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5 Thyroid Patterns That Won’t Show up on Standard Lab Tests

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Reviewed by Christina Graham, MSN, APRN, AGPCNP-BC

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 a misdiagnosis can happen in the management of hypothyroidism and other thyroid disorders. If you go to a doctor with hypothyroid symptoms, you may be given replacement hormones without first determining what’s causing your thyroid issues.

Or, if you have hypothyroid symptoms but your lab tests are normal, your doctor may not realize you’re experiencing thyroid issues in the first place. You may even receive treatment or medication to deal with the symptoms you’re experiencing—like an antidepressant to address depressive symptoms—but you won’t receive anything that will help your thyroid disorder.

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.

All cases of hypothyroidism do not share the same cause—and, as you might guess, they require different treatments.

In this article, I’ll present five patterns of thyroid dysfunction that may not 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 depending on the tests your doctor runs, you may not get a diagnosis of hypothyroidism; and, if that’s the case, you won’t receive the treatment you need.

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A standard thyroid panel usually includes TSH and T4 only (while some panels will also look at free T3, free T4, and check for thyroid antibodies). 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)

Are you experiencing hypothyroidism symptoms even though your lab work is normal? You may still have hypothyroidism, though it may not show up on standard labs. Check out this article for more. #functionalmedicine #chriskresser

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. (1) 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).

2. 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 percent 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. (2) High cortisol also suppresses the conversion of T4 to T3. (3)

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.

3. 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. (4)

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.

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4. 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. (5) 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.

5. 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. (6)

Thyroid Treatment Depends on the Right Diagnosis

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. Without understanding precisely what’s causing the problem, you may end up with a treatment that isn’t well-suited to your specific situation.

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

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841 Comments

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  1. I have had bowel, prostate, headache issues for years. Tests always normal. Doctors always insisted I was ok but I had some sort of systemic issue. I went to Ecuador for vacation and doctors there found I have thyroid cancer. Came back and went to ucla. Confirmed I have cancer and need surgery due to growth. Dr believes it has been growing for years. Dr in Ecuador was dumbfounded why my thyroid was never checked for symptoms he said were unusual for someone in early 30s. I recommend you tell anyone loved ones that have unexplained gastro issues to request a thyroid ultrasound.

    • I have Hashimotos, and hypothyroid symptoms… Yet my bloodwork comes back in the normal/lower range. I have had “nodules” for about 6 years. They did a biopsy about 5 years ago and as of then, they were non-cancerous. I went in again recently and now my right side nodules have definitely grown in size. I have non-stop stomach issues with heart burn and diarrhea numerous times a day. That has been going on for over 13+ years. Dr’s keep acting like its no big deal to have diarrhea every day, after every meals, numerous times. It’s come to the point I no longer enjoy eating. I can’t lose more than 2-3lbs ever! I feel like I’m lost in a system of everyone getting a piece of the pie for insurance costs… And I never get any answers or what has caused these issues. I’m feeling like I will never get answers.

      • Gluten intolerance/ Celiac disease can cause the thyroid to malfunction and also can cause heartburn and diarrhea, along with intestinal damage.

      • They keep saying i might have Hashimotos but when they do the blood test for my thyroid it comes back normal. I have had nodules in my thyroid for about 4 years or at least that was when they found them. Im so tired and lacking motivation. Constant stomoch problems and diareah. Pain all over even in my feet and hips. Cant control my weight and its creeping up more. This has been going on for 10 or 15 years. At wits end why i feel like this

  2. I have all the symptoms of an underactive thyroid. Excessive weight gain over a short period, brittle nails with vertical lines, tingling & numbness in arms and hands, can’t sleep, constantly bloated, loss of libido, hairs falling out, constantly bone tired, aching muscles and joints, swelling in ankles the list is endless and I went to the Dr and she instantly said thyroid and lets get tested.

    Tests are back and she says they are normal 🙁 but then she only requested 2 tests :

    TSH – 0.9mU/L
    free T4 – 13.2pmol/L

    Electrolytes, seem on the high side:
    Serum sodium – 142mmol
    Serum Potassium – 5.0 mmol
    (these results show that my kidneys are CKD Stage 2)

    Blood showed elevated blood sugar

    Anyone help, I’m desperate now?

