Jane, a 28-year-old nurse, told her primary care physician about her classic symptoms of a thyroid imbalance: dry skin, hair falling out, fatigue, weight gain, and lack of concentration. On her insistence, he ordered a T4 test, which measures the level of T4, one of the two thyroid hormones produced by the thyroid gland. Her results came back within the normal laboratory range, whereupon he declared that Jane could not have thyroid disease. However, he had not checked her TSH (thyroid stimulating hormone), the pituitary hormone that regulates the functioning of the thyroid gland.
“Being told that nothing was wrong with me made me think I might be crazy,” she said. “I have a history of people trying to deny me my feelings, trying to tell me that what is going on in my body is not real.” When her TSH level was measured by an endocrinologist, she was diagnosed as hypothyroid.
The search for a correct diagnosis is lengthy in many patients. To determine whether you have a thyroid imbalance, you must be tested for the level of TSH. The TSH test is much more reliable for detecting an underactive thyroid than the measurement of thyroid hormone levels in the blood. If your doctor relies only on the T4 and T3 measurements and fails to order the appropriate test TSH, you may not be properly diagnosed for hypothyroidism.
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