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Dr. David
Dr. David, Board Certified Physician
Category: Medical
Satisfied Customers: 42806
Experience:  Experienced Physician trained in New York City. I'm ready to help.
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I was experiencing more than usual fatigue, memory

Customer Question

Hi - I was experiencing more than usual fatigue, memory loss, dizziness at times, also noticed dryer than usual hands and hair and often feeling cold. Blood tests came back with higher than normal TSH. Was tested again 1 month later and the test just came back normal for TSH. All the symptoms seemed to indicate hypothyroidism. But now with a normal test - what should be my next step?
Submitted: 7 months ago.
Category: Medical
Expert:  Dr. David replied 7 months ago.
This is Dr. Davidyou should see an endocrinologist to get specialist anti thyroid antibody level testing to check for conditions such as autoimmune hashimotos thyroiditis which can cause your thyroid levels to go up and downyour TSH levels should be level and between 0.3 and 3.0 range.if your TSH levels to up and down, it could be due to thyroiditis inflammation of the thyroid gland which can be sporatic.let me know if you have questions.
Customer: replied 7 months ago.
First test - Thyroid Stimulating Hormone [TSH] 4.67 in a range of 0.30 - 4.00 mIU/L
Second test - Thyroid Stimulating Hormone [TSH] 3.34 in a range of 0.30 - 4.00 mIU/L
It's over 3, but according to this range it shows it's normal. Not sure what to make of that.
Expert:  Dr. David replied 7 months ago.
these could be normal variationsor could be due to thyroiditis.you need to see an endocrinologist to get more blood tests which I mentioned before to know for sure.let me know if you have other questions.if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you todaywe only get credit for helping clients after positive feedbackyou can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questionshere is my website if you need to reach me:http://www.justanswer.com/medical/expert-dr-david/Thanks for using JustAnswers.com
Customer: replied 7 months ago.
I think i had those other tests done. Here are the valuesThyroxine Free [Free T4] 13 9 - 23pmol/L
Thyroglobulin Antibody 14 < 40kIU/L
Thyroperoxidase Antibody <^10 < 35 kIU/L
Customer: replied 7 months ago.
sorry it didnt' go through right - let me try again
Expert:  Dr. David replied 7 months ago.
it looks like your anti thyroid antibodies are not elevated.
Customer: replied 7 months ago.
Thyroid Stimulating Hormone [TSH] 3.34 0.30 - 4.00 mIU/L
Thyroxine Free [Free T4] 13 9 - 23 pmol/L
Thyroglobulin Antibody 14 < 40 kIU/L
Thyroperoxidase Antibody <10 < 35 kIU/L
Customer: replied 7 months ago.
Thyroperoxidase Antibody <10 < 35 kIU/L
Customer: replied 7 months ago.
Not sure why that last value isn't going through but it's <^10 < 35kIU/L
Customer: replied 7 months ago.
i think the system just isn't accepting the values for some reason. must not recognize some of the characters
Customer: replied 7 months ago.
anyways it was at 10 and below 35 which apparently is normal
Customer: replied 7 months ago.
So with those tests done, what would you conclude?
Expert:  Dr. David replied 7 months ago.
i would conclude that you don't have hashimotos thyroiditisand something else is causing your fatigue and memory loss and dizziness symptoms
Customer: replied 7 months ago.
okay that could very well be. Maybe more tests are in order. But last question - one test shows I had abnormally high TSH, the next test was normal - why would it go up and down like that? could I have another test next week and it be abnormally high again. Could one of the tests have been improperly handled by the lab?
Expert:  Dr. David replied 7 months ago.
it could be normal for your to have slight ups and downs of your TSH levelslab errors are possible but rare and unlikely.you can do another text next week.but more thyroid blood testing most likely wont get to the bottom of your symptomsif you have excessive anxiety, this can cause dizziness, memory loss and other symptoms.let me know if you have other questions.if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you todaywe only get credit for helping clients after positive feedbackyou can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questionshere is my website if you need to reach me:http://www.justanswer.com/medical/expert-dr-david/Thanks for using JustAnswers.com
Customer: replied 7 months ago.
sorry I have one more question based on your last response...you mention it could be normal to have slight ups and downs...I know what the normal range is, but what is essentially the extreme end of the scales when it comes to TSH values? 10, 20? help to have that perspective
Expert:  Dr. David replied 7 months ago.
TSH should not be above 5 and that can be a sign of hypothyroidism. small variations between 3 and 4 TSH levels most likely are not causing your symptoms.
Customer: replied 7 months ago.
thank you. I won't trouble you any longer, but that answer really isn't consistent with your initial response - "your TSH levels should be level and between 0.3 and 3.0 range."
Expert:  Dr. David replied 7 months ago.
yes, your TSH levels should be between 0.3 and 3.0 range.TSH levels above 4 can be a sign of mild hypothyroidism.usually mild hypothyroidism doesn't cause symptoms such as dizziness, memory loss