    • When my thyroid panels kept coming back normal, but I felt that I was having hypothyroid symptoms I asked my primary to check my thyroid antibody levels. They came back high – although an endocrinologist would not treat me I am seeing a functional medicine doctor to lower my antibodies and relieve my symptoms.

    • I finally got an appt to see the Dr and she said my thyroid results were “perfect, absolutely beautiful” (her words) but I showed her your article, with my low TSH and mentioned the pituitary and she said that I didn’t have pituitary symptoms (which are EXACTLY the same as the thyroid symptoms that I do have), she said that I should give it another month and see her again and she “may” put me on a small dose of thyroxine.

      So I do not understand – if I have all the symptoms and yet she says my thyroid is perfect – why would she put me on the medication?

      Does anyone else have a similar issue?

        • I have to say it is somewhat comforting to realize but I’m not the only one out there who has all the symptoms but yet all the test results keep coming back negative.

        • Check out the book on Type 2 hypothyroidism. It will only be treated when we all push for it.

          • I for one, will definitely check that out Valerie.

            As an update, the Dr put me on a small dose of levothyroxine – although it’s only been a couple of weeks, I do feel slightly different. Although I still feel horrendously tired by mid-afternoon, I think it may be other drugs I take interacting but I don’t feel as exhausted ALL day, I’m sleeping slightly better, my hair seems to be falling out less, the aching joints seems to have eased a bit. I’m on a course for 3 months and then we will see if there have been major changes.

            It does seem strange though as the Dr was ADAMANT my thyroid is working perfectly – she gave me thyroxine anyway – that’s what I don’t understand

            • Exactly my issue with doctors. I have Fibromyalgia, Scoliosis, Degenerative Disc Disease, Diabetes, AFib etc and I have been having issues for YEARS and firmly believe it’s hypothyroidism. My blood always “checks out fine.” Doctors keep telling me I’m fine. I can’t lose weight to save my dad gum life. I starve myself and can’t lose, eat right can’t lose, I can’t exercise too well which is why I can’t lose . Firmly believe there’s something wrong with my thyroid.

                • I asked if perhaps my pituitary was at fault (after reading on here) which was why i had thyroid symptoms but bloods were fine although my TSH was 0.9 and the Dr actually laughed and said no way have you a problem with pituitary there are absolutely no symptoms! This is the same Dr who said my thyroid was “perfect” and then put me on thyroxine. In all honesty I don’t understand what the pituitary can do that would affect the thyroid

                  I’ve been on thyroxine now for nearly 2 months and in the beginning there was a difference less hairloss, constipation and bloating eased slightly, joint aches weren’t so bad and I managed to lose 1.5lb but now I seem to be going backwards – I dont know if its helped because it was a boost but now my body is used to it, I was only given 25mg, maybe it needs increasing. I see my Dr again in a month so I will ask her and also make sure she takes more bloods to check the thyroid again.

      • Jayne. I had all of those symptoms too yet my TSH and T4 and even T3 were NORMAL!!! I found a good functional medicine doc who prescribed me Armour and my symptoms are just about GONE. You need a new doctor or one who will treat you with NDT for a trial to see if your symptoms improve. My mom died with renal and heart failure because her thyroid test was always normal and her doctors recognized it too late. Doctors rely too much on lab tests to treat thyroid when they should be looking at THE PATIENT!

    • Get another doctor & preferably a DO. They need to run Free T3 Free T4, TPO, Thyroid Antibodies for Hashimotos, Reverse T3 to see if there is a conversion issue and Iorn/Ferritin levels. Also get a copy of book ‘Stop the Thyroid Madness’. Also look at Mary Shomans Blog with the same name. Best of luck!

    • Have they tried testing your calcium? Or parathyroid hormone levels? Look into that!

    • I have the same symptoms as you have and am desperate for a diagnose and a treatment. The doc said that I have type 2 diabetes but was cought early. It doesn’t make sense I feel worse when my glucose level is below 6. Then I self medicate with a thyroid supplement and feel better. Im afraid to do damage doing this but its unverable otherwise.
      Please someone help!😣

  3. In getting an ultrasound on the thyroid what does it mean when it’s at the upper limits? My blood test comes back ok but that is what the ultrasound said. I’ve got a lot of symptoms of hypothyroidism and some family history of thyroid trouble.

