Can a normal TSH result hide hypothyroidism?

Yes. Subclinical hypothyroidism can persist for years even when TSH (a pituitary hormone) remains within the standard laboratory 'normal' range. Patients may still experience muscle aches, joint pain, and unexplained hair loss.

What is non-pitting edema in thyroid disease?

Non-pitting edema is a specific type of swelling often seen in the lower legs and feet of hypothyroid patients. Unlike standard swelling, it does not leave an indentation when pressed and is a hallmark sign of myxedema associated with thyroid dysfunction.

Why is Ferritin linked to thyroid health?

Low ferritin (stored iron) is a common clinical finding in hypothyroidism. Iron is required for the proper conversion of thyroid hormones and the maintenance of hair follicle health, making unexplained iron issues a potential indicator of thyroid struggle.

To Hell and Back - recovering from hypothyroidism

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Introduction

In the summer of 2019, I was feeling fantastic after losing 55 pounds and putting my type 2 diabetes and hypertension into remission.

Fast forward to August 2020, when I got Covid. It was new at that point and none of us knew what to expect and it took months until I began to feel reasonably normal. I had become resigned to living with muscle aches, joint pain, ‘brain fog’, and fatigue. It was hard for me to wrap my head around the fact that I was reasonably active and now finding it difficult to walk up or down a flight of stairs.

Eventually, the symptoms eased, and life carried on.

In March 2022, despite having had both vaccines (April 2021, July 2021), I came down with what my doctor assumed was Covid again because the symptoms were very similar to those I had in August 2020 — muscle aches, joint pain, feeling exhausted, and cold all the time with bluish lips. I had been loaned an oximeter and I found it odd that my body temperature was always two degrees below normal, even though I had fever-like symptoms of being cold and shivering. I didn’t think much of it until I began to develop symptoms that were not associated with Covid, including significant non-pitting edema in my lower legs and feet.

Joy in June 2022

Two month’s later, in June 2022 at my youngest son’s wedding, I could barely walk on the beach or get out of a car without assistance. The groom’s eldest brother assumed that it was a result of me having “aged” as he had no idea that I was hiking in North Vancouver and Golden Ears Provincial Park for several hours at a time the summer before.

I looked like I did when I was 55 pounds heavier, but without significant weight gain and began to think that my symptoms were consistent with hypothyroidism.

After my son’s wedding, I called my doctor’s office and made an appointment.

After a thorough examination, my doctor pointed out several other physical symptoms that I had that were consistent with hypothyroid and said “Joy, I think your conclusion is right on” and requisitioned additional lab work. He reviewed my past lab results and noticed that my TSH had been “high normal” since 2013, and that I often had low ferritin with no explanation, as well as past “unexplained” issues with hair loss.

Today, the blood tests came back confirming that I have Hashimoto’s disease and my doctor said that I had “profound hypothyroidism“. He said in all his years of clinical practice, he has only seen one other person with more significant presenting symptoms. In retrospect, I have been experiencing symptoms of subclinical hypothyroidism for nine years (since 2013). No testing was done because my TSH (a pituitary hormone) was still within range.

Final Thoughts…

I am grateful that my doctor involves me in decision making about requisitioning blood tests and is open to discussing medication types and dosages with me.

It is my hope that my clinical knowledge as well as almost a decade of dealing with sub-clinical hypothyroidism positions me to better help others recognize possible hypothyroid symptoms and to discuss diagnosis and treatment options with their doctor.

To your good health,

Joy

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LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Joy Erdile, MSc, RD

I am a Registered Dietitian Nutritionist and the owner of BetterByDesign Nutrition Ltd. With a postgraduate degree in Human Nutrition and a background as a published mental health nutrition researcher, I have been dedicated to supporting my clients’ clinical needs since 2008.

I hold active professional licenses in BC (CHPBC), Alberta (CDA), and Ontario (CDO), allowing me to provide regulated Medical Nutrition Therapy across these provinces. My expertise spans chronic disease management, complex digestive health, and therapeutic diets. I am deeply passionate about helping people reclaim their health, rooted in my firm belief that Nutrition is BetterByDesign©.