Question: I suspect I have hypothyroidism. My PCP doesn't much think so (he is VERY resistant to any time a patient makes a suggestion or self-diagnosis), and says my blood test is normal (although he would only order the most basic test which I understand does not always indicate hypothyroidism).

I have about 50 symptoms of hypothyroidism (with no other explanation), the most noticeable being severe fatigue, weight gain (despite eating less and exercising more), chronic constipation, and as I said BUNCHES of other things that can be attributed to low thyroid function.

Several physician friends said they would suspect hypothyroidism. My gastroenterologist TOLD me I was hypothyroidal, and had a blood test to back it up (I'm unsure what the test was or what the numbers were, this was a couple of years ago).

My PCP refuses to believe that though, he basically said "Thyroid symptoms do not come and go," as SOME of mine do, but I've been dealing with this for 20 years. He offers no other help or suggestions though.

I would like to independently have thyroid tests done by an outside lab, which is readily available.

I do not, however, know which test(s) to order, as they have 11 different ones to choose from....

I will list the available tests and their descriptions below if that is helpful.

Thank you.

Thyroid Function Test Level I

(The combination of the Thyroid Profile (T3 uptake, T4, T7) and the TSH test evaluates thyroid function and/or symptoms of an overactive thyroid (hyperthyroidism) or an under active thyroid gland (hypothyroidism).

Thyroid Function Test Level II

A Thyroid Stimulating Hormone (TSH) blood test is combined with the Free T3 and Free T4 tests to provide the most accurate overview of thyroid function. Test also includes T3 Uptake, T4 and T7

Thyroid Profile (T3 uptake, T4 and T7)

The Thyroid Profile is an important test for evaluating thyroid function. The profile is a three part measurement of triiodothyronine (T3 Uptake) and thyroxine (T4) which is frequently ordered with TSH.

TSH (Thyroid-Stimulating Hormone)

The thyroid-stimulating hormone (TSH) blood test is used to check for thyroid gland problems, frequently ordered with the Thyroid Profile to measure levels and ratio of of T3 and T4.

Free T3

Measurements of free triiodothyronine (Free T3) levels are not be affected by certain protein levels, remaining more constant, and therefore correlating more reliably with the true concentration of T3 levels in the blood.

Free T4

The free thyroxine (T4) blood test is not affected by protein levels and is therefore a more reliable measurement of T4 levels in the blood.

Triiodothyronine (T3)

The T3 blood test assesses both free and bound T3 to help determine what may be causing an abnormal thyroid-stimulating hormone (TSH) test.

Reverse T3, Serum

Diminished serum T3 levels (the most biologically-active thyroid hormone) are thought to reflect altered thyroid homeostasis as a mechanism of adapting to severe illness.

Thyroid Peroxidase (TPO) Antibodies

The thyroid peroxidase (TPO) blood test measures the level of an antibody that is directed against the enzyme thyroid peroxidase.

Parathyroid Hormone (PTH), Intact

Diagnosis of parathyroid disease and other diseases of calcium homeostasis; monitoring patients undergoing renal dialysis.

Thyroid Stimulating Immunoglobulin (TSI)

Thyroid stimulating immunoglobulins (TSI) are autoantibodies that are produced by the immune system and associated with Graves' disease.

Thank you for your response. I already have the blood test results.

My gastroenterologist feels that I have hypothyroidism and says his blood tests confirm that. My primary care physician does not seem at all interested in considering that, though (although offers no other explanation or concern for my many symptoms), and virtually refuses to even order any additional tests other than the initial pituitary test he did. This is why I was seeking an additional opinion and further testing.

There does not appear to be any way to upload or attach a file in a follow-up question (unfortunately), so I am sending you a link to the actual lab results which I have placed on my company's server, and also write the results below...

Here is the link to a PDF of the actual report:
http://fantasticplastic.com/labs.pdf

And here are the written results:

Thyroid Panel with TSH
TSH 1.250 uIU/mL
Thyroxine (T4) 7.0 ug/dL
T3 Uptake 27 %
Free Thyroxine Index 1.9

Thyroid Antibodies
Thyroid Peroxidase (TPO) Ab 6 IU/mL
Thyroglobulin, Antibody <1.0 IU/mL

Thyroxine (T4) Free, Direct, S
T4, Free (Direct) 1.07 ng/dL

Reverse T3, Serum 15.0 ng/dL

Triiodothyronine, Free, Serum 3.6 pg/mL


I appreciate your review of these results and look forward to hearing your opinion.

Thank you very much, XXXXXXX XXXXXXX