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Nurse Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience:  RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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i literally have every symptom of hypothyroidism . . . eyebrows

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i literally have every symptom of hypothyroidism . . . eyebrows falling out, fatigue, weight gain, very heavy menstrual periods, feeling of choking, sore neck, etc. An ultrasound shows slightly enlarged thyroid but not out of normal range, blood work shows low thyroid levels but not out of normal range. So no treatment was prescribed, am i just supposed to live with these symptoms for ever?
Submitted: 2 years ago.
Category: Health
Expert:  Nurse Susan replied 2 years ago.
HelloCustomer

Id like to try and help you but I need some more information. Specifically, when you had your bloodwork done, what was your TSH value? Do you have any other medical conditions? What medications do you take?

Thanks for clarifying,
Sincerely,
Susan
Customer: replied 2 years ago.
tsh value is 2.45, t4 1.0, test done this month, ultra sound done this week, cholesterol is very high hdl 39, triglycerides 271, ldl 198, vitamin d very low 15. no other health problems at this time except the symptoms i mentioned. i did have hep c 8 years ago went through treatment of interferon & ribovarin, it has remained undetectable since treatment
Expert:  Nurse Susan replied 2 years ago.
HelloCustomer

One more question for you...have you had any other blood tests or just the thyroid levels? Was your calcium checked? If so, what was it?

Thanks for clarifying,
Susan
Customer: replied 2 years ago.
calcium 9.1
Expert:  Nurse Susan replied 2 years ago.
HelloCustomer

I am sorry for all of these questions, and I hope I can assist you. Please understand that online no one can state what anything definitely is, all we can do is offer a best guess based on what you wrote. That your lab work was deemed "normal" is somewhat odd; in my own reference book, normal T4 is 5.4 to 11.5 micrograms deciliter or 57-148 nanomoles per liter. If your value was 1.0, that is quite low....except for a neonate, which you are not.

However, if your thyroid hormone was that low, I would expect your Thyroid Stimulating Hormone, or TSH, to be very high, as it would be desperately telling your thyroid to make more hormone. But, yours was quite comfortably in the middle range. So these lab values as you have written them are confusing. I would recommend a repeat of them.

However, your vitamin D levels are very low, and that gives me a little to work with. Vitamin D "makes its living" by helping calcium be absorbed; if there is not enough Vitamin D, at times, calcium can build up in the blood stream. While your calcium was in the normal range, it was a bit on the high side at 9.1; my books cut off level is 10.2. The question then becomes, is the high calcium only cause of the low Vitamin D, or because there is a problem with a gland in the body that also regulates the way calcium is used, called the parathyroid gland? People with a hyperparathyroid CAN have low vitamin D, often do have high calcium but it can be normal, and can display some symptoms of what you describe.

Here is more information on the parathyroid and how it can malfunction: http://www.parathyroid.com/index.htm

My advice here is to repeat the labs...as 1.0 is low for T4 as per my reference manual. (6th Edition A Manual of Laboratory and Diagnostic Tests). My advice also is to speak to your doctor about testing your parathyroid hormone levels as well.

I hope I was able to help, and I hope you feel better,
Sincerely,
Susan
Expert:  Nurse Susan replied 2 years ago.
Hello Shana.s.mcbride,

In the interests of completeness, I am adding that there is a rare form of hypothyroidism that results from a tumor on the pituitary gland where production of TSH is impacted. Some tumors secrete TSH and cause a hyperthyroid; others cause TSH NOT to be produced or what is produced not to be used well. In those cases, the TSH is usually very low, but can be normal...and the T4 is low as well.

Here is information from the Merck Manual on this: http://www.merckmanuals.com/professional/endocrine_and_metabolic_disorders/thyroid_disorders/hypothyroidism.html#v981919

And information about T4 lab test...I liked the chart it had regarding TSH and T4 values:http://labtestsonline.org/understanding/analytes/t4/tab/test

Sincerely,
Susan
Customer: replied 2 years ago.
my lab repost states T4, FREE 1.0, normal range:0.8-1.8 ng/dL RGA
i was prescribed a large dose of vitamin d to take weekly, will that help my symptoms? is it uncommon to treat someone with "normal" blood work with a low dose of thyroid hormone to see if symptoms improve?
Expert:  Nurse Susan replied 2 years ago.
Hi Shannon.s.mcbride,

Ah, that clears it up nicely. My apologies for the misunderstanding. Free T4 is indeed 0.7-2.0 ng/ dl. At 1.0, it is on the low side; your TSH is normal. I highly doubt the pituitary tumor scenario but anything may be possible no matter if improbable.

IF your symptoms are caused by a malfunctioning parathyroid gland, Vitamin D will help your immune system (I bet you get frequent colds as well) but it wont really solve the problem.

I suggest you speak to your doctor about testing your parathyroid hormone. It is another blood test. And, you may want to speak to him about a trial of very low dose synthroid, its possible that you may need more hormone to feel normal even though the levels are "normal" and the TSH "normal".

I hope that helped,
Sincerely,
Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience: RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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