ZocdocAnswersAll the symptoms of hypothyroidism, but normal TSH?

Question

All the symptoms of hypothyroidism, but normal TSH?

I am a 25-year-old woman; I was treated for an autoimmune disease with steroids at age 10-11. Both grandmothers and my mother have diagnosed hypothyroidism. I'm constantly sleepy, though I take 20-30 mg of Adderall per day (by prescription). Without the Adderall, I am so exhausted that it is unsafe for me to drive. I am always cold- people comment that my lips turn blue and I visibly shiver. I have been going gray since my late teens. It is hard for me to lose weight (although I am a healthy weight at 110lbs for 5'2"). I have 'brain fog'. I will walk into a room and not remember why. I forget how to spell or pronounce words that I have known for years. Despite all of this, my TSH is 1.2 mg/dL. I've had a full sleep study and vitamin/blood screening, which came back normal. I am seeing a psychotherapist occasionally, but I don't feel depressed- I love my life! I don't understand why my TSH is normal or what else could make me feel so sick. I take Seasonale daily, and the Adderall.

Answer

I would definitely suggest going back to see your doctor about these symptoms, which sound very complex! The first issue that you might want to address with your doctor is describing to them what kind of "autoimmune disease", exactly, you were treated for when you were a child. I say this because some of your symptoms might be consistent with an autoimmune disease, especially feeling fatigued and having your lips (or potentially other body parts?) turning blue from time to time. If your doctor knows the specific details of your history, they will be able to perform a more thorough evaluation. Also, a normal TSH does rule out most kinds of hypothyroidism, but it does not rule out a form of hypothyroidism known as central hypothyroidism. This can only be diagnosed with a full panel of thyroid function tests. So, if you have not had this done, this might be another area for your doctor to investigate. Seeing a psychotherapist is a great idea. However, I do think that you deserve a more complete medical evaluation before chalking up all of your symptoms to a psychiatric condition. Make an appointment with your primary care doctor to discuss these issues!

This answer is for general informational purposes only and is not a substitute for professional medical advice.

If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdoc’s Terms of Service.