Hypothyroidism Support Group
Hypothyroidism is the disease state caused by insufficient production of thyrohormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. Advanced hypothyroidism may cause severe complications, the most serious one of which is...
About 20% of people with Hashi's will test negative for the antibodies. Diagnosis can be confirmed via biopsy. Since hypothyroidism is treated the same regardless of the cause, biopsy isn't necessary.
I can't really explain why prednisone helped you feel better but, I can tell you that it doesn't look like you're optimally medicated for your thyroid.
Most people who are optimally medicated on T4 meds such as levothyroxine will have TSH 1.0 or lower.
The fact that you are reporting a mixture of hypo and hyper symptoms leads me to believe that your actual thyroid hormone levels haven't been optimized.
Very often, when people take T4 only meds such as levo, their FreeT4 level is high in the range.
But, if those people are having trouble converting their T4 storage hormone into T3, the active hormone, they will have a low FreeT3 level....and a mixture of symptoms.
Has your doctor ever checked these levels?
"Thyroid for Dummies" confirms the importance of these tests as does many other medical references including this PubMed article:
http://www.ncbi.nlm.nih.gov/pubmed/12915350?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed
You will note that the final sentence reads: "TSH determination is diagnostically misleading and only free hormone measurements are reliable for thyroid function assessment."
(the free hormone measurements are the FreeT4 and FreeT3 tests)
The FreeT4 test might look like this on a lab slip: T4 (or thyroxine), free, direct......and the FreeT3 test might look like this: tri-iodothyronine, free, serum
If you can get those tests run and post the results here, we can show you how to interpret them. You'd need to post the reference ranges for each result since different labs use different ranges and your result can only be properly interpreted within the context of your lab's ranges. The ranges are usually listed to the far right of the result on the lab report.
However, it is a bit lower than the type of level a healthy person would have.
Based upon your lab's ranges, a healthy person would have a FreeT3 level of 3.4 - 3.8.
Since you are normally quite active, you would probably need a FreeT3 level closer to 3.8 to feel well.
I suspect your FreeT4 level is lower in the range - thus, the reason for your too-high-for-someone-on-levothyroxine TSH.
Once you confirm your FreeT4 level, I suspect you'll want to talk to your doctor about a dose increase.
You shouldn't be dealing with all the symptoms you have if you are optimally medicated.