Suspecting hypothyroidism: what should I ask at next appt?
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H217
Posts: 24 Member
Current Symptoms (most worsening in last 2-3 months): fatigue, pressure in lower front of throat, sensitive to cold, dry skin, blood pressure that went from too high (all year 2012) to borderline too low (last couple months), forgetfulness and difficulty concentrating, puffy eyes, frequent headaches, resting heart rate of 57-59 (but I do endurance running), something always hurts a little somewhere (but I think that's normal for everyone)
Family History: a lot of thyroid problems on my dad's side of the family (grandma = hashimotos, great aunt, dad, at least 1 aunt, 3 cousins) and a handful of autoimmune disorders (including celiac, lupus, RA) on my mom's side.
My weight is on the lower side of normal, my iron levels are normal, TSH = 3.5 (some say borderline high, others say normal) and white blood cell count at last exam was borderline high (not sure if related). ANA results were in the normal range. I was also born with a slightly underactive thyroid (treated and cleared within about 3 weeks; I have no idea whether that would affect future chances of developing a thyroid problem).
For sure at the next appointment I will try to get T3 and T4 levels tested, and I will relay everything I listed above (probably printed out, since I'll never remember it all), but are there any other tests or things I should bring up that would be useful when I go in to the appointment?
This would be my first real appointment addressing, and since I've only started fitting things together in the last couple weeks (had milder versions of the symptoms for a while, but only made connections once they started getting worse), I really feel like I have no idea what I'm doing or what to expect.
I really just want to get to the bottom of things (whatever they may be) so that I can finally start feeling better.
Family History: a lot of thyroid problems on my dad's side of the family (grandma = hashimotos, great aunt, dad, at least 1 aunt, 3 cousins) and a handful of autoimmune disorders (including celiac, lupus, RA) on my mom's side.
My weight is on the lower side of normal, my iron levels are normal, TSH = 3.5 (some say borderline high, others say normal) and white blood cell count at last exam was borderline high (not sure if related). ANA results were in the normal range. I was also born with a slightly underactive thyroid (treated and cleared within about 3 weeks; I have no idea whether that would affect future chances of developing a thyroid problem).
For sure at the next appointment I will try to get T3 and T4 levels tested, and I will relay everything I listed above (probably printed out, since I'll never remember it all), but are there any other tests or things I should bring up that would be useful when I go in to the appointment?
This would be my first real appointment addressing, and since I've only started fitting things together in the last couple weeks (had milder versions of the symptoms for a while, but only made connections once they started getting worse), I really feel like I have no idea what I'm doing or what to expect.
I really just want to get to the bottom of things (whatever they may be) so that I can finally start feeling better.
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Replies
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Current Symptoms (most worsening in last 2-3 months): fatigue, pressure in lower front of throat, sensitive to cold, dry skin, blood pressure that went from too high (all year 2012) to borderline too low (last couple months), forgetfulness and difficulty concentrating, puffy eyes, frequent headaches, resting heart rate of 57-59 (but I do endurance running), something always hurts a little somewhere (but I think that's normal for everyone)
Family History: a lot of thyroid problems on my dad's side of the family (grandma = hashimotos, great aunt, dad, at least 1 aunt, 3 cousins) and a handful of autoimmune disorders (including celiac, lupus, RA) on my mom's side.
With your family history of not just autoimmune thyroid disease but also other autoimmune diseases, I would definitely get tested. Autoimmune issues tend to run in families, and they also like to travel in packs (Hashi's and celiac love to hang out).
I would tell your doctor that you have a family history of autoimmune thyroid disease, and that you want to get checked. You want them to test:
-free T3
-free T4
-anti-TPO antibodies (to test for Hashi's)My weight is on the lower side of normal, my iron levels are normal, TSH = 3.5 (some say borderline high, others say normal) and white blood cell count at last exam was borderline high (not sure if related). ANA results were in the normal range. I was also born with a slightly underactive thyroid (treated and cleared within about 3 weeks; I have no idea whether that would affect future chances of developing a thyroid problem).
I wouldn't call a TSH of 3.5 "normal" - not with your family history, and your personal history! The top range for TSH was changed 10 years ago to 3.0, and many educated doctors are arguing for 2.5. I personally couldn't go over 2.0 without feeling crappy. If you had hypo as an infant you should have been regularly checked all your life.
