We regularly receive phone calls and e-mails from people who suspect that they may be suffering from hypothyroidism. We present here correspondence we have received from a few of them. Whether or not these people turn out to have thyroid problems remains to be seen. Our thanks to them for giving us permission to publish their correspondence to us.

ARE THEY HYPOTHYROID?

Kathy from New South Wales

Kathy is 31 years old and has a 16 month old son, born in March 2000. She suffered an early miscarriage in May 2001. She has cold, pale ivory skin which bruises easily and, when damaged, heals slowly. She also suffers from eczema. She always feels cold in her extremities and her body temperature is below normal. She sometimes suffers from pins and needles. She has had some hair loss on her scalp. Her nails are splitting. She feels that everything is an extreme effort, has lost her “get up and go”, and feels a “100 years old”. She wishes she was able to sleep excessively! She says she has been fatigued for years, but there was always something else that could be causing it. Even now that many of those situations are gone, she is still very tired. Her mental processes are sometimes slower than usual, but feels it is hard to tell whether it is due to fatigue or not. She finds it hard holding her son for extended periods of time. She was treated with anti-depressants for post-natal depression after her son was born. This ceased in February 2001 as she was feeling much happier. Her aunt suffers from hypothyroidism, and Kathy suspects that her mother might also have mild thyroid dysfunction. Her father suffers from late-onset diabetes.

She has had two thyroid function tests – in mid 1999 and in April 2001. Her TSH in mid 1999 was 4.3 (the upper limit of the reference range was 5.5). This fell to 1.85 (0.1-6.3) in April 2001. In April her T₃ was 4.2 (2.5-7.2). She has never had a thyroid antibody test. Kathy wrote:

16 April 2001 - I hope you can advise me. I recently had tests of my thyroid function but my GP said my results were in the normal range. I still feel lousy. My basal body temperature is consistently below 36.5 degrees, and I suspect I may be hypothyroid.

Later on 16 April 2001 - Thank you very much for your prompt response. I know that my TSH level was 4.3, and the upper limit of the lab’s normal range was 5.5. My T₃ and T₄ levels weren’t tested. Armed with the information you provided. I am seeking a second opinion from another doctor. Hopefully I’ll be able to get some answers with respect to the chronic fatigue and lethargy that I feel. I had a son in March 2000, but I don’t know whether that is long enough ago to rule that out as a cause of any thyroid problem.

4 July 2001 - I went to another GP to get a second opinion. He requested a bunch of blood tests that basically showed that my blood chemistry was normal, including a much lower TSH level of 1.85. This doesn’t explain my fatigue etc, so he referred me to a medical immunologist, who has in turn referred me to a psychiatrist to evaluate whether I am suffering from depression and also for a sleep study. The appointments with these specialists are this month. Anyway, it APPEARS my thyroid function is normal. I’m still unsure about the thyroid diagnosis.

6 July 2001 - I saw a psychiatrist today who told me that I have “Subsyndromal depression” and that is why I am so tired, although I don’t have the negative thinking associated with depression. He recommended antidepressants.

Cris from New South Wales

15 March 2001 - ...

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