Do I have Hypothyroidism????

December 11, 2003

Hello:

I have been lurking and reading for several weeks. All of this stuff

is so new to me and I must admit confusing as well. I am sure this

post is going to turn into a rather long one so for that I apologize

and appreciate your patience. This is all so frustrating as I know

you are aware. I just want to feel like a normal man. I would

appreciate your help.

I am a 49 year old man. I was diagnosed with sleep apnea in 1999. I

have been told I do not seem to have the body of someone with sleep

apnea and that throat does not appear. In August of this year I was

diagnosed with hypogonadism (low Testosterone.) Since then I have

been on testosterone replacement gels. First I was on AndroGel and

now on Testim.

I have not felt well for a number of years. I have suffered with

fatigue (run down, lethargic, sluggishness) and have a sleepy

appearance especially around my eyes. People comment from time to

time that I look tired. I have problems with concentration and feel

like i live in a fog most of the time. About 10 years ago I was

diagnosed with major depression disorder and panic disorder. I do

have mood changes which seem to worsen with stress. A lot of the

time I feel like the least thing can set me off and that I am ready

to explode with anger. It really feels weird as I realize how I feel

but it is like I have no control over it. I have been on anti-

depressants and anti-anxiety meds since that time. I do not feel

depressed and rarely take the anti-anxiety medications anymore. I do

continue to take the anti-depressant but at a reduced dosage. The

anti-depressant I take is Wellbutrin XP.

Since I have been on a testosterone gel it seems to have helped some

with the fatigue and low sex drive but still not anywhere near where

I feel I should or want to be.

As a child I was always very thin and never had a problem with my

weight. Now I am 6' tall and weigh 200 lbs and continuing to climb.

I can not seem to lose weight without continously dieting. I do not

over eat nor do I feel I eat an unhealthy diet. I just feel my

metabolisium has slowed so much that I continue to gain even though I

exercise. The majority of the weight gain has been in my stomach and

abdomen where I suppose most men gain weight. I workout doing mostly

cardio type excercise at the gym 3-4 times a week for 30-40 minutes.

I don't always feel up to doing it but try to force myself. I really

feel I should be in good shape as much exercise as I do.

I also have been having pain in the joints from my knees down to my

toes. This is not exercise related. When I get up in the mornings

my legs are stiff and the bottoms of my feet hurt to walk on them.

The foot pain improves as the day goes on. I was once diagnosed as

having fibromyalgia but do not believe that is true because I do not

hurt nor have pain all over my body as people i know that have it.

My knees do not bother me much except when I walk up or down steps.

I do not experience constipation all that much. I used to more than

now. If i eat more fiber the constipation does not seem to be a

problem.

For years I have had a problem with my bad cholesterol being high but

the doctors never seemed to be concerned because my good cholesterol

was so high. Recently my bad cholesterol levels have been on the

increase and my good cholesterol has been on the decline. Even with

the exercise I do the good cholesterol continues to remain low. The

doctor tells me to exercise and when I explain I do he seems to act

as if he does not believe me. I did try a medication to lower the

cholesterol but it made the fatigue so much worse I could barely put

one foot in front of the other.

I experience night sweats which I understand can be part of the sleep

apnea but they are really bad. My head, neck, pillow and sometime

the bottom sheet as well as the top will be soaked in the area of my

head, neck and upper back areas. I will be seeing the pulmonary

specialist about this in the near future.

I am hot natured and am intolerant to heat. Also, I do not tolerate

cold temperatures especially when it is windy. I do not tend to have

cold hands and feet except in the wintertime.

I was advised =by a friend to take my temperature at different

times. I did this lastnight and today. Below are the results so far.

10:30 pm 97

6:15 am 97.8

9:15 am 97.8

2:00 pm 98.4

These are the test results I have had done and the dates they were

done.