Which white blood cell test was done? It can be common with Hashi's to have high lymphocytes and low neutrophils, for example, especially when your immune system is all riled up.For sure at the next appointment I will try to get T3 and T4 levels tested, and I will relay everything I listed above (probably printed out, since I'll never remember it all), but are there any other tests or things I should bring up that would be useful when I go in to the appointment?
Getting your free (not total) T3, free T4, and your Hashi's antibodies tested is the best first start.
You mentioned getting iron tested - did they also check ferritin, your iron stores? I would also recommend getting your Vit D levels tested.
Make sure you get a copy of all your labs, and don't just accept an interpretation from your doctor. Often levels are "within normal range" but aren't "optimal".
Are you female? (sorry, can't tell on your profile, haha!) If so, do you have any kids? Pregnancy can also make thyroid issues start up or worsen, in sensitive individuals.
With the history of celiac I'd also consider getting tested for that, although with the normal iron levels I wouldn't be super concerned.0 -
Stop the Thyroid Madness has a good list of thyroid tests request of your doctor. Here's the link: http://www.stopthethyroidmadness.com/recommended-labwork/
Hope you are able to get the answers you need.0 -
Wow, thank you! This was exactly the kind of information I was hoping I would get...
Which white blood cell test was done? It can be common with Hashi's to have high lymphocytes and low neutrophils, for example, especially when your immune system is all riled up.
The lab results didn't specify, but I will call in to check it out.
Are you female? (sorry, can't tell on your profile, haha!) If so, do you have any kids? Pregnancy can also make thyroid issues start up or worsen, in sensitive individuals.
Yeah, I'm female, but only 20 so no kids/pregnancies just yet. On the other hand, I believe all 3 of my cousins (ages 24-35) with hypothyroidism were also diagnosed before getting pregnant.
I can't possibly explain how much I appreciate advice on this subject. I'm trying not to get my hopes up too high, but I can't help getting increasingly optimistic that I might finally wake up (so to speak)!0 -
Side note: I was doing a little more research, and read that Hashimoto's can sometimes lead to brief bouts of hyperthyroidism. I immediately remembered a 3 week period in fall 2011 when I had just about every classic symptom of an overactive thyroid, complete with losing 7% of my body weight in 2 weeks (very significant for my size-- I was underweight by the end of it).
I'd considered going in to a doctor to get it checked out at the time, but by the time I had the chance to go, the symptoms were already gone and I sort of forgot all about it. Oops.0 -
Side note: I was doing a little more research, and read that Hashimoto's can sometimes lead to brief bouts of hyperthyroidism. I immediately remembered a 3 week period in fall 2011 when I had just about every classic symptom of an overactive thyroid, complete with losing 7% of my body weight in 2 weeks (very significant for my size-- I was underweight by the end of it).
Yes, that can definitely be something that happens with Hashi's. I would make sure they do an ultrasound of your thyroid to check for nodules (the most common cause of that).
I'd also ask them to check for TSI antibodies, just to make sure you don't have both Hashi's and Graves - not totally uncommon. But with your family history and symptoms it sure sounds likely to be Hashi's.0 -
I have a great doctor who can diagnosis amazingly well. She has found 3 diseases that I did not know I had. What you need is a good doc who can figure out what disease or diseases are causing your health problems. If your doctor can not diagnosis I would search for another one who has that skill, unfortunately they are rather rare, but they are out there.0
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Hopefully they will also take any medications you might be on into consideration. I was on 3 different prescriptions and the specialist took me off all of them. She felt it was a domino effect kind of thing leading to the thyroid issue (have a symptom, get a Rx, it covers the symptom but creates 10 more issues, and so on and so on). So far, I am doing well without them. Of course, I don't recommend to everyone to up and stop their meds.
One thing that was also recommended for me along with the blood work was a saliva test. It checks adrenal hormones: estradiol (estrogen), progesterone, testosterone, Dhea and Cortisol. Unfortunately, most insurance providers do not cover this test. I'm doing it anyway and paying out of pocket so I can make sure to get a clear picture of what I need to do to fix this.
Hope you are able to get some answers.0
