Normal Labs And Still Having Thyroid Symptoms?

Thyroid

My goal is to inform (and sometimes entertain if the mood strikes!), with articles I've read, my personal experiences, clinical experience and stories shared by my patients. To delve right in, I cannot tell you how many patients I've seen who share common stories. Most start like this: ".Well, my primary care doctor ran a TSH test (thyroid stimulating hormone), and said my levels are fine. I'm still experiencing (and fill in the blank here.... with ANY of the following): fatigue, hair loss, hair thinning, mental fog, insomnia, low sex drive, premature wrinkling, thinning of the skin, feeling tired, weak, or depressed, dry skin and brittle nails, not being able to stand the cold, constipation, and I could go on and on. Here is why you need a doctor who is willing to look at your TOTAL health and help you really put the pieces of the puzzle together.

LISTEN UP! Low thyroid causes or contributes to the symptoms of many conditions but the deficiency is often missed by standard thyroid testing.

A great article I read from the National Academy of hypothyroidism, states in part: Due to the differences in the pituitary's response to physiological stress, depression, dieting, aging and inflammation as discussed, most individuals with diminished tissue levels of thyroid will have a normal TSH. Continue reading...

3/20/2018 7:00:00 AM
Dr. Scott Shapiro
Dr. Scott Shapiro grew up in Dallas, Texas. He attended medical school at Texas Tech University and completed his training in Obstetrics and Gynecology at Emory University Affiliated Hospitals. Dr. Scott has been a board certified Obstetrician and Gynecologist for over 20 years. The most rewarding part of his practice ha...
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Comments
I have pituitary failure, and my hormones are anything but balanced. I cannot find a doctor who knows how to work with full pituitary failure. Is there an expert or physician somewhere that anyone can recommend?
Posted by Natalie Wahl
I take a 7.5 levothyroxin eberyday I still have all the symptoms listed above I'm not sure what I should discuss with my doctor
Posted by Julie Smith
I read this article, and I'm not sure what I should discuss with my doctor. Is it that I should ask my doctor to prescribe T3 medication instead of, or in place of, T3? And what medication is that?
Posted by jadailykc
I have tried to find a doctor who will run more than the basic tests. I was diagnosed with fibro and CFS 5 years ago, my mother has had thyroid issues her whole life, and recently I have had hair loss, and terrible cystic acne (hormones?) (I am a 40 year old female) But GP docs say I am "fine" and refuse to do tests, and no endocrine doctor will see me without a diagnosis and lab results! I am tired of paying copays just to get to a doctors office to find out they will not listen to me and help. I am giving up, exhausted and depressed.
Posted by Kristin
Thanks for some great information, Dr! But I have to admit that a lot of it went over my head. I've had hypothyroidism for over 25 yrs. and have always felt that I still have all the symptoms of this condition! My dosage has gone from 150mcg to125 and anywhere in between that, depending upon what was happening at that time, eg. pregnancy, peri-menopause, menopause.How do I approach the questions your article raises? I'm in the process of finding a new endocrinologist, previous one just retired in December.
Posted by Ann
You are in the early part of a long journey, Scott. Thyroid hormone is a bus (transport buffer) on which sit iodine molecules. Single celled creatures, 1 billion years ago used monoiodotyrosine as a signaling molecule. Your specialty, Ob-Gyn, is given control of a small set of sterol signaling molecules. A pitfall of that was the overprescribing of estrogen.
You politely avoid stating the obvious that “endo-crine-ology” is an anachronism. They live in a soundproof room and fashion themselves as experts of a small set of signaling molecules.
Fish do not have thyroid glands. When oceanic creatures crawled up on land, they had to fashion an iodine storage pouch for themselves because of its paucity on land. You give it a fancier name that belies its nature. Most iodine is stored in the mitochondria.
Iodine, along with iron and sulfur work on the electron transfer chain in the only place where oxygen is burned and energy (ATP) is created, the mitochondria. They have regulation pathways of which medical science knows nothing. Medical students are taught that Iron is just a cushioned seat for oxygen molecules hidden inside hemoglobin. Its most important job is inside the mitochondrial furnaces quenching the embers of the ox-phos fire.
The symptoms of hypothyroidism that you describe are far more complex than thyroid deficiency and speak more of chronic immune up-regulation. The hard job with the patients you describe are detecting how and why the immune system is drifting toward some bad ending. There is a strong association between Hashimoto’s thyroiditis and gluten intolerance. Fish, frogs and gerbils (almost) never eat donuts or pasta.
Essentially, our ontogeny has out run our phylogeny and we are exceeding our design specs.
Study the evolutionary biology of iodine and energy metabolism. It contains secrets that your mind will greatly appreciate. Our lives (ontogeny) are evolution writ small and caught on the wing of chance.

Posted by D. Finlayson MD
Dr.Shapiro, are you suggesting that a pt. with symptoms of hypothyroidism and elevated TSH should be supplemented with both T3 and T4,how do we know which one to use.Thank you
F.A.Munasifi
Posted by F.A..Munasifi
I have been taking 100 mcg of Levothyroxine for some time and my blood levels are "perfect" (according to my endocrinologist. I have most of the symptoms you highlight-
brittle nails, dry skin, depression, night sweats with rapid heart beat and depressed libido. Is there something I should do to identify the cause of these symptoms or am I on too low a dose despite my good blood levels?
Thanks for the article, its food for thought.
Posted by Joan
That sure is a wealth of information Dr. Shapiro. I was actually diagnosed with hypothyroidism about 10 years ago, due to Hashimoto's disease. I was 40 years old and not experiencing any symptoms, but a good physician caught the imblance in my bloodwork during my annual physical.

As any good general practitioner would do, he referred me to a really good endocrinologist for treatment. I've been lucky b/c my 100 mcg of Levothyroxine have brought my numbers within normal range and I haven't had any issues since diagnosis. But I've read horror stories about people who still don't feel right even after diagnosis and treatment. I've read that, like you state here, the problem is often doctors who don't try hard enough to really help the patient. Not to mention the millions of people out there who have a thyroid condition and do not even know it and are walking around with symptoms thinking they are attributable to some other condition.

I've had to self-educate myself on the condition since even my "good" endocrinologist did not advise me about how best to take my medication (for example, make sure you don't take your thyroid pill in the morning and then have coffee with milk or cereal with milk as the calcium can negatively affect your body's ability to absorb the thyroid medication). I learned a TON about this condition and how best to live my life by SELF-EDUCATION.

Thanks for the very detailed physiological info here Dr. Shapiro. Patients can print this out and visit their doctor with the info; I'd love to be a fly on the wall during that visit!
Posted by Bryan Moore
Thank you for the valuable information. I think this is a topic that is not well understood by many people and we welcome the education you are providing.
Posted by Rob Greenstein

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