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What are the symptoms of hypothyroidism?

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Posted on Tue, 24 Mar 2015
Question: Hello,
I have had consistently high mpv and high monocyte levels on my blood work. I have systemic lupus and Sjogren's syndrome, but they have been in remission overall. Are these two levels just an indicator or my existing autoimmune diseases? I've been having significant fatigue, headaches, weight gain, hoarseness in voice, LPRD, carpal tunnel syndrome, extremely dry skin, foggy thinking and poor memory. My TSH has been up and down over the past several years with multiple hypothyroidism symptoms...but doctor won't give me medication. I'm 48, and on low dose birth control to possibly treat menopause symptoms with no change of symptoms...no family history of issues in menopause. Two siblings with hypothyroidism and both on medication. Are all of these things pointing more to thyroid issues...and should I get more testing?
doctor
Answered by Dr. Shehzad Topiwala (50 minutes later)
Brief Answer:
Thyroid

Detailed Answer:
You have compelling symptoms of hypothyroidism. I see you are saying your TSH has been bouncing around for some time, and that your siblings are on thyroid medication.

I suggest the following:

Get your blood tested for

TSH
Free T4
Anti TPO (Thyroid Per Oxidase) antibodies
Anti Thyroglobulin antibodies

If the TSH is not optimal, particularly if the thyroid auto antibodies are positive (even either one) then there is a strong case to offer you levo thyroxine ie medication for hypothyroidism.

When I see someone like you in my practice I also order, in addition to a thorough physical examination:

CMP
25 hydroxy vitamin D

Regarding the monocytes, it is likely related to the SLE but I suggest you seek an opinion from a Rheumatologist or a Hematologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala (56 minutes later)
I had those Thyroid panel tests done three years ago, and the T3 was low (2.5 pg/mL). The other tests were negative. I do have an appt with endocrinologist on March 18, so I'll push for all of those to be completed again.

I had the CMP (results had MPV & MONOS both high; ABS Lymphs were low, bilirubin low, albumin low, Alpha 1 was high, SED Rate was 16 and has been rising steadily...everything else was normal) and 25 Hydroxy Vit D (result-43.7) done in XXXXXXX of this year at my Rheumatologist appt. I asked her to do the TSH, and that came up as 4.33. She told me to follow up with my PCP. NOTE: My symptoms were at their worst at the time of this January visit.

I did finally get to see my PCP last week (she was out on maternity leave)...she only did the TSH which came up as 2.98, so the T4 wasn't done. She suggested that I was being hyper-vigilant...but I know my body, and something isn't right. I've put my SLE and Sjogren's in remission, and I'm not on ANY medications for them since 2005. I do more diet, exercise, supplements (omegas, multi-vitamin, multi-minerals, vitamin c, vitamin e, glucosamine-chondroitan) meditation, etc.

The reason I'm not on medications for my lupus and sjogren's is BECAUSE I went to XXXXXXX XXXXXXX Center for Integrative Medicine and they made all of the recommendations that have helped put them in remission. My doctor there passed away, and I'm looking for another Integrative Medicine doctor currently.

Thank you for your response! XXXXXXX

doctor
Answered by Dr. Shehzad Topiwala (2 hours later)
Brief Answer:
Follow up

Detailed Answer:
Good to note your vitamin D is fine.

Yes thyroid antibodies are a useful test in your case, and will help interpreting future TSH results
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What are the symptoms of hypothyroidism?

Brief Answer: Thyroid Detailed Answer: You have compelling symptoms of hypothyroidism. I see you are saying your TSH has been bouncing around for some time, and that your siblings are on thyroid medication. I suggest the following: Get your blood tested for TSH Free T4 Anti TPO (Thyroid Per Oxidase) antibodies Anti Thyroglobulin antibodies If the TSH is not optimal, particularly if the thyroid auto antibodies are positive (even either one) then there is a strong case to offer you levo thyroxine ie medication for hypothyroidism. When I see someone like you in my practice I also order, in addition to a thorough physical examination: CMP 25 hydroxy vitamin D Regarding the monocytes, it is likely related to the SLE but I suggest you seek an opinion from a Rheumatologist or a Hematologist