentioning them to my GP. I have just changed GP and hope to get somewhere with this one, now see a holistic Dr as well but nothing is happening quickly enough for my liking. I have spent my whole adult life battling my Dr’s knowing something is wrong, the whole health system is a mess and has no leaning towards health – just medicine. They are in the ‘illness’ business, not the happy healthy people business.

    • Sam says

      Hi Angie,

      Just a quick question. Did you go over your blood work your self? Do you see any items that are close to the high or low of the lab ranges? Hows your calcium?

    • Katie says

      Hi Tamsyn,

      I completely understand where you are coming from! I have seen doctors since I was little trying to find the answer to my symptoms. I believe I have Hypothyroid and my last naturopath (as I have see so many normal doctors) in America ordered standard tests came back ‘normal’ and dropped the whole subject. My mother has hypo and my father had hyper and now he has hypo. I am convinced what I have been battling for so long is finally becoming clear.

      I have just moved to the UK to settle and now am nervous how the doctors on NHS will accept me. They have never liked me much, and when it comes time for me to ask them to add more tests to the chart, they will dismiss it quickly.
      Haven’t had the best experience with UK doctors in the past (student).

      Totally agree with the medicine bit. It gets hard to trust that a new doctor has your best interest at heart when they all seem to conduct their business that way.

      I wish you the best of luck!

  61. Bonny L. says

    am I crazy

    TSH levels in May were 1.6
    September they were 2.4
    & cholesterol levels were slightly elevated
    And so was glucose level
    I asked for a Free T3 & Free T4 run. Results fro free T3: 2.7 & Free T4: .79
    I have itchy skin. Put on 12 pounds after dropping 10. So gain the 10 back plus 12 in a months time. Lightheaded at times, eczema issues. And just feel lousy and tired all the time. Should I seek a specialist I am tired of hearing your levels are in normal range.

    • Tina says

      You sound just like me. I had multi- nodulnar cysts in my thyroid gland that were cancerous. My gland was remover and I am on Synthroid and numbers are always good. But I feel like crap…same symptoms as you reported.

  62. says

    Wow. What an excellent article! I myself have studied thyroid time and time again, and have to revisit it with every thyroid case I see, because I haven’t been able to put the information into basic terms so that I can remember it (or describe it simply to my clients). Thank you so much for this clear explanation.

  63. Melinda says

    I need help but don’t know were to turn I was recently told I have a 2mm cyst on my thyroid but my labs came back within normal limits but I have all the symptoms of hyperthyroidism what can I do

  64. Cori B Lerner says

    I was just told I should get an MRI bc my TSH is low (.010) and T4 is also low. Dr suspects pituitary. I feel like my situation could be pattern 1 because I have been so stressed for so long… If the MRI reveals normal pituitary, what are my options for treatment for pattern 1? Thanks, Cori

  65. Lindsey says

    I have all the symptoms of hypothyroidism but my blood tests came back normal. So what do I do now? Do I need to find a specialist? My doctor told me there is nothing else he can do. You said standard tests will not show the 5 patterns you listed so how do you know if you have one of them? Is there a specific test I can ask for?

    • Lindsey says

      My test results were as follows:
      TSH: 0.910 microIU/mL
      T4 0.91 ng/dl

      It looks like my TSH levels are bellow the functional range and my T4 is towards the lower end of the spectrum. Could it possible be a pituitary gland problem? How do I test for this?

  66. Eliana says

    I just had extensive blood work done and have high TSH (9.94). I do not see that listed among the five thyroid conditions you mention.
    Most of the other thyroid-related levels are within normal range, though toward the low end. Hemoglobin A1c is high, as is LDL and total cholesterol.
    I would appreciate your commenting on this configuration, at least the high TSH.

    • Ronnie Wagner says

      Does anyone know the answer to the above question? What would make TSH high when thryoid supplementation has brought low T3 and T4 up to normal range?

  67. Laura says

    I just had my thyroid tested. I have so many of the issues that would be associated with hypothyroidism and my sister was recently diagnosed so I wanted a picture of what was going on. I purchased “they thyroid sessions” and have watched, listened and read until my brain hurt but I am still confused. My labs came back normal but I know normal isn’t always that clear. Can someone please help me understand them and offer guidance if I missed asking for something to be run? Thanks so much.

    Results: T4 1.0
    T3 80
    TSH third generation 1.430
    Thyroglobulin <0.9
    Peroxidase 1.6

    I am so thankful for any help and advice on understanding all of this!

  68. Grace Green says

    I have an underactive thyroid…TSH, T3 & T4 tests seem to support this diagnosis.
    How important is it to know the cause of this?
    e.g. Do I need to know if it is Hashimoto’s?

  69. Emily says

    I think I’m having this issue, but with hyperthyroidism instead. I’ve had my levels tested and the first showed up slightly high and the others have been normal, but I’ve done so much research that I’m pretty positive it’s the issue. Are there reasons like those for hypothyroidism having “normal” tests with hyperthyroidism?

  70. Jessica says

    Hi Kris,
    Please tell me, how is hypothyroidism caused by pituitary dysfunction treated by endocrinologists? What do you recommend? Thanks!

  71. jean says

    I have all the symptoms of hypo, tired, weight gain, can’t lose weight, const cold, dry skin, hair falling out, Mother has hypo etc… but labs are T4 free 1.0, total T3 112, TSH 2.03 and doc says normal! I’m thinking of self medicating by getting Amour or Synthroid from the internet. What else am I to do?

    • Catherine Johnson says

      I hear you. I am thinking about self medicating also – my hair is falling out at an alarming rate…

      • Amber Ferrano says

        Self Medicate but first do 2 things. 1). Add Seaweed then you are self medicating but not going to do too much. Eat Seaweed snacks. I like the wasabi flavored ones. I can find them almost anywhere now; The Co-Op, Trader Joes, Grocery Outlet and of course any Asian Market. Costco has a really good Seaweed Salad. I find it to be a lot as you are nbuying in bulk? Find someone to share it with. There are also Kelp Supplements. KLB I feel works the best. One needs to keep a journal and pay attention. 2. Alkaline your body. That means no junk food as in GMO, Pesticides, No poison shampoo, soaps, makeup etc. This is your responsibility and a doctor has no control over only you do. I love WellnessMama as she provides solutIons, how to and places to purchase. Makes it easy when you have little time.

  72. Virginia says

    You never mention anything about treatment. Do you have a link about suggested treatments? My doctor said all my test are normal but I have all the symptoms. I would love to explore some holistic alternatives rather than a prescription anyway. Any advice?

  73. Alicia says

    Hi Chris,
    My thyroid antibodies are rising since I changed to desiccated thyroid. What’s the deal with having a lot of antibodies- is it dangerous? It sounds bad!

  74. Hélène says

    Janelle re: convergence issue–I can’t find ur new comment, but I just got it in my email.
    My 9yo daughter has severe issues with reading. She also is now being labelled as having tracking problems, last yr it wasn’t bad enough to worry about. I thought tracking was a convergence thing. Her vision therapy trained optometrist hasn’t mentioned multifocals or any glasses for this. He just wants to do therapy. I homeschool and already do physical therapy exercises with her for this, among other things to help her brain learn the things we all do naturally in order to read. Last yr he had given her glasses for slight farsightedness, this year he said ditch them, not needed. I am very interested in your experience with this. Please email me my_bba at yahoo. Thank you so much :) Hélène

    • Misti says

      Have you considered dyslexia? Both my children are dyslexic and tracking was one of the first indicators we noticed in their reading problems. I home-schooled both of my children and even trained with them in Monterrey Cal. for their dyslexia with dr. Joan Smith. She has written some excellent books on dyslexia that can be found on Amazon. Hope this isn’t redundant. Please contact me if you would like more info.

  75. vicky says

    I am definitely pattern no. 1. I have been for testing and told ‘im fine’ but I know something isn’t right, I was offered antidepressants! So with pattern 1 do I need something for my pituitary gland? I’d like to go armed with the right info to my dr so I can finally get this sorted.

    thank you so much for this information

  76. Catherine says

    Thanks Chris. I looked over my daughters recent lab tests and her situation is best described by the first scenario I think. TSH 1.64. Free T3 2.7 Free T4 1.0. If supplementation isn’t the answer what steps can she take to feel better and function normally. She has the usual low thyroid symptoms
    Thanks
    Catherine

  77. Trudi says

    Wanting to investigate some health issues before they become too great, I went to see an environmental dr to get to the bottom of what is actually happening in my body. Results show that I have elevated homocysteine levels. Other tests showed my TSH to be 0.8 (of which the dr was happy that all is well there, but which you interestingly list as being sub optimal). I have sometimes wondered about my thyroid hormones but a lot of the symptoms for hypothyroidism are the same as I those of Pyrrole Disorder for which my levels were found to be very high, explaining a lot of my symptoms. I was happy therefore with the outcome and that my thyroid hormones must be fine. I commenced nutritional supplements for the homocysteineand pyrrole issues and have been on for about three months. A couple of weeks ago I woke up with a huge lump on my thyroid, which was ultrasounded and found to be a burst cyst. The other thyroid lobe was found to have a 20-30mm nodule on it. My questions are: What causes nodules? Is it an indication that something IS going on with my thyroid? Can nodules be reduced in size or healed altogether? And you mention possible Thyroid resistance along with high homocycteine. How is this diagnosed? I am now lined up to get TSH, free t3, free t4 and thyroid ab’s. Is this enough? I certainly don’t want anything to be wrong with my thyroid. Am wanting to be over-tested? Or why is it so difficult to just get the whole picture on this?

    • Maria says

      Have you been tested for MTHFR gene mutation? If positive can cause high homocysteine levels. Its basically remedied by taking methylated folate, the natural form of folic acid, not synthetic folic acid. See MTHFR.net. My nodules went down when I started taking the right thyroid medicine and iodine which were prescribed through naturopathic Dr not allopathic Dr. Even my family physician knows how better test my thyroid than my endocrinologist so its important to go to the right Dr. one that has experience with actually healing the thyroid vs just treating the lab results, assuming the proper labs were done in the first place.

  78. says

    Following brain aneurysym have metal clip next to my pituitary gland. Since then have gone from being extremely hypo to
    being extremely hyper with thyroid readings according to
    my GP as being “like a galloping horse” . Also had extreme
    weight loss and barely able to function followed by adrenal
    failure.

    Since then my thyroid functioning has been extremely labile
    with both hypo/hyper symptoms for the past 20 years.
    Constantly have had my thyroid meds adjusted – major
    weight loss almost 20 lbs. despite truckdrivers appetite –
    Intense fatigue forcing my eyelids to close and again
    being forced to sleep. I also have IBS and with my now
    current very low TSH have gone to the other extreme
    of my IBS – constipation.

    Having coped with this misery for more than 20 years
    wonder why surgical removal of diseased multinodular
    goitre not being recommended – resolving the thyroid
    having any further influence on the pituitary gland
    obviously being effected by the brain aneurysm metal
    clip positioned beside it.

    Would like quality of life which my erratic thyroid
    functioning persists in denying to me – thankfully
    I am positive thinking and sure hope that a
    competent thyroid expert will be able to figure
    out the complexity of my symptoms.

    Thanks for listening.

    Marnie

  79. Deanna says

    So I can see myself in two of these scenarios, but I don’t see where it says what the treatment that works so well would be if my doctor won’t prescribe Armour because my blood tests have me within a “normal” range even though I have been suffering symptoms for a long time and they are getting worse.

  80. says

    Hi, Chris,

    I admit I did not read every comment … but I have Hashimoto’s and am working to find a cure for IT instead of simply treating my thyroid. I have been on Armour for about 4 years now (Synthroid did nothing to alleviate my symptoms) and would LOVE to get off of all the medication if I could. I have other complications as well: insulin resistance – pre diabetes. Bummage. I am using a (mostly) gluten-free diet, selenium, and iodine supplements. Any other advice you have for me regarding Hashimoto’s would be welcome.

    Meanwhile, I love proofing – I would happily proofread your articles before you post them for free. Let me know if you’re interested in that. :)

    God bless!
    -C

  81. says

    Hi I’m sitting in an exotic country where I cannot get T3 and my pharmacist miscalculated how many tablets I’d need and I’ve now had to take 1/4 of the dose to make it last til I get back to reorder back home. My husband has noticed my brain has “turned to mush” (his words) and of course I’ve noticed. My conservative doctor (I see two) didn’t believe in it, nor it seems do some other countries. All I can say is: I regained back a life with them, and without them I cannot function properly. Can someone explain in a quasi scientific manner at least, why it effects one’s brain functioning, so we both know?! Why this reluctance to acknowledge its benefits? Why does the mainstream research not back up people’s experiences?! I very much doubt it’s psychological…

  82. synthroid guy says

    Trying to get the insurance company to cover the screening for resistance to thyroid hormone is near impossible. Has anyone been able to get this passed through? Its $1000 test!

  83. Mia Harris says

    Please help!!! So what is the solution? I have been to so many doctors and had so much blood work done, only (as you have stated) for them to come back completely normal. Yet, i have still have MANY symptoms of thyroid diseases. What type of doctor do I need to go to or is there a specific type of blood work that i should request? PLEASE HELP!!

  84. Hélène says

    Dr. Bryan Walsh is Da Bomb! He will educate you above most endos in just a few hrs!! Thyroid physiology is very understandable for the average layman. Even an endo could get it ~wickedgrin~
    The problem is finding doctors covered by health insurance and then paying for the pricey bloodwork and supplements needed. Especially as you try different treatments—needed even with the bloodwork (out of pocket again as not covered by insurance). Getting it exactly right off the first labs is unusual. Then more labs and more supplements.
    It’s out of the pocketbook of the average American and that is very frustrating. Dr. Walsh has the best model I’ve seen though…I noticed Chris is using it in his article :) Very familiar info!

  85. Mellissa says

    All of my thyroid hormones came back normal but I was very symptomatic. Sleepy, swollen face hands feet, etc., weight gain even with calorie counting. Ends up on a routine physical i had nodules on my thyroid (large ones) that I didn’t even know about. They all came back as Papillary Carcinoma. In surgery it was found that the Papillary Carcinoma had metastasized to the lymph nodes on both sides of my neck. I just went through radiation treatment two days ago. Strange is that I have been feeling better than I have for a LONG TIME just being on 25 mcg of Cytomel. Also I have lost 21 pounds! I have yet to start permanent thyroid hormone replacement because of my recent radiation treatment. Hopefully my body will be able to convert t4 to t3, since Cytomel is t3 and appears my body has responded well to it.

    • Mellissa says

      Also! I lost all 4 of my parathryoids due to lose of blood supply from the cancer around my thyroid..i hade deficiency in Vit. D and my nails started falling off.

  86. Tamara Summers says

    Hi Dr. Kresser,

    I’m a 40 yr old woman, who lives in India, and currently weigh 260 lbs. I have battled the bulge for the past 20 years… and do have PCOD and Diabetes… I was diagnosed with Hypothyroid when I was 12, and was cured of it by the time I turned 16…however, at 17 I was diagnosed with a growth / tumor in my pituitary gland, however when I reached London for the surgery, which disappeared in 2 months on it’s own. after which, I did get tested every 6 months for 3 yrs, however, I was told it was all good since.
    I also am convinced that I do have Hypothyroid for the past 10 yrs, since I do have all the symptoms that define it…however, since all the usual tests, T3, T4 & TSH, always come back within the normal range, the Doctors here keep telling me that I’m normal and that my weight is only a result of my diet & lethargy! That all I have to do is eat less & exercise. Like I haven’t done that!!!
    What they don’t seem to grasp is that I actually do eat pretty healthy (NO sodas, fried foods, sweets, carbs and processed foods) and I do try and work out at least 3 times a week… and in spite of all that, my weight just doesn’t come off!!!
    My current medication is: I take glycomet (metformin) 1gm twice a day, glucobay-50mg thrice a day & glynase 5mg twice a day For my Diabetes. Since my periods come on time, I have not been given anything for my PCOD.

    Dr. Kresser, I really need your help and advice.
    Please write in to me at: [email protected]

  87. Kate says

    Just had thyroid testing done and was told I was not in the optimal range, but was in the “normal” range. Endocrinologist tested my TSH, Free T3, Free T4, cortisol, glucose serum, and several other things. He’s prescribed Armour Thyroid (60mg) daily, but if my levels are fine why am I being told to take this drug? I’m confused. Here are my results: cortisol 6.5 ug/dL, Free T3 2.5, Free T4 1.14, and TSH 2.18, glucose serum 112. My blood work was done in the late afternoon w/o fasting.

    Any help would be great!!

  88. Laura says

    I have a T3 deficiency as a result of non-conversion of T4 into T3. My TSH and T4 levels are normal. My question is, how do I reduce my cortisol levels? I have alopecia areata as well which is an auto-immune disorder and probably as a result of elevated cortisol levels too. I have been taking synthetic thyroid hormone for the past 4 years which makes me feel alot better, however, my hair loss has not improved and I’m guessing this is because the underlying cause has not been addressed.

    • Lisa says

      If a T3 to T4 conversion is your issue, then you need to be on Armor (which is cheaper) because it is a natural thyroid and helps you with this conversion. None of the synthetic thyroid give you the T3 to T4 conversion. There is a great doctor in Fredericksburg, VA called Dr. Hill. His office is by the hospital. He is fairly good. It was a free clinic doctor who without seeing my test results, told me I was on a synthetic. and prescribed Armor. It made a hugh difference and it worked. Also, Silkence Shampoo volumnizer that helps my hair grow back. Rogaine for women did not work for me. Also, Witch Hazel is a great medicine for skin cleanser(acne), blemish and itch reduction. Great stuff.

  89. Gina says

    Where do you go to get definitive answers? What other test are needed or what type of Doctor to get help? I want to sleep around the clock, have lost my eye brows on the corners on both sides. In desperation I went to a weight clinic for diet pills. Not losing weight but I can at least get out of bed a few hours like a normal person. I am at wits end.

  90. Tracie Arnold says

    I am 44 and been dealing with this same problem for over 10 years now. I have been through the gammit of testing as you spoke of by a few Endocrinologists and was told that ALL my levels were “normal” yet I still struggle to lose weight/keep it off, my hair is thin and falls out constantly, my skin is dry and seems tough and nothing helps. I developed KP on my upper arms which I never had before and have no family history of. I have stripped my diet down to 1200-1400 calories a day and only eat natural protien from lean meat/fish, fresh vegatables, fresh fruit, brown rice, moderate dairy in the form of greek yogurt or small amounts of milk in coffe or cereal and not every day. I only drink water and the occasional ice tea and coffee. THis seems to only help in mantaining my weight where it is at but that is all. I admit that I do not get the proper amount of exercise that I should as I am a night shift nurse so going to the gym or even taking walks etc is a challenge since I sleep during the day but my job does offord me to be physical 75% of the time as I work with ALS patients and am doing 100% care from meds to the physical so by the time I have finished a 12 hour shift I am pretty well worked out just from that. I wear a pedometer and walk the equivalent of 6 miles or more a day just at my job alone. Yes, I know I need more variety and I am working on this aspect. Also I will point out that this problem started long before I became a nurse or worked night shift. My delima is how do I get an MD to listen to me when I tell him that this is more than an activity/diet problem regardless of my tests coming back “normal”. This started when my children were very young and I was extremely active. I have gone through 2 Dr.’s now and 1 specialist. Both of which get back normal test results. The specialist and 1 MD put me on phentermine or phendimetrizine to solve the weight issue rather than trying to get to the bottom of the issue. This DRUG FIX only ever helped me loose 10 to 15 because it made me not want to eat anything since both drugs are and anorexic/stimulants. Well Duh! Starvation of course will make you loose weight. This was a temporary fix and never helps solve any of my other issues including the weight problem since I need to loose 50 pounds not 15. My problem is not my eating habits or how much I consume it is something else. Clearly that is and was not the answer and I feel like they were treating me like a diet drug seeker (which by the way I didn’t ask, suggest or hint that I wanted diet drugs). I wanted answers as to why my hair was falling out and I keep gaining more and more weight year after year without increasing my dietary intake and my activity level staying the same. This problem actually started back when I was in my late 20’s just after having my gallbladder removed but got increasingly worse after I hit my 30’s and now 40’s. Another lovely side effect of whatever is going on is I now have been growing very coarse man like facial hair on and under my chin which is multiplying bit rapidly. I read this suggests increased testosterone but when I have brought this symptom up they just ignore me. I’m no expert but I just wish I could find an MD who actually cares and wants to get to the bottom of the problem rather than prescribe “diet pills” as an answer since all my blood work is normal? Being a nurse this makes it more frustrating because I know something is wrong and if you try and rationalize the symptoms verses the tests and that there must be something underlying that the tests are not showing they tell me its not possible? Um not possible? Hello that is a nice way of saying “I don’t want to try and get to the bottom of it, now run along and deal with your weight problem since you obviously just eat too much”. Ok but ALL my test results are normal so if I eat too much and all the wrong things why is my BG levels, A1C etc.. normal? Liids, cholesterol, trigycerides etc…. NORMAL….. When I say all my test were normal it was like reading a chart of a very healthy early 20’s something year old with no diet issues who gets ample exercise etc… One of the endo’s said if even one of these were on the low side he at least could start there but there not? How do you move forward from there? This is also the MD that prescribed me phendimetrizine by the way? I am so frustrated. I am also so tired of feeling tired, gaining weight for even stepping out of my diet box for 5 minutes and sometimes even when I do not step out of my diet box I still gain. Any advice, help, direction etc.. would be SO appreciated. A guide/list if you will that I can take to an MD or Specialist that tells them what I want tested and done and followed up on etc…. HELP PLEASE…… Here is a list of my symptoms: Thin hair that falls out constantly and never grows beyond my shoulder area before it breaks off and or falls out, dry and pale skin that seems like it has thickened with patches of KP like rashes on upper arms, flank pain on my right side under my rib cage where my kidney is that comes and goes (had sonogram, checked and tested for stones, infections etc… with negative results) , fatigue, constipation, thin brittle nails, depression, joint pain, muscle pain, unexplained weight gain, thin eybrows and eye lashes. Puffy face at times, painful reaction to consumption of alcohol ( if I drink 1 oz of liquor I get a burning red flush on my face and chest. It feel like I have acid under my skin and then I start to itch on my face and chest)I almost never drink because of this. Any guidance or help would be greatly appreciated. I have always been very in tune with my body and I know something is wrong. I’m tired of feeling tired, depressed and having horribly thin hair on my head and dry skin that looks like a red bumpy dry war zone. I struggle everyday with remaining positive and persisting through all these problems but I’m starting to lose this battle as it has been a 15 year struggle and I am so tired of being told to watch what I eat and exercise as a solution. There has to be more to it than that if those recommendations are not working. Ok I will stop ranting now and hope for some advice and help. Thank you in advance to whomever responds. P

    • says

      Hello Tracie….I just found this website and it’s AMAZING how much I have in common with most people here. Did you ever receive a response from anyone regarding your thyroid problem? I’m new to this site so I’m not sure if someone actually responds or what? How are you doing now?? Hope you have received the help you need!! Thanks!

      Donna

    • Catherine Johnson says

      I am sending you good luck for proper diagnosis and treatment – it just got “real” for me – as my hair has been falling out at an alarming rate now – I am going to try to find an endocrinologist and get all the tests run I can (of course the generic thyroid test came back “normal” – it’s going to put me in debt – but I can’t live like this anymore – I am praying for us all…

    • Kat says

      Hi Tracie. I certainly don’t have all the answers related to thyroid but the weight part and chin hair actually sounds like estrogen dominance. I would suggest getting your hormone levels checked by a naturapath. It has to be the spit test one, not the kind regular docs run. If you’re not in a state that recognizes holistic practioners you can order the test and do it yourself. It’s spendy but not crazy expensive like some of the tests they’re talking about here. Check out John R Lee’s website http://www.johnleemd.com/. He’s actually an MD. There’s lots of info and a symptom checklist and you can order the hormone test kit from there. It’s possible that you may get some relief from progesterone cream or by taking vitex which helps the body make more of it’s own and supports pms, perimenopause and menopause as well as the parathyroid. Vitex takes about three months to work fully though. Vitanica is an excellent brand. There are also some products like DIM that help with clearing up excess bad estrogens. All of these things are pretty inexpensive and you can get them from Amazon. The hormone issue may not be the main issue but it might help with some other stuff. My irregular periods and feeling cold all the time has cleared up since I started using natural progesterone cream. I too have a super weird acidic reaction to alcohol as well as soda of any kind. Good luck and I hope some if this may help!

  91. Leanne Mcc says

    Hi my tsh was 27 last Wednesday then checked it again on Friday to be sure and it was 2.58 & they also tested T4 this time which was also what they called normal at 9,9!

  92. mudd says

    Hello, I have all the classic symptoms of hypothyroid, I have seen 3 doctors, this last doctor is a surgeon, I have had the right part of my thyroid removed in 2004 due to a nodule. I have never been on any medicine for it. Now all of the sudden I have all these symptoms and the doctors do not know what to do. All my labs came out fine, I had a sonogram that showed my left thyroid is alittle bit swollen. I have now lost my voice. Now the surgeon wants to put a camera in my throat to see what is going on and why I am so hoarse in my voice. My gut is saying he wont find anything. I am very lost now. I dont no what to do. And yet I still have all the symptoms.

