Source
r/thyroidhealth•
ASK8ep

Can I have hypothyroidism with normal TSH results?

Requesting Advice

I (F33) went to my PCP with a long list of symptoms (see below) that are troubling me for a few years now (they got worse after the birth of my daughter, 3 years ago.) I got a blood test, but my TSH levels came back normal. I had this strange double feeling of relieve at one end, but a weird feeling, almost disappointment at the other end. Because I was almost convinced that I finally found what was “wrong” with me. I was wondering if there any of you guys that had similar symptoms and a normal TSH, but still got diagnosed in the end. And if someone has any advice for me. I don’t know what to do now. My PCP was talking about seeing a psychologist next.

My symptoms:

  • Extreme fatigue
  • Always cold. Mostly my feet (extreme), hands and the tip of my nose. Sometimes in have chills going up and down my legs and spine for over an hour at the time.
  • Very dry skin with a yellow-ish tint
  • Trouble concentrating (also diagnosed with ADD (attention deficit disorder))
  • Slow in thinking / coming into action
  • Bad memory (short term)
  • Depression
  • Stiffness and sometimes pain in muscles
  • Sudden weight gain, without eating more/different
  • Hair loss and breakage
  • Thin, brittle nails
  • Constipation
  • Very emotional (up and down, out of nowhere)
  • Restless feeling all the time
  • Low self esteem
  • Non existent libido
  • Short in breath
  • Heart palpitations
  • Feeling burnt-out
  • lateral cyst in my neck (3 by 1 cm)

Posted Apr 3, 2021, 7:51 PM UTC · edited

730
BVO120•

Short answer: yes your TSH can be 'in range' and you can have hypo (with other thyroid levels out of whack).

A full thyroid panel gives a clearer picture. You may have to ask for each test by name and insist. Some doctors are taught that only TSH matters (mostly GPs who don't actually have training in endocrine disorders). That's false.

A full panel is TSH, free T4, free T3, reverse T3, and both thyroid antibodies- TGAB and TPO.

6
Lovi63•

My endocrinologist refused to do a full panel and insists if TSH is good there is no need. 🙄

3
BVO120•

Run awayyyyyyyy.

3
chipperxyz•

Oh my goodness. What an idiot!

1
ASK8epOP•

Thank you so much! I will have to get back to my pcp and request the other tests too, then. Hopefully he will agree.

2
likeateatrayinthesky•

How's your magnesium levels? Vitamin D? Iron?
A lot of vitamin deficiencies have overlapping symptoms with thyroid issues

5
ASK8epOP•

Thanks for your response. Only my vitamin D levels were low-ish. The rest were fine. I’m taking extra vit D now. Let’s hope it will make a difference...

2
querico•

I do! My TSH was 2.07 last time I was tested and I had low antibodies. I was diagnosed with an ultrasound which showed visual signs of hypothyroidism and nodules. My endocrinologist told me that my thyroid was twice the size of a normal person's.

3
ASK8epOP•

Thank you die your reply! I’ll look into that. I hope you are doing better now that you’ve been diagnosed and probably on meds.

1
One_Ad_1872•

Were your FT3 or FT4 levels abnormal?

1
querico•

FT4 was 1.14. I can't find FT3 in my results though so I guess they didn't run that one.

1
One_Ad_1872•

That's very similar to my case, they tested my TSH yhe first time and it came back normal. Then they tested it a few months later is was higher than normal range but barely and my FT4 was 1.32. I have been having hypothyroidism symptoms for months and think I might have a thyroid nodule. They also said I was vitamin D deficient but even though my values have increased symptoms have not improved

1
querico•

Oh yeah, we are indeed similar. Definitely see if you can get an ultrasound done.

1
J894ty•

What is your TSH level? There is a lot of controversy over what is the correct TSH reference range. When they came up with it in the 1970's, they used a pool of people that included people with thyroid disease. Other studies have been done since then using only people without thyroid disease and the reference range for that group has a range only going to 2.5 mU/L. Many people feel best with a TSH 2 or less. I personally do best with a TSH just below 1.

2
ASK8epOP•

I’m not sure. I’ll have to call the PCP’s assistant after Easter for the actual level. She just told me over the phone that the results came back normal.

1
littlemtns•

I agree with above. Normal could be under 5 but you want to be optimal less than 2.5. Mine was always high twos or low threes. Blood tests were 'normal' but I had many of the same symptoms. Had a few benign nodules years ago so was diagnosed with hashimotos but never put on meds. If you take biotin it can interfere with your results too.