  4. I am a 37 year old male. For really the last 15 years I have had a big problem with fatigue and feeling tired all of the time. I have had been to the doctor many times over those years and each time they test my thyroid. The symptoms line up. Each time the results come back and I am told that they are normal.

    The last time I was tested was just a few days ago. They also ran a testosterone test to see if those levels were low. Both came back as “within range”. I have got to get this figured out. I am tired of being tired. Is it possible to have numbers within the lab range as normal and still have a problem in either of these areas?

    TSH – 2.030 uUI/ml range (.450 – 4.500)
    T4 – 5.9 ug/dL range (4.5 – 12.0)
    T3 – 106 ng/dL range (71-180)

    Testosterone, serum 410 ng/DL range (348-1197)
    Free Testosterone, direct 13.6 pg/mL range (8.7 – 25.1)

    • When my thyroid labs kept coming back within range I asked my doctor to check my thyroid antibodies – which did come back high. An endocrinologist refused to treat me because my TSH was considered normal so now I am currently going to a functional medicine doctor.

        • A functional doctor looks at the cause of the disease, while conventional doctor do not. Functional doctors look at environmental factors such as diet and stress and treat the symptoms – not only the labs. I recommend doing some research to see if a functional doctor is right for you too.

    • Have you by chance had your B12 levels checked. My husband had similar issues but everything kept coming back fine until they checked B12. He had a severe deficiency that led them to test for other things. They found out he actually has Celiac Disease and it led to severe malabsorption of vitamins and other nutrients. He is now on a gluten free diet and taking weekly B12 shots and feels like a new person.

    • As you can see, the normal range for testosterone total is quite broad and covers a wide age range. You are young and suspect that even though your T is in the acceptable range, it could well be low for you. I have a patient now that was put on a T booster while it total T was in the low-“normal” range. His energy improved within a couple of weeks and he won’t get the full benefit for a couple of months. Maybe you can get a referral to an endocrinologist. Problem is that primary care docs are reluctant to treat when labs are “normal”. In T there is a huge difference between 348 -1197.

  5. I stopped reading after you made the statement ” Lab values are based on sick people” it’s actually the complete opposite. Lab values are within +/- 2 standards deviations (SD) of a healthy population. Which means 95% of the population fall within those values. If you were referring to those who fall within +|- 3 SD or the 5% not mentioned in reference ranges, that would be a different story…

  6. Blah you’re like one of the first people to explain what I’ve been thinking. I have very elevated TbG and my t3 and t4 we’re falling despite normal TSH. I also have a huge nodule and am finally deciding to have it removed. I’m on the waiting list for a doctor in your practice.. I don’t know what else to do! My hormones are starting to get all screwy too probably because the NatureThroid isn’t doing it’s job if it’s all bound up…

  7. Hi! I have normal t4 and t3 but elevated tsh. Trying to figure out if armour or synthroid will be best for me. I know armour is t4 and t3 but I don’t “need” extra t3. I feel like synthroid is the better option because it’s not giving me any extra t3. Would that be correct? Also is it safe to say that I do not have an issue converting t4 to t3 if both of my levels are normal? Thanks

  8. Hi, I’ve just had bloods taken to check my thyroid,my periods have became erratic and other symptoms but the day after the blood test was done my period started they where 2 weeks late, would this effect my results.

  9. T3 is low. T4 is low. TSH is normal.
    Thyroid antibodies are high. I have tried levothyroxine with bad results so doctor said you don’t need medication but I suffer with all of the hypothyroid problems. Where do to recommend I go for help? I also have c677t and Hypogammaglobulinemia. Not on medication for these disorders.

  10. What does it mean if my TSH is 7.92 but my T3 uptake is 28, T4 Thyroxine is 7.0, free T4 is 2.0 my iodine from urine is 232 DHEA is 191, my estrogen, progesterone, prolactin and testosterone are normal. Is it my pituitary gland? Thyroid resistance?