  93. Coinneach says

    I have kind of a weird thing going on – after a total thyroidectomy in August 2012 (multinodular goiter, and the pathologist found an encapsulated papilloma), my endo started me on 150mcg levothyroxine. I felt OK on this dose, but my TSH was still 0.0 (don’t recall my T3/T4 numbers). He proceeded to decrease the dose to, eventually 112. That dose brought my thyroid numbers into range, but everything else collapsed into a perfect hypothyroid presentation – weight gain, depression, brain fog, chills, etc. Against his orders, I started taking 1.5 112 pills daily. My weight started going back down, the fatigue and depression lifted, the shivers went away, and I felt genuinely good for the first time in years. The problem is that, yep, my thyroid numbers now indicated *hyper*, which made doc very angry. I stopped the 168, and sure enough, hypo. Now he’s threatening to reduce the levo to 100mcg, just for the sake of good thyroid numbers at the expense of everything else. How do I make him understand what he’s doing to me?

  94. Staci says

    I recently found this page and I’m so thrilled. I’m 43 and have been dealing with what I think are thyroid issues for years despite my doctor saying “everything is normal.” I’m NOT normal. I’m textbook thyroid and it doesn’t matter to even try to treat the symptoms instead of my bloodwork! How do I get someone to listen to me. I have a 1 inch nodule on my thyroid, cells are fine from biopsy. I’ve read about deiodinases and am trying to find out more research on that subject. Again, how do I get them to take me seriously instead of just thinking I want a weight loss pill (that would be nice, lol) but it is SO much more than me spending 4 months at the gym and only losing 4 pounds. My endo told me years ago that I had PCOS, however, I truly felt she was just giving me a diagnosis to give me a diagnosis. My ob/gyn checked my ovaries due to diagnosis but they were not cystic and I had no problem conceiving. I’m at a loss and so frustrated. Just had bloodwork done with PCP and of course “everything is within normal range.” Then WHY do I feel like this?

  95. Maria says

    Go to different Dr. or several different Drs if you have to. I was recently disappointed with endocrinologist for not running full thyroid panel, only to get full lab script from family MD during recent physical.

  96. JW says

    Chris,

    I was diagnosed with Grave’s Disease in December of 2010. I had Radioactive Iodine (RAI) treatment in December of 2011, which ablated my thyroid gland. I was immediately put on Synthroid afterwards to normalize my thyroid hormones. I conceived in October of 2012. During my pregnancy, my thyroid levels were completely normal (within mid-range) so I stopped taking Synthroid for the duration of my pregnancy. I felt BETTER THAN I EVER HAVE while I was pregnant. I lost 20 lbs within the first two months of being pregnant. My headaches were gone, I had NO brain fog, or ANY other hypo symptoms. I’ve done research and concluded that it was because of my elevated HCG levels. I was 175 when I was 6 months pregnant, 185 when I gave birth. After the birth of my child in August of 2013, I was not put back on Synthroid because my levels were still normal. I decided to go on a diet to lose about 15 lbs of baby weight. I was only able to lose 4 lbs in 4 months eating 1200-1500 calories a day. Still – I was just happy to NOT BE GAINING WEIGHT :)

    I went back to the Dr. for a checkup on my thyroid levels in April of this year, and my T4 was low at .7 (.6-1.75 NG/DL) I’ve also gained 17 lbs since January 3 of this year while dieting – that’s almost a pound per week!!! I’m sure it’s related to my low Thyroid levels, especially since I’ve had ALL my previous symptoms come back.

    My doctor will NOT prescribe Synthroid to me because she say’s my levels are in “normal” range. She is aware of my RAI treatment, and my previous doctor’s recommendation to be on Synthroid for a LIFETIME due to me having Grave’s Disease.

    What are your suggestions? I feel like my doctor is not doing the right thing by keeping me off Synthroid.

  97. ChrisK says

    Thank you for this very helpful article–I just found out that half my thyroid is atrophied. Just starting my info gathering, so I really appreciate this.

  98. Debi says

    I have fibromyalgia but believe I may also have hypothyroidism. I have severely swollen glands under my chin. I am cold all the time. I the last six months I have developed a chronic vomiting problem. Whatever I eat it seems to come back up. I cough incessantly and choke while drink eating or jist swallowing saliva. My cough is continual. Of course I am always tired but can’t sleep at night without sleeping pills. The nausea seems constant. My GP seems to think I am a hypochondriac and my rheumatologist was annoyed when I brought in a list of 19 symptoms to be addressed. I know my body better than they do and I KNOW something is wrong other than the fibromyalgia. Can anyone help me? Give me suggestions? Thank you

  99. Jessica says

    Hi there – I have had lymes disease (bullseye rash, tested positive twice etcetera) and now seem to be in an epic endless post lymes syndrome with all the joy that this entails. My thyroid tested fine last December but a lot of what I’m experiencing also seems to correlate with low thyroid. Could lymes trigger low thyroid and it not show up? I never used to get ill and now I feel ill all the time, I can’t exercise because I get lymes crashes and I’ve out on so much weight. I’m a bit desperate.
    Thanks in advance for any comments or help that might be offered. Jess

  100. AMANDA says

    MY DAUGHTER HAS GAINED 27LBS IN 5 MONTHS ALL IN THE BELLY, THE DOCTOR DID A FEW BLOOD TESTS AND HER T3 UPTAKE IS 29, HER HEMOGLOBIN A1C IS 5.5 AND HERGLUCOSE PLASMA IS 77 I WAS TOLD SHE IS FINE,,,,,BUT IS SHE, AGAIN SHE IS ONLY 8.

  101. Diane says

    Dear Chris,

    Such helpful work you are doing– Thank You.

    I have a puzzle for you! I work with an “integrative” MD– my initial comprehensive thyroid labs (two consecutive) revealed normal levels on all: TSH, Free T4, Total T4, Reverse T3, T3 Uptake, Free T3, but LOW Total T3. I have many low thyroid symptoms and have for many years. I do not have elevated Testosterone (actually, low), or elevated Cortisol (although my cortisol 4 pt. test indicated some adrenal fatigue.) I have been taking cytomel for a year- felt a little better for a while, but no longer. My last labs indicated LOW TSH, Lower T4, ELEVATED Free T3, and normal levels of Total T3. I don’t believe the medication is my solution. Any ideas on what it could be? Not even Dr. Kharrazian’s book can help me with this one.

  102. says

    I would really like to know what one may do if reason #5 is the issue. It doesn’t seem like there is a way to fix that, or is there?? I am pretty sure that is my exact issue. Not 100% though. I do have lower T3 and elevated reverse T3 too. My TSH and T4 is basically in the normal range, all for functional med. parameters.. I have a few hashi’s antibodies, but they are not high.

  103. Jose Blose says

    This article is riddled with misleading information. I realize there are an army of people suffering symptoms, but this site is not accurate.

    1. Reference ranges are not determined from ill individuals.
    2. TSH and FT4 values do vary between labs; the reference ranges also vary along with the values (it is not once size fits all with the wrong ranges applied blindly)
    3. Bell curves are not used to establish reference ranges (except where values are clearly normally distributed, an rarely even then).
    4. FT3 is helpful for detecting hyperthyroidism, but is not a panacea for detecting occult thyroid disease.
    5. T3 uptake testing is fraught with confounding, some of which you list and pathological conditions (estradiol, binding protein concentrations, contraceptives).
    6. There seems to be a complete misunderstanding of free hormone and bio-availability. Binding proteins high, low, or in between do not affect free thyroid hormone concentrations, which are the only factor that really matters.

    Readers, seek medical information from reputable sources (Pubmed, well-known tertiary care center websites, UptoDate, Quackwatch), not an acupuncturist with an opinion!

    • says

      Hmmm… let’s see. Quackwatch – a website run by a retired psychiatrist with LOTS of opinions, but apparently a guy who hasn’t even treated a patient in over 20 years!
      20 years is an eternity in the development of thyroid disease treatment. The information on Quackwatch on hypothyroidism is pathetically outdated and misguided. Dr. Barrett seems more interested in attacking those with opposing viewpoints than he is in actually helping anyone.

  104. Debsta says

    What’s the difference in between T3 uptake and reverse T3? Please clarify.

    I’m having a bad reaction (last 5 days) to a new batch of a natural thyroid medication (with a tighter +/- than Armour). With my usual dosage, felt like ADHD going nowhere and not able to communicate, hyper symptoms and then depressed in afternoon, like spent. Great small company, called them up. Don’t even know of or the specifics of how to find a good “compounding pharmacy”, if needed or how to advocate for that if necessary???

    I’m due for my annual panel and I want everything tested and not sure what would be helpful; please advise. I probably need to be specific and relentless. I was originally diagnosed with Hashimoto’s and was allergic to Levethroid. I went off of everything and was put on a natural thyroid I had researched because they said I had to be on thyroid medication and my numbers were that of a coma (this was years ago). I had to start with baby dosages of the natural thyroid.

    Anyway, what do I prioritize? So, TSH (given), free T3 & T4, do i want reverse T3? How’s that different from T3 uptake? Is there a reverse T4? Do I want TBG?

    They don’t like it when I tweek my medication down or up, but I need to function in my body. I couldn’t drink a cup of coffee until this afternoon and stayed home from work today. Basically my feelings are the tests so far, don’t seem to give an accurate picture of what is available, resisted, and used by my system, and I would like a more complete picture to better understand how to compensate.

  105. Meri says

    Thank you, thank you. I have been so frustrated with my doctor. For three years she has been checking my TSH at my annual exam. It has been trending lower and lower but is still in the “normal” range. This last test was 0.58. She keeps saying, “It’s normal,” but I have just about every hypothyroid symptom. I can’t even get her to do other tests. Pattern #1 sounds just like me. I was beginning to think I was crazy. Do you think an endocrinologist would be willing to look into this? The last time I went to an endocrinologist she wouldn’t look past my pre-diabetes diagnosis. With a simple google search I find that the two can be related. Do you have any recommendations for what I can ask to get the ball rolling in the right direction?

  106. Molly Franken says

    Chris

    Thanks for your thyroid series, first and foremost.

    Secondly, do you have any insight for people that are low across the board ie TSH .006 T3 low T4 low? This seems a perplexing situation as the normal ‘see-saw’ effect isn’t occurring. My current physician is stumped and I’m suffering a bit without the answers I need (waiting to get into a new endocrinologist).

    Many thanks!

  107. says

    “…. we don’t have a way to test the function of cellular receptors directly.”

    Have you heard of Wilson’s Temperature Syndrome? Dr. Wilson asserts that body temperature is the best indicator for poor T4-T3 conversion when all other tests are in the normal range. He treats this condition in a novel way – time-released T3, once every 24 hours. This is designed to “reset” a person’s thyroid system and they often go off medication completely.

  108. Jan Marie says

    I am asking for help from anyone on this site who has knowledge of thyroid issues involving sporadically very high and very low testosterone lab results. I see that SALLY posts a low and has a lot of knowledge.

    I discovered thyroid cysts in 2006 and was deemed to be euthyroid, which I was not and am not. I am hypothyroid but have a low TSH ranging from .4 to .7. I had a high rT3 two years ago and supplement T-3 solved that. I also take 5 mcg of T-3 (bio-identical compounded) in the morning now and at night I take Young Living’s THYROMIN one capsule supplying 550 mcg of Iodine and T-3 and T-4 and some essential oils to support the thyroid. I have good energy most of the time, in fact almost great. I still do have some occasional fatigue but nothing really bad. I still work all day long with the fatigue. Before taking thyroid supplementation I worked on the adrenals and supported them. I do not see any signs of having high cortisol even though I have central weight gain and an untypical big waist (historically I have had a very small waist). I had a very stressful event (in fact horrific) in August of 2011 and a few months later began losing hair. I had very thick hair prior. The issue that triggered this loss is still not resolved, but I do not have exposure to it, but rather it is in my psyche. I work hard at not thinking about it. I am happy and my health is remarkable for being a senior. With the hair loss I worked on anything that needed to be remedied in supplements and did all the appropriating testing to maintain. I looked at vit D3, iron, zinc, magnesium, copper, all vitamin levels. I have supplemented everything humanely possible using science not guesswork. I still have not regrown my former very thick hair. I still do have a bit of fatigue but not much. TO NOTE: I have very high and very low testosterone readings and I cannot make any sense of it. I also have low normal DHEA. I am currently supplementing 5 mg of DHEA daily. I am taking progesterone to correct estrogen dominance. Maybe I am not taking enough progesterone at 1/5 of a ML two times a day. I use to supplement bi-est but quit that long ago. I do like sweets and have worked hard at controlling the intake. I have an fasting insulin of 6 which is perfect. I just had an MRI and so far it does not look like I have a tumour on my pituitary.

    Could I have something malfunctioning in my pituitary that causes my Testosterone to go wildly up and down, test results a month to two months apart? I also have VERY hard time to lose weight. I am overweight by about 30 lbs. I am not grossly obese but have central weight gain and a large waist. I sleep very well and so I do not suspect cortisol involvement. When I did have cortisol issues I would awake in the middle of the night and sleep was bad.

    I just cannot find any practitioner, not even my functional medicine doctor, who can tell me WHY my Testosterone goes up and down and how this can be tied in with lack of hair regrowth and inability to lose weight even when on a nutritarian awesome diet. I am so at loss to get some help.

    Anything anyone can contribute would be so appreciated. I plan to call Chris and see if he will consult in regard to this. In the meantime I read a lot and am trying to get help.

    Thanks so much for any consideration………..Jan Marie

    • Nelly says

      Hi Jan Marie,
      I like yourself would fit into the category of senior. I don’t have thyroid issues that I know of although I think my thyroid has always been a bit sluggish as I have fought the battle of the bulge all my life. However, ever since menopause, my body has a distinct tendency to put extra weight around my middle. This is a common occurrence with age and I don’t think it is necessarily linked to hypothyroidism. It is, as I understand it, caused by an abundance of androids in the system that are no longer being suppressed by other hormones. This is also a cause of hair loss. I myself have experienced hair thinning for several years now and, due to taking certain medications, experienced severe hair loss for several months. I am now remedying the situation with a Thera-Dome (a helmet similar to a bike helmet that is outfitted with infared lights inside and worn several times a week on the head for 20 minutes) and it seems to be working. My hair stopped falling out which is the first stage, my individual hair shafts are thickening again which is the second stage, after the first month already and new hair growth should begin soon during the third stage of improvement. So I am pleased with the result. As for the weight around my middle, I am currently on the HCG diet which I have done before and lost 20 lbs on, but which also had the wonderful effect of reducing my middle area first instead of last as is usual with other diets. You can read up on it if you do a search on Dr. Simeon’s Pounds and Inches. His manuscript is freely available online. This all takes work of course and will most likely not do anything to correct a thyroid imbalance. But I suspect those two complaints are more about age related symptoms than thyroid issues I wish you luck with your thyroid and research on thyroid and hormone balance. I just wanted to suggest a couple of quick fixes for those age related issues.

  109. Pamela Plumley says

    Interesting convo! A little health history: I’m 53, have had bad headaches since 13 (which evolved into migraines at 24 after an auto wreck) and bad neck/shoulder pain since my teens. I have been told since my twenties that I have arthritis and subsequently fibromyalgia and one doctor told me I have spondylitis. I am proven by MRI to have degenerative disc disease and some reversing of the cervical lordosis, etc. I just hurt a lot.

    I also had a sigmoidectomy for colon prolapse in 2007 and uterine ablation for polyps and severe menstrual problems. I have had one miscarriage, but surprisingly to doctors, two children, including one at the age of 39! When my son was born in 1987, I was very toxemic.

    I have even had “unknown seizure” episodes, not epileptic, just uncontrollable jerking of the arms, legs and tongue until I could not talk, walk or hold anything in the early to mid 2000s.

    I began having hypo thyroid troubles at around 19, which flipped into hyper or normal until it went severely hyper with a goiter and Grave’s disease at the age of 23. I was given I- 131 uptake (nuclear capsule) (in 1984) after a round of heart medication, etc. in order to “kill off” the overactive thyroid. After that, of course, it became hypo. However, it has flipped between hypo and hyper since that time. The first endo told me I had abnormal thyroid binding globulins (sorry if that is not spelled correctly) and that it may have thrown off the test. Of course, free tests have become the standard now.

    I have ranged in doses from 1.5mcg to 1.00, .112, .125, .50, .75 and currently .88. I have diagnosed with bipolar, although the first psychiatrist told me he felt it was a very hyper thyroid causing the problem at the time.

    I have definitely been through a ton of stress in my life. Still am to a degree,as my husband just came through prostate cancer last year, and just things of life. And yes, I have tried supplements off and on, perhaps not long enough though.
    I rely on Ambien to sleep, but hate it and am stopping soon; hopefully something better will help me sleep.

    I have been to the stopthethyroidmadness.com and I know it’s said that hypothryoid can mimick a lof of other diseases or be the cause of them. I seriously wonder at times if I truly have bipolar, and if some of what I have gone through is just stress related. I would love to think I could reduce this pain by normalizing the thyroid! That would be a miracle.

    In January, my new doctor, who knows I have had a whacky thyroid history and believes in frequent testing, included some things on the thyroid panel I have never seen before, when I looked them up, at least one or two was in relation to Hashimoto’s dx. This month, he tested for TPO, third generation TSH and a TSI. These are all new to me also.

    I am kind of wondering why my doctor is ordering these different types of panels lately, knowing that this hypothyroid is secondary to the nuclear radiation I had years ago. This is a very confusing issue I think, but glad some people are talking about it.

  110. cindy says

    Hey, this article is exactly what I’ve been looking for…. just one quick question…. what test should I ask my doctor to preform? I want to go to the office completely informed and armed with the proper information to help with my diagnosis..

  111. Saska says

    I have a question reg.
    Hypothyroidism caused by pituitary dysfunction
    This pattern is caused by elevated cortisol, which is in turn caused by active infection, blood sugar imbalances, chronic stress, pregnancy, hypoglycemia or insulin resistance.
    I did saliva test last year when I felt ‘outside’ myself. My health has been declining for a couple of years, since 2005 as a matter of fact. It started off by anxiety, panic attacks (no reason really). I have been struggling with added on symptoms throughout the years. I am today 46. Thyroid disorders run in my family (my mothers side) and this is what I suspect to be the culprit. Here are some of the symptoms I have been struggling with the past years:

    – panic attacks/anxiety
    – dizziness
    – shivering/tremors/shaking/sweating
    – rapid heart beat (85 and up, in 2010 heart monitor showed 100 beats/min during rest/sleep)
    – low blood pressure
    – hungry fast after eating a meal
    – migraines optho only
    – sweating
    – blurry vision/floaters
    – nearsighted
    – pressure behind eyes/eyes easy watery (have no allergies)
    – seizure (first/recent)
    – immunity lowered since 2005
    – between 2003 and 2007 I had lactating breast, no pregnancies. Gone now.

    The saliva test showed increased cortisol in morning and very much so at night, right before bed. I also am feeling hungry soon after I have eaten, even though I eat big meals, and do not gain weight. Thyroid tests within normal range at all times. 3 years ago, one time it was at 2.30 Tsh. Glycemic testing all ok, 99.

    I know all this may sound confusing, but its tough to start at one end and make sense for you all. What I am thinking is, reactive hypoglycemia or thyroid issues? My FREE t4 tests have always been fine….Any advice? I want to get back to my normal self.

    • Saska says

      Forgot to add, the question was, if my cortisol is higher than normal, should then the pituitary function be tested? What do you recommend?

      • Saska says

        Here is what the report from my saliva cortisol lab wrote (I don’t eat any medication beside magnesium at night): DHEAS is within mid-normal expected age range. DHEAS is highest during the late teens to early twenties (10-20 ng/ml) and drops steadily with age to the lower end of range by age 70-80. Cortisol is high in the morning, normal throughout the day, but rises to a very high level at night. The very high night cortisol unlikely indicates stress-induced adrenal cortisol production (levels are much higher than high physiological range) and more likely reflects evening use of some form of medication that either contains a glucocorticoid or stimulates the adrenal glands to produce high levels of cortisol. Glucocorticoids could include cortisol (hydrocortisone) itself or synthetic analogues (Prednisone, Betamethasone) commonly used for asthma, autoimmune diseases (e.g. Lupus, rheumatoid arthritis), or other inflammatory conditions. While physiological levels of cortisol are essential for normal immune function and the normal cellular actions of other hormones, particularly insulin and thyroid, long term endogenous production of cortisol by the adrenal glands, or use of excessive amounts of glucocorticoids (natural or synthetic) can lead to immune suppression, inability of normal tissues to utilize glucose for energy (insulin resistance), functional thyroid deficiency (normal thyroid levels but thyroid deficiency symptoms), and excessive breakdown of normal tissues (catabolism) which include muscle wasting, thinning of skin, and bone loss. Exposure to high levels of glucocorticoids, whether produced endogenously (within the body) or taken as medication, increases risk for serious long term health issues (rapid aging, osteoporosis, cardiovascular disease, obesity, diabetes, immune suppression). Some of the most common symptoms/conditions associated with high cortisol include sleep disturbances, fatigue, depression, weight gain in the waist, anxiety, bone loss, functional thyroid deficiency (normal thyroid levels but thyroid deficiency symptoms, and insulin resistance/metabolic syndrome.

  112. k l says

    I’ve been having almost all of the symptoms of hypothyroidism for years. Specifically weight loss problems. I eat very healthy and watch calories very carefully. My two thyroid tests came back negative. I was so frustrated.
    I also suffer from extreme fatigue and chronic stress. The stress was so bad I got alopecia areata.
    Could this be a misdiagnosis? If so how do I treat this?

  113. Lisa R says

    Mark,

    Have your son been tested for food allergies, had a bio scan, and also does your son play videogames or watch a lot of cartoons?

    w/r

    Lisa

  114. shoshana says

    hi i am from israel/
    i have lat oncet 21 oh hyd. def.
    what can i do abut it
    what other disorders can i have?
    thank you shoshana

  115. Laurie says

    Can someone please direct me to the foods to eat and avoid lists that are referred to (above in post of “Joyce
    March 13, 2014 at 5:55 am”) ….. I searched the site and was not able to find them.

    Thank you SO much.

  116. Ginny says

    Chris,

    One thing you said does not sound right.

    You say that lab reference values are based on the values of sick people. Yet the medical director of Quest Diagnostics says the opposite. That “normal” values are based on the results of healthy people who do not have illness.

    Which one of you is right?

  117. Ginny says

    Oh my goodness!!! This makes me angry. Just now read this. No FREAKING wonder I haven’t improved on levothyroxine. I told my doc felt a bit better at first for about a week then felt just the same almost as bad as before! Of course she upped my dose which did nothing but increase palpitations. So I made no more complaints because I knew it would do no good.

    I’m going to copy this, if I may, and send it to her. I wonder if she will be offended? If so, I will find another doctor! I want a correct diagnosis!

    • Lisa R says

      Ginny,

      I found out that levoxyl did not work for me as well. Try Armour thyroid instead. As a natural thyroid base it converts T3- T4. Levoxyl is a synthetic that does not,. Also, Armour 30 mg costs about 5.50 for 30 day supply at CVS.

      w.r

  118. Pam says

    So if normal lab results do not show these, where do suggest get test done? My allergist says there are NO (yes she said No)tests for food sensitivities. Is that correct if not who do you suggest I turn to?

  119. Kelly says

    I’m SO glad to find this article, yet still wonder where I fall. I’ve been miserable with hypo symptoms for months. The first test was only TSH which was “normal”. 5 months later and I still feel lousy, so I asked for more testing. T3 is normal but T4 is low. How does that happen? He’s putting me on synthroid, but I wonder if that’s the solution or just a band-aid. Should I ask for additional tests to find a root cause? Thanks so much.

  120. Marcia says

    Thank you for everyone’s comments, its wonderful to see I am not alone in this 10 year struggle to find answers.

    Heavy Periods, Fatigue, loss of energy, depressed, full body rashes lasting months, weight gain no matter low calorie count, natural whole foods with natural herbs and regular exercise.

    I am strongly opposed to medications, coffee, alcohol, soda, or beverage with color dyes, sugar or sugar substitutes. Only minimal amount of sea salt in the kitchen and dinner table…

    The human body is obviously very complex….most times trying to find balance feels impossible…

    I found bentonite clay simply mixed with water clears away rashes, lots of water (without chlorine or flouride), fresh lemon assists in ongoing cleansing- removal of toxins…

    But as of January 2014 have discovered essential oils- therapeutic grade, that addresses every symptom typed into the internet :) included thyroid issues, liver, kidney function and more.

    Join me in this journey of learning how naturally to heal our bodies, without the medications offered to us in every office and over each counter.

  121. Dan says

    Chris – I have symptoms of thyroid problems. Low heart rate, cool body temperature, fine brittle hair. Plus both my mother and brother take synthroid. Yet my blood tests don’t show any problem. Who can I see in the Miami, Florida area that can perform more comprehensive testing? Thanks.

