Ask the Doctor

A patient came to see me for chronic fatigue, weight gain, and hair loss. For years her PCP and OBGYN have been treating her without any success. Her bloodwork was always normal so she began to wonder if she was just depressed. I saw her and noticed that her thyroid labs although were so called normal were at the low end of normal. So I prescribed thyroid medication to see if it would help. A month later she returned and was doing better with weight gain, hair loss, and fatigue. I saw her and said you are better but I would like to check your basal body temperature. It came back low so I adjusted her thyroid medication higher. She came back feeling fantastic and she had lost her previous weight, and no more going to bed early. So, I rescheduled her thyroid labs. The Free T3 is the actual thyroid hormone. The normal range is 2.3 to 4.2 and hers was at 5.1. At this level she would be considered overdosed on thyroid hormone but she has no signs of having too much thyroid hormone i.e. increased heart rate, anxiety, and nervous feeling. Her basal body temperature was 98.1. This is right where the experts say it should be! Her PCP was very upset and wanted to reduce her thyroid medication back to her old level of 90 MG but my patient said why would I go around feeling tired and gaining weight and losing hair. She refused and has continued at our recommended dose of 120 MG and is feeling fantastic with no signs or symptoms of an over active thyroid gland. Maybe the old way of testing the actual thyroid function is still the best. We are not numbers we are individual people.  Do we treat only on a lab number or do we engage with our patients to see how they really feel? Now that’s an idea!