  11. Hi my 19 year old daughter has just been diagnosed with an underactive tyroid she has been numerous times to the surgery only to see locums (our surgery is closing down due to poor service) however a good doctor sent for bloods and was shocked and appologetic as her levels were a shocking 169 my poor daughter is attending college 3 a levels rides 6 horses a day and looks after 9 alongside college she doesnt eat lots and is only a little over weight, we have been told she is lucky to be here her reproductive system has stopped working prior to that her digestive system she was told ibs, and she has down days and now i believe her when she says she is exhausted, poor child, she has probably had this from puberty we have been told, also as she is so fit and active she is running dangerously on empty but thought this was all normal, i feel awful pushing her everyday i thought she was just lazy. she has also collapsed on a few occasions and we are now told her body must have shut down witht the volume of work. she also competes on bsja. she has been on thyroxin for 4 days now, any advice would be appreciated.

    • Maybe u should go see a doctor who practices Functional Medicine instead of looking for answers online.

      • I can’t find a Functional Dr. in the whole state of Ohio. There is one Endo in our town who does not show any concern about me. I’ve seen him 4 times in 16 months..grrr!
        I felt great until my PCP got TSH labs back of 0.015 in 11/15 and sent me to an Endo. He did radiation therapy, has me on meds, I can barely function I’m so tired, put on 50 lbs , MAJOR Brain Fog and my TSH has not budged thru all I’ve gone through in 16 months!

      • Hi Alyssa,
        This is probably a dumb question but are any functional doctors covered by insurance??

  12. 1.Make a timeline of your symptoms, your age, where you lived at the time, and the type of food that you ate.
    2. Incorporate your personal changes of life. teen years, your menses, Men you go through this as well.
    3. note how your life changes your exposure to daylight and activities.
    4. also note the time of year respective of what you ate. In spring, cows eat fresh grass. During winter they may be eating hay. Eating seasonal foods may bring things to light.
    5. and latest factor is your ethnic group. a DNA check may be helpful. Studies are being conducted relating that norm for one group may be different than another group.
    6. You can purchase your own tests independent of a doctors prescribed tests. But, get all of them done. They are cheaper than if a doctor orders them anyway.
    7. Do a body cleanse til you have that ruled out.
    Fluoride is in city water. If you have softened water or mineralized well water. Living along the ocean (seafood and salt). Regional food also affects your system. If you were raised in land locked area and now live in another part of the country, make note.
    8. Provide a COPY of this information to your chosen doctor.

    • First how do you order your own tests? Also I moved from a landlocked area to a coastal area. What does that have to do with all of this? Can u please explain? Thank you so much!

      • You were raised in a fresh water area. Being on the coast, you are exposed to salt air and salty water growing areas. Food that is favored here is also potentially raised in arsenic tainted soil. ( If radon is tested that is possible). Also, hard vs softened water. Basically, consider the cultural and environmental differences.
        Search for independent labs that perform the tests online. I had located one in California. But there are many other labs.

      • I legally can not direct you to a specific lab. But, they are available via an online search. Also, there are well known walk in labs that can perform the testing. You need to seek them out.

  13. I’ve had all the symptoms of Hashimoto for almost 2 years, but it’s getting worst. I’ve been under the care of my PCP and Rheumatologist without any treatment since I 1st tested positive for an ANA. In Nov 2016 my TSH and T3 test were normal range, but my T4 was out of range and my antibodies testing was 584. Last week, I repeated the THS, T3&T4 at a different lab. Now all normal range. My ultrasound showed nodule growth and inflammation, so I had a biopsy done today and waiting on the results. Very frustrated, because I feel the doctors aren’t listening to me, because my labs continuously jump back and forth. The Endo Doctor suggested I speak to someone about depression, and also suggested maybe I have sleep apnea after she told me I had Hashimoto. The end results was still no treatment, see her in a month, and she will repeat the labs. Any suggestions?

    • Find a functional medicine doctor in your area. They are not dismissive like many traditional doctors and want to treat not just your labs but also your symptoms. They also try to find the root cause of what is making your thyroid go whack, rather than just medicating you to suppress the symptoms. Good Luck!