  122. says

    Good Morning Chris ~

    I’ve been diagnosed with hypothyroidism for a little over three years now. I have no symptoms nor have I ever.

    When first diagnosed, I inquired about managing with diet and was told it wasn’t possible. The doctor allowed me three months to try on my own, but offered no suggestions where to go for information. Obviously, I was unsuccessful.

    He also gave no indication or information about the effects of chronic stress. I was diagnosed at a time when my marriage was falling apart, my mother had been diagnosed with a terminal illness, and there were signifiant issues at work. All of these had been long term, on-going issues of which the doctor was aware (and for which had tried to prescribe me anti-depressents). After reading a considerable amount in the past few weeks, I’ve begun to suspect I am actually experiencing your point #1 in this article.

    I’ve recently been introduced to Paleo/Primal and was sent some of your writings on Thyroid. I want to thank you for giving me an avenue to begin research of my own self and personal reactions to food and stimuli.

    I’ve printed your foods to avoid and (shocker) a good majority of them were favorites of mine. Artichokes, asparagus, coffee just to name a few were in my diet multiple times weekly. Asparagus fills my freezer in the summer.

    I now have a new doctor due to insurance change. I see her for the first time later this month. I’ll be walking in armed with many of your articles as well as articles from some of the others associated with the Paleo movement who research this area. I will have been on the Whole30 elimination diet, including avoiding FODMAP foods, for slightly more than three weeks at that point, four weeks off of the foods you recommend avoiding for hypothyroidism.

    With any luck, I will not be renewing my Synthroid prescription. It’s out of stock half the time anyway, which is an indicator to me that this condition is not well managed by the medical community.

    I wanted to thank you for your research and for sharing it with the world at large. Please keep it up so that we can continue to educate our medical practitioners or at the very least be more self-aware.

    Thank you.

    • Laurie says

      Joyce, can you please direct me to the foods to eat and avoid lists that you refer to….. I searched the site and was not able to find them.

      Thank you SO much.

    • Lauren Coppela says

      I have no symptons other than a one off week where I had a few heart palpitations and I have as a result of bloods being taken been diagnosed with Hypothyroidism. Not tired, slim very very active and sporty. Been prescribed levoflaxine but don’t want to take it as don’t feel I need anything and taking the hormone will make me too hyper. Looking to try and find out exactly what is going on. My TSH level was 24.8 and T4 10.4. Perhaps it is early diagnosis and the tiredness etc will be coming soon? Lauren.

  123. Sharon says

    I have a lot of Hypothyroid symptoms, but the blood tests have come back normal and after another trip to the Doctor I was nearly escorted off the premises for wasting their time.
    I’m almost at breaking point with not being able to cope with the symptoms, and want to go back to the doctors to insist on further tests or to see a Expert on Thyroid problems.
    what tests or expert do i ask the doctor to refer me to?
    sorry if that question has already been answered above, i notice there are a lot of comments, and is a relief to actually know there are other people suffering out there.
    i’m now being avoided as being the complete nutter in my work place.
    thanks for your help.

  124. JoAnn says

    i have been diagnosed with everything but hypothroid even though I have been to numerous doctors with numerous tests and nothing in the blood. I was tested as a new born because as a newborn I was born with constipation issues which I guess is not right and have had all the symptoms of a thyroid issue my enitre life. Finally, my regular doctor put me on a very low dose of levothroxine which did absolutely nothing. Now I am on numerous anti depressandt drugs and more of the like as I have all the mood indicators, aniexiety, lifelong depression, panic attacks etc….. Both my children and I have suffered from severe migraine headaches since age 3-4. Mine have gotten somewhat better after a hystorecotomy at age 36. I am now 45. So the end result is the diagnosis of fibromyalgia which to me looks exactly like a thyroid issue. I feel that this diagnosis has been given to me as they can’t “find” anything else with test results but i don’t remeber fibro making your hair fall out among other symptoms of thyroid that I have. I don’t have the money to keep running from my regular doc and endochronologist and back to my regular doc. back and forth all the time and I am now on disability due to my “Fibro” and some issues with my back and neck. i never feel good even with all the meds from the phych doc. I take adderal so that I have a little energy and dont sleep my life away. It helps a little. I take 2 anti depressants and 1 anexiety medication. So, in other words it is all in my head ans therefore stick me on all these phych drugs that dont really help much at all…. Oh what to do what to do… my whole life i have been told by family and friends how they think I have thyroid issues. One even bought me a book about it and it was me completely. Now my daughter just recently did get the diagnosis of hypo with her blood test. She gained a huge amount of weight and was so tired she was missing more work that working along with her migraines. We both have very low basil temps. In fact she says that if she ever hits a normal 98.6 she knows she is getting sick. She is 26 now but has had high cholestorol since she was 20 or so. I have worked out 5 days a week which is hard to do when you feel so crappy. I can loose a bit of weight that way as long as I dont eat anything but i have battled my weight my whole life. I have only lost weight even with diet and exerciise with the help of phentermine or adderall. When the body gets used to those they stop working and the weight comes back even if I continue to follow a workout regimin and a diet. I am at a loss. My daughter is now on a dose of levothyroxine but she is still super tired and still getting headaches of which of course she takes a pill for. Seems like we complain and end up with another drug to take. My maternal grandmother had thyroid issues as well as paternal family members. Some no longer have a thyroid and are on complete replacement drugs. I have had gout and both my daughter and i have vitimin d deficiencies. I am in the sun alot as it feels good on my sore body but she is very fair skinned and almost looks aniemic. She also has an iron deficiency and my mother has hematchromotosis as do all of her siblings. My mother has all the signs of thyroid as well but she was a nurse and is old school so the test didnt show anything therefore she she doesnt believe anthing that a test cant prove. Her hair is also extremely thin, weight issues, mood issues, gout in big toe, loss of most of her eyebrows. Mine too. I guess is what I am trying to get at here is that there is a definate history of thyroid issues in our family. I have almost every symptom there is from my nails to my hair to my skin to my weight and my moods. EVERYTHING matches…. I dont know what to do….

  125. Lisette Bornman says

    Hi, I was diagnosed with a underactive thyroid when I was 13 (after experiencing excessive hair loss, fatigue/lethargic- don’t know whats the correct term for very very tired all the time, and rapid weight gain) my mother also has hypothyroidism- and I was on medication for a while, I had to go for test every 6 months to check the levels, I cannot remember everything they tested. However after 3 years on Eltroxin 0.1mg, the doctor stopped my medication because she said that my tests show as normal. Since I have stopped it I had a sudden increase of weight gain to the point where I did not even lose weight when on a diet and I have been on a number of diets. I did not really notice that being overly tired as a result of stopping the medication but thought of it as just being due to stress from exams and later stress from work. Last year I once again tried to lose weight and have successfully lost 25kgs, the first 13kgs I lost in a period of 9 months and the other 12kgs in the past 3 months after a drastic diet and hectic exercise program and using “Duromine” 30mg (Since last year December). Where my question comes in is; I still have 10kgs to lose to be what I need to be according to my BMI, however it is becoming very difficult to lose that last bit, I have not deviated from my diet or exercise program and still on Duromine. Now Duromine helps to give you more energy, the first month on it was great I didn’t feel tired anymore like I used to, but then around the second month I was once again forced to rely on energy boosters to get me through the day, I use a multivitamin (Spectrum Hi-performance), which also helped but also only for a while. I have lately noticed that I am also experiencing excessive hair loss, constantly. Has my under-active thyroid really stabilized, is my weight problem, fatigue and hair loss enough symptoms to get retested and if I do test and they show normal how will I know for sure that they really are, because as I understand your article, the doctors and labs don’t really then know what they are talking about??

    In conclusion; I don’t want to waste my time and money going through all of this just so that at the end the doctor can tell me I’m fine, when she actually has no idea of what she’s talking about. What can I do to make sure I’m correctly diagnosed because I can’t tell her shes wrong, if my symptoms are due to my thyroid, I will need a prescription from my doctor.

  126. Mellisa says

    Sensitivity to Synthroid! When my Hyper converted to Hypo, I was placed on Synthroid. I had an incredibly bad reaction to it, I had vomiting, nausea, my hair fell out in clumps and I had steady weight gain. I was changed to Tirosint and had positive results. Most recently I had my dosage increased, my TSH numbers are super high and my T4 is low. However, I was not given Cytomel for the weight gain which is my biggest problem.

    Has anyone had any success with Tirosint/Cytomel combo?

  127. Rita Hodges says

    for all of those with these problems you should also have vitamin levels checked low D3 causes depression, low B12 will cause you to be tired. There are more effects than I have mentioned but these are I feel are the worst because if you have these you do not want to go outside and by not going outside and not taking D3 supplement will make your mood lower because we get natural D3 from the Sun. If you Fybromyalgia by it’s self or in combination with low vitamin levels and a Thyroid problem makes finding exactly what meds you need very hard also it is still hard sometimes to find out you ha Fybromyalgia because many in the medical world still do not accept it as a real condition. there is also another problem mentioned on here was “leaky Gut” which is a condition not recognized by the medical community as yet but my Gastroenterologist says sounds right is from a woman named J.J. Virgin who is a nutritionist and dietitian she explains about food sensitivities which are very mild allergic reactions which you are often told its your age or your not getting enough sleep etc. this can cause leaky gut I can only remember one of the symptoms right now and that is when you eat a regular meal with in 2 hours you feel hungry again (it might be 2-3 hrs.) not sure that is how mine goes. The best thing about the Virgin diet is you take out 7 categories of food for 3 weeks and then add them back one at a time to see if first the problems all or partly go away and when you add the items back what problems come back. Then you choose to limit intake or cut out the category. these sensitivities can also cause many of the other symptoms so like with vitamins check out every option available to make sure of every issue you have so you can get to feeling better. And please don’t just take my word for it with these issues search for yourself because as much as I am trying to help it is always possible I am not remembering everything correctly. I always tell people knowledge is power and I would add especially when it comes to your or your families health.

  128. Grace Hurtado says

    Dear colleague. I am a cardiologist, so these issues about rare causes of hypothyroidism are pretty unusual for me. But the fact is, that I have a daughter turning 34 who has been going to several doctors, experts in Endocrinologist, but none of them have given her a solution. Lets go to the point. She has all the symptoms of hypothyroidism, as gaining weight, fragil and lis of hair , weaknesses from time to time. She refers this symptom like an on and off. The blood test she was run were absolutely normal. In case the cause is a matter of high resistance of tissues, wich is the best treatment? To take T4 or T3 orally? And which will be the accurate dossis of T3 for her. Tnanks a lot. Best regards

  129. Mellisa says

    I’ve been battling hypothyroid for 3 years and before that hyperthyroid for 4 years. My problem is weight management. I live a very active lifestyle and have a very healthy diet and I am afflicted with no other illnesses. I take my medicine and am in the normal hormonal range for hypo management, but I keep gaining weight. I have put on a total of 25 pounds in the last 18 months and cant get it off. I am within my weight class for my height but not for the amount of physical activity and diet that I carry. I am also not comfortable with the additional weight. Has anyone else done everything right and still have trouble with weight gain not associated to overeating? What helped you overcome?

  130. Katy says

    Thank you so much for this. Now I can check what was tested and go back to the doctor if TS3 levels weren’t checked. This totally makes sense why blood results are normal when I am so sleepy. A sleepiness which does seem to get worse with stress, though not ruling out Chronic Fatigue Syndrome yet either.

  131. Tamara says

    So, any idea how to or what doctor to go to that will listen? I have had thyroid disease as a child, and was on Synthroid for 6 years. Now my thyroid levels have been from 5.3 to 3.5 to last week 4.7. I have gained over 100 lbs without eating much. I am so tired all the time. I sleep 90% of the day, not wanting to I Have to. I am fatigued. I am freezing all the time to the point I Have 2 heaters in my apartment in addition to my regular heat being turned up to 90. I also need heating pads and blankets…because I am always cold. My hair and eyebrows are thinning. My skin is dry, I am light headed. My voice recently has started to get hoarse. But because my damn levels are withing the 5.0 normal range save for once no one will help me. I am seriously about to buy synthroid online or find another way to obtain it to get some relief. I KNOW what is wrong with me, no doctors listen and this is upsetting me. Do I have to die before they listen?

  132. Celine says

    Hello,

    Thank you for this great article; However I wasn’t able to find the answer to my question, maybe you would have advice?

    I have Hashimoto’s and my TSH is normal, T4 as well and T3 is low. I tested my cortisol levels, they are normal, and my oestrogen/testosterone levels as well. Selenium is within normal range but more on the high side, vitamin A and D are under-range. Iodine is under-range too.

    I still have thyroid symptoms, more than before.

    Could my symptoms be due only to the vitamins and iodine deficiencies? Or could it be something else?

    Many thanks for your help :)
    Celine

    • Kathy says

      My numbers are similar to yours except I wanted to be tested for Hashi’s and Thyroglobulin numbers are OK. My D3 is 47 which is in range but I would like it higher (and this is with supplementing 4000 units/day) and I live in Florida! My T3 is LOW! I take supplements including one for Thyroid that has selenium and iodine and L-tyrosine. How do I get my T3 up? Do I take Cytomel?

  133. Nada says

    I do a regular blood test once a year and i realized that my TSH level has gone lower this time but my T3 & T4 are the same and according to the lab test they are within the normal range. should i be concerned that my TSH level has gone down?

  134. Holly says

    So – you’ve described my plot. And yes my MD just continues to increase my dose despite no change in symptoms or lab work. But my question is – who can I go to to correctly diagnose and treat me???
    I’m currently being seen by a very well reproduction endocrinologist at UT Medical School.
    FRUSTRATED and confused in Houston –
    H

  135. andi says

    i have had test done on T3 and T4. i know in my gut something is out of whack with my thyroid. i have tingling, pins and needles all over my body, i am 51 and female, i am tired when i wake up, i have gained 20 pounds in two years with no life style changes to account for it, yet my tests are “normal”. i am not floating in dough and am hoping to figure this out on my own because i am a substitute teacher and don’t make enough to go to endocrinologist. my mother had a goiter removed. i just want to feel better. Not everything is aging. if there is one thing i have learned from this, do not except all the changes as aging and dismiss your body trying to get your attention! that is my hope for all of you who read this.

  136. Mike I says

    I love this article on thyroid disorders and have a question. Would the following lab results fit into one of these categories.

    TSH: 1.8
    T4: 2.4
    T3 Uptake: >50
    Free Thyroxine Index: >1.2
    T4, Free(direct) 1.63
    Reverse T3, Serum 12.8
    T3: 75
    Triiodothyronine, Free, Serum: 2.8

  137. Rebecca says

    Hi there,

    I was just wondering if you might be able to shed some light on my symptoms. I am 24 and have suffered with quite bad tiredness, aches, pains, and sore glands plus a ‘slow’ kind of feeling, on and off for a few years now. I am always intolerant to cold and always have cold hands and feet. Anyway all of this was always fairly tolerable. I managed to get through uni ok for example. After having my son last January, symptoms have got far worse. My legs feel super heavy and I seem to be always tired, weak all over and slow in myself no matter how much sleep I get. My ankles hurt and have tiny fluid cyst like things on both. Along with this I now also get short of breath just by climbing the stairs, have indigestion and acid reflux type symptoms too, have chronic tonsil stones and I sometimes feel dizzy upon standing. I’m not overweight and was always active before pregnancy. In the past year i’ve been to the emergency department over this and also seen my gps several times. All tests showed normal including the thyroid function tests they did. My blood pressure has always been on the lower side of normal.
    The point is is that there is history of hypothyroidism in the maternal side of my family. (My mum developed it after having my sister and my grandparents on her side also have it).
    I’m tired of hearing there is no physiological cause for this since I do not feel that simple bloodwork is exhaustive enough to conclude this. I’m not depressed and I also don’t believe it is the usual ‘new mum’ type of tiredness. Are there any better tests I can get to check for thyroid problems? Any advice or suggestions would be grateful.

  138. Romidla Morrison says

    Eight years ago I was diagnosed with Restless Leg syndrome. I had insomnia for 3 months and had a hypothyroid diagnosis. Dr stated it wasn’t low enough to treat. I was given Mirapex for the Restless leg and had taken it for the past 8 years. Until last November. I had gained weight from 156 to 206 over those eight years. Under much stress ect. I crashed November 30th 2013. I can’t seem to find a Dr. who cares enough to even run blood work. I have to tell them what to do and I am no Dr. I no longer take any kind of medication and have experienced withdrawal from the Mirapex. I feel surges in my head in the location of the pituitary upon waking in the morning. My body twitches, arms and rt leg, Neck ect. I have changed my diet and lost 15 lbs. I have an enlarged node on the left side of my neck. Which Dr. says check it again next year and will not refer my to the endocrinologist. The twitching has decreased greatly but is still experienced each night and morning. I must return to work soon and I am concerned I will not be able to handle the stress without proper treatment. TSH 1.060 uIU/ml thyroxine t4 10.00 ug/dL t3 uptake 26 free Thyroxine index 2.6 I am 60 years old Female. Is this twitching still part of the Mirapex withdrawal or do I need to find a new DR? Still very tired. Thanks

    • Chimonger says

      Romilda,
      It is a concern your Doc failed to listen to you enough, AND that he blew you off until next year to recheck that swollen gland? [maybe I misunderstood?]

      People can order and get their own lab tests these days–insurance probably won’t cover it, but, SOMEtimes, that’s Worth it!
      Places like:
      http://www.directlabs.com
      http://www.healthonelabs.com
      http://www.accesalabs.com
      And many more, on google search.
      People order, the kit is sent to you, OR, can go to a lab-draw-point near you. Results are sent direct to you; I believe you pay directly for their services.
      FIRST: one needs to learn what tests to order, before ordering willy-nilly.

      Surge-feelings in head: me too–they don’t seem to happen as much when using a good Natural Desiccated Thyroid [NDT] at high enough dose.
      Docs shined me on for years, only dosing the low 30 mg Armour–they err on the side of caution?
      I kept feeling like I was losing ground.
      So I tried doubling that dose for 2 weeks, and felt significantly better–EVERYTHING felt better [that’s saying a lot!].
      Rather than have to argue my case as if it was a legal brief with HMO Docs, I found an outside clinic Doc who also does some alternative medicine.
      She listened; paid attention. I did bring in a sheet of paper to add to my file, listing:
      1. probable causes of my low thyroid; [family, exposures…]
      2. symptoms I had without taking NDT; [litany!]
      3. how I felt when taking double that does [60 mg. Armour]; 4. concerns Armour Company changed formulation–many people stopped getting relief of symptoms.
      5. why I came there for this: because I was too tired of struggling to get help from HMO’s, etc., something was needed…I’d seen too many people on tiny doses, getting no relief, who’s Docs actually said “Don’t expect to get relief from your symptoms when you start taking thyroid”.
      [[really!?]]
      She immediately RX’d 60mg dose in WestThroid Pure [WP], enough to cover using that new kind until the next HMO Doc appointment for lab tests [annual labs for thyroid testing are mandatory, or the RX will not be refilled].
      Getting that RX filled, was a whole ‘nuther circus–had to call a dozen+ pharmacies, 3 said they stock it, but really don’t–they stock the regular WestThroid, called “NatureThroid”, which they try to foist.
      My HMO Pharmacy finally DID order it for me: I paid out-of-pocket close to same as it cost them to order it–though they billed it on the records as having about double that practitioner price .

      Romilda, LOTS of things can cause muscle twitches, including low thyroid. Magnesium and/or potassium deficiency can also cause it, as could other things less likely. Some even get twitches and bad charlie horses from being Dehydrated.
      One Solution: Drink more water–at least 6cups or more, depending on your weight… daily, with some fresh lemon or lime juice squeezed into it–that gives hydration, a little electrolytes, and it helps alkalinize the whole system as it needs–and it’s very cheap!

      Detoxing from medications usually doesn’t take too terribly long–a couple weeks?? Average? “Hard drugs” can take longer.

      PLEASE look for a different Doc.
      IF your insurance only covers Docs/services they authorize, then to get coverage, you will need to try working within their “chain of command” rules, to get what you need.
      That means asking questions of that insurance system, learning the rules, and finding other potential providers that are in the network. You can interview staff, and ask questions like “How does this Doc evaluate patients for low thyroid? Does this Doc listen to symptoms the patients report, as well as lab tests? Does this Doc have good knowledge of “sub-clinical low thyroid”? Etc. to help screen for one that might do better for you.

      OR, pay for an alternative medicine Doc, out of pocket.
      I did, and never regretted it—but you still have to quiz the Doc or their staff, about whether they have any experience in this–OR, if they would be willing to help be a “Medical Sleuth” for your needs. [[my outside Doc cost $150 for a new patient work-up; follow-up office visits cost $45–I think that is for at least 30 minutes+; labs are extra, or, she can order them, and I can get them done at the HMO labs]]

      If I’d kept letting the HMO Docs keep me buffalo’d into accepting their “erring on the side of caution” any longer, I’d still be feeling bad, losing ground, related to low thyroid.
      Now there’s at least one Doc on my side, and I’ll have several months of the higher dose evidence to present to the HMO Docs doing the labs—the proof is in the pudding!
      THAT brings peace of mind!

  139. Michelle says

    About 10 years ago I was on a low dose thyroid medication and than my doctor went out of the country so I had to find a new doctor. My new doctor did thyroid test and they said I’m in normal range and they did not refill my thyroid medication. I have it checked every year and it still comes back normal. I have all the symptoms of hypothyroidism: I’m cold all the time, my BP is really low, I’m very healthy but yet I had an increase in my LDL cholesterol, and I’m tired and have no energy. I have another autoimmune disease called Interstitial Cystitis. Anyways, after my last lab results from my primary doctor I made an appointment to see an endocrinologist; hopefully I will get my answer. In the meantime I’m doing my own research. My primary physician only tested TSH and Free T4. They said my results came back in normal range but yet I have all the symptoms. My TSH read 2.495 and my Free T4 read 1.36.

  140. Amy says

    Hi Chris. Great article. Are you familiar with the work of Dr. Alex Vasquez? He reports that thyroid receptor resistance can be inferred by testing for the total T3 to reverse T3 ratio. Optimal is 10-14, with lower values indicating thyroid receptor resistance. He suggests treating initially with T3 alone (no T4) and possibly pulsing every few months, with T3/T4 supplementation in between as appropriate. What are your thoughts on that?

  141. christine says

    Hi Chris,
    I had some major concerns about my current health.
    I am a 27 year old female, smoker (unfortunately), am 5’9” and weigh maybe 120lbs at best.
    6 years ago, I know my weight was at 140lbs and that to be was perfect. So, I know I am underweight.

    My symptoms tend to fluctuate between hyper and hypo. I did an intense research tonight, and I learned a couple of things. Firstly, I know that hyper/hypothyroidism cannot be caught using the basic simple tests that are used, also, that fasting and time of day can possibly affect the results. Also, I didn’t know that there was a possibility that I could have Hashimoto’s and Graves’? From the article I read, I don’t feel quite right, and sometimes it feels like a tug-of-war with energy, my weight loss, cold intolerance, heart palpitations and the pounding that is felt through the whole body, trouble concentrating and foggy memory. This has been going on most probably on and off for the past couple of years.

    I was tested once, but I have the distinct impression that I have a thyroid problem and the tests came up negative despite the symptoms of both hypo and hyperthyroidism. Just read this just now, ”hyperthyroidism (Graves’ disease is a common type), in which the thyroid unleashes a flood of excess hormone. This can shock your body into sudden weight loss, rapid heartbeat, insomnia, or bouts of diarrhea. Sufferers can feel constantly wired, warm, and shaky, as if they’re hooked up to an IV filled with espresso.”

    And a few hypothyroid symptoms are ”forgetfulness, fatigue, frequent chills, constipation”. It’s just a whole big combo of both hypo and hyper symptoms.

    But is it possible it’s also a mal-absorption deal?

    I would appreciate any advice.
    It’s definitely a trip to the clinic on Monday.

    Thank you

    • christine says

      Also wanted to mention that currently I am not suffering from swollen lymph nodes, but I had a swollen lymph node on the right side of my neck, at the back of my neck, two inches from my ear. It stayed there for months, and disappeared.

  142. Umair Ahmed Khan says

    Hello there…It’s a really good place to ask about my thyroid condition…I am form Pakistan…3 months ago in August i started to feel a bit tired but i didnt notice it and carried on my life but gradually gradually it started to get worse and after few weeks i was very tired and had sleepy brain all the time..whatever i eat whatever i do i will always drowsy and tired…I got my sugar,Thyroid and Cbc checked and as a result…i had TSH 6.9 and in cbc i had low platets 64000 and my sugar was ok with 86mg….the ENT Doctor gave thyroxine 50mcg and i have been using it for 1 and a half months now but i still feel tired and my brain is unfresh even i sleep all the night with peace…plz help me to get out of this condition…i want my brain freshness and agility back again :( My parents think that i mostly stay at home all the time due to no job so i m taking stress on my mind and i am depressed…i try to keep my mind calm and do not think of it but my tiredness don’t leave me…I really want help from you people…i had vitamin d3 test also in which my vit d level was 28…i recently had a cb and thyroid test again and all came normal…Tsh T3 T4 were all normal and platelets now increased up to 115000….last year i had kidney stones issue which i dont have now…Now i am waiting for you people to help me out…Plz

    Regards

    Umair Ahmed Khan

  143. Kathy says

    I am curious about your number 1.:
    Hypothyroidism caused by pituitary dysfunction

    It is about the only place I”ve seen hypothyroid considered when TSH is low.

