For healthcare professionals only


Thyroid function tests and hypothyroidism

BMJ 2003; 326 doi: (Published 08 February 2003) Cite this as: BMJ 2003;326:295

Severe Hypothyroid symptoms with normal TSH

I read with interest your article which at first seemed to state that
TSH is the "gold standard " in the first line of diagnosing Hypothyroidism
and your early statements about patients insisting they have hypothyrodism
when the TSH is los even though they have symptoms is egged on by some
clinicians.Well what I found odd was your article then gave proof at the
end that people can and do have normal TSH and Hypothyroid disease and
should be checked for it with symptoms...I don;t get the point of your

I myself had a rapid weight gain after a lifetime of being a very
thin person even after four children..I was an ER nurse at the time and
was also getting weaker and weaker,,I also had asthma and fibromyalgia and
undiagnosed Rheumatoid arthritis..By the time I left my primary doctor to
find another I had gained 80 lbs!!! One particular time I remember was
when I had come home from a camping trip with my husband where we had
been hiking 20 miles every day this is while I was around the 40lb
overweight stage and I had gained 7 lbs,,,the doctor was not
concerned,.,,As a nurse I realized that it was impossible to hike like
this and gain weight without a serious metabolic disorder...but since my
TSH was normal..still nothing was done..

Worse still I have a mother with Hashimotos and a sister with Graves
...this did not phase them..

I was still working and going to other docs for my other troubles so
having little time to search for new docs but when my GYN saw me for my
routine visit he ordered a T4 and T3 resin uptake and these were abnormal
but really not that awful but sent me to an endocrinologist...I had
brittle hair,nails that bent in half and peeled,my legs had three plus
pitting edema by this point ,my heels of my feet were so dry a thick layer
of skin fell right of of both heels...I was now so tired I could no longer
drive,,,,My eyes were puffy and I had a sed rate of 54 my cholesterol was
and is high at 250 I am now on Synthroid and very slowly getting better

Competing interests:
None declared

Competing interests: No competing interests

31 August 2008
Maureen hallett
RN (retired ) due to ill health