        • A functional doctor looks at the underlying cause of disease, they treat you according to your labs AND symptoms – not just your labs unlike traditional doctors. I am going to one now after my primary doctor and endocrinologist did not treat me for having high thyroid antibodies with normal TSH even though I have all the symptoms of hypothyroidism. I would do some research to see if this is the right kind of doctor for you too. To look up some in your area you can try this link: https://www.functionalmedicine.org/practitioner_search.aspx?id=117

    • Omg, Hashimoto’s causes depression. I hope you actually happen studying this for about 20 years look up leaky gut look up Mega Flora all I’m saying

  14. YOU COULD set this up to PRINT!!!! I am getting every last comment ,BEFORE the contents of the article print out.
    Back in the “old days” of technology a provision would have been made for a print version……..Now we are so advanced………it doesn’t work as well.

  15. I also fight with hypothyroidism and this is horrible how many people is not diagnosed well. Many of my friends had no idea they were hypothyroid (or hyper or Hashimoto’s). One of my best friends was struggling for depression and no one could help her. What it really was – Hashimoto’s. Moreover, there is no rule, even the laboratory blood norms are not absolutely reliable! My THS levels were in norms…and what? And I was hypothyroid. You can read more on my blog https://iamthyroidtoday.com/blog/ , hypothyroidism is a reason why I started to write about that, and now I know much more and do not only rely on T4 synthetic hormone, addicting by the way.
    Good luck to everyone trying to come back to normality with sick thyroid. Stay strong 🙂

  16. For nearly 4 years I am batteling with my childs dr, who keeps him on levothyroxine, t4 always either 19-25 and even 30!!!! And TSH 4-5 and once 12 when t4 dropped to 19.

    Basically both t4 and TSH are high and Dr doesnt know why.
    Child has insomnia, very hard to control his emotions, seems to get headaches abd generraly irritable.

    What would be your view on it? Pls

    • Pituitary or hypothalamus problem. Check all of the pituitary hormones. Check T4, T3, and TBG at the same time. Do the blood draw in the morning. Bring the results to at least five different endocrinologists. They will probably not all give you the same diagnosis. Good luck 🙂

  17. I am 42, and recently found that I am anemic through a routine health screening at employer. I have been chronically tired, swelling in ankles, hair loss, weight gain, cold, and difficulty losing weight, decreased libido, thinning fingernails, all for over a year. The dr found through more detailed labs I had low Vitamin D, and requested I have an upper and lower endoscopy to rule out bleeding for iron deficiency. Those tests were fine (but not fun). I switched PCP doctors because he would not check my thyroid. New doctor checked TSH only and it came back 1.66. Because this was in the normal range for the lab, no further tests were done. My iron and D levels were better, too (after taking supplements for 2 months) so I am basically on my own until a 6 month check up. Some days I feel ok, others I am extremely tired, hair still falling out, still cold, etc. I have gone to a gluten free diet 2-3 weeks ago and am losing about 1 lb a week with some exercise. I am avoiding peanut butter and a couple other foods I read are bad for thyroid. I feel like I have hypothyroidism, but feel like my new doctor is going to think I am not trusting his judgement. Also, essential oils are very popular in my community right now. Any luck with using these for hypo? Should I see a specialist and push this? My daughter is getting married in 10 months, and I would like to look nice and feel nice again.

    • I had hypothyroid symptoms with normal labs until I convinced my primary to test my thyroid antibodies. Go to a functional medicine doctor -no other doctor will treat you, not even an endocrinologist.

    • I had hypothyroid symptoms and normal labs for years. I finally convinced my primary to test my thyroid antibodies-which came back high. Going to an endocrinologist did not help-he refused to help because my TSH was normal. Your best bet is to go to a functional medicine doctor.