    About me: turned 40 yrs Jan 2013. From 2004 when I stopped breastfeeding until approximately Jan 2013 I weighed between 128-132. I am 5’1″.
    Since Jan 2013 to now Nov 2013 I have gained weight and now up to 143. Gain of 11 lbs. It might not seem like I lot, but remember I didn’t gain for 9 years. My exercise has always been on the lower side.

    I also have been perimenopausal for the last 9 years or so and on bcps since the diagnosis. I did stop them in 2012 for some time, tried hormone replacement, then went back to bcps (Sprintec) in Sept 2012. This was the first time I discontinued bcps since 2004. I’m adding this b/c of course the perimen and/or the bcps might be the real issue, who knows.

    I do have some autoimmune history – psoriasis, mono, some evidence of immune issues when trying to conceive.

    Here are my last thyroid test results from august 2013:
    T3 Uptake 26.3 22.5 – 37.0 %
    Thyroxine 9.5 4.5 – 12.0 ug/dL
    Free Thyroxine Index 2.5 1.01 – 4.44 Ratio
    TSH 0.911 0.55 – 4.78 uIU/mL

    Symptoms besides weight gain: constant fatigue, sleep a lot, stressed, extra facial hair (testosterone levels were normal), intermittent hair loss on head, dry hair, tire easily, low energy, anxiety and depression (on effexor 150 mg which helps but not completely).

    As you can see, my TSH is on the lower side, as is the T3 Uptake. TSH has gone down about 50% in last 2 years. The test previous to that was in Dec 2011 and it was 1.4 at that time.

    I’m not sure how I can be hypothyroid with a TSH of .9, but according to your number 1, it can.

    So my question is, if you agree that this is worth pursuing, where do I go from here? An endocrinologist? What do I ask for? How do I figure out if this is the issue? What other symptoms would I have?

    I really don’t feel like my life or eating habits have changed all that much to cause this weight gain. Yes I have been eating late at night more, but not a LOT more. I have cut back on what I eat during the day. My regular diet is pretty reasonable, I don’t pig out, don’t drink much soda, I eat a lot of fiber, etc. I have not started any new meds this year except for the Sprintec bcps last September (restarting them after 9 mos off of them but I was on hormone replacement some of that time). My day 3 fsh was 24 last September (perimenopausal). That’s all I can think of…

    • Kathy says

      Two things that just occured to me: 1. My tsh says it is in uIU/mL but most of what I”m reading online says uIU/L…what’s the deal there?

      ANd 2. other symptoms are really bad memory, especially recall memory, word finding, short term memory, difficulty concentrating, and also, well, saying the wrong word (like I call a doorknob a car). Of course these are all stress related as well.

      Would I go to an endocrinologist to get cortisol levels tested? I really like my nurse practitioner, but I hate to ask her to order tests that she isn’t personally recommending. This is not exactly her speciality. Would getting cortisol levels tested help clear up the picture?

      • christine says

        ”bad memory, especially recall memory, word finding, short term memory, difficulty concentrating” that’s me most days.

  144. Debbie says

    I am so Ill, can anyone offer any advice please?
    I have now completely stopped my Thyroid Medication (a total of 17 days so far) – I can not tolerate the terrible symptoms it causes, so would rather go without it – along with my underactive thyroid I also have Adrenal Issues & a Multinodular Goitre. I have tried building the Thyroid Medication up very slowly and it is not working – after nearly three years of trying I feel that it isn’t the only problem. I did wonder if Stomach Acid was a problem but don’t know where to go to find that out, or maybe Aldosterone is the missing link. I have used T3, Levothyroxine & Nutri Thyroid and all have had the same effect, out of all of them T3 was the one that done some good as well as causing terrible Symptons to. Does anyone know what is going on? I feel so bad and full of pain all the time.
    Thank you

    • Mike says

      Debbie. I’d be curious to know what your cortisol levels are. I’m finding that it is very important in relation to not only your adrenals but thyroid function as well. I believe something is making your thyroid work way too hard. Have you had your iodine level checked?

    • Mike says

      Debbie. I’d be curious to know what your cortisol levels are. I’m finding that it is very important in relation to not only your adrenals but thyroid function as well. I believe something is making your thyroid work way too hard. Have you had your iodine level checked?
      Do you track your temps? This too can provide valuable info.

      • Debbie says

        Hello Mike,

        I had the ASI test done (privately) July last year and the Adrenal Function was low throughout the day & evening, I was told to take Nutri Adrenal but that disagreed with me and I couldn’t take it, My private DR thought that Vitamin C with Liquorice & Gingseng Tincture would be enough to get them working again. this was wrong and as the months past I was getting extremely Ill, my Temp would be around 34.2 and my pulse would be about 98bpm and had lots of terrible symptoms including struggling to breath & Chest Pains. In Feb this year he told me to get Hydrocortisone – It was nearly to late – I didn’t even have the energy to lift my hand, I just laid on my bed praying that I wasn’t going to die. After approx seven hours after taking just 5mg of Hydrocortisone – It was wonderfal and I though I was then on the road to recovery. I was wrong and soon realised that taking more than 5mg would cause terrible symptoms including the feeling my chest was burning, sweating, struggling to breath and terrible pain. My GP was not interested in checking Iodine – and advised me to not take vitamins because they were danagerous. He said my Adrenals were fine and all that was wrong was that my TSH was aliitle high. I just don’t know what to do, I can’t take anymore (than what I am doing Hydrocortsone) & can’t take the Thyroid Medication. I have had stomach problems for years and wonder if thats part of the problem

    • Amy says

      Debbie, have you considered you may be intolerant to inactive ingredients in the pills? You may want to try a compounded thyroid supplement. My understanding is that Westhroid Pure and Tirosint are gluten-free.

  145. Lee says

    I am a male who has been taking straight T3 (Cytomel) for a number of years for my autoimmune thyroid disease. At 40 mcg per day (spread out over 4 doses), my TSH, FT4, and RT3 have always been very low with my FT3 running between 4.0 and 5.0 pg/mL. In addition, I have to supplement calcium and magnesium at 133% RDA or more due to my high calcitonin (thyroid tissue flooding my bloodstream due to autoimmune attack), low PTH, and low potassium. Recently, acute hypothyroid symptoms started coming back (dry skin, painful finger and toe joints in the morning, and shoulder and neck muscle pain). Lab test indicated no RA and my typical results, with the exception that my TSH is now 11.5. What would cause hypothyroid symptoms with a high TSH, even though my FT3 is at the high end of normal? T3 resistance? My doctor does not have any ideas besides pituitary adenoma for the high TSH, but thinks my hypothyroid symptoms are due to the relatively high amount of refined sugar I have recently had in my diet.

    Further info: My testosterone levels are normally quite low, though they were not tested with this lab. My corrected serum calcium was at 8.5 mg/dL, which is very strange for the amount of calcium I take, and my VitD25-OH was 37.1 ng/mL, though I have been taking 5000 IU per day of VitD3 for years. My serum iron was at 153 ug/dL, which is unusually high for me. I have also been taking low dose naltrexone for few years in order to keep my thyroglobulin antibodies down near 1000 IU/mL from their previous high of 16,000.

  146. Sophia says

    Thanks for taking the time to write all these informative articles, Chris.
    I was wondering if you could write an article about the converse – over medication with synthyroid and if there are any patterns that won’t show up on TSH.
    For example, my levels have been fluctuating for over a year now after many years treatment for hypo, with my need for synthyroid mostly steadily decreasing. I am again having symptoms of hyperthyroidism, and the nurse taking the blood thought I was hyper as the veins on my arms and hands are very prominent, but the TSH came back firmly in mid normal range.
    Does one feel it long before it shows in tests or are there other causes? Hopefully others might find that subject helpful too.

  147. Jolien says

    I read your article because I have been taking Thyrax, levothyroxine. for 4 years now and somehow I feel rotten sometimes and good at other times. Anyway I try to get more info on the thyroid.
    What strikes me is that in yuour five types of thyroid disorders I find none of the ‘normal’ types (which I had). High TSH and low fT4….how is that possible???

  148. chimonger says

    It gets to be a lot of work, when searching for suppliers of NDT’s [Natural Desiccated Thyroid].
    My Doc told me she wanted me using “Westthroid–the kind that has no “inactive ingredients” except inulin and MCT’s”. OK, great!
    Several days & hoards of phone calls to lists of pharmacies showed:
    1. Doc wrote the script using old name [WestThroid], and failed to included “WP” in order to get the kind she discussed. She didn’t know that it came in bottles of #100, or she’d have weritten it for round numbers, instead of “a 90 day supply”.
    2. American pharmacies apparently tend to be labeled “NatureThroid”, not “WestThroid”, and few understand the difference between “Regular” and “WP” or “Pier”.
    3. ANY pharmacy can order things not on their formularies: but they usually refuse to order anything not on their lists from their main suppliers.
    Some will order it, but will charge you dearly for it.
    It is most always “out-of-pocket”.
    4. It comes in bottles of #30, #60, #100, for instance. If your Doc orders a quantity of pills that is less than a full bottle, you still pay for those wasted pills the pharmacy cannot give you.
    5. Smaller pharmacies/stores are more likely to either carry it, or, order it for you.
    6. IF you are a Medicare recipient, and your coverage is rolled into an Advantage Plan, you MIGHT be able to have your Plan’s pharmacy fill an order from an outside-the-system Doctor for this med.
    BUT you might need to spend time, phone calls, and numerous days to achieve them filling that script, and may or may not get some coverage for the cost of it.
    7. NDT’s are cheap.
    Pharmacies that charge large prices, are usually paying for high overhead like a remodel or move of their store, etc. [like one Compounding pharmacy in our area, which quoted almost $80 for #180 NatureThroid, [more than 4 x the practitioner cost].
    Wholesale cost for NatureThroid Regular, is less than $11 / #100.
    Wholesale for NatureThroid WP #100, is less than $17 or so…just to give you a clue.
    MOST Pharmacies will try to have people believe that all meds are expensive, that NDT’s are more costly than man-made, etc.
    But NDT’s are still way cheap! Don’t let yourself be buffalo’d into paying too much for them.
    8. Any MD, ARNP, or PA, [and others?] usually can order NDT’s directly from the companies that make them, at wholesale, or close to it—IF they are willing to do that [not all are willing].
    Practitioners authorized to prescribe meds, can then fill the orders they write for these—AND save their patients money, too.
    Many practitioners who prescribe and sell/provide other supplements, have included NDT’s in their stock, too. We used to do it at our office, keeping a bottle of Armour on hand to at least get patients started while they found a regular supplier; a practitioner needs to know: they need to sell whole bottles, not partials [sensible]; selling/providing a whole bottle of #100 tabs, makes it easier for everyone….most practitioners have no idea how hard it has become to find NDT’s in stock anywhere, much less the rarely stocked “WP” form.

  149. Veronica says

    Is this a joke? “Now, follow me on this. Who goes to labs to get tested? Sick people. If a lab creates its “normal” range based on test results from sick people, is that really a normal range? Does that tell us anything about what the range should be for health?”
    That is one of the most absurd supposed-medical line we’ve ever heard. Don’t blindly follow absurdity, no matter how simple it sounds.

    • Lee says

      Veronica,

      Who is “we” and what is absurd about it? This is a pretty well-known fact. Labs test the community of people, which includes various genetic populations on an American diet, and some with non-diagnosed diseases. How can a true “normal” range be established from that. Merck Manual seems to be a better source of what is normal.

  150. Bethany says

    I’m starting to suspect that I have a thyroid condition of some form. I’m displaying some of the symptoms, not to mention that my diet is clean (90-95% paleo), I’m doing appropriate workouts, and I’m not overeating calories, yet my weight remained unchanged in a three-week period and my body fat % went up by 0.9% in that same time frame. Since many of these patterns won’t appear on standard thyroid panels (I have a dr appt this Monday), how should I go about further investigating this? Should I see a practitioner of another specialty? I’m going to request that all thyroid-related tests be done when I’m at the doctor, as well as my cortisol levels and any other hormone levels.

    Thanks so much!

  151. Amanda says

    So I am one of those people that has had conventional thyroid tests that are “normal”, but suspect that I am actually hypo. I think my best route would be to do the lab tests independently, and out of pocket at this point. Are these tests normally HSA-elligible? How do I find a good lab? I live in Los Angeles. Thanks!

  152. Pat says

    I have a lot of the symptoms of hypothyroidism and would like to know what type of doctor I can go to? I live in Connecticut. Bloodwork done in 12/2012 showed:
    TSH, Highly Sensitive: 1.91
    T4, Free: 1.49
    Thank you for any help you can give me.

  153. Stephani says

    Thank you so much for this article. I seriously would have been undiagnosed and still feeling like CRAP. I finally switched doctors, recommended to be retested and test T4 and T3 as they were not done the first time and found out that my T4 and T3 levels were high. THANK YOU THANK YOU THANK YOU!!!

  154. chimonger says

    Beverly,
    I failed to locate your post on here, but trying to answer:
    In the 1950’s Docs most likely would have been dosing a dessicated thyroid product, like Armour.

    It is fairly common for pregnant women to have some thyroid deficiency–pregnancy can magnify sub-clinical hypothyroid, and can cause larger weight gains, edema, high BP, etc. signs that someone might miss, many Docs mistakenly labeling it “just normal pregnancy for some women”.
    More savvy Docs know what it is, dose dessicated thyroid, and relive symptoms, keeping Mom safer, healthier. Some women, like my Mom, get “crazier and fatter” with each successive pregnancy.

    My Mom should have had it; Docs failed to recognize or dose her for symptoms she has had her whole life–her behaviors suffered direly, making her life and us kids far too “interesting”.

    An old Doc, back in the 1920’s, observed Gma’s symptoms in pregnancy and perinatal issues, & in my dad, too, when he was a kid, so dosed both of them.
    They both took it for some years, then moved, got new Docs who never paid attention to that, so doses got stopped. IMHO, in retrospect, factoring in their other health issues over their lives, both would have been healthier, if they’d kept taking it.

    Mom’s life, and us kids lives, would have been massively improved, had Mom gotten dosed regularly with thyroid. Now, she’s too far gone mentally to understand how badly she’s always needed it, and refuses to see Docs at all unless it’s an emergency. My siblings also do not understand [and likewise demonstrate hypothyroid issues] & block any progress towards helping her get it.

    It’s a real problem–how many in general populations have mental issues, which might simply be regulated by dosing dessicated thyroid?! IMHO, it’s not only sex hormones that can be blocked by hormone-interrupting chemicals in the environment. Just about all hormones can be blocked from use in the body, by the many thousands of chemicals in the environment…it’s a bunch of complicated studies begging for being done!

    • Chimonger says

      Beverly,
      DES would be a different discussion…but I will say this, since I have no other way to reach you to answer:
      It was VERY common for those receiving bad drugs, to get swept under the rug, back then.
      Unfortunately, those affected by it are suffering consequences more now, than before.
      The habit of closing class action lawsuits in a limited number of years, or ignoring doing studies on them, result in repeated mistakes, and perpetration of more bad medicine.

      As for a nurse failing to take note on their own meds? OMG! that happens ALL the time.
      Also, since Dessicated Thyroid was about the only treatment for hypothyroid then, who’d pay much attention? It was the only thing used..so, one only had to say, I took meds for this condition, and anyone in the Biz would know it was that—so it was kinda a non-issue—until BigPharma cooked up artificial hormones in the lab. It simply easily feel from memory.

      Hey…I’ve been the queen of “I will always look it up before I take it”
      …yet, when one is ill, there’s usually some degree or more, of mental fog or dysfunction
      –it might be all we can manage to simply follow orders.
      I made that mistake twice–and it resulted in a heart attack from adverse effects of a blood pressure med and a diuretic that both has similar adverse effects– additive effects that really crashed me….I was ill, not thinking straight, and -just took them- without questioning or looking it up.
      AFTER that, I got hold of myself, looked it up and determined to make rational choices, to take control of my health again.

      In the1950’s, as knowledgeable as nurses were then, it’s -almost- minor, compared with what nurses must know now. It’s to easy to make mistakes, omissions, or miss things related to daily overwhelm…trying to function in that milieu, AND be ill, such as from Hypothyroid, makes it far too “interesting” a challenge.

      A Mom in my family also took DES during each of her 3 pregnancies, to block nausea.
      It worked. Kids popped out seemingly healthy. She felt decent. But when information got published about it, she was also proactive, and kept her kids informed as much as she could.
      With that knowledge, the 2 girls chose to not have babies themselves; the boy eventually did have a son, late in his life, BUT, that man now has to make healthy choices, monitor his health for potential cancer or other residual consequences of that Mom taking DES, which could mangle genetic expression for generations, and make sure his –now teen–son ALSO does that. We have no completely clear idea how many generations it might affect, nor any surety of how, or if epigenomics science might show how to reverse damages. One of those daughters actually has had breast cancer–though her Docs swear it has nothing to do with that DES her Mom took, I suspect more sweeping-it-under-rugs might be happening there. She’s been successfully treated, though. The other daughter has taken great measures to keep healthier, make better choices, than the others, which can likely result in her overall better health..

      As prevalent as DES was in the 1950’s, it’s a miracle or few that my Mom didn’t take any–her poverty may have saved us all from it!
      Poverty meant she never got some treatments that were available–she nearly died from hemorrhage post-partum…also likely related to hypothyroid—but she survived.

      IF we could just get science to over-ride industry, to pay more attention to correcting how the thousand of chemicals in our environ can block use of all hormones, and correct the poor testing we do! Affected people might then get needed treatment; I believe we’d soon see a drastic drop in mental health issues, behavioral problems, and probably see better functional capabilities.
      Our world could rapidly become a better place, just on that alone!

      So don’t blame Mom for not pursuing it, or not paying attention—-her nursing profession meant she achieved greatly, in the face of adversity related to hypothyroid issues as well as bad drugs taken in medical ignorance & industrial/science/legal cover-ups—-that is remarkable!
      Those who manage to get thru life despite hypothyroid issues, have struggled mightily to do so, in the face of great adversity all too often.
      We’ve likely endured other foibles related to being in that condition, which otherwise might have been more deftly avoided.

      Oh yes–and miscarriages CAN be related to hypothyroid issues–multiple generations of that in my family–some couldn’t carry to term without being treated for it. .
      It might be debatable that Medical professionals are getting more incompetent—it’s more that they are completely overwhelmed by so much information, pressured greatly and too distraction from having insurance companies over-lord them at every turn, dictating what they can and not do, AND being forced to churn through unrealistically large numbers of patients per day just to “break even” on their operating costs. That whole setup is a guarantee to fail.

  155. Pegster says

    Chris,

    Could you explain what you mean by physiological ranges for thyroid, as opposed to standard lab ranges? And could you give us the figures for the various physiological ranges?

    great topic and clearly a lot of hurtin’ people!

    thanks,

    Peg

  156. Chi says

    I know how licensing and finals are! I wouldn’t want to have to go thru that again! It makes perfect sense that anyone could produce some typos and mis-stated info under those conditions!

    THANK YOU! Chris, your article is so helpful to understand better!
    AND, it provides data I can show my Doc, to better hope the dose and med can be kept properly adjusted.
    I’ve been on Armour on a tiny dose–30mg–for some years, with little relief–but at least it was preventing feeling worse.
    Apparently, for somewhere over a year, my Provider Group has evidently been replacing [?] Armour Thyroid with “C29″. They had given Armour thyroid to begin with, then at some juncture, it changed to being labeled C29.
    Shame on me for not paying better attention–however, when a person is ill, not functioning right, it’s really hard to be one’s own advocate!
    Just couldn’t figure why I was feeling worse, until I paid closer attention, and discovered the new label.
    I called the Group’s pharmacy, and was told first, “It’s just like Armour thyroid”…then in same conversation, he said “It is Armour thyroid”.
    Hmmmm…!?
    Asked to clarify, he reiterated, “It is Armour Thyroid”.
    But he couldn’t answer why it was labeled C29.
    I’ve called a few other mainstream pharmacies; none can tell any salient information on it.
    Has ANYONE heard of this?
    Had anyone heard of a shortage of Armour Thyroid?
    Or that the company was not going to make it anymore?

    ALSO, I missed any mention of Anti-Thyroid Antibodies testing–especially if other thyroid tests show that so-called “normal” range? Where should this test come into the picture?

    Thanks!

  157. Ruthie says

    Hi,
    I have had symptoms of hypo for a couple of years now. I’ve been tested twice and told I was in the normal range. Not sure of first results but did see the second TSH. It was 1.0 last month. Also back in the spring I had an ultrasound that determined I have an enlarged thyroid with nodules. Go back in November to see if its grown. I have trouble swallowing at times.
    Anyways just wanted your medical OPINION on this and if I should be seeking out help.

  158. Lindsay says

    I had my first child 3 years ago. After his birth I breast fed for a year. I never felt “normal” after I had him. At one year and 1 month postpartum lab results revealed I was hyperthyroid. Prior to that I had several labs….which indicated extremely elevated calcium which eventulally came down on its own. I had an ultra sound which indicated nodules followed by an uptake scan and was seen by an endocriniologist. I was never medicated. I was diagnosed postpartum thryoiditis and told I would likely end up hypothroid. Although my thyroid level stabilized within 6 months the symptoms never went away. I am 31, I have night sweats, hot flashes, occasionaly feeling of a “lump” in my throat, chronic dry eye, hair loss, feeling of lethargy/sluggishness, difficulty concentrating, memory loss, irregular menstrual cycle, joint pain, muscle weakness etc. My “female” hormones were also tested due to the irregular cycle which I have never had an issue with. I was recently placed on the lowest dose of Levothyroxine with the only improved symptom being sluggishness. My thyroid functioning prior to medication over the last 6 months has indicated a normal TSH, followed by slightly elevated TSH, followed by a normal TSH but slighty low T4. They have also checked the parathyroid with lab as well which was normal. What should my next step be? I’m extremely frustrated. My primary dr. referred me to an OB/GYN about 3 months ago when my menstrual cycle stopped for over 90 days. The OB/GYN is the one who started the thryoid meds. Should I see an endorinologist?

  159. Christi says

    I’m going crazy. All my lab work comes back fine. However, I’m still tired and now for the last 2 months my legs swell and have anxiety attacks. Went to a Cardiologist and all is good there. My Endo just increase my Synthroid to 175, trying to get me regulated and still hasn’t done anything. Still tired, still swelling, still grumpy and still having the anxiety attacks. Does this sound like my parathyroid?

  160. Em says

    I would really, really be grateful to anyone who can give me some suggestions about my case. I had an appointment with my doctor who said that my thyroid is normal and my fatigue is not due to that. But I’ve read enough about the thyroid online to feel skeptical.
    2 years ago, my TSH was 4.1
    As of last week:
    My TSH was 3.1
    My T4 levels are normal.
    My T3 uptake is low.
    Other things that may or may not be relevant:
    Last week, my iron came out low.
    2 years ago, my “good cholesterol” came out as quite low (really weird b/c I exercise plenty).

    I would love to hear anyone’s thoughts. thanks so much!!
    My iron is now low.

  161. Tim Hamill says

    Chris, your last paragraph in the introduction is WAY off. Labs (at least good ones) do not derive or normal ranges by testing patient samples. As you point out, testing a bunch of samples from sick people would give you a very skewed look at what ‘normal’ is. Lab go to great efforts to secure samples from healthy adults who are ostensibly clinically ‘normal’….typically volunteers or samples collected at the time of blood donation from healthy donors.

  162. Lisa says

    Anya, There are free clinics you are eligible for. But, make sure they check for allergic reactions. After many frustrating years, I found out through a free clinic, I was allergic to the synthetic medication. Your symptoms are the same as I had.

    Go the the local Salvation Army or the Social Security Office, and find out what you can have access. Most free clinic have a sliding scale. And , See a general practice doctor… endocrinologist do not necessarily look at all the symptoms combined. Before you go, prepare a list of issues/ changes with a timeline.. Once in writing, the doctors can not ignore what you have described.

    good luck.

    Get a second or a third opinion as well.

  163. Anja says

    Can anyone tell me short and precisely EXACTLY what lab tests I need to get done in order to be diagnosed correctly and be given the right treatment ASAP?
    I know for a fact I have hypothyroid disease – I was diagnosed over a year ago during a hospital stay under other circumstances but never did anything about it. I am now really sick, only 23 years old and experience every symptom of hypothyroidism on a daily basis. I am 6′ tall, I model and I was under 130 lbs just a couple of months ago – I sweat at the gym for 3 hours (loosing nearly 3,000 cal/day) and eating under 1,000 cal – however I have GAINED a tremendous amount of weight in a short time under this regime, and still gaining. I have my period or period like symptoms every week (+5 months now), my hair is falling out (half my hair is gone), my skin went from being oily for as long as I can remember to being extremely dry and I have been passing out several times for no apparent reason (blood sugar and head is fine!). I am not a US citizen and medical expenses are costly without insurance so I am not looking to go to a bunch of different doctors to seek help. I would very much appreciate it if someone with a friendly soul could list me exactly what tests I would need done so I can put an end to my miseries. Thank you so much for reading.

