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Not taken treatment for hypothyroidism. Recent test showed normal tsh and high esr. Any thoughts?

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General & Family Physician
Practicing since : 2009
Answered : 3041 Questions
About 4 years ago I was told that I had sever hypothyroidism (myxedema) but I wasn't treated because I was pregnant and he was not my "normal" physician. He said that I needed T4 and that I should come see him when I was done breastfeeding. Unfortunately I lost my insurance before I could return so I am still untreated. Recently my thyroid has become enlarged. I am doing my externship at an Endo office and the Dr. told me to go have my TSH done. I did, but it came back at a 2.35. I have more Sx of Hashimoto's when compared to hypo. I am confused now since this came back in normal range. When in Lab class (I am studying to become a CMA) we did ESR testing I came back high at a 35. My venous blood is also bright red and not the normal dark red color. Does any of this coincide?
Posted Tue, 2 Apr 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Luchuo Engelbert Bain 2 hours later
hi and thanks for the query,
Hi and thanks for the question. Hypothyroidism however is not only diagnosed based exclusively on T4 and T3 levels. Three hormones are usually evaluated at a time. These are T4, Thyroid Stimulating Hormone (TSH) and Thyroid Releasing Hormone(TRH). The interpretaion of results is actually based on these thre findings. It could be possible to a test today which comes back with normal T4 levels, this does not in any way exclude hypothyroidism. Myxoedema, presence of an enlarged thyroid or Hashimoto s thyroiditis are further indications that me feel, you really got to undergo a complete evaluation of the thyroid by doing the T4, TSH and TRH levels.
For your venous blood being brighter than normal, remember also depending on the time of the day and temperature, variations in the color of blood might change . An increase in the Erythrocyte Sedimentation Rate is comfortable with any inflammatory process, and is compatible too with Hashimoto s thyroiditis.
I suggest you book an appointment with your endocrinologist or internist, for a complete clinical evaluation, blood testing and management.
thanks and best regards.
If there are further questions or clarifications, feel free asking.
Thanks and best regards,
Luchuo, MD.
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