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Question: Thyroid test results. Is my doc confused?

brokenseraph - Mon Apr 16, 2007 3:16 am

Hi. I have been ill for the last 3 months and whatever it is seems to be progressing pretty fast. At first Lupus and scleroderma were suspected but so far my ANA has been negative. I started with deep pain in my legs, hips, and knees. I thought it might be a blood clot due to my smoking and being on birth control. From there I have developed severe pain in my hands, feet, ankles, knees, and elbows all with mild redness and swelling. Heart palpitations and Chest pain with jaw pain that they suspect is SVT's. A bounding pulse. Numbness and tingling in my hands and feet, particularly with temp changes, migraines, skin changes, telangiectasia on my arms, hands, lips, and face. breathing restrictions, fluctuating weight, hot/cold sensitivity, night sweats, hot flashes, the whites of my nails are turning pink and or disappearing, fatigue, and dry mouth and eyes. My doctor suspected thyroid problems and did some labs. My TSH was right in the middle my T4 was high and my T3 was very low. Prior to this only my T4 was high but only very slightly. The doctor said she thinks I have hashimotos but am hyperthyroid. Is she confused or is this type of lab response something that occurs early in hashimotos prior to they thyroid fully hitting a failing point. I still feel like they are missing something. Some symptoms seem to match and some do not.

Dr. Chan Lowe - Mon Apr 16, 2007 3:38 am

I think there may be more to the story. TSH is the best marker for proper amounts of thyroid hormone in the body. If the TSH is normal the body is not sensing a need for more or less thyroid hormone. If you did not have a free T4 level tested that would be helpful to check. Free T4 is the active hormone in the body (mostly). I suspect in your case your Free T4 is normal and your other labs (T4 and T3) are off due to varying amounts of binding protein in the blood. In regards to Hashimoto's thyroiditis, it can present as Hyperthyroidism, Hypothyroidism, or normal thyroid depending on the phase that the disease is in. Ultimately most Hashimoto's patients end up hypothyroid as the thyroid gland burns out. Your symptoms are very suspicious for a rheumatologic problem. I would suggest you see a rheumatologist and continue down that path. Of note, most but not all lupus patients have a positive ANA. Best wishes.

brokenseraph - Mon Apr 16, 2007 3:48 am

Thank you. I did see a rheumatologist but he was horrible and barely listened to me and did no tests at all, just a very rough physical exam. He was rude and mean and yelled at me for asking questions so I do not trust his rulings which were that I was fine. I am shopping for a new one and being that I am in Phoenix hoping to get into Mayo clinic in the future. :)

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