  164. Adam says

    Hey all! My wife is pregnant with our second child and has been experiencing hypothyroid symptoms for severl months now. She just got her lab results in and her TSH is at 0.67 and her Free T4 is at 0.9. . . this would lead me to believe that she would fall under the category of Chris’ first classification “Hypothyroidism due to Pituitary Dysfunction.” Can anyone shed some light on what types of treatment can be done given this classification?

    I was reading that B12, Selenium, and Zinc may play a role in this. . .

  165. Debbie says

    Hello Rhoda,

    As with this condition & all the symptons/problems that it causes – all are classed as OK with the Dr.
    I have a multinodular Goitre – which as far as they are concerned is ok, they do not seem to think it is caused by mis treatment of the Thyroid.
    Are you concerned by the Nodules? If so I would recommend a book by Dr Barry Durrant – Peatfield
    called Your Thyroid and How to Keep it Healthy: The Great Thyroid Scandal and How to Survive it – It is a fantastic book and may well help with your worries/concerns, it certainly did for me.

    Kind regards
    Debbie

  166. Debbie says

    Hello Hoosier,

    In my case the TSH was high because the T4 was not getting processed very well and it was just building up in my body causing toxicosis – which is terrible, you still have your underactive symptoms but you also get what appear to be overactive as well.
    What needs to happen depends on how you are feeling.
    How are you feeling?
    Best wishes
    Debbie

  167. Hoosier says

    This essay is interesting, but it doesn’t say what it means if the TSH is high but the T4 is normal. What is the most likely cause of that scenario? What most likely needs to happen to correct this?

    Thank you.

  168. betty says

    Hi, I’m 29 and have had my thyroid tested several times and everything comes back normal. I moved toanother state and they have found I jave a small nodual. I have several symptoms of an under active thyroid and am very concerned that the nodual will get bigger and need surgery. My question is does anyone know what causes a nodual to form?

    • Debbie says

      Hello Betty,

      Do you mean a mulitinodular goitre? – I have one of these and I am of the understanding that these are caused by the thyroid not having the correct treatment.
      Unless it causes any problems for you then their doesn’t need to be an surgery.
      Just because your blood tests come back as normal doesn’t really mean anything, it is very important it is monitored by how you feel, your Pulse & Temperature.
      Best wishes
      Debbie

  169. Lynn says

    Yes, but you need to get a copy of the actual figures. Most endos don’t actually even know how to interpret a STIM correctly.

    • Debbie says

      Hello Lynn,

      Yes, I did have concerns about the endo’s – that why I have been putting off going.
      I will certainly get the test results if they do tests.

    • debbie.paxman says

      Hello Lynn,

      I am reading the book you recommended – recovering with T3, It seems to be a fantastic book, thank you for recommending it. I was shocked to see the large list of suppliements & Vitamins he takes every day, Did you take such large amounts of vitamins & minerals and did you continue taking them when you were well?

      Kind regards
      Debbie

      • Lynn says

        Hi Debbie

        Yes, it’s a fantastic book. I feel it has a tremendous amount to offer, even to those who don’t do T3 only. I used to take iron, but don’t need to now. I take: Vitamin D, B Complex, B12 a few times a week and a lot of supplements for interstitial cystitis.

        • Debbie says

          Hello Lynn,

          I spoke with my GP today & asked if I could have certain vitamin & mineral levels checked, he said that they didn’t check vitamin/mineral levels & that Vitamins were dangerous as they can react with each other.
          I am now concerned what to take – I did think by the book that I was lacking in Magnesium & B1 but how will I know?

          • Lynn says

            I find it hilarious when doctors think vitamins are dangerous, as they pass out prescriptions for statins/antacids/addictive painkillers/diet drugs. Yes, vitamins are dangerous if taken in extreme excess and without keeping an eye on levels, but taken in a moderate way they are not. Sheesh! I forgot the magnesium. I use the oil as well. In the modern world, most ppl are deficient. Plus, unlike say Vitamin D, you can’t overdo the magnesium as the excess washes out.

            And you don’t *ask* a doctor for tests. You assertively demand them. If he won’t budge, just go to a different doctor! I have had to learn to be demanding in order to get my needs met. Sad but true…

            • Debbie says

              I must admit I was shocked when he said that about the Vitamins & Minerals.
              He is saying that They won’t check anything other than Vitamin D & Magnesium, He has said that in July my Magnesium level was fine but going by the book I really thought I would benefit by having more. The problem is hard enough as it is without them being so unhelpful.
              He also said they will only every presribe T4 and are not allowed to presribe anything else – he is either clueless or being arkward

              • Lynn says

                Hi Debbie

                Well, even the Vitamin D and magnesium tests are useful, so find out the results of those. I’d *demand* B12 testing though, as it’s important to know if you are deficient before starting it. B complex vitamins are water soluble and very safe to take, but you need to know if you will need to take B12 for life before starting. Unfortunately, it sounds like you need to go doctor shopping. Sadly, most of us had to do this to find someone good. :( :(

                • Debbie says

                  Hello Lynn,
                  I have my appointment with the Endro next month, so I will see what the results are from that – although I am not optimistic.
                  I have been taking vitamin B complex for about 6 months now, along with various other supplements, but still the outcome is the same whatever t3 or t4 I have I get a nasty reaction to, that even happens with the HC. I don’t understand why this is and I am still feeling really terrible, nothing seems to help with the pain either. It’s going to be really terrible if this endro goes along with my GP, Im just so fed up and would give anything to be well

                • Debbie Paxman says

                  Hello lynn,

                  I have seen Dr Peatsfield 3 times – I think very highly of him and he has helped me and all credit to him he is still trying to help

            • Debbie says

              Hello Lynn,

              Where do you buy your T3 from?
              I can get the Cynomel in 25mg but that is far to strong, The book said that Tertroxin can be puchased in 5, 10,15 & 20mg but I can not find a supplier.
              Kind regards
              Debbie

              • Lynn says

                Unfortunately I don’t live in a country where I can just buy my meds online. So I had to hunt *hard* for a doctor to treat me. Anyway, so I get an rx of Thybon, which is the German version of T3.

                • Debbie says

                  Hello Lynn,

                  I think I may also have to hunt hard for a doctor to prescribe it, the prices seem to have gone through the roof, now their is only one site that I can get it from, but people are saying pressure is being put on them, to force them to stop supplying it.
                  I have started crumbling the T3 up and taking just a tiny amount to see if it goes in better.
                  I am glad you are well Lynn & you can get it prescribed, It gives me hope – thank you

                • Lynn says

                  Hi Debbie

                  What country do you live in?
                  It was a hard slog to get it prescribed, so don’t give up if it takes a while.

                • Debbie says

                  Hello Lynn,
                  I live in the UK in a little village in Suffolk, I left my local doctor & got accepted in one in 20 miles away, now I am being told you have to have a Doc in the catchment area.
                  I am getting rather concerned to be honest my breathing problems are getting worse and my pulse is normally around 94 (even the waking one) I get chest pains sweating and all sorts of nasty symtpons. I am half way throught the book but his symptoms were normal for that of an under active Thyroid, Mine are mixed. The only time my pulse drops below 80 is if I haven’t had any thyroid/adrenal meds for about a week, as soon as I take a tiny amount it shoots back up. Their must be something else going on and I really need the help of a Doc – but know one will listen – my blood tests always come back now with a High TSH but they say I am getting by. I am taking vitamins/Supplements, walking and doing yoga but its still the same. The T3 eases the underactive symptons but gives me all the hyper ones.

  170. Debbie says

    Hello Lynn

    I have got an appointment with the endo in Oct. I certainly do have an intolerance to the Thyroid Hormone but I am sure the results will come back as normal.

    Kind regards
    Debbie

  171. Lynn says

    Hi Debbie

    That test would have to be done by an endo, generally. Your very low iron is likley to be a significant factor in your intolerance to thyroid hormone.

  172. Debbie says

    I haven’t had that test yet, I am searching where I can have it done. The Iron & Vitimin D levels were very low but everything else was ok.
    I am taking lots of various vitamins

    Kind regards
    Debbie

  173. Debbie says

    Hello Lynn,

    Thats great to hear you got you life back. I must admit I am not keen on trying the T3 anymore but I will read up about the RWT3 method.
    My test results from the ASI were as follows
    On waking 11.6 nmoI/L – range should have been between 12 -22
    Mid day was 4.8 nmoI/L – range should have been between 5.0 – 9.0
    Evening was 1.5 nmoI/l – range should have been 3.0 – 7.0
    Just before Bedtime was 0.5 – range from 1.0 – 3.0
    So total score was 18.4 when the ranges should have been 21 – 41 – so not really dreadful
    DHEA: Cortisol Ratio was 3.72 which was in the OK range.
    Kind regards
    Debbie

  174. Lynn says

    Hi Debbie

    Yes, T3 only has given me my life back. I specifically used the RWT3 method, as most other T3 methods out there include raising too fast and by too much at a time.

    Re: blood tests, I was specifically referring to the ACTH stim test and a.m. cortisol blood test results. :) You need to find out if the adrenals are the root cause of your problems, IMO.

  175. lynn says

    Get a copy of the ATCH stim test results and the bloods. “Normal” is a setting on a dishwasher, not a blood test result. :) Very few doctors know how to interpret the results completely. As for T3, I had an extremely bad experience my first time on T3 too. So much so that I was terrified to go on it again for years. However, thankfully I girded my loins and started it up Again in 2012. This time however I used the Recovering with T3 method and my life is completely different now. I’d suggest checking out the Recovering with T3 website and the CT3M method before discounting them. They are worth researching in terms of the potential to heal the adrenals.

    • Debbie says

      Lynn – does that mean that you are completely well on T3 and that their is hope for a full recovery?
      I to am terrified of taking the T3 as everytime I take it I get a nasty response, no matter who small the dose or what i am taking.. I have gone back to T4 but have been concerned that I may have the conversion problem.
      I have purchased a copy of the recovering with T3 book – it is on it’s way.
      I do have copies of my blood tests and it was quite clear that the amount of antibodies attacking the Thyroid is much higher now than before I started treatment over two years ago.

      Kind regards
      Debbie

  176. Debbie says

    Hello Lynn,

    Thank you for your information – I will look into it and hopefully find out what needs to be done to make me well, I have spent a small fortune on differen’t medicines. I really don’t want to take T3 ever again – it is far to strong for me but I will find out where to get those tests done you mentioned and see what shows up. I did have the Synacthen test done by my GP last June but that said everything was fine, just like the blood tests.
    Kind regards
    Debbie

  177. Lynn says

    Also, when you get the STIM test and the a.m. cortisol test, come post at addisonssupport.com. Many doctors do not know how to interpret these tests, so you need to do your own research. Also, CT3M can be done with a very small amount of T3. I’d at least research it if I were in your shoes anyway.

  178. lynn says

    The ASI does not test for Addisons. That is why experts would recommend you come off all adrenal supplements and sex hormones for at least 6 weeks and then do an ACTH stimulation test and an a.m. cortisol. Have you read Recovering with T3 or heard of the CT3M method. Many people with issues like yours seem to do well with the CT3M. You can find out more by googling it. There are also FB groups on it.

    I’d do the proper adrenal testing first, and then move onto other issues after that.

    • Debbie says

      Hello Lynn,

      Thank you very much for your advice, I will get the test done. I am not keen on taking the T3, that is far to strong for me, even just quarter of a tablet is to much.
      I have gone back on the T4 (one day a week) and hope I don’t have the conversion problem.
      Thank you Lynn – you have been a great help
      Kind regards
      Debbie

  179. Lynn says

    I figured that’s what you were doing. Hence your issues. Those tiny increase are likely to be your problem due to the HPA axis feedback loop: http://forums.realthyroidhelp.com/viewtopic.php?t=239. In a nutshell, dosing with small amounts shuts down the loop but does not replace enough to make up the deficit. Hence a person ends up with less cortisol, not more.

    What type of adrenal test did you get done? What were your results? What is the maximum amount of HC you have ever taken?

    I am not a doctor, nor do I play one on TV. :)

    • Debbie says

      Hello Lynn,

      I am very greatful for your information. The Adrenal test i had was the ASI which showed the Adrenals as under performing They were not terrible and I was told to take some adrenal support (not HC) but that had a reaction, so I had to stop taking it, sadly after that my private Dr thought all I would need was various Vitamins, this was not the case and in Feb things were terrible and in all honesty I thought I was going to die, I laid on my bed for three days barely able to move, struggling for breath & full of pain, luckly my HC arrived and after about 9 hours after taking just 5mg this massive relief came over me.
      I kept trying to increase the dose, as 20mg seemed to be the normal amount but my body wasn’t having any of it.I did at one point get up to 30mg but the symptons were terrible (I thought it was the T3 causing the nasty symptons). – it was both.
      As things are I have been taking less that one mg a day for many weeks now, anymore I get these problems.
      The problem being if I need more HC, then why is my body reacting against it and if it isn’t the Adrenals at fault anymore then why can’t I tolerate the Thyroid Medication? .I am now 32 and would hope that things are going to get better than this.

      Kind regards

      • Lynn says

        Ah, sounds like you did indeed try the correct dosing then. I wonder could you be allergic to the fillers used? Some people actually need to switch brands because of this. Again, I suggest checking out addisonssupport.com for great info.

        • Debbie says

          Hello Lynn,

          Thank you for your advice, It is really aprreciated, I have tried a different form of HC and that does the same thing. I had a look back over my results and they said that I did not have addisions disease, just adrenal fatigue.
          I was wondering if the Oestrogen & Progesterone levels were low, as that effects the receptor uptake. I believe that they are are available in creams but I am unsure of what dose to take or if their is a reliable test available? Do you know about these Lynn?

          Kind regards
          Debbie

  180. Lynn says

    Hi Debbie

    What symptoms do you get when you increase cortisol? Sometimes increasing it to a low amount can cause issues due to the HPA axis feedback loop. It’s complicated but happens a lot. How much HC do you take when you increase your HC?

    • Debbie says

      Hello Lynn,

      When I increase the HC i get a really nasty burning sensation in my chest, My Breasts become very sore and even have like a stinging sensation, my pulse will go up and my breathing gets very laboured and it feels like my heart is thudding. Thats why I started taking the DHEA but at present all I can take is half a gram of HC a day. I really thought I would need high doses of the HC after going by how bad things were before having any HC.
      Kind regards
      Debbie

    • Debbie says

      Hello Lynn

      Thank you very much for your advice, I will certainly have a ATCH test done.
      Since being on all this differen’t medications I do seem to get a mixture of underactive and overactive symptons, for example my pulse is always high & erratic, I have heart palpitations, I struggle for breath at times, I can have lots of energy and my back, chest and face will burn with heat and those parts of me will sweat, on the other hand the rest of my body is freezing cold, all my muscles hurt very badly, I am confused, I am very pale, I have lost my sense of smell & taste almost completely, my blood pressure is Iow, I can not sleep etc and only if I go without any form of Thyroid medication for about a week do I become weak and lifeless.
      I can’t seem to take anymore Cortisone because of the symptons I get from that. My body seemed to be getting on ok until I started on my first lot of Thyroxine – then all hell let lose – I wish I could go back before I ever took anything, I may have been Ill but I would never have felt as terrible as I do now.
      Kind regards
      Debbie

  181. Debbie says

    Good morning,

    Please could you offer some advise? I have an underactive Thyroid, but I can not seem to tolerate any form of Thyroid Medication. My TSH levels go from minus 0.5 to as high as 13.5, my Doc kept increasing the T4 – which made me much worse, I ended up seeking private professional help from a Thyroid Specialist. A test was done and it showed that my adrenal gland weren’t working very well, but my DHEA levels were fine. thirteen months later even though their has been a reasonable improvement in my adrenal glands i still can not tolerate the thyroid medication. I was under the impression that once the adrenal glands were working better I would be able to take a little T3 (Cynomel) for three days on just a quarter of a tablet things went from improvement to sheer hell as it has always done – I am now frightened to take any off these things as the effects are extreme. Even with the Hydrocortisone I can tolerate only very little of that. I am really very Ill now and their doesn’t seem to be any help for me, I have tried three different forms of thyroid medication and every one has gone the same way. I am taking various Vitamins, DHEA, Co-enzyme Q10, slight amounts of Hydrocortisone and only quarter of a tablet of T4 only when I really have to. Thank you

  182. Mike says

    Hey Chris my lab results are free T3 at 2.9
    Free T4 at .9. And TSH at 1.19
    My doc is a believer in treating patient and not relying totally on labs. He has me on 1/4 grain of Nature Throid once daily. Since my t3 and t4 are on very low end of scale. Sound reasonable? I’ve had low-thyroid symptoms for years. My family doc wasn’t interested in my opinions, even after I begged for him to check my thyroid and ultrasound showed slight enlargement. He said that means nothing. My normal temp has been low for years. Barely reached 98. He also thought that meant nothing too. Frustrating

  183. says

    My last TSH leve was .81 and my T4 Free was 1.1 and my T3 Free was 2.6 all of which show in normal range. Do you think there could still be a problem? I am always tired and have gained a lot of weight although I did find that I was also in menopause but my TSH leve prior to menopause the year before was .88.

    • says

      Also, not sure what kind of doctor to go to since everything is in normal range. I have bee reading so much about this and seems even endocronologist don’t think anything is wrong if they are all in normal range.

  184. Lisa says

    I posted on June 30, no answer. I don’t see very many people getting answers on this forum. Is there a better place to post for Chris?

  185. Jennifer says

    Hi Chris, I am at my wits end. I am 27 and since I can remember every summer my throat gets really tight and uncomfortable. Most of the time my ears are swollen and painful, I have memory and focus issues, 6 family members have been hypo thyroid, I have daily head aches, extreme fatigue, and my nails are very brittle and break way far back. I had allergy and asthma testing both negative. I had labs done for hormones, vitamins, and thyroid all came back normal but a little low on Vit D. I feel like my symptoms scream thyroid but the test said its normal, what do you feel especially about the tight throat feeling. It is like that all summer long and it makes me miserable.

  186. jen says

    thanks so much for the very informative articles! my integrative doctor said my labs came back showing TPO Antibodies of 280. i had a full thyroid panel done (not TPO) at the beginning of the year and, while the numbers weren’t awesome, they were all within normal range. my question is: is the TPO Antibody test enough to diagnose Hashimoto’s and, if so, how do i know if any of the above scenarios apply? for the record, i do have symptoms….horrible symptoms…and all of my regular docs say what i need is a good antidepressant :/

  187. Brenda Guadagnoli says

    I am having a battle with weight. My Dr does basic test on thyroid. Are there more exclusive test I can have on my thyroid that will help me with this problem

  188. Marcia says

    I have had hypothyroid for over 20 years always very low I was tested 5/3 and my tsh leave was 260.500 my t4 leave was .7 I had been very sick for three weeks before they took these leaves and wasn’t able to keep my meds in me…. So they didn’t change my dose of synthroid this test 7/17 came back with a Tsh leave of .036 and a t4 leave of 1.5…all my life it has gone back and forth with to high to to low… My doctor told me I just had to live with it… Any help would be great!

  189. Kir says

    Hi Chris. Thanks for the great info. I have had nearly every symptom on the extensive hypo symptom list for 20 years. Labs, which includeTSH, T3 and 4 as well as Free T3 and 4 are almost always normal, with an occasional low normal over the years. My mom was hypo with nodules, as well as possibly her mom. I have been treated with the smallest doses of Armour in the past but reacted horribly to it. I also have AF, low cortisol in morning and high at night. I also have MTHFR, Lyme and Epstein-Barr and I think the unresolved AF is what made my reaction so severe. I meet the criteria on many of the 5 you have listed above. My question is, can any of my health issues be contributing to the false negative thyroid results at all? Are there any further tests you could recommend to get a more accurate answer? I am absolutely miserable. So tired of being sick and tired, bloated, anxious, overweight and watching my hair fall out. Thanks.

  190. Yolanda says

    I’m 41 years old and im sufre ring from high TSH and high testosterone and have suffered in the past from ovarían cists, Im not currently on any medication yet. Everything that I’ve read that says that hypothyroidism caused by high testosterone caused by PCOS or even just hypothyroidism caused by high testosterone will show a normal TSH and T4 but that is not my case; all my thyroid test came back normal only my TSH is high and my testosterone. Have you come across this scenario? What would be the cause?

  191. Lisa says

    Chris,
    I am an active 55 year old female who has always enjoyed good health. Over the past year or so, I have developed a lot a joint pain in shoulders, neck, hips, knees. So much pain it has affected my tennis and exercise classes. ( heck just getting my sports bra on and off takes my breath from the pain). Even if I get through the classes, the recovery of the next two days makes me feel like an old lady. I can hardly get up and down. I went to a rheumatologist, he ordered a thyroid ultrasound. I learned that I have several thyroid nodules, and in fact only have half of a thyroid. Referred to an endocrinologist, my blood work (TSH and T4 ) are normal. They did not do a T3. Anyway, they just told me to monitor it and come back in a year. I didn’t really complain about the arthritis to the Endo because I never related it to thyroid. IS IT related to thyroid??? What is the best most comprehensive next step?

  192. Di says

    Thanks for this very interesting discussion. I’m 61 and have been on 300mcg of a synthetic thyroid supplement since a demi thyroidectomy in 1998. Despite this massive dose I am frequently exhausted, have extremely dry, ridged nails, joint pain, and tinnitus. My concern at taking such a large dose has always been quashed by the medical profession however my cholesterol has now reached unacceptably high levels and I am losing bone density, despite an excellent diet, moderate excercise and the fact that I’m not at all overweight (5ft 2 & 8st 4lbs).
    My recent test results showed TSH right up at the top end of normal, & T4 & T3 both at the lower end of normal. Ferritin, & Vit D were low &, white blood cells and neutrophils were below the normal acceptable range. Everything else was fine.
    I’ve never participated in something like this before but I would be grateful to hear your comments on my situation. Thanks.

    • Debbie says

      Hello Di,

      Have you had your Adrenal glands & DHEA levels tested, not by your GP as they only offer the Synacthen test for the adrenals ( this only shows up anything if you have addisons disease).
      The reason I say that is your on a high level on synthetic thyroid but it doesn’t sound like it is being taken up properly. Have you ever tried other forms of thyroid medication like the natural product – some people feel a lot better on that.
      Best wishes
      Debbie

  193. Lisa Rothwell says

    1. YOU NEED TO SEE A GENERALIST FIRST. You need to have all of your symptoms evaluated. I went to three endocrinologists all gave the same response after seeing the same test results. Unfortunately, the medication prescribed I was allergic to. They all prescribed a higher dosage, which made the reaction even worse. I finally returned to see a generalist doctor at a free clinic. The first response was… you are allergic to the meds. I was put on the natural alternative and am now “normal”. (After one month.)

    2. HAVE YOUR OWN TESTS performed. I used the internet to find a lab and had ALL the tests done. (applied costs on taxes). When I showed to a general doctor who also was a holistic doc. I learned that it was more than hypothyroidism.
    The tests cost about $200. Including the saliva, and hair test. Blood and urine tests were done locally.

    3. Trust yourself, research, and ask questions. If not, write them all down, and give the list to a medical advisor.

    4. By the way, between the medicine and silkense volume shampoo, my hair is growing back.

  194. Matt Owens says

    I’m a 37 year old male who has been type 1 diabetic for 21 years. I’ve also been recently diagnosed with Hashimoto’s. I was told that I wouldn’t be a candidate for synthetic thyroid treatment until it progressed to hypothyroidism despite having fatigue, muscle pain, joint swelling, weight gain, & depression. The mention of hypothyroidism related to pituitary dysfunction struck a chord with me due to the fact that I have endured several severe hypoglycemic episodes over the years. I was wondering if you could give any guidance with how to proceed, and possibly refer me to someone in or near Las Vegas?

  195. Caitlin says

    Hi there, I found your article very interesting. I am a 29 year old female, and I synthroid until 18 when the endocrognologist took me off to see if my thyroid would kick back in, and it did, supposedly, but I have been suffering with fatigue since. I have had my thyroid checked yearly, but it always comes back as normal. My bloodwork has shown that I am deficient in Vitamin D and B12. I also have enlarged red blood cells, which the hematologist never found an explanation for. I also had problems with hypogyclemia as a teenager. I also have had migraines since I was a child. I have GERD, IBS and lactose intolerance, and a history of endometriosis. I also have red blood cells in my urine, which the urologist can not pin point a cause for. For over a year now I have had a severe case of plantar fasciitis which is not responding to treatment. I read about how people with hypothyroidism can develop connective tissue disorders like plantar fasciitis. I feel like I have been passed around from specialist to specialist but no one can seem to fix me. I have been to the neurologist, gastroentrologist, gynocologist, podiatrist, hematologist, urologist, chiropractor, ENT.
    Between the foot problems, frequent migraines, fatigue and some weight gain I was concerned something was wrong with my thyroid, so I scheduled an appointment with and endocrinologist. I referenced your post, but she “doesn’t believe that you can be hypothyroid if you have normal lab results”, and she told me there is nothing she can do for me.
    Free T3 was 3.1
    TSH was 0.67
    Free T4 was 1.1
    Thyroglobulin Antibodies <20
    Thyroid Peroxidase Antibodies <10

    I know you aren't taking new patients right now, but any advice you can give would be most appreciated!

