Northeast Wisconsin
  • Northeast Wisconsin
  • April 2015
Written by 

Why do I still have thyroid symptoms when my lab work is normal?

Are you suffering from symptoms of low thyroid (hypothyroidism) but your medical provider has told you that your TSH (thyroid-stimulating hormone) test was normal and thus your thyroid is working fine?

We help hundreds of women each month with multiple hormone problems, including those seeking a diagnosis and treatment for symptoms of low thyroid. One of the most frustrating things that happens for many of my patients is that they truly do have hypothyroidism but their TSH result is somewhere in the broad range of normal, so they are told that their thyroid is not the cause of their problems.

Many of my patients report hypothyroid symptoms such as:

  • I feel cold all the time — especially my hands and feet — and sometimes I wear socks or extra clothing to bed. (This is not normal!)
  • I am gaining weight for no reason or cannot lose a pound no matter how hard I try. (It is very difficult to lose weight if the cells in your body do not have proper thyroid signals.)
  • I am always tired, sluggish or lethargic.
  • I am sleeping more than usual.
  • I am constipated and may not have a bowel movement for several days. (For best health you should have at least one bowel movement daily before 10 a.m. and perhaps a second one later in the day.)
  • My skin is dry, thick and sometimes scaly.
  • My hair is thinning or falling out and is more dry, coarse and brittle than normal.
  • I have frequent muscle cramps in my legs and/or toes, and my muscles feel weaker than usual.
  • My memory is poor and I have a hard time with math.
  • My eyes, hands and feet are puffy.
  • My low-density lipoprotein (LDL) cholesterol is elevated for the first time in my life.
  • My periods are heavier and my cycles are getting more irregular or are more than 28 days apart.

The thyroid controls many functions in the body and there are a multitude of symptoms that can signal a thyroid problem. Every single cell in your body has a receptor for thyroid hormone, so if your cells are not getting enough thyroid hormone stimulation you will certainly not feel well.

The thyroid is a butterfly-shaped endocrine gland in the base of the neck that controls metabolism and many of the body’s systems — from brain to bowel to libido and fertility. The American Thyroid Association reports that 1 in 8 women will develop a thyroid disorder during her lifetime. Low thyroid is an inherited condition that can also cause fertility problems, miscarriages, premature births and severe developmental problems in children. Undiagnosed low thyroid can also lead to heart disease, insulin resistance, arthritis, osteoporosis, depression, dementia and twice the chance of Alzheimer’s disease.

We help our patients determine if they have a thyroid problem by interpreting their symptoms, physical exam findings and lab results including TSH, free triiodothyronine (FT3), free thyroxine (FT4), reverse triiodothyronine (RT3), thyroid peroxidase (TPO), thyroglobulin (TG) antibodies, vitamin D and ferritin levels. We utilize a wonderfully helpful thyroid/adrenal/sleep screening questionnaire and machine called the Thyroflex that gives us very objective data of thyroid function at the cellular level. A Thyroflex test is a five-minute, Food and Drug Administration-approved test that measures the speed — in milliseconds — of a reflex in the arm. During an in-office evaluation, a small hammer connected to a computer is used to strike the brachioradialis tendon located near the elbow. The computer measures the rate and caliber of the reflex response to determine thyroid function. The longer it takes for a reflex response, the more thyroid hormone a person generally needs.

I often order female/ovarian and adrenal hormone testing for my patients and may follow up with thyroid testing depending on symptoms. Ovarian and adrenal hormone testing is done at home, is quite easy to do and can tell us which of your levels are low or out of balance. We can then decide the best course of treatment for the patient’s unique symptoms and health situation. I find most of my patients prefer customized dosed, bioidentical hormones as they tend to offer timely symptom relief and minimal side effects along with decreasing risks for bone loss.

It is very important to seek care from a medical professional who is skilled and experienced at hormone management to help you. At our center we have helped thousands of women feel like themselves again through proper diagnosis and hormone management and lifestyle guidance. Please join us at our monthly End Hormone Havoc seminar to learn more about the symptoms of hormonal imbalance and treatment options so you can feel your best no matter what your age or where you are in your hormonal transition!


Randi Mann, NP

Randi Mann, WHNP-BC, NCMP, is a board certified Women’s Health Nurse Practitioner, NAMS Certified Menopause Practitioner and is the owner of Wise Woman Wellness, LLC, an innovative, wellness and hormone center in De Pere. She is an integrative, functional medicine provider offering natural treatments and prescription medications for thyroid and hormonal imbalances including customized dosed, bioidentical hormones.

She combines the best of conventional, functional and integrative medicine to help women. Attend the introductory “End Hormone Havoc — Stay Sane, Slim and Sexy” seminar — offered monthly. Call 920-339-5252 to register. Visit for details.

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