3
ASK8epOP•

I’m not on biotin so that won’t be a problem. I do have a lateral cyst in my neck tho. It was examined and benign, thank god. I’ll have to get surgery and are on a waitlist now.

1
ASK8epOP•

UPDATE: I finally got my lab results that I requested. My TSH was 2,8 on March 3rd. In the meantime my symptoms got worse. I demanded a second opinion from my PCP and got it. A referral to a endocrinologist. Hopefully somewhere this month.

1
chickadee827•

This is my biggest PEEVE! They should tell you the number, not just “it’s normal”. If you really feel thyroid could be the reason for how you feel, you need a doctor who will help you find YOUR normal. Just because the TSH number is within the range doesn’t mean it’s at an optimal level for YOU.

3
KBaddict•

Always get a copy of your labs. If your Dr won’t test the other ones, either find one that will or you can do it yourself

2
KBaddict•

Yes! Absolutely. That’s what happened to me and it cause me to have a heart attack

2
ASK8epOP•

Oh my goodness. I’m so sorry to hear that. How are you doing now?

1
KBaddict•

I’m sick unfortunately. Going so long without essential hormones that every cell needs caused my immune system was impacted as well. A year after the heart attack I was diagnosed with so many things. Lyme disease, and 5 co infections (babesia,bartonella, Ehrlichia and anaplasma), 4 reactivated virus’s (EBV, HHV-6, parvovirus and one I can’t remember now). I also found out my adrenals were basically making no cortisol or aldosterone which are 2 out of the 3 steroid hormones you need to stay alive and my actual thyroid levels were extremely low. It’s been a rough 4 years!

1
ASK8epOP•

I’m so sorry you had to go trough (and still going) that! That just sounds like a living nightmare. I’m sending you all my strength and love. I hope you will feel a bit better soon.

1
KBaddict•

And OMG! I just re-read your post. You need to fire that Dr. TSH is not the best indicator on thyroid disease and you don’t not need a psychologist because it’s not “all in your head.” That’s insulting. Where do you live? I can help you navigate through some of the more difficult things, like getting proper testing.

FWIW, my TSH was 2.5 when I had a heart attack. TSH isn’t even an actual thyroid hormone

1
ASK8epOP•

Thank you! I didn’t like his answer either. I’m going to request a full panel medical examination for my thyroid. And I am seeing a psychologist right now because of my ADHD problems, but my gut feeling says more and more that my ADHD symptoms may be because of my physical health.

I’m from the Netherlands, so thank god we have a good medical system (money wise). I can request a second opinion when I want, but I want to see what my PCP says first. He is a good guy, honestly, but a bit theoretical like most docters. When it’s not in the books, it won’t get looked at...

2
KBaddict•

All of this is in a book. Check out the book called Stop the Thyroid Madness, read it, and then give it to your Dr to read. If he won’t, then he’s not willing to learn and he will be of no help. There is also a website (same name) you can start looking at immediately to help educate yourself and be your own advocate. The specific tests you need are

Actual thyroid hormones (make sure they are the “free” and not “total”) total is not helpful at all Ft3 Ft4 RT3 Anti-TPO TBAB

Full iron panel: Iron serum TIBC Saturation % Ferritin (make sure this isn’t the only thing tested for iron. It’s a iron storage protein, not an actual indicator of how much iron is available in your body now. Also, things like low B12, inflammation, MTHFR snps can effect the number and if they do, that’s a problem of that’s the only lab your Dr does because it gives him a false reading. You could actually have low iron, but ferritin will show high of there’s inflammation, or your iron could be optimal, but the ferritin is low because of low B12 which is super common in hypothyroidism.

Other B12 Vit D Magnesium Potassium Sodium

ADHD can absolutely be a symptom of a thyroid disorder. As can depression, bi-polar, and schizophrenia. But like you said, they are cause by physical reasons (not having enough thyroid hormones, specifically T3 which is the active hormone every single cell in our body needs to function properly.

Hypothyroidism often gets worse after child birth and ALL of your symptoms are very common hypothyroid symptoms

2
chickadee827•

I think most of us can say at one point or another a doctor dismissed our symptoms because TSH was “normal”. I hate that...TSH WAS NORMAL. Define normal. I know the range, but everyone’s “normal” is different and any doctor who ignores all of your symptoms and only diagnoses based on a lab result (especially one as useless as TSH alone) should be fired as your doctor. A good doctor will know that paying attention to how you feel is equally, if not more important, than some lab results.

1