  196. Darek says

    Great articles. My name i Darek i’m from Germany i am specially interested in the 5. point. What may I do if in case of thyroid resistance ? How may i renew my receptors to be able to absorb more ft3 and ft4 ? Besides of reducing stress in my life. I am suffering for a long time actually and i am giving armour a chance know. I would be really glad for an answer.

    • Tina says

      Darek,

      I am in Germany, too. I posted to ask for confirmation of what my levels were in German, lol.

      Just wondering if you were able to find a doctor that listened to you. I cannot find anyone in Frankfurt. I have “normal” levels but I have a high level of TPO Antibodies. But I have an assortment of hypo symptoms. Worst is zero energy and weight gain of 9kg in the last year. I have gained tons of weight in my stomach. I cannot lose a single pound. Nothing. A year ago, I could do this with one small change if I needed to. I am irritable and have no patience. My hair is breaking all the time, I am cold, I am short of breath, I have allergies and asthma I didn’t used to have. And I am just exhausted all.the.time now which is a big change and gotten progressively worse for me in the last 3-6 months.

      I have the same trouble as I always do here. They want to do every test and it takes me about 8-12 weeks between appointments and then they want to schedule a separate appointment to discuss the results and meanwhile, my life is falling apart because I can barely function and deal with work, my son, get any exercise. Anything. And in the last couple months, I have gotten depressed. My doctor was trying to tell me I was always depressed and I was like, “No, I was not always depressed.” How can I have been a person that had fun, participated in and appreciated my life, enjoyed every minute with my son, laughed all the time be depressed?! NOW I feel depressed. I cannot get anyone to listen to how my entire quality of life has disappeared.

      I am starting to really dread the coming years which is really bad. If I can’t get this resolved and I just continue to gain weight and be tired all the time? And don’t have energy to do anything with my son? But I don’t know who to talk to. No one is listening.

      Tina

  197. Mel says

    Great article. I’m glad someone has their head on straight! Thyroid resistance sounds like the worst of all these conditions–is their any treatment? Can these conditions ever be fully corrected?!

  198. Jimmy says

    Great post. Can you point us in a good direction for more information on #5: Thyroid Resistance? Would like more information on how this one would be diagnosed and/or treated.

  199. Erin says

    Thank you so much! After reading this article, I printed a copy for my Doctor. We discovered I have Thyroid resistance due to chronic stress. We are working on adjusting my dosage and lowering my stress and supporting my adrenals. I feel so hopeful!

  200. Lisa says

    After years of working with the :best” in the world (D.C.), I still was mis prescribed. pay for the tests from your pocket. do your own research. and ask for second, third, and fourth opinions. Try to find a doctor who listens to ALL of your ailments. After looking at my blotchy calves. I was told that I was allergic to the synthetic thyroid medicine. and I needed to go to Armour thyroid. Drs get kick back from Abbott labs thats why they prescribed the synthetic. I also found out it was my adrenal gland as well affected. Consider looking for a doctor that is an MD as well as a homeopathic.

    you know you……. trust yourself.

    • Allison says

      Good luck with finding these docs. The one’s that seem to know this stuff, interrupt test properly, etc seem to be a precious few, (and or) charge outrageous fee’s. And that doesn’t mention the cost for the testing, supplements, trial and error, and so on.

      Perhaps it would be useful if people start making recommendations in their area’s of these “rare” docs. List their experiences. As Chris said the immune system is very complex. It’s very difficult for a layman to sort through all this clutter by theirself.

  201. Teena Tucker says

    My daughter has had problems since she was in high school with her periods, very severe cramps. She seems to me to have symptoms of mild hypothyroidism, very sluggish and fatigue. At times, we thought maybe she was hypoglycemic. Nothing has ever tested out. She is 30 now and experiences infertility and yeast infections and bladder infections. She did get pregnant after 4 rounds of AI. Her tests show no signs of hypothyroidism but I am not convinced. I have hypo and hyperthyroidism in our family on both my mother and fathers side. My daughters doctor says her tests are fine. She is not fine and cannot get pregnant. Where do we go to find a doctor that will treat her old school? Should she go to a nutritionist? I am thinking this could be the reason she isn’t getting pregnant. In 8 years and 10 AI’s she has had one pregnancy. Any advice?

  202. Monic& says

    My TSH shot up through the roof and I was heading into thyroid storm. Be very careful when playing with the thyroid.
    I am sure my thyroid issue is an autoimmune and felt I could heal through diet and natural supplementation, did not work. Just my own personal experience.

  203. Monica says

    We really need to be very cautious when dealing with the thyroid. I went off off of my levothyroxine cause I felt I was feeling betterwith special focus on diet. My TSH ahot through

  204. mcgww says

    I have number 1 elevated cortisol levels from being pregnant. I have all the symptoms of hypothyroidism but all my test come back great except for my cortisol and B12 levels. I felt as if my doctor blew me off, she stated we would watch it. I definately feel different sometimes I have no energy and other times I feel extremly energtic, but not good energy. I never feel normal. What to do?

  205. says

    OK, Let’s cut through this mess.
    1. What tests should be taken to determine the type and severity of hypothyroidism?
    2. Is there a list of doctors that could act as advisors?
    Every Endocrine doc I have seen just looks at former tests. I paid out of pocket for the 4 X a day saliva test. Then they started to take me seriously.

    I have been seen by 3 of the best docs in the world when I lived in the Washington DC area.
    The Synthetic stuff makes me higher than a kite after one dose. I am now living out of my truck and on food stamps because this illness has caused me to lose DoD contractor jobs. I need help! I am tired of being mollified and patronized by young and older male doctors and older women doctors, as well as LPN and interns.

    So again what tests should I take and how do I find a doc that will correct my situation quickly.

    thanks for being there

  206. Jules says

    My husband is 66 years old and was diagnosed with a tumor on his pituatary gland about 22 years ago. He seems to have all of the symptoms that you describe in the 1st dysfunction. They just recently tested his thyroid and of course the test showed nothing. He is on a lot of medications including testostorone injections, anti depressants, acid reflux medicine and sleep medicine just to name a few. He has been tested for everything under the sun and no one has been able to really help him. Physically he is in great shape. Although it is a struggle he works out just about everyday. He recently has had a lot of trouble urinating and his bowels are irregular and have been for a while. He will be seeing his doctor next week. Do you think we should bring you article to the Doctor?

  207. T says

    I am 43, normal weight, reasonably healthy eater, work full time. I have a problem with my spine that restricts me from a very high level of physical activity, but I am not ‘dormant’ and I move about as much as I can every day, moderately active. I have had serious depression in the past dealing with a particular problem, and overcome this with CBT and I am now good at managing any mood difficulties. For the last four years I have noticed a deterioration in my energy levels and general feeling of fitness and well-being. My mood also deteriorated, and for the last 12 months depression crept up on me and I am on antidepressants again for the last three months, although this feels very different to previous depression – there is nothing I am depressed about, I just feel all the symptoms. My mood has improved, however. But I am exhausted so much of the time and I cannot trace it to anything in my lifestyle – I seem far more tired than I should be for my age and health and activity. I have never needed more than 5-6 hours sleep, but in the last 12 months seem to need more and more, and after significant activity fall asleep within minutes and can sleep for 15 hours at a time, so deeply that I miss alarm clocks and people trying to wake me – this is absolutely out of character for me. Even after little or moderate activity I am physically exhausted, not necessarily sleepy, and have to sit or lie down. My concentration is appalling, although a bit better since taking the antidepressants. I am always freezing cold, with cold extremities and cold skin all over most of the time – I wear layers and layers of clothes whilst those around me are in shorts and t-shirts. In the last 3 months I have started having headaches, and I have never suffered from headaches.
    I have had blood tests and I have low iron and now take an iron supplement and have that monitored frequently. I also have had thyroid blood tests, and they are in normal range. Every female on the maternal side of my family has under-active thyroid, my mother, her sister, my grandmother, and 4 female cousins. My GP said I have raised TSH but normal thyroxine.
    I feel like a fraud when I talk to the GP about how I feel, because I am told ‘everything is normal’, and especially because I had depression previously and I think GPs automatically think it can account for everything, whereas on this occasion I feel like the depression is a symptom of something else, rather than is the central problem.
    I don’t know what to do, but I am becoming unreliable and I think my job might be at risk.
    I would actually like to think this is not a thyroid problem and work out what else it might be, but I am running out of explanations. I don’t know how to proceed. Thanks for any advice

  208. Nicole Dougherty says

    I was told by my doctor that I have Hashimotos and that from my test results my T4 isnt converting enough T3. Im on a combination of both T3 AND T4 but since had to get off medication due to the Low Dose Naltraxone Im on for my Urticaria. The LDN is also suppose to help Hashimotos and is suggested that you go off your thyroid meds to avoid hyperthyroid symptoms. Now that Im into my second week of the using this new medicine im more tired than normal. Do you he any info on LDN?

  209. steaders says

    Hi im desperate for help!I I started experiencing unexplained weight gain over a year ago,Ive always been healthy and active.I visited the gym regularly and would run 4 miles about 3 to 4 times a week.I eat healthy and for some reason have gained a stone,which is impossible to lose.having to eat low calorie diet to try to maintain weight but if I was too eat 3 normal square meals a day i put on 4/6 pounds overnight,I weigh myself daily!I started getting dizzy spells last year with pins and needles in my hands and wrists,also around this time my memory started getting worse and worse.I visited docs and she tested tsh level which was 0.7 and tpo was 9.8 she said these were perfect and sent me on my way.Pins and needles disapeared but memory remains awful,i feel foggy all the time and cant remember putting things down a second after ive done it!Four weeks ago i developed an irregular hearbeat,went to doctors and they said my cholestrol was high it was 5,referring me to cardiology at hospital.I am convinced it is to do with my thyroid and worry about heart damage.Feel tired,shaky most days and totally no sex drive for last year(poor husband!)Any ideas I would be most grateful for.thankyou!

    • Angela says

      I know how you are feeling. My symptoms started back in November. I don’t know your age but I am 45 and am entering menopause . My thyroid is a bit under active and I gained weight. I am having all my hormone levels tested and it shows my adrenal gland is low and my testosterone an progesterone is also low. I have all the same symptoms as you. I have went on a 2 hr a day workout and very clean diet. No sugar or caffeine and off bad carbs. I lost 20 lbs and feel better but not 100%. I have a dr. Who does bio- identical drugs. I can’t use the progesterone because I am one of the rare people who react to the cream but I am hopeful I will find my treatment for the hormones. As for thyroid, I have Graves’ disease and through my life it has caused trouble and now I am a bit under active . I think going into menopause throws the thyroid out so you might want to check into that . Hope this helps

  210. Brendan says

    Hi Chris,

    I realize you may not be able to respond directly to me, but I’ll try nevertheless because I’m frustrated with my current health situation. I am a 30-year-old male who was diagnosed with hypothyroidism at age 17. Ever since, I have had a steady dose of Synthroid which has helped stabilize my thyroid hormone levels. However, I still have many autoimmune symptoms with no diagnosed cause. My skin is the worst part – I get lesions and deep sores all over my body which don’t go away and which cause me immense pain (not to mention loads of shame). I have joint issues, general body pain and stiffness, abdominal pain/cramping/constipation/diarrhea, dry eyes/mouth/skin, constant fatigue, trouble concentrating, irritability/depression/anxiety, and trouble getting a good night’s sleep.

    I have no family history of autoimmune or thyroid diseases. I exercise regularly and eat a balanced, low-fat, low-salt diet. There are no structural problems with my organs which would suggest a problem with them. I am neither coeliac nor lactose intolerant. My blood work is always impeccable, so doctors never go further in investigating the causes of my problems.

    If there is any suggestion you can offer in terms of how I can go about getting properly diagnosed/treated, it would be very much appreciated. I’m at the end of my rope!

    Thank you.

  211. marie anton says

    May I add endrocronologist 2 of them say she is fine all she has to do is eat well to lose the weight . She has been eating very well now for 2 yrs vegetables , fruits all organic even almond milk and nothing. No weight loss no changes in symptoms.

  212. marie anton says

    bottom line what to do if my daughters that is 15 has been tested for Thyroid , TSH and according to her pediatrician all thyroid test have been done and keeps coming out normal. However my daughter is overweight has tried every diet , excercise nothing works. She also has trouble sleeping, has anxiety, depression and has loss of hair. Desperite please help! What do u recommend when everything comes out normal but these symptoms dont go away. no family history either.

  213. says

    Hello Chris,
    I’m sure your super busy. My question if it’s possible at all to answer. I was tested for thyroid and my results were TSH.49 . freet4 .73 and freeT3 2.19. My symptoms are super cold,10lb weight loss that I’m happy about, rapid heart rate although in the normal range even though it is faster then it has ever been. Sleep issues, waking up, up for hours tired in the morning. I scared to go on medication because I model,normal size not skinny, if I gain weight I can miss out on lots of jobs. My freet3 was considered low. I am on birth control ortho novum 777 and my diet is not very good although I’m improving. I eat alot of suger but am thin because I run 5 miles a day. Any thoughts? I’m more then happy to switch drs if i need to as i am in the sf/sj area:)

  214. shaz says

    Hi Chris, I wonder if you could shed any light on this, I had my levels checked for my annual test while on levothyroxine and my TSH is 0.02 so the doctor dropped my meds. I agree it’s very low but so is my FT4 and FT3 – both bottom end of range. Do you know what could cause the TSH to become so low without FT4 going high? I have to go back for follow up bloods and if the FT4 and FT3 go lower still as I suspect I’d like to know what tests to ask for next as I got the impression the doctor didn’t really know why the result was like this but just wanted the TSH to come back up. She actually asked me if I had been taking my medication.

  215. Susan says

    I have classic hypothryroid symptoms but test results of TSH 1.44, FT4 1.34 and FT3 3.1. I am so sick of feeling fatigued, of my thinning hair, my growing intolerence for cold, my overall sluggish feeling both physically and mentally, low body temperature and so forth. How do I need to approach a doctor about these symptoms? Any help is appreciated

    • Pam says

      I feel the same way as you, Susan. Almost identical test results. I have every single symptom of thyroid issues but no doctor will help me. I am at a complete loss as to how to find help. I’ve lost my teaching career over this.

      HOW do we get doctors to help us? I even paid very large sums of money out of pocket to see two Integrative doctors here in Florida, but neither of them think it’s thyroid since my labs are normal. I know they are wrong. I even had a thyroid scan and it showed that I have an inhomogeneous thyroid, but nothing was explained as to what that is. I also have TPO antibodies, but was told they were low enough( below range ) and not an issue.

      Symptoms: Extreme fatigue/lethargy, hair loss/brittle/dry, super dry skin, dandruff, cold intolerance, menstrual problems, low ferritin that is difficult to raise, high cholesterol, weight gain and near impossible to lose even 1 pound unless I just stop eating, scalloped tongue, abdominal pain ( lost my gallbladder last summer ), brain fog, depression ( who wouldn’t be?), gritty eyes, spine pain, sore knees, sore heels, ridged nails, puffy/frumpy face.

      But I always just get antidepressants thrown at me and told I’m just aging. I’m 45 and my health fell apart when I was 37. I have very little quality of life because of this.

      Chris….please…help :(

      • Lynn says

        I’d suggest checking out the Recovering with T3 book and FB groups. Also stopthethyroidmadness.com. You can get good doctor referrals from these places. It sounds like you may be a person that does well on T3 only rather than combination therapy.

      • mary says

        OMG pam i have the same problems the doctors wont listen..the thyroid doctor i went to asked me if i was depressed..I was at my wits end to begin with and after i get done explaining to him how i feel he asked me that..OMG i am at a loss to i dont know where to turn..all my test come back normal and i still feel like crap…I stopped going to the doctor in 2010 begining 2011 because they werent listening ..so i figured it was me but 2 years have past and i still feel like crap so i thought i would give it another try..and low and behold they are doing the same thing they did two before..so now i am at that same wall i was back then…so if you have any answers please reply back to me…oh yea another doctor told me to read a Jillian Millian book OMG i wanted to scream..i am a LIFE TIME weight watchers i know what to eat how much blah blah blah…

      • Debbie says

        I also feel exactly the same as you and everything you have discribed happened to me.
        Things got so bad that I had to seek private medical advice. What I will suggest to you is to go onto the thyroid uk website and on their they recommend a particular Dr – he has written a wonderfal book which will lift your spirits, you can go and see him or just work through his book.
        I really know what it’s like, I was 29 when things fell apart for me and now at 32 I am still very poorly – but I seem to be an exceptional case sadly, but I won’t give in – their is hope out their, people do get better, it just takes along time and getting the right medication, as we all respond in a different way.
        Good Luck
        Debbie

      • RenegadeRN says

        Not to sound like a broken record, as I had the same recommendations to another poster-

        Please check out parathyroid.com. I had these symptoms, had been pretty stable on thyroid meds for over 20 years when they started…dr. Norman removed a small benign parathyroid adenoma and now I feel great!

        It was a gradual decline that I wanted to attribute other things , such as oncoming menopause, thyroid meds, Etc etc… The insomnia, brain fog, apathy, and stomach pains were new onset and told me it was something new. Oh! I also had bone pains in my hip at night. No identifiable reason , until the parathyroid tumor diagnosis.

  216. Stacy says

    For last 3.5 yrs since my daughter I’ve been breaking out with hives on my legs. They come and go and are worse in the winter. My family doctor has sent me to a Allergist (that I would NEVER recommend) and he ran some blood tests and put me on allergy shots. The hives never went away. Also since my daughter was born I’ve not been able to lose the 40lbs I gained during pregrancy even with diet and excercise. Now I found out that I borderline diabetic and suffering from Hypertension. I did have my thyroid checked a few yrs back but it came back normal. My OB/GYN also said my thyroid felt very off the other day. I’m waiting for the test results and it comes back normal again what should be my next step? I should mention that I’m only 32 yrs old with no family health history and I’m by far the healthiest in weight, diet, and exercise then my parents and siblings. Any help would be apperciated.

  217. mary says

    HI.BEEN ON thyroid mere for 32yrs. Recently went in for a tic bite and asked for thyroid test. Had results mailed to me. They do TSH test only. Was 6.83 and docs comments said to stay on current dose 100mcg & retest in 6 mo. Icalled a month or so later and told nurse I thought this was off and could she ask doc to change. Was changed to 112mcg. I’ve had breathing problems: weakness; right neck pain; extreme aches. Am 54. Menopause at 46-47. High cholesterol mere were added at recent visit but have not taken Cuz I believe thyroid is off. I was prescribed a antiboitic for the tic bite as had a ring around it. This was in July 2012. This is the worst I’ve felt. Any help or suggestions would be appreciated.

    • Debbie says

      Hello Mary,

      My suggestions would be to get your adrenals tested, not by your GP – as that will confirm nothing, that test is as unreliable as the blood tests. It does sound like the your thyroid medication is not being taken up properly and breathing problems along with your extreme aches and weakness could be down to that adrenal Issues.

      Best wishes
      Debbie

  218. Jules says

    What concerns me about the two schools of thought on tsh is that unless medical community can reach consensus. We as patients cost ourselves and medicine a lot of money and continue to suffer poor quality of life. I know that I have low cortisol tested by 24 hr urine and its probably why my original tsh antibody was over a thousand when diagnosed with hashimotos 6 years ago. However because I can’t get a physiologic dose with dhea I continue to suffer even though labs say I’m optimised. The future will be tablets for low bp. Maybe tabs for depression a ppi for gastritis it will go on until someone can totally identify why inflammation starts and how it can be treated rather than the resulting disease and that’s going to take a huge study. In all other forms of medicine disease prevention seems to get a hearing. Talk about cortisol and doctors will hear hydrocortisone and rebound. Putting back the small 10mg dose with a catabolic match would surely help some of us with has hasimotos whose autoimmunity started with poor adrenal function or am I hooked on a theory which I’ve heard but can’t prove!!!!

  219. Tasha says

    Hi Chris,

    Great article!

    Can I please get your thoughts on what’s happening with me as my results are a bit odd? Symptoms are fatigue, anxiety, quicker heart rate, insomnia, clammy hands and feet, weight loss and symptoms are usually worse in the morning than in the evening. My naturopath did a thyroid reflex test and said I was hypothyroid, yet my symptoms seem to be hyperthyroid. I did try 30mg of dessicated thyroid for 2 days and I didn’t like how my appetite ramped up, so I discontinued it. About a week after, my endocrinologist finally ordered the T4 and T3 bloodwork (my TSH has historically been in the normal range) and my TSH is 0.5 (normal range is 0.38-5.5mU/L), T4 free is 21.3 (normal range is 10.5-20 pmol/L) and the T3 free is 4 (normal range is 3.5-6.5 pmol/L). Do you think I’m hyperthyroid as opposed to hypothyroid? Could my T4 free be elevated from taking the 30mg of dessicated thyroid for 2 days?

    If you are able to reply to this, thank you very much!

  220. Alice says

    I am on Armour thyroid, 125 mg per day, because I had an incorrect dosage of thyroid (Synthroid I think) many years ago (when i was just trying to see if thryoid drugs would help even if my tests didn’t show problem except for weight gain), – too high of dose seems to have destroyed or seriously damaged my thyroid function. It took a long time to catch – long story so won’t explain here.

    So… Hashi’s is not the cause of my thyroid problem. My doctor recently bumped up my Armour from 90 mg to 125mg so I think I may be one of those that Armour doesn’t work on after it changed.

    I seem to have a serious lack of “get up and go” much worse than ever. I am 66 so maybe some of this is expected but I want to “try” something else. I don’t mind leading my doctor in some direction (which I hope she will go in) but I’m not sure which direction. Your 5 reasons didn’t seem to address someone who has thyroid problems because of damage due to incorrect treatment, do them? (maybe except for the comment from someone whose husband you thought should be tested for Grave’s disease?)

    What “direction” should I go in since my doctor may not want to try a lot of things? If you were to pick 2 or 3 directions (or maybe only 1 if there is one main obvious one) – which would it be? or which article of yours applies mostly to my situation?

    • sally says

      You could simply try a different thyroid med i.e. ERFA Thyroid instead of Armour? You can simply swop tablet for tablet; but they each have different fillers and sometimes this can cause problems for some people. ERFA is the same as the original Armour Thyroid.
      There is not a problem increasing your dose until you feel ‘well’ and your symptoms resolve; for example I take T3 (liothyronin) 100mcgs PLUS 3-4 grains ERFA Thyroid i.e. 180 – 240mgs; this dose makes me feel good but any less and I get a return of symptoms and don’t feel so good. This is a high dose of thyroid supplement but it works for me. Someone else might feel well on 1/2grain or 30mgs of Armour or ERFA Thyroid; it really is a personal thing but its not dangerous so long as you feel well on the dose.
      So changing the type of desiccated thyroid might help or indeed increasing the dose; your lack of get up and go is likely due to low thyroid hormone.

  221. Becky says

    I am currently experiencing hyperthyroidism, and they are trying to rule out Grave’s disease. I don’t have the antibodies, the eye or skin problems, and no family history of thyroid issues. I’m 35, 6 month post partum, have TSH that is almost non existent. And high T4 (70)
    You seem to be very knowledgeable with regards to hypothyroidism….do you know of any other reasons besides Graves that I would be hyper? I also forgot to mention, my thyroid ultrasound showed one small colloid nodule that they figured was in the process of degeneration…..they don’t want to biopsy, just look at it in another 6 months. It was hypervascular though, and inflamed.
    Thanks so much for any info!

  222. Thera says

    How does ReverseT3 come into play and how do you feel about the Wilson’s temp therapy with the sustained release T3?

  223. twiggynot says

    At 28yrs I was dx as having an underactive thyroid.
    rx: .75mcg? Synthroid.
    went up to .150mcg Synthroid within 2yrs.
    I go up and down but can’t figure what the pattern is.
    Dr: tests tsh only most of the time. I am 40 now with same dr. She has only tested antibodies once and it came back with a speckled reading. I don’t understand these tests very well. She sent me to get tested for lupus and it came back negative.
    For almost a yr now I have been on taking two 60mg of Armour plus half of another pill. On top of that was put on Adderall since I was having trouble focusing and keeping things organized at home and work. Adderall has worked well but Armour is not. I am still losing hair and extremely fatigued. I have to drink coffee or frapps at work to help me continue to have energy but by the time I am home I am ready to drop and I can’t because I have a family to care for. What tests should I ask my dr to request?