        • After realizing no endocrinologist would treat my hypothyroid symptoms caused by high thyroid antibodies because my TSH was in range I did research on a doctor who would. After convincing my primary doctor to check my thyroid antibodies after continuously receiving normal thyroid labs she sent me to an endocrinologist because my thyroid antibodies were high. The endocrinologist told me he would not treat me because of my normal TSH, but said I would likely have a thyroid problem in a few years because of my antibodies and to come back. He also blamed my multitude of hypothyroid symptoms on various different ailments such as anxiety, fibromyalgia, and depression even when I mentioned no mental problems and had the signature symptoms of low thyroid. Thyroid antibodies attack your thyroid for years and regular doctors wait til the damage is irreparable to treat you-functional medicine doctors want to prevent the disease from developing further. A regular doctor looks at how to treat your labs-not your symptoms like a functional medicine doctor. A functional medicine doctor also tries to find the root cause of why your body is producing antibodies (multiple factors such as vitamin deficiencies etc.) and how to stop it-while a regular doctor would just give you thyroid hormones and ignore the fact that there is an underlying autoimmune problem going on. Functional medicine doctors also look at diet and lifestyle factors and do not rely solely on prescribing medications. These doctors tend not to accept health insurance, but I think it is worth it since it is the only way I can get treated. Unfortunately you cannot trust every doctor you meet- I tried to listen to multiple doctors for years telling me my thyroid is normal. Advocate for yourself now.
          Here is a website if you are interested at looking for a functional medicine doctor near you.
          https://www.functionalmedicine.org/practitioner_search.aspx?id=117

        • You need to see someone who looks at all of your symptoms.. make a list of issues that you have had leading up to this need to even consider that something is wrong. If you see a specialist, they will only consider what is in their wheelhouse and test accordingly. It could be associated with hormonal changes of life, when you lay out the timeline of symptoms. Maybe it is the pituitary, spleen, adrenal glands, etc. They pushed the doctors for information and evaluation.. synthroid is not the only solution for hypo, some require Armour. You can order your own full spectrum.. Take those results to a doctor. Fluoride, heavy metal, mercury, also have an effect. Lack of iodine. Finally found out that he has a rare condition. And, it required an orphan drug to control it. He also had a previously unknown food allergy. He could have fresh dairy during the winter but not the summer, when the cows ate stored hay and not fresh grass. Become your own advocate. do the research. Make sure that the prescription does work for you. But, it is up to you to seek out a holistic doctor. so that all of your symptoms are considered. Dryness of mouth, sensitivity to foods, age when issues started. I have started home grown fruit and vegies. Radon/ uranium / environment issues could be contributing factors. Stress and what you eat during that time affects you. coffee, tea, carbonation, fish, msg, every thing needs to be accounted for. Feed your craves in moderation. real cocoa not processed milk chocolate. real cane sugar, not pho sugar substitutes. Just don’t know until you start making notations of how you feel vs. what you eat, and when. note: synthroid treat the T4. if your body doesn’t convert T3 to T4. then you may need Armour which helps your thyroid with the conversion. For me it was diet modification and to grow what I ate, non GMO. But now, I can eat whatever I like as long as I make it. Cocoa is allowed, non pasteurized sauerkraut, real kimchi, gyros, home made fresh cheese,. Pasteurization, for me, killed off the beneficial vitamins. Removing minerals from water. This has led to living a rural area with my own water source. I am learning to control my environment. Also, creating an edible landscape with permaculture has aided in reducing stress. But, this may not be the answer for you. Do your research and an historical timeline of symptoms. The internet is your friend, if you ask the right questions.

    • I am 49, and suffered fatigue for yrs, I stopped eatting carbs and although I did crave sugar (kept it limited ) I lost weight fast..and I got specific blood work done at obgyn, and found that my hormones weren’t way, way off, I Started bio identical hormones and it is life changing, I sleep, have energy, and desire to actually get things done,..hope this helps.

  18. My T3 is always been normal since they diagnosed me with hypo. Now my THS is the one that seems to have the problem. They gave me immediately 25 of thyroxin or something like that and now they increased it by double. I do exercise normally. I have no problem to loose weight. I eat healthy, sometimes I doubt my results. I dont know if i should stop taking medications or continue. Please help.

  19. Hi!
    I have been having issues which seems more and more like a possible thyroid issue. I finally got a doctor to run a test and I was told that I had normal normal TSH and T4 but low vitamin D. Suggested that I take 2,000u of VitD and come back later.
    I’m not sure if I should pursue another doctor or try the VitD but honestly Im tired of being tired.

