DEAR DR. GOTT: I am writing because I have not felt well for a long period of time. I go to my doctor every few months and come home discouraged. In November 2006 I was sent to the hospital with chest pain, nausea and abdominal cramping. I also had a rapid heart beat and clammy skin. Four days and several tests later nothing significant showed so I was allowed to go home. I have an extra heart beat that is sometimes very pronounced but a 30-day heart monitor did not show anything significant. I have been to a rheumatoid doctor and he told me there wasn’t an autoimmune disease yet. I feel fatigued, depressed, joint and muscle pain, thinning hair, ringing in the ears, bruise easily, tingling hands and feet, and am very sensitive to the cold and extreme heat, especially my feet. I need help.

I had some blood work done more than a year ago and am sharing the results with you. My doctors don’t feel the work needs to be repeated. TSH 3.48, T3 2.8, T4 1.06, rheumatoid factor 8, ANA, 80, potassium 3.8, bilirubin 0.2, and sedimentation rate 2. I hope this helps you.

DEAR READER: Based on your symptoms and lab results I strongly believe that you have hypothyroidism. This means your thyroid gland is not producing enough thyroid hormone to maintain your health. The thyroid gland produces several types of hormone, mainly thyroxine which contains iodine that allows for normal body growth and function.

As for your lab work, your TSH (thyroid stimulating hormone) should be below 4 but anything higher than 2.0 coupled with an abnormal T4 (thyroxine) (4.5-11.2) is a red flag for early-stage hypothyroidism. Your T3 (triiodothyronine) level should be 1.0 to 2.0. Yours is elevated because your body is attempting to fix itself by releasing more of one hormone to compensate for the lack of another. However, this attempt is failing in your case. The ANA is abnormal and in some individuals with thyroid disease can be increased, much as yours is. The other levels are all within normal limits.

I strongly urge you to see an endocrinologist who specializes in glandular disorders such as thyroid disease. He or she should run more tests to get up-to-date results. I suspect, they will clearly point to hypothyroidism. The specialist should also check you for other disorders and forms of thyroid disease such as Hashimoto’s thyroiditis and others.

Treatment is simply thyroid medication taken every day. Once on medication you should start to feel better within a few days.

As an aside, depression is not generally associated with thyroid disease but given your situation and lack of resolution it can be expected. If your depression does not go away once you start to feel better, I recommend you see a psychiatrist or counselor. He or she can work with you and, if necessary, prescribe medication.

To give you related information, I am sending you a copy of my Health Report “Medical Specialists”. Other readers who would like a copy should send a self-addressed 4 ¼“ X 9 ½“ letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.