    I am 40 and weigh 185lbs (5’7″) this is what depresses me.

  224. Judy says

    Great post Chris. However I believe your response to Angus #5 was somewhat weak. The only studies I’ve seen suggest that thyroid hormone resistance does not affect the pituitary. This is why synthetic T4 replacement can “normalize” blood tests without relieve symptoms.
    Also while low BBT is not definitive, it is a good indicator because it is a symptom that can be measured non-invasively at home.
    For those considering Armour, you now have to chew them for full effect.

  225. Ann says

    Hi Chris, Don’t know exactly where to start but will try to put everything together quickly. In 1983 I ended up with Thyroid Cancer and had a thyroidectomy and also lost my parathyroid glands. So I currently take Levothyroxine and Vit D replacement. Slowly but surely I have been losing my battle with weight gain, fatigue, depression, insomnia…you name it. My labs show hypothyroidism most of the time, and in the last 5 years I have developed high blood pressure and extreme fatigue and was diagnosed with fibhromyalsia. I have elevated TBG and show signs of anemia, all tests for sugar levels have been normal. I have started taking B-12 and increasing my Calcium intake. It really sounds like the iodine and selenium could also be involved in this picture. I have always questioned the normal levels on the bloodwork especially since I am
    struggling with everything like I am and it is getting worse. What is the best way to talk to my doctor about checking things out further as well as trying the iodine and selenium. Oh I also should say that I am a strick Vegetarian (I do not eat fish or eggs but I do eat dairy such as milk or cheeses w/no rennet). Any suggestions you could give would be greatly appreciated. I am only 55 and I feel like I am 75! Thanks Ann

  226. Camille says

    Hi Chris,
    I was wondering if you could help address my questions. I am 35 and suffering from painful, heavy periods due to a large uterine fibroid. I went to a “natural approach” doctor who checked my Thyroid (TSH, antibodies, T4/T3, etc). My TSH was 2.8 and she said my T3 was 2.4. She also noted that I had some antibodies (she said the range is 0-60 and mine was 45). She prescribed Armour Thyroid (30 once a day) and Prometrium (to get my progesterone up to help fibroid issue) and Iodoral iodine. I have been too nervous to take the Armour meds or the Iodoral for fear that it will do damage rather than help? According to another Dr., my thyroid is in the “normal” range, but to her I need Armour (she seems to think it will help with the bleeding, but my ultrasounds show that it’s the large fibroid causing it). My only “hypo” symptoms are hair loss, fatigue, and constipation (but then again those could be from being on iron supplements due to losing so much blood each month?). What would you advise? Take the Armour and Iodoral or will it do more harm? I’m 5’7 and 120lbs so weight loss is not an issue for me. Thank you:)!

    • sally says

      Taking Armour thyroid is not dangerous; at the very worst you will experience palpitations and then you stop taking the Armour Thyroid and the palpitations will stop within 12 hours or less.
      Fibroids and heavy periods can be due to untreated or undertreated hypothyroidism; you are lucky to have someone who is willing to take that route.
      You appear to be suffering a number of symptoms of hypothyroidism and I bet if you thought about it you are suffering many more; in which case taking Armour thyroid is not dangerous. You are being offered a very small dose, 1/2 grain is 30mgs so dont worry about that.
      I would though avoid taking the Iodine for now, take one thing at a time then if you experience any changes you know what it is due to.
      The TSH blood test is open to debate and certainly determining whether the result is high or low is very much open to interpretation; in my opinion yours is slightly high but definately higher than you would wish for. Many people experience hypothyroid symptoms when the TSH is greater than 2.0; just as you are.

  227. Jennifer says

    Chris,
    I need your help!!!! I had my thyroid removed a year and 1/2 ago and was put on levo 100 mcg after surgery. I have had many of the hypo symptoms since even though all labs were normal. The worst symptom light headed very low heart rate (40’s) and blood pressure sent me to the ER. Had tons of tests in ER for heart and lung and all came back normal. After having every test under the sun and all came back normal I decided to take it upon myself to increase my levo to 125 mcg with my internal med doc’s approval. Gradually my symptoms subsided.

    I had been feeling good for 5 months and woke up one day with breast pain and went to doc for exam and he found breast discharge. Had mamo and ultrasound and they said ducts were a little off but normal. I had my doc test for prolactin levels and they came back very high 107. My doc ordered a pituatary MRI and found a 7mm tumor.
    I’m now on cabergoline to stop prolactin and shrink tumor.
    After all of this my endo doc also decreased my levo to 88 mcg because he said my TSH levels were hyperthyroid (even though I had no symptoms).
    I expressed my concerns in changing the dose because of the hypo symptoms i might experience again but he would not listen and said I had to lower it because of the pituatary problem.

    It has been 7 weeks since he lowered my dosage and I have the hypo symptoms back (low heart rate, feeling faint, cold hands, chest pains etc)
    HELP!!!

    • sally says

      No Dr should titrate your thyroid meds with your TSH levels. Also when taking meds most people feel ‘well’ when they have a suppressed TSH. It is not appropriate to compare someone taking thyroid meds TSH with someone who isnt taking thyroid meds – apples and oranges.
      There are studies and articles out there which describe in detail the reasons why TSH levels are not a good way of measuring hypothyroidism both on and off meds; so I would check them out. (Sorry dont have any details to hand.)
      I can though tell you that your pituitary gland has a very strong affinity to thyroid hormone and this is many times greater than all other tissues around the body. There is plenty of evidence to suggest that the TSH can be suppressed due to the pituitary gland being soaked in thyroid hormone, when actually the peripheral cells including CNS and the brain and heart can be depleted. Your endo is wrong and you are right; after all is he treating you or the blood results?

  228. Crystal says

    Chris,
    In 2010 i went for my phy due to being tired (excessively) and weight fluctuation. I was had maintained 120 lbs w/ no weight fluctation. I was and am highly active workout daily and was eating semi healthy. My prim dr discovered a nodule on my right side of my thyroid. Long story short the TSH came back saying i was hyper. But none of that made sense as i was exhaused and gaining weight. I tried for almost 2 years to manage my healthy w/o pills but in Feb of 2012 after putting myself on a high protein diet, prenatal pills and using every nail growth nail polish when my nails split putting on a necklas (and w/ my weight then and now at 130-133 desiptie my working out and caloire watching and prioir they were long and strong!!) i went and was tested and put on 50 mg of lthyrxine 6 weeks later up to 100 then 3 months later back to 75). It seemed to help some of my symptoms (better sleeping no excessive sweating on my armpits) but now 8 months later my nails are not growing (i have never bitten my nails and they look like i chew on them) I am training for NPC competition and eating the same clean diet no soda no junk and my body isn’t responding ( i am 135 lbs @ 28%fat). I was tested for the anit bodies and that was positive and yet my TSH levels reflect i am hyper but my T4 and T3 are normal. I am at the point of going crazy. I am at a loss what to do!! i am at the point of having the nodule removed as since it came to be is when all this has changed and impacted me. I am looking for direction on what i should ask my dr and i feel like my body isn’t converting things correclty in my body based of my nails (hair dry skin …low engery) and weight etc. ? can you recomend anything to me?

    • SoccerMomTeri says

      Crystal, I had many of your health issues and was dx with Graves. I told my Endo I felt like I had Hashimotos. He insisted it was Graves and quickly scheduled me for RAI, which I declined and went on 3 surgery consults instead. After my total thyroidectomy June 2011, the biopsy showed I did indeed have Hashimotos… My suggestion to you is to get ALL the antibody tests to see if you are like me and have BOTH Graves AND Hashis. The tests I had done were: TG-AB, TPO and TSIG. My antibodies were high for all of them. Have you had your ANA labs done, with the ANA Pattern? I did, and my ANA was positive, with a speckled pattern, with a positive SSA antibody, so I also have Sjogrens. My point is, if we have one autoimmune disorder diagnosed, often times, we will also have a second autoimmune (or even 3rd, like me). Over half the battle is getting an accurate dx. Good luck to you.

      • crystal says

        Hey thanks for the heads up! I guess my results in Feb were suppressed tsh and t3 &t4.. thus the l thyroine but w no weight loss and now my tsh ar. 01 i went off (& i am training for npc comp..so clean eating 2 a days and no fat loss). Went on hypo meds and i gained 5lbs in a week!! Now am seeing a sports metabolic dr specialist.. she thinks there is something bigger going on so testing all ny # hormones tsh etc ) hoping they can find out what i will let u know and willask about alk that

        • crystal says

          So after labs and all have been done .. am being treated for insulin..and leptin resistance…will see how this pans out but fingers crossed

          • Nena says

            Your case sounds so similar to mine regarding all the symptoms and body weight issues…the only thing different is that my dietitian was actually the one that told me to do all these tests again, eventhough I had been doing it for 3 years in a row, and all doctors (neurologist, alergologist and gynecologist would say everything is normal). I am currently waiting for TPO and TG-AB results, my TSH is low and T3 and T4 are normal. How did your experience ended?.

            • sally says

              Have they checked your pituitary gland output? Also it isnt totally uncommon to have both HYPER and HYPOthyroidism simultaneously. You need a new Doc perhaps; someone who fully understand thyroid issues. How about Dr Brownstein?

  229. Kimm says

    Hi,
    I came across this forum trying to figure out what my doctors apparently are not able to. While I do not expect you to provide a proper diagnosis simply based on what I write here, I was hoping you could possible point me in the right direction. I have been suffering from insomnia for the past (at least) 3 years. About the same time I started having difficulty sleeping, I had an abdominal surgery (2009) (I have Crohn’s disease, which currently appears to be in remission as of my last colonoscopy a month ago) and put on 30 pounds following the surgery for no apparent reason. I did not change my eating habits at all, I did not change my exercise routine at all and my stress level really did not change either.

    The following summer, we went to take our first annual bike ride (we are avid riders and would ride 15-20 miles every weekend with the kids) and by the time I got to the corner of our street, I was literally crying because my legs burned and hurt so badly, I ended up walking my bike back because I could not pedal it home. I went to my doctor, again complained of being exhausted by this point, still from lack of sleep and the burning in my legs. He ran a bunch of tests, of which I cannot recall, I was told all levels were normal except my triglycerides, which were over 500 or something crazy high like that. None of my other cholesterol levels were above normal, just my triglycerides. I did not want to start statins because my legs were already hurting, so I modified my already relatively healthy diet to exclude the small amount of occasional fried foods. Of note, prior to the surgery, my weight fluctuated between 125 and 130 and I am 5’2″ tall.

    Fast forward to a bunch of normal tests and I end up at a rheumatologists office who tells me I have fibromyalgia and prescribes Lyrica, which is in addition to the Ambien my doctor has prescribed for sleep (or lack thereof), neither of which did much of anything for either of my issues (sleep or leg burning).

    About 5 months ago or so, the insomnia was getting worse and started to affect my cognitive function….. forgetfulness……so badly, I actually forgot to go to work on two separate occasions (who does that right?), inability to follow along in simple conversations, excessive daytime sleepiness to the point that I would lie down and take a nap for 3-4 hours every afternoon or I could not get through school.

    I went back to my doctor because one afternoon last week, it took me 7 hours to answer 15 simple questions in my psychopharmacology class, which happens to be a subject I excel in…..my GPA is 3.98 on a 4 point scale and I have never in my life ever struggled with school and rarely have to study. So, for me, this is a new symptom or I should say worsening symptom. I am also working on my supervised hours for addiction counselor and “forgot” a very important court date I had to appear at for one of my clients.

    My doctor has now added a low dose of Adderall (10 mg) as a “temporary fix” until they can figure out what is going on with me and it has greatly improved my energy level and clarity. I easily recall things I need to, do not have a need to take a nap, and for the first time in 3 years feel “normal”.

    I had a sleep study performed a few weeks ago (prior to the addition of Adderall)….This showed no evidence of sleep apnea. With taking 3 mg of Lunesta (changed from Ambien because of no improvement) prior to retiring for the night, I only entered REM sleep for 7% of my total sleep time and woke up or cycled back to stage I sleep 29 times. I feel asleep in 11 minutes, the study lasted for 371 minutes and it took me 271 minutes to get to REM sleep, where I spent approximately 26 minutes. Of most clinical significance, it was noted that my O2 saturation dropped to 84% and it was suggested I have an overnight O2 saturation study. I had that study performed immediately after and in a 6 hour period, my O2 saturation dropped 31 times to between 80.4% and 80.8% and staying that low for between 21 seconds to 5 minutes. Restless leg symptoms were not noted, nor was there any evidence of snoring.

    In addition, TSH was normal (using that term loosely), CRP was normal, B12 was low (I was given a B12 injection), WBC normal, CBC normal, triglycerides still elevated, but decreased to 282, all pulmonary function studies were normal and I have no evidence of asthma nor do I have any shortness of breath while awake or during exercise.

    My doctor sent me to an ENT thinking my tonsils may have something to do with my O2 sat dropping. ENT thought I was crazy and asked if I was depressed…..went to a second ENT (since I thought it was impossible for a proper diagnosis from the first one when he did not even take the time to look at my tonsils or examine me in any way) who informed me I had tonsiloliths, but not significant enough to cause O2 desaturation and this one also asked if I am depressed. By this time, I am frustrated, exhausted and don’t really care if they call it the chicken pox, I just want it to stop so I can get some quality sleep. I calmly told him that since my profession is to recognize signs of depression and provide counseling services to my clients, I am pretty sure I could recognize if I myself was experiencing depression. I went on to tell him I had a very happy childhood, was never sexually abused, have a pretty good relationship with my mother, am involved very happily in a relationship and we are planning on getting married when I graduate in the spring, I absolutely love my job and while I occasionally get a day when I feel like life is treating me like its own personal toilet bowl, for the most part, I am very happy and not very dysfunctional. I also wondered out loud, in an inquisitive tone, when depression started to cause ones O2 saturation to decrease as I have been taught that it can cause difficulties sleeping or excessive tiredness, but have never heard that oxygen desaturation can be caused by depression. I suspected, again out loud, that if my oxygen saturation issue was solved, that likely my sleep issue would also be solved.

    So, now that I have taken up a great deal of your time, my question is this……how possible is it that my issue with O2 sats dropping as low as they are is caused by either my thyroid or my adrenal gland? The ENT wants to perform yet another sleep study, which I think is a tremendous waste of my time since I have already had one done only a few weeks ago. Should I be seeking an opinion from an endocrinologist to explore a thyroid or adrenal issue? I feel like I am going out of my mind because even simple tasks like remembering to take something out for dinner is incredibly cumbersome. I struggle to do even basic activities throughout my day and my legs are still burning so bad I cannot even go grocery shopping because of the walking involved. I should also mention that I did have ABI testing performed to rule out any clots or arterial/venous issues and I have had a complete cardiac work up, also normal.

    I would appreciate any direction you might be able to lend.
    Thank you
    Kimm

    • liverock says

      Kimm

      People with Chron’s Disease tend to have low selenium, low zinc levels and high copper levels.

      http://www.ncbi.nlm.nih.gov/pubmed/8362213

      The high copper can affect women with Chron’s especially as most women already have higher copper levels due to such things as copper IUD’s and birth control pills. Copper also rises as estrogen levels rise. and it needs very good adrenals and liver function to eliminate excess copper. which sress will deplete.

      High copper can cause a lot of your stated symptoms including insomnia and muscle problems. The low selenium and zinc could also cause
      thyroid problems. To reduce your triglycerides google” fish oil reduces triglcerides”

      I have found this site to be helpful for those with excess copper problems and she will answer any questions.

      http://www.tvernonlac.com/copper-toxicity.html

    • sally says

      I am sorry you are having a tough time. It might be helpful to have a hair analysis; this will tell you what is happening in your tissues – often different to what is happening in your blood – and the hair analysis I use here in Europe will also give advise on diet and supplements but more importantly will diagnose low adrenal output and low thyroid hormone too. The feedback is specific to you and you would inform them of Chron’s.
      Certainly insomnia is a symptom of low adrenal output and low thyroid hormone since I suffered with it for around 28years. Insomnia where you wake around 2-3am is due to hypoglycaemia and that in turn is due to low adrenal output, low thyroid hormone and resulting low liver funcion. Sometimes I couldnt even get to sleep let alone wake up.
      Hair analysis gave me information and a determination to get the right diagnosis; this came after 33years. Since treating my adrenals with vitamins, minerals, trace elements and herbs plus DHEA and also getting the right thyroid meds, I USUALLY now sleep like a baby. Best of luck.

      • Tina says

        Sally – where can you get the hair analysis? I am in Germany and having a horrendous time finding a doctor that will listen to my *symptoms* despite normal results.

        General question here…I am getting a bit confused as my “normal” levels use the German names:

        Free “trijodthyronin” (FT3?): 4.2
        Free “thyroxin” (FT4?): 14.2
        “Thyreoidea-stimulierendes Hormon” (TSH): 1.69
        “Thyreoidea-Peroxidase” Antibodies (???): 312
        “TSH Rezeptor”, Antibodies (???): negative

        But, despite my “normal” levels, I feel like hell. I have a long history of PMDD that no doctor will do anything to help so I was already running with about 50% of a ‘normal’ existence (pmdd for me always sucked all the life and energy I had out of me plus made my moods and emotions uncontrollable, my appetite rage out of control, my concentration disappear completely – for two full weeks every.single.month.) But then I returned to normal. Happy, with energy, focus, PATIENCE, normal appetite.

        Within the last 3 months, my energy level has vanished completely. My hair has been breaking for a long time, I am fully exhausted, if I do anything (do the shopping on Saturday afternoon) it takes hours to recover. My appetite has gone crazy, I crave sugar and salt, I am short of breath, I get really cold (i freeze), I have serious brain fog, I am irritable and NOW I am depressed. This is a major change to “just” the PMDD. This is horrible for me and my little boy. I have no energy to do things with him. I feel hopeless of ever getting to the bottom of this.

        My iron levels were a bit low. I have been taking iron pills for the last 4 weeks, but there is no major change there. I do have a lot of stress though, but in general, have a lot of positive things happening. I was feeling pretty darn good on my non-PMDD days) It’s just a lot in for a long time. My cortisone level is 127.

        My mother, father and sister all are hypothyroid. My gynecologist (from an Endocrinology practice) thinks I am just depressed and prescribed Zoely which is a birth control pill with “natural hormone replacement”. The pill was a nightmare for the PMDD when I tried it before. I have not started this.

        But I have several other Hypo symptoms. These are just the ones that are truly making my life miserable right now.

        Does anyone have any ideas? Sorry, I started with just general questions and just kept going. 😉

        Thanks for any thoughts. I wish us all the help we’re looking for.

        Tina

    • RenegadeRN says

      Kimm, I know yours was an older post, but parathyroid adenoma comes to mind. Did anyone run a serum calcium on you? Better yet, an ionized calcium.

      If you are over about 30-33 years old ,your calcium should be in the nines, anything over 10, on a regular basis or climbing, coupled with insomnia and fatigue points to primary hyperparathyroidism.

      • RenegadeRN says

        Forgot to add, check out parathyroid.com for a complete list if symptoms. This condition is grossly under diagnosed , and many providers do not have an accurate picture of clinical HPT. Most have outdated information.

  230. Mark says

    I’ve got another one for you. A friend of mine was recently diagnosed hypothyroid do to a medication side effect (carbamezapine). This manifests as normal TSH, low T4, and low T3 – but in the early stages, T4 (and possibly T3) are depressed but not out of range. This develops over time. It’s unclear if this is acting through the pituitary or something else entirely. Troublesome for anyone on continuous treatment with these sorts of drugs, as the TSH remains normal, and many doctors test only that. In our case, we discovered the change due to a sudden and rapid increase in cholesterol.

  231. Elizabeth Strong says

    Once again, no high cholesterol, but I am hypothyroid. I’m getting far too much thyroid medication according to my primary doctor, but my endocrinologist lets me stay on the present dose because I don’t have high cholesterol, or heart probems, and bone density is fine. And no diarrhea.

  232. says

    What about when labs indicate Hashimoto’s but I felt healthy with no hypo symptoms to report (I had a TSH of 10, FT4 of 1.0, and FT3 of 297, TPO >1000, ATA 1268)? I went off gluten for 5 months and now my TSH is 2.08 and all of a sudden I feel terrible — brain fog, fatigue, mild depression (FT4 of 1.2, TPO 447, and ATA 260). I started a dose of Armour Thryroid a week ago and am hoping this will help alleviate these unpleasant symptoms!

  233. says

    I forgot to add that at the moment (as of yesturday) I have started to supplement Betaine HCL, as I also have some symptoms of low stomach acid. Not sure if I will get any results from that.

    I have scheduled a phone consultation. Thank you Chris.

  234. Lynn says

    Nope, he isn’t, but the point of thyroid replacement is to mimic normal phsyiology. So, if thyroid patients do best at the top of the FT3 range; I would venture that healthy people should be there too.

    I also FIRMLY believe in fixing underlying causes low thyroid such as low adrenals, low iron/ferritin, low B12, gluten intolerance etc.

  235. Lynn says

    Well some labs use the range 2.0 – 4.4 for FT3 and other labs use the range 4.0-6.8 for example. People who are doing well (absence of thyroid symptoms) on their thyroid meds tend to have their FT3 at the very top or slightly over the range. This observation comes from years of interaction at patient groups. Apparently the ranges used to be higher, which explains this.

  236. Chris Kresser says

    Ranges don’t differ that greatly, in my experience, for FT3 & FT4. He’s at the high end for FT3, though he is towards the low end for FT4. It’s more likely he has thyroid receptor site resistance secondary to dysregulated cortisol rhythms. It’s perfectly possible for people to have normal thyroid labs and still have symptoms.

  237. Lynn says

    I should have phrased that more clearly. I meant that that the FT4 and FT3 are more important than the TSH, and that just because his TSH is low does not mean he is euthyroid.

    Without ranges, it is hard to tell where Bill’s numbers are though. Ranges differ from lab to lab and they don’t all use the same units.

  238. Chris Kresser says

    Lynn: I disagree that TSH isn’t useful. I think it’s very useful. It tells us what hormone levels are feeding back on the pituitary, and whether the pituitary is functioning properly.

    Bill’s FT3 and FT4 levels are within both the functional and lab ranges.

  239. Chris Kresser says

    Bill,

    I wish there was an easy answer I could offer you. As you have no doubt gathered, thyroid physiology is complex and multi-factorial. From reading your story, I suspect (as you do) that it’s your HPA axis that’s driving your symptoms. This isn’t uncommon – I have several patients with normal thyroid labs, but still have weak thyroid function secondary to pituitary or adrenal dysfunction.

    There’s really no way to know more without doing a full work-up. If you’re interested in that, please visit my professional site to learn more about how I work with people and schedule a free, 15-minute phone consultation.

  240. says

    Hey Chris

    I am hoping you can help me. I have many of the thyroid symptoms, but all my levels check out:

    TSH 1.27, FT4 1.1 and FT3 3.7

    Negative or “normal” for antibodies. TSH was tested separately and I was on “the raw milk diet”for both the tests.

    Testosterone was 306 on the first test, on the second it was 438. I was not fasting during any of these tests which I now have read could screw up results.

    I have been gluten-free, Primal type diet, no cheats with any grains whatsoever, since December. Unless there was gluten in something I ate at a restaraunt, although I was very persistant about being “gluten intolerant.

    I have had folliculitis caused by gram negative organisms, usually Enterobacter Aerogenes for 3 years, it waxes and wanes. It’s not “horrible”, but it definitely has ruined my face.

    I have been on Tetracycline in 2003 for Acne. Then nothing till 2007, where since I have been Doxycycline twice, Amoxicillion, Erythromiycin, and Clarithyromycn. Never for more than a month at a time.

    Obviously my gut flora is screwed. I did the raw milk diet and am now taking Theralac and Ohhiras. The condition has improved and definitely improved when I let go of topical therapy (a huge waste).

    But now my thyroid symptoms are really showing up, and I can’t tell if my folliculitis is flaring from the very dry skin from thyroid, or if the Enterobacter is still going strong. I wanna say it’s both.

    I was VERY underweight for about a whole year (all of 2007, some of 2008)due to being an overzealous cross country athelete who could not recognize when my overly competitive attitude was doing me wrong. I restored my weight with a junk food-binge type diet quickly by 2008.

    Found Primal in 2009. Many health problems left. But now things are much much worse. Did Zero carb for a bit, Very low carb for a few months.

    Never had thyroid symptoms till now, but clearly I had them coming.

    I am guessing my pituatary, adrenals, and thyroid are just fed up with me.

    I have been overfeeding, at least 2500-3500 calories a day for about two months now. There have been days when I feel and look great. But then days where I feel horrible, my eyes get puffy and baggy, skin flaring.

    Really don’t know where to go. I really just want that fecal therapy done to correct my gut flora, and then address the rest of the issues. I am afraid to go on antibiotics again unless I can get fecal therapy right after. Folliculitis get’s worse after each antibiotic and I really don;t need any other immune issues.

    I am ruling out Hashimoto’s for now. Just because for years I ate gluten and never had any thyroid symptoms. I gained and lost weight like a normal person, slept alright, didn’t really display any food intolerance symptoms besides acne and ADD, some anxiety sometimes about sleep.