    • K REID – You need to have the lab retest your TSH level. Go as early as possible in the morning on an empty stomach as the TSH level is the highest that time of day. Also, I have just been diagnosed with very low Vitamin B12 due to the terrible fatigue I’ve been trying to deal with, so have that tested, too. Good luck, I know the doctors think the TSH ranges are the gold standard, which I think are way too high.

    • Hey K,
      Few sensible people here but most of them are fecking hypochondriac head cases!! Take this with with pinch of salt.
      P.s.
      I’m in same boat as you.

      • Do some research on Wheat grass. Cacao, and Spirulina

        I have lost weight, feel better, and am no longer feeling the effects of Hypothyroidism. Our systems are too acidic. This affects bones, joints, and digestive system.
        My mind is clearer and I am happy again.
        Best wishes,

          • Crystal for everyone it is different. Also, it worked for my thyroid condition. I have a friend who is hypo parathyroidal, who this process can not apply due to gout. I can just suggest that you research your type of Thyroidism.
            In researching his prescribed medicine, which is sensipar, this apparently for hyper not hypo. This is the cause of his gout.
            My advice is to work with your doctor. make sure that you are addressing the problem not the symptoms. If you don’t feel that the doctor is listening, seek out another and get another set of tests perform..

  20. So then my question is, what test do you ask your PCP for? I’m 99% positive that there’s something wrong with my thyroid, but like so many others, when it has been tested, things come back normal. I have an appointment with a new doctor in the next 2 weeks, and I am asking her to test my thyroid, but I want the right tests done to ensure that I get proper results / answers, etc.

    • For years I thought I had a thyroid problem and kept getting normal labs back. After doing some research of my own and seeing that many doctors don’t test thyroid antibodies I asked my doctor to check them and they were high. But because my TSH was in range an endocrinologist would not treat me, but told me I would likely develop a thyroid problem in a few years. Now I am with a functional doctor who looks at autoimmune thyroid from a different perspective and more importantly is willing to treat me-without using typical thyroid medication. I would recommend telling your doctor you want the thyroid antibodies checked.

      • What was your symptoms, I too was diagnosed with Graves after the birth of my last child, he is 13 now, I its been in remission for years now, but I have been having the same symptoms again just had them tested came back normal, but I swear it’s my thyroid.

        • I was probably displaying different symptoms than you Rhonda because my problem is hypothyroidism not graves. I have fatigue, coldness, stomach problems-pretty much everything on the list of hypothyroid symptoms. If you cannot get answers from your primary doctor or endocrinologist I strongly encourage you to find a functional doctor in your area. They look at the whole picture by treating your symptoms not just your lab results and try to prevent disease rather than waiting until it becomes worse. They don’t take insurance but I think it is worth it because every other doctor refused to treat me or didn’t know how. Also: I started displaying my symptoms while I was in middle school and am 19 now.

    • Exactly — what labs should a client ask for when getting Thyroid testing… and one step further, the entire endocrine system as well?

      • Go to Healthunlocked and look up thyroid. There is a wealth of info. on that site. They will tell you exactly what tests to ask for! Good luck!

    • You need to have the lab retest your TSH level. Go as early as possible in the morning on an empty stomach as the TSH level is the highest that time of day.

    • I found out through a tech that was doing an echocardiogram on me that an echo of your thyroid can be done. It needs to be ordered through an endocrinologist. All of my thyroid labs came back normal for 10 years, even though I experienced every symptom of hypothyroidism. I demanded to see an endocrinologist and have an echo performed. The echo showed that I did have hypothyroidism and am now being treated for it. The problem is that going undiagnosed for so long may have contributed to my heart failure. I’m 43 and there are no known causes as to why this has suddenly happened except for this. I wouldn’t have known about the availability of a more definitive hypothyroid diagnosis through an echo without the tech. She suffered the same problem of normal labs too but was diagnosed with hypothyroidism after the echo. Hope this helps.

      • What does the echo show? I have had hypothyroid symptoms for years and after researching why my labs always came back normal I finally had told my primary to test my thyroid antibodies and did have high antibodies. Just curious what an echo would show.

    • i was told i had a slightly underactive thyrod to come back in three months for another test to see symptoms bit worse but nothing showed up so i m thinking and saying thats strange but they leave it at that tou have to keep going back i dont no why im not getting asked or tolc im getting more testd done