Hi Becca and welcome. Sorry you are having such a hard time.

First I want to ask if you are getting the Ft4 and Ft3 test done along with TSH? And do you have any recent thyroid lab tests results that you can post?

Hello!
My last lab was in Oct.
TSH .610
T4 1.39

I know about the TSH, but not too much on the T4.

I am scheduled to go get new labs tomorrow. I recently moved and have just now got a new PCP and no endo yet... So for now I am at the mercy of my new PCP. I did explain to her that the expectations of my old endo was to have my TSH around a 1.

I am open to any input you may have!

Hi Becca and welcome!

Hmmm... your TSH would be considered normal but... I think we need a bit more info on your T4 results.

For example, is this the free T4 test or total T4 test? Also, what were the lab's reference ranges? Ex: My Free T4: 1.0, range: 0.7-1.8

This can help us to help you.

Now, you know that TSH is a hormone secreted by the pituitary gland that sits below the brain, yes? It is not an actual thyroid hormone.

T4, along with T3 are the actual thyroid hormones that the thyroid produces and is the major controlling factor of our metabolism, i.e. ability to lose or gain weight, feel warm, have energy and mental function.

T4 is a storage thyroid hormone, in other words it is not very biologically active. T4 has to be converted into T3, usually through the tissues and organs in the body.

T3 is the biologically active thyroid hormone. This is the hormone that enters into your cells and activates them, creating what's called thermogenisis which is just a fancy way of saying your metabolism increases.

It's a good idea to have the free T3 tested as well since you could have a high level of T4 but a low level of the active T3 hormone due to a conversion problem. If your body cannot convert the T4 into T3, then you will experience far less relief from levothyroxine (T4 only synthetic hormone) than if you are on a combo of T4 and T3. And you will not know if you have a conversion problem unless you get the T3 tested as well.

The problem with Hashimoto's is it is an autoimmune disease. Your body has decided that your thyroid is a foreign substance and is attacking it. This can often be linked to gluten intolerance or even celiac disease. Why? Because the gluten molecule very closely resembles the thyroid molecule in shape. If your body developes a defense againsy gluten and then finds another molecule similar to it in the body, it will attack it as well.

Since your thyroid is being attacked, the thyroid will sometimes release a copious amount of thyroid hormone into the blood stream due to the inflammation that then tapers off as the gland dies. This can wreak havoc on the TSH testing, along with the T4 and T3 tests. Why? Because one day you will have a really low TSH level and high T4 and the next, you could have high TSH and low T4. It's like a roller coaster ride that is anything but fun.

This also means you can switch back and forth from having hypothyroid symptoms to hyperthyroid symptoms.

However, the important thing is to test the T4 and T3 serum levels and if they get low, treat it with thyroid meds, whather your TSH is normal or not.

Okay, I'm done now. I hope this makes sense and helps :)

Wow! Thank you!!

I do not know the 'rest of the story" on my labs, but I go in tomorrow for new labs.... I will get a copy of them and see what the scoop is.

I will ask tomorrow when I go in what all I am being checked for. considering I am being sent for labs by my new PCP it won't surprise me if she does not do all the numbers. I learned, before I moved, how important it is to have a good endo as GP's usually just don't know enough about it and treat folks based off a TSH and old normal range info.

Thanks again for all the info! I think I'll print it off and study it so I am better informed at next doc visit! :)

I have been to eight MDs some were DOs and they only worried about the TSH.

Hopefully you will get the right test, but don't be surprised if they only focus on TSH because I do believe they are monitored to make sure they are going by the TSH.

Actually, a lot of Endo's also worship the TSH test and only rely on it to tell the story.

There are one in a few that will look further, especially if you go in calm and logical.

I kinda went to war with my previous endo and wrote him a scathing email because he wouldn't look past my TSH, which is right at the lowest limit of the reference range. Never mind my T4 and T3 were still low.

Who would've thunk that my next endo, at the same clinic was willing to hear me out and actually consider my unusual circumstances.

I've been diagnosed with Hashi's for 10 years now and this is the first time I've found an endo willing to work with me. And I can tell the difference health wise!