    Too long of a comment, I am sorry. Hopefully I can get some advice. I have a doctor at Whitaker Wellness.. but so far that is going no where.

    • Sally says

      You have several other people commenting on your post but one thing to think about due to high amounts of antibiotic therapy is fungal infection. It is highly likely you have fungal infections which are causing some of your symptoms.
      I have used Lufenurone to good effect and without side effects which has to be a bonus with everything else you have. You will need to take Lufenurone for around 6 months and then repeat it again next year and so on until those symptoms resolve. It will then enable you to work on your gut dysbiosis and then the other things including thyroid. It is a long and windy road but its possible to get there; be patient; though I understand that is frustrating when you feel so Sh*t. Best of luck

  241. Carina says

    Lynn,
    Yes, I meant raising the dose until optimised.

    Chris,
    I´m with you. I was just pondering the accuracy of such trials. I guess I should have directed my question to Angus who was the one mentioning it in his comment.

  242. lynn says

    Hi Carina

    It is normal to raise the dose quite often when you first add thyroid hormone. You do this until you reach your sweet spot. Then, some need to increase slightly in winter and decrease a bit in summer. Otherwise, if you need to constantly tweak your dosage there is something wrong. Check out all the things Chris mentioned in his series as well as ferritin, B12, electrolyte and adrenals.

    Also, T3 or natural thyroid works better for most.

    • Steinalder (Norway) says

      If you need to increase your thyroid medication in winter, you probably want to think of getting some D-vitamin instead….. My underlying issue with hypothyroidism was gluten and dairy intolerances and vitamin and mineral defciencies as well as a gut infection.
      2 months after I went paleo I had to get off all thyroid medication (I have been taking Levaxin for more than 15 years!). The thyroid medication never worked for me, all the low thyroid symptoms were there all these years despite the medication. My doctor said “everything is OK” year after year – he trusted the results from the blood work…..
      Thank you Chris for all your hard work informing and educating us all!

  243. Chris Kresser says

    But that’s exactly my point, Carina: that “normal” thyroid labs don’t necessarily equate “normal” thyroid function. This is the argument I’m making in the article.
    These 5 mechanisms I listed here can suppress thyroid function, but they won’t necessarily show up on lab tests and they won’t necessarily respond to replacement. The value of those trials is that they confirm that replacement won’t work for patients when their underlying mechanisms haven’t been addressed.

  244. Carina says

    Chris,
    I guess I digressed there from your article, but these questions always pop into my head when I hear of trials like the one mentioned.

    I really thought it was normal to raise the dose quite a bit. But even so, if some of the test persons had one of the underlying dysfunctions, then that would skew the results, so I would still say that there are problems with trials trying to determine whether or not patients with “normal” labs would benefit from thyroid meds.

  245. lynn says

    I assume Carina meant that when you first start treatment you increase the dose every 6-8 weeks until optimised. Not that you change the dose every six weeks for the rest of one’s life. This is very common when the above mechanisms are not addressed or a person is on T4 only though.

  246. Chris Kresser says

    Carina,

    The point of this article is that there are physiological mechanisms which depress thyroid function that won’t respond to standard thyroid hormone replacement.

    For example, if your cells are resistant to thyroid hormone, supplemental thyroid hormone will have a limited effect. If you underconvert T4 to T3, taking Levothyroxine or another T4 replacement won’t help much.

    The reason thyroid patients have to continually increase their dose is that these underlying mechanisms aren’t being addressed. It’s not “normal” to have to raise the dose every 6-8 weeks. It might be common, but it’s not normal.

    • Sally says

      I’m not sure I agree with what you are saying here Chris. You place a lot on thyroid resistance when it is more likely hypothyroid symptoms whilst taking thyroid meds is due to other matters such as low/high Iron and low/high cortisol, poor functioning adrenals etc. These are easy things to test and sort out and should be so. There are also other things such as high flouride/bromide levels, high toxic metals such as mercury or lead etc. These too are things which must e addressed but may cause someone to eed higher doses of thyroid hormone meds.
      Of course for most people who are put on levothyroxine they may suffer the problem of poor conversion and rT3 conversion and so their meds must be changed otherwise they will always be hypothyroid and no matte how much Levothyroxine they receive their symptoms will not abate.
      It is normal to raise your thyroid hormone meds every 6-8 weeks but only until the best dose is attained and that is the dose which relieves your symptoms – and not lowers your TSH to whatever level.
      So I agree with Carina that study is not a study to base any treatment on, since the hypothyroid issue is too complex and should not be affected by that one study; I’m not sure what the point of the study was to be honest, if you need thyroid hormone then a placebo will not do -simples!

  247. Carina says

    “In trials where people with normal blood tests but symptoms of low thyroid are given thyroid hormone or placebo (inactive pill, e.g. sugar pill) (e.g. BMJ 2001;323:891-895) there was no benefit in giving thyroid hormone over placebo.”

    I´m curios how these trials can possibly work, since you have to raise your thyroid hormone until symptoms are relieved and the sufficient amount is so individual. For me it took 100 mcg of tyroxin to get any real benefits, but even that wasn´t enough. I did feel a little better on 50 mcg than on nothing but I was still sick as a dog. I would have probably been written off as one that didn´t respond better than placebo. How high a dose do test patients get in such studies? And do they raise the dose every 6-8 weeks as a normal thyroid patient would?

  248. Kathleen says

    Can you please state which tests to order for a full thyroid evaluation  —name them in order in a way the lab will understand and/or I can take to my doctor.
    thanks for the great information.

    • Chris Kresser says

      The problem is not what tests to order, but finding a doctor that knows how to do a proper thyroid evaluation. You can order the right tests, but if your doctor doesn’t know how to interpret them, it’s not much use. The standard tests I order for each patient are TSH, TT4, TT3 and T3 Uptake. If I suspect autoimmune involvement (almost always the case if TSH is elevated), then I’ll order thyroid antibodies as well.

      • Jennifer K says

        So, even if I order the TSH, TT4, TT3, and T3 Update as well as the Thyroid Antibodies… the doctor may not realize if something is wrong looking at the tests? So far they only order the T3 and TSH (I believe)… But since my cholesterol is high and my Vitamin D is low and I have other symptoms of what could be Thyroid issues (sure, they are symptoms of other things as well)… I’d like to truly rule out the Thyroid. I do also have recurrent Iritis (an autoimmune disease), so I am relatively sure that my other non-eye symptoms are autoimmune in nature… just can’t pin them down.

      • n king says

        i have had underactive thryoid for a year now, i am on 125mg levothyroxine. Recent blood test shows my t3 and t4 are ok but TSH is high. My doctor has advised me to go to 100mg and then re-test in a month. My joints ache at the moment and feeling very tired. Do you think I have thryoid resistance? What is the best way to treat this. I have never felt 100% since being diagnosed and long to feel like the old me :(

      • Ro Ro says

        So T4 Free (1.1), T3 Uptake (31), & T3 Total (86), will not paint the complete picture? What else should I take? Is TSH necessary?

      • Mark Flynn says

        I am starting to feel like there is a link between my son’s mental health and his Thyroid.

        My son has been diagnosed ADHD and we tried every type of stimulant. They did not even touch the problem. In fact they made things worse (very out of control mood swings).

        My son is 8 years old. Off the medicine he is incredibly active can literally run all day (I have 5 children and my wife is a school teacher… his activity level stands out). He also has emotional outbursts when he is off the medicine, getting very upset, and then eventually crying and coming back down to normal. During his outbursts he says things like, “I wish I was never born.” and other very sad/ low self-esteem things (This is odd for someone so young).

        All the ADHD stimulants made his outbursts worse. At some point he was prescribed a small dose of risperidol and it seemed to help, but he started to gain a lot of weight, so we took him off of it. His weight normalized and then we tried Abilify, that definitely helped, but again weight has started to creep up.

        One of his doctors actually did a thorough blood work on him. I noticed that his TSH level was 7.34. (I have other blood info if useful)

        Do you have any recommendations? What type of a Doctor should I see to get to the bottom of this. Psychiatrists are not the right answer…

        Thanks
        Mark

        • Kathy says

          Mark, I would strongly consider getting your son evaluated for Bipolar disorder. That sounds like a better description of his symptoms than ADHD and explains quite well why stimulants make things worse and why Abilify helped. Abilify is a mood-stabilizer and is used with people who are bipolar.

          Note: I am not a doctor nor a therapist. I do, however, have a masters in exp. psychology and used to own and run a counseling office with my then-husband who was a clinical psychologist. I am not diagnosing your son as bipolar. Just suggesting that it is a possibility and if that is what he has, then treatment might be able to be better geared toward that than adhd. It is not unusual for kids to be diagnosed adhd when they are really bipolar. Here’s a quick link about the two: http://www.webmd.com/bipolar-disorder/guide/bipolar_disorder_or_adhd.

          Good luck!

          • Saska says

            If I were you Mark, I would have your son taken to a endoctrin specialist..your sun has obvious hypothyroidism. Insanity…above 7????? He needs treatment. Psychologists or psychiatrists do sometimes more harm than good…as they do not understand the hormonal connection and your body’s needs. A friend of mine had tsh 4.90 and used to be deeply depressed with severe anxiety. When they found out here levels, she received treatment and feels much better now.

        • Sally says

          The brain must have adequate supplies of T3 to function well. Certainly the TSH levels appear high but interpretation of TSH levels is so variable. I would persue the thyroid issue since it is well known that hypothyroidism causes mental health issues amongst a myriad of other symptoms.
          Whether he has Bi-polar or ADHD it is likely whatever he has is due to low thyroid hormone.

        • Maria says

          Mark, my kindergarten son would have emotional outbursts like yours everyday after school. In 1st grade diagnosed ADHD combined. For him the meds seemed to help but I was never comfortable putting such a young and underweight child on Ritalin. I researched and went to different Drs. Finally when he was in 4th grade found a naturopath to do neurotransmitter tests (way off!) and food allergy tests. Once child had his food allergies removed which for him were gluten, dairy, eggs, bananas and 3 different types of beans, he was like a totally different child. He was able to totally come off the meds and do even better in school. When originally diagnosed I was concerned about him getting through the 1st grade and now he’s shooting for the honor society in middle school. Also remove any known GMO (genetically modified ) foods from the diet as there is concern that the BT toxin engineered into the plant, along with the pesticide residues can lead to leaky gut, causing the food allergies in the 1st place.

          • Mark Flynn says

            I am headed to the Dr. with my son tomorrow. This Dr. specializes in Pandas (which I don’t think my son has), but I think this Dr. may lead me down the right path.

            I have heard from several different sources that food allergies/inflamation may be to blame. I want to make sure I suggest the right tests… Is there a food allergy test that is more accurate/revealing than another?

            Also, I had his neurotransmitter levels tested (urine test), and they were all over the map. Almost none of them fell into the “normal” range… I have some Drs. say that the test is not a useful indicator of anything.

            I am trying to avoid quackery while not just settling for the easy answer. Either way nothing has really worked yet.

            Thanks for the help.

            • Maria says

              Mark, in response to your original post, there’s a great book “Healing ADD: The Breakthrough Program That Allows You to See and Heal the 6 Types of ADD” by Daniel Amen and one of the 6 types does not respond well to stimulant meds. Not sure where you live. Here’s naturopath web site for neurotransmitter testing http://stevenenninger.com/ I would no longer go to the Drs who say that neurotransmitters do not mean anything because they most certainly do especially to a Dr skilled in analyzing them and knowegable in correcting any inbalances by removing food allergies and using corrective supplements. Unfortunately such a Dr will most likely be a nathropath and may not participate in your ins. plan. There’s various food allergy tests IGG, IGA testing across 96 foods. Its impossible to have normal neurotransmitters when there’s hidden inflammation because the body is reacting to unknown food allergens. My 10 YO on ritalin for 3 yrs, was so allergic to gluten,dairy, eggs that whole digestive tract and neurological system was inflamed causing ADHD sym. and stunted growth. Diet + supplements- ritalin and w/in 1 month child became new person. Was able to avoid ritalin with younger son, using these techniques.

  249. Elizabeth says

    I don’t see the connection between thyroid hormones and cholesterol. I have hypothyroidism, have had for 55 years, and normal cholesterol. Ben, I’m really sorry you have to use statins. The only time I would recommend statins is in a case like yours becaue they can have deleterious effects.

    • Chris Kresser says

      There is indeed a connection between hypothyroidism and high cholesterol. Thyroid hormone is needed to activate the LDL receptors. So when thyroid hormone is low, there will be a larger amount of LDL floating around in the bloodstream.

      • Ashley says

        My blood work came back with that very thing (elevated/high cholesterol and low t3 uptake). My TSH was at the low end of normal (well below functional levels) and my T4 was mid range, I think. (I’m going off memory for the latter stuff). Haven’t been able to speak with my Dr yet (phone tag) but with the results coupled with the symptoms (cold hands/feet, fatigue, aching joints, mood swings, etc) I’m hoping the Dr will be amenable to exploring if medication might be beneficial. What do you think?
        And are there any books that are recommended for further education about thyroid?
        Thank you!!

      • ucgp says

        My last lipid panel (a few years ago) also showed crazy high LDL. My doctor recommended medication (statins, I assume.) I insisted on an LDL particle test and a CRP test. The LDL particle test came back normal and the CRP test was lower than they could measure. I would never take statins based on an LDL number alone. From a standard lipid panel, the Triglyceride to HDL ratio is the best indicator of heart disease risk. My ratio was excellent, which accurately predicted that the particle count and CRP would be fine too.

  250. ben nguyen says

    Low thyroid hormone supposedly can cause high cholesterol…
     
    Unfortunately, my doctor says all my thyroid numbers (t3, t4, etc) are normal.. so i’m on statins to keep my cholesterol on check (otherwise it shoots up to above 400!!))
     
    There’s a book by David Brownstein, that I’ve heard covers how to step by step diagnose thyroid issues!   In the meantime I’m minimizing my pufa intake, and increasing the number of antioxidants!

    • chimonger says

      Please, anyone using Statin drugs to control cholesterol, PLEASE also be taking SIGNIFICANT amounts of CoQ10!
      In Japan, as far back as the early 1990’s, Docs understood clearly, Statins strip critically necessary CoQ10 from muscles–especially from heart muscles where it’s so greatly needed.
      They’ve been dosing Statin takers with -several hundred milligrams- CoQ10 daily.

    • Ginny says

      Statins can be very dangerous – I won’t use them. I am using niacin at 500mg at night(you must use the flushing kind and it is a bit like hives so I take it at night). Brought my cholesterol down from 280 to 220. You can also try fish oil – 3g per day or policosanol. All these work to lower cholesterol altho like a statin the policosanol should be used with CoQ10. Niacin was what was used before stains came on the market – very cheap.

    • Sally says

      Rising cholesterol used to be the diagnostic test for hypothyroidism due to the fact that hypothyroidism causes rising blood cholesterol levels. Why? Low thyroid hormone affects the liver as much as it affects other aspects/organs of our body. The Liver is unable to process cholesterol; you will also find it cannot process Vitamin A either, etc., etc.
      Statins will cause more problems and are contraindicated in hypothyroidism; further are you taking CoQ10 at the same time?
      Have a 24hour urine thyroid profile test done this measures how much thyroid hormone your body has actually used. Do some basal temperature tests over several days too. Write a list of your symptoms and any other signs of hypothyroidism and also write a detailed history including family/medical history; these should take precidence over TSH testing; oh and get some studies which demonstrate TSH testing is rubbish, read them and understand them so you can argue your point.

  251. Jin says

    Hi Chris, I noticed in this article about thyroid testing you didn’t mention Free T4 or Free T3.
    My MD has always ordered TSH, FT4, FT3, TPO & TgAb when checking my thyroid, stressing the importance of measuring the Free’s.
     
     

    • Chris Kresser says

      T3 uptake gives a rough idea of free thyroid hormone status, is included on most standard lab panels, and is cheaper than running FT3 and FT4. But yes, if I am particularly concerned about the free hormones I’d probably run them too.

        • says

          My thyroid goes up and down. I have autoimmun problems from rheumatoid arthritis. I gained weight, got alopecia in my eye lashes, splitting nails and fall asleep all the time. My doctor has been checking my blood for three years. He can’t give me any medicine because it’s turning out my lab tests are normal.

          • Sally says

            Your Doc should not be treating the lab tests he should be treating you and your history and your symptoms and your signs that includes basal temperature test. Don’t be put off – change your Dr if necessary.

      • Annette says

        You mentioned for one scenario with high estrogen to clear some out of the body. How is that done?
        Love this article! Most helpful I have found!

  252. Chris Kresser says

    Sorry it took so long to approve that comment, againstthegrain.  It got caught in my spam filter.

    I like directlabs.com for ordering labs w/o a prescription.

  253. Lynn says

    Something tells me Angus is from the BTA or the BTF, with his talk of good doctors being struck off. He seems obsessed with the TSH, which is a pituitary hormone for a start!

    • Chris Kresser says

      I don’t have time to answer in the detail I’d like to right now because of my upcoming exam. So I’m going to wait until I do.

      • Kate says

        I have a nodule on my thyroid, persistence of both hypo and hyperthyroidism, and yet every doctor I have been to trying to resolve this has given me a blood test and told me my levels are fine. I have hairloss, brittle nails, anxiety and depression, and huge fluctuations in my weight for seemingly no reason. Not to mention lots of family history. Could you reccomend a doctor that would properly diagnose me? I would be more than willing to travel to get proper care. Help!

        • Jonna Yager says

          Hi Kate,

          I also have nodules on my thyroid. However, I do not have symptoms thus my doctor said I’m fine because my TSH is normal. I insisted that I get my T3 and T4 tested and they both were well within the normal range. I’m wondering what I should do next?

  254. says

    FYi, it isn’t always necessary to go through a doc to get the tests you need (though it is great to have a good doc to help with test result interpretation – so I’m not knocking consulting with a good doctor).  In many, if not most cases, patients CAN order the tests themselves, without having to hurdle a gate-keeper doctor, pay unnecessarily for an office visit, or share the results (except in NYS where the legislature seems to think the residents are too feeble-minded to mind their own health).
    If you are willing to pay out-of-pocket instead of billing your insurance co, have a good PPO plan which will reimburse fees for any accredited lab, or if you already are paying out-of-pocket for lab tests, consider using a service that will allow patients to order their own tests.
    There are numerous labs that will take a lab order direct from patients, such as MyMedLab.com (no affiliation other than as a customer).  The test fees are often discounted, especially when “bundled” with other tests typically ordered for common conditions, and include the doctor’s order necessary to run the tests (except NYS, where this arrangement is specifically prohibited by law).  Test samples are collected at many convenient locations, including the widespread Lab Corp network.  Results are usually speedy and communicated directly to the patient, though can be also copied to a physician if desired.
    I couldn’t get my endo to run thyroid tests for thyroid antibodies (he said it wouldn’t make any difference in my treatment) so I ordered the test my self from MyMedlab.com and had the blood draw done at LabCorp.  I received an email the next day that my results were in (avail via secure log-in at the website).  The fee was very reasonable.
    I also have ordered my own tests at Enterolab.com to check for gluten sensitivity.

    • Eli Renwick says

      I totally agree with this! I think its so so important to get the advice of medical professionals, but when you know you need some tests, its ok (and sometimes cheaper) to just order them yourself. I went way way too long without knowing this, so I am glad that someone has already posted about it here. I found a helpful site for me to find info about ordering my own blood work at http://PrivateHealthNetwork.net

      I really hope that Chris does/did well on any exams he has- This is one of THE BEST sites that I have seen for Thyroid information. It really has helped me- I have been scouring the web trying to find info about my condition, and this is one of the few sites that has helped!
      Thank you!

    • Maria says

      I’m one of those in NYS. What can we do about getting the same rights as other states to order our own tests? Why do New Yorkers pay so much in taxes and have so few medical rights? This alone makes me want to move!

    • Julie says

      But how do you fund someone to help you when you have the results and don’t know what to do now??

  255. Angus says

    This article displays  lack of understanding of basic thoiroid function. Taking the points above in order:
    1. T4 will be low in hypothyroidism secondary to pituitary dysfunction
    2. Control of TSH is dependant on feedback from T4 and T3 levels acting on the hypothalamus and pituitary. The action of T4 and T3 on inhibiting TSH production is proportional to peripheral activity (ie T3 has more peripheral activity  and more feedback (for a given concentration). Therefore if you are poor at converting T3 to T4 you will secrete excess TSH until the combined action of T4 and T3 is at a physiological level (T4 may be above ‘normal’ and T3 lower but overall activity will be unchanged.
    3. Assays which measured total thyroid hormone went out in the 1980’s. All assays used now measure free hormones therefore changes in TBG are irrelevent.
    4. Now I’m completely lost. Tempting to say you couldn’t make this stuff up but of course you have. High levels cause thyroid underactivity? Well obvoiusly thats why all those people with thyroid overactivity have symptoms of underactivity. Except they don’t they have symptoms of overactivity (sweats/palpitations/weight loss etc). Can you produce any evidence for this? Thought not.
    Also, for your information I expect the testosterone levels seen in female to male transexuals are rather (about 10 times) than the slight increases seen in PCOS.
    5. Untrue. Usually Thyroid hormone resistance (which is mainly inherited) affects the receptors in the pituitary and hypothalamus in a similar way to to those in the rest of the body. The end result is elevated TSH levels and T4/T3 but the peron with the condition has no symptoms.
    Sadly the symptoms seen with underactive thyroid are very non specific, really common, usually not caused by thyroid problems and often caused by complex factors with no simple cure. In trials where people with normal blood tests but symptoms of low thyroid are given thyroid hormone or placebo (inactive pill, e.g. sugar pill) (e.g. BMJ 2001;323:891-895) there was no benefit in giving thryoid hormone over placebo. Unnecessary thyroid hormone treatment carries a risk of side effects including osteoporosis and changes in heart rythm. There are good reasons why UK doctors who prescribe thyroid hormones to people without any evidence of deficiency are struck off and national guidelines are explicit in advising against (http://www.british-thyroid-association.org/news/Docs/hypothyroidism_statement.pdf).


    • Chris Kresser says

      Sorry it has taken me so long to respond to this. As some of you know, I was preparing for the acupuncture licensing exam in early August, and then on vacation until last Sunday night.

      1. T4 will be low in hypothyroidism secondary to pituitary dysfunction

      That depends what you mean by low. It’s possible in this pattern for T4 to appear within the normal lab range, but below the functional range. Lab ranges are not based on scientific studies, but instead on bell curve analyses of patients who get tested in labs. Who gets tested in labs? Sick people. Therefore standard lab ranges represent what is “normal” for sick people, not what is normal for healthy people.

      What’s more, many people who have their TSH & T4 tested are taking supplemental hormones, which further skews the lab ranges.

      Finally, as much a we’d like to think that these feedback loops work in a textbook manner, they don’t. For example, I have a patient with confirmed Graves’ disease. According to the textbook, she should have low TSH (she does) and elevated T4 and/or T3 (which she never has). In fact, it’s not at all uncommon to have patients that don’t fit the expected patterns.

      2. Control of TSH is dependent on feedback from T4 and T3 levels acting on the hypothalamus and pituitary. The action of T4 and T3 on inhibiting TSH production is proportional to peripheral activity (ie T3 has more peripheral activity and more feedback (for a given concentration). Therefore if you are poor at converting T3 to T4 you will secrete excess TSH until the combined action of T4 and T3 is at a physiological level (T4 may be above ‘normal’ and T3 lower but overall activity will be unchanged.

      There is some controversy on this issue. But I can tell you that I’ve seen lab work on patients with normal TSH, normal T4 and low T3. If it were always true that low T3 would increase TSH, then such a result shouldn’t be possible. But as I mentioned above, patients very often don’t present with the textbook pattern.

      I’ve also seen and heard of patients improving when treated for T4 to T3 conversion problems even when their TSH is normal.

      3. Assays which measured total thyroid hormone went out in the 1980′s. All assays used now measure free hormones therefore changes in TBG are irrelevent.

      I don’t know what it’s like in the UK, but here in the US the standard measurement is total thyroid hormone (which includes free and protein bound). Few doctors order free T4 or free T3 routinely. Therefore TBG is not at all irrelevant. This is why T3 uptake is still included on standard thyroid lab panels.

      4. Now I’m completely lost. Tempting to say you couldn’t make this stuff up but of course you have. High levels cause thyroid underactivity? Well obviously thats why all those people with thyroid overactivity have symptoms of underactivity. Except they don’t they have symptoms of overactivity (sweats/palpitations/weight loss etc). Can you produce any evidence for this? Thought not.

      It is well-known that receptor site expression and sensitivity are both down-regulated in the presence of excess hormones – whether thyroid, insulin, leptin or other.

      It’s true that a large excess of thyroid hormone will produce hyperthyroid symptoms. But it’s a question of scale. To illustrate this, let’s look at a similar pattern that occurs with another hormone: insulin resistance. Chronic elevations of insulin cause insulin resistance. The cells are less sensitive to circulating insulin and hyperg