TSH 09/24/2003 .665 uIU/mL Range 0.350 - 5.500

TSH 10/23/2003 .865 uIU/mL 0.400 - 4.000

Free T4 10/23/2003 0.9 ng/dL 0.2 - 6.0

Cortisol 10/23/2003 21.9 ug/dL 5.0 - 25.0

MRI of the Brain and Pituitary Gland on November 18, 2003 results:

Small pituitary gland with no microadenoma. Otherwise completely

normal intracranial contents.

The doctor had said I had a goiter so an ultra sound was done. Below

are the results of it which I had a copy faxed to me today. Can

anyone tell what the findings mean??? Also, what are thyroid

antibodies?

THYROID: With a normal TSH of 0.865, the patient who had an exam

palpable thyromegaly had a normal isthmus at 3.4 mm. Left and right

respectfully with bilateral, inhomogeneic granular tissue, showed

normal size at 1.9, 3.2 and 1.5 cm on the left and 1.9 x 3.6 x 1.9 on

the right. The density is compatible with AIDT. Linear, non-

specific calcifications are compatible with chronicity. Since the

patient has a normal-size thyroid, his exam showed a pseudogoiter,

therefore, in retrospect. This will be discussed with patient next

visit; and unless the thyroid antibodies or the TSH are abnormal,

then the patient will not be given l-thyroxine.

Thanks again for your time and for any thoughts, suggestions or

additional test you feel I need to have done.

Joe

December 11, 2003

Hi, Joe: )

I'm by NO means an expert (plenty of those here, though), but it sure

sounds to me like you need to get some labs done! Reading your post,

I wouldn't be at all surprised if you were hypothryoid. There are

great books out there, and I'm too brain foggy myself right now to

think of the titles (and I have two of them myself), but someone here

will post the titles I'm sure.

And...as you probably already know...don't rely on the TSH findings,

and if your doctor does rely on them and they're not what " he "

considers high enought o diagnose you, find another doctor. Or, cut

to the chase and look for a thyroid " top doc " in your area. Go into

the links section, or do an internet search under " thyroid top docs, "

or visit Shomon's site at about.com for a list of top docs.

....I'll let the real experts fill you in on the important stuff. )

Ella

December 11, 2003

You have a lot of symptoms that can be hypothyroid symptoms, but also some that

come from other problems, too.

If you have an immune system hypothyroid disorder, (Hashimoto's Thyroiditis),

you can have a normal TSH but low levels of T3 and T4 (thyroid hormones). With

Hashimoto's, to diagnose you need a low TSH and/or antibodies or goiter. In

Hashimoto's, the body creates antibodies that attack the thyroid and destroy it

over time. Based on the action of the antibodies, people may show different

test results and may feel differently and need medication adjustments over time.

The counterpart to Hashimoto's is Graves' disease...same thing, but this time

the immune system causes the thyroid to be overactive instead of underactive.

's Syndrome is a thyroid disorder in which a person has symptoms but

appears to have a normal TSH.

You might want to get some more tests, maybe TSH, T4 and free T3 along with R-T3

(reverse T3) and the thyroid antibody tests. I like to get them all at the same

time, even if I just had one or two of them, so I can see what is going on all

at the same time.

A word of advice...if you have a thyroid disorder you may have trouble getting

diagnosed, and you may have trouble getting doctors to re-test and change

medication after you have been diagnosed, so a good tactic is to get a notebook

and start keeping copies of all your lab tests in the book. You can also stash

professional articles you find that might enlighten your doctor or help you

argue for a particular test or treatment. Records of diet, exercise, and

medicine taken (dosage, type, etc.) are also helpful. I have a notebook like

this and the entire thing goes with me to the doctor. It helps me monitor my

own illness, and if I change doctors, I can show the new one very quickly what

is going on and what my progress has been. Most doctors I have been to

appreciate this very much.

You can get a wealth of thyroid information at http://thyroid.about.com . It is

worth checking out.

Joe <imjoseph45@...> wrote: