All the hallmark symptoms of severe hypothyroidism but blood test results showed everything is fine.
Ferritin: 113 ug/L
Free T3: 5.1 pmol/L
Free T4: 11 pmol/L
TSH Ultra-sens: 1.56 mIU/L
VitD: 65 nmol/L
Even though I asked for a full thyroid panel, Reverse T3 and Thyroid Antibodies were not measured. I am a 20 year old male, started experiencing symptoms in 2022, my mother has hypothyroidism so there is a significant increased risk of developing it.
These results are confusing to me because I display all the symptoms of severe hypothyroidism.
Extreme fatigue especially, I spend roughly 90% of my day lying down in bed, 9% sitting up and 1% standing up because I get orthostatic intolerance/POTS when standing. My resting heart rate lying down is 56 BPM (bradycardia), 83 BPM upon sitting up, 90 BPM upon standing up, and 113 BPM after 15 minutes standing and profusely sweating (doubled heart rate from laying down).
Some days I've drank two energy drinks per day (320 mg caffeine) and am able to fall asleep right after without problem and no significant energy boost. I'm consistently sleeping 10-12 hours a day and I wake up feeling no refreshment. I'm so exhausted I've started to neglect basic hygiene like brushing my teeth only once a week and showering twice a week, with showering being the most exercise I ever do by standing more than 15 minutes and I dread having to shower.
I am not overly overweight but I do have stubborn stomach fat and an incredibly slow metabolism, maintaining my weight eating one meal a day and finding it impossible to lose weight, as well as bloating incredibly easily from water. I probably drink too much water and have to urinate constantly.
I have mild cold intolerance and poor circulation in my legs leaving them cold to the touch but my temperature is a stable 37 C.
My skin is dry, and my hair is dry and incredibly tangled, falling out easily from any disruption like combing. I always have constipation and incomplete evacuation. My muscles are very weak in the neck and middle back leading to me having anterior pelvic tilt and forward head posture. My working memory and concentration skills have severely declined and I have severe brain fog and executive dysfunction.
My voice is noticeably weaker and higher pitched, speaking feels a lot more difficult and less automatic. Even breathing deeply through the diaphragm is difficult and not automatic, I have incredibly shallow breathing and occasional shortness of breath that mimics symptoms of a panic attack. I've noticed my face has gotten a bit more puffier and less defined.
I have delayed puberty and no major growth spurt, facial hair is severely delayed with very weak and short peach fuzz on moustache, underneath chin, and sideburns that stop growing after a few weeks. I still look 15 or 16 years old if I were to guess my age from someone else's perspective. Most strangely, my total testosterone is 952 ng/DL and free testosterone is 548 pmol/L, which is above average. But I display all the symptoms of low testosterone: fatigue, low libido, low muscle mass, skinny-fat appearance, irritability and high stress, and little facial hair. I don't think I have a goiter but I do feel tightness in my throat, my blood test results also showed high cholesterol which is a common result of hypothyroidism.
I'm at a loss for what could be causing this if my blood test results show a healthy and not low T4, and a healthy and not high TSH, it's incredibly debilitating.