Why your doctor says your thyroid is “normal”

by West Conner · 46 comments

I get requests on a regular basis to help people get their thyroid hormones balanced. Most of them are women as they are generally more susceptible to hypothyroid. By far the most common complaint I hear is, “My doctor said my thyroid test came back normal but I don’t feel normal.” When they go back to their doctor to insist they are not “normal,” they are sometimes written a prescription for an antidepressant as the doctor quickly scurries out of the exam room.

So, you get your thyroid test back and the “doctor” says you are fine. You know you are not “fine” so what are you to do? Here are five reasons that you have hypothyroid even though the standard test says you are “fine.”

1. You could be producing enough hormone but your body cannot convert it into the active form. Your thyroid produces mainly T4. It is inactive and must be converted in the cell membranes into the active form, T3. This issue is usually caused by high cortisol and inflammation.

2. You could be producing enough hormone, your body is converting it to the active form, but too much is being bound to proteins making it inactive. The thyroid hormones are transported by a protein called thyroid binding globulin (TBG). When TBG levels are too high, the thyroid hormones cannot enter the cells. This is usually caused to too much estrogen. Clear out excess estrogen with cruciferous vegetables and DIM.

3. You could be producing enough hormone, your body is converting it to the active form, but you don’t have enough TBG. It sounds counterintuitive but too little TBG, meaning too much thyroid hormone, will actually cause your cells to become resistant to the hormones. Think about the heel of your foot building up a callous. The cells build up a callous to the thyroid hormones. This is usually caused by too much testosterone.

4. You thyroid works just fine, but the signaling gland, the pituitary, isn’t functioning properly. The pituitary “tells” the thyroid to produce thyroid hormones. If the pituitary is not functioning properly because of stress, high blood sugar, infection, or another reason, it will not send out enough signal for the thyroid. Therefore, the thyroid will not produce enough hormone.

5. The thyroid works fine, the pituitary works fine, but your cells are not taking in the hormones. All your lab test will come back normal in this case and there is no way to test whether or not your cells are resistant to your thyroid hormones. This issue is usually caused by chronic stress and high cortisol levels.

Maybe your doctor has listened to you and does write you a prescription. Ninety nine times out of a hundred, you will get Synthroid, which is 100% T4. When you return to say you still do not feel right, you will get an increase in dose. This pattern will continue until you begin to have side effects from the increasingly high dose of synthetic drug.

Unfortunately, most traditional doctors will not look deeper into the issue. They continue to increase the dose. If they would simply pick up a book, stop learning “medicine” from the cute little pharmaceutical sales rep pushing a drug, and actually learn something new that wasn’t standard practice in the 1970s that has been handed down from teacher to student for forty years maybe people can get some relief.


{ 46 comments… read them below or add one }

Barb August 26, 2015 at 9:41 PM

My symptoms… shortness of breath, fatigue, touchy reflexes, heat intolerance, profuse sweating, inability to remain asleep, weight gain(weird i know) depression, brittle hair, muscle aches. Lobectomy 1989. Last week tsh .096, t4 low normal, t3 mid normal. Help please!


Antonietta Mileto June 26, 2015 at 8:03 PM

Hey guys I’m 19 my doc recently took blood tests on me and every thing came back fine but I know I’m not fine my throat is swollen it’s hard to breathe I feel dizzy and high all the time I eat like crazy gaining weight my head pounds all the time I feel weak and sick to my stomach and my heart races when I get up too fast please if anyone if you know what’s wrong with me cause my docter doesn’t :(


chance July 6, 2015 at 4:47 AM

Did they test your iron levels or a CBC (complete blood count)- I was having a lot of those issues -(no swollen throat) but my hemoglobin was 7.2 and should be 13- I needed to take iron supplements & eat alot of iron enriched foods


Susan May 30, 2015 at 7:44 PM

I read this article & started crying, again. Only this time for joy. I’ve been on thyroid meds since I was 17. I’m now 66. That’s almost 50 years. I’ve been on 150 mcg. Levothyroxine for about 3 decades & was told several years ago that my thyroid died & I would be on meds the rest of my life. It’s an inexpensive pill so that isn’t a problem for me. When I start to see a new PCP they will usually bring it down to 137 mcg & 3 months later right back up to 150 mcg. Now the problem is that a test last year came back with my TSH at 19.172. I’ve been told normal is .45 to 5.1. Wouldn’t you consider this to be a big, red flag? My PCP raised my thyroid meds to 175 mcg & I got so sick. I told her it had to be a mistake, but they wouldn’t take another blood test. 3 months later the new test came back .016. She put me back on the 150 mcg. She started treating me as if I trying to manipulate the test. This year I went with another PCP whose test came back .018. She wanted to put me on 125 mcg. We talked & compromise with the 137 mcg. I’ve never bothered to get lab results. All the doctor’s in my life kept me feeling good so I didn’t care. Now I care. I got tests going back to 2006 & thought there must be a correlation here. The test results are all over the board & these doctor’s kept me at 150 mcg. Again, I’m so sick & I don’t know what to do. This new doctor must have talked to last year’s PCP because now she is treating me different & her nurse grouses at me every chance she gets especially when I told her I was researching this. She told me I should never do that as who know what bad information I might get. What gets me is both these doctor’s won’t look at me, as if I were lying. I’m not!!!! This 2nd PCP is now on maternity leave. I’ve got an appt. with a new PCP, but I’m afraid of the same treatment. Am I going crazy??? If a thyroid is dead how can this happen? One other thing that started in April, I have a horrible craving for salt. Could my adrenal gland be the problem? Is there a test for the adrenal gland?


Daniela June 19, 2015 at 9:49 PM

Im sorry to hear your story. I’m 37 years old, and i was diagnosed 5 years ago with Hypothyroidism.My TSH level was 135. i didn’t know why, what, and the cause, but since i found out,i’m learning and reading everyday about it. First my dr. put me immediately on Synthroid 25mg, to start, increase my dosage every week, till i got to 137mg. then i was told my levels are good and i should keep this dosage, but i was just feeling worse and worse everyday.i gained about 40 lb, and I’m an active person. In january 2013, after i read a lot of articles and educate a little bit, i asked my doctor for a different thyroid medication, a natural alternative. So i start taking Armour Thyroid (2 grains). I feel a lot better, however, i’m still gaining weight despite all the sacrifices I’m doing. Last month i joined on Facebook several groups(hypothyroidism, Hypothyroidism ladies, Hypothyroidism Mom), and i found out so much more. Im now gluten free(it’s been a month), i feel great and i wouldn’t go back for nothing in the world, i already lost 10 lb. Soon i am going to see a naturopath doctor.
Did your Doctor ever order ALL these tests? If not, please ask for:
Basics: TSH, Free T4, Free T3, Reverse T3, TPO, TgAB, TSI, Vit. D, RBC Magnesium
Hair issues: Ferritin, Iron, Sex hormones, Cortisol test, Minerals
Inflammation: CRP, ANA, SED, Homocysteine
Weight issues: Free T3. Reverse T3, Ferritin, Vit D, Sex Hormones, Cortisol
Also important: B12, Parasites, H. Pylori
Other Root Causes: EBV, Lyme, Heavy Metals


Fern September 19, 2015 at 9:07 PM

Oh yes I was also told it’s my age and hormones haha I’m 54 come on crazy.


jane Moxey May 6, 2015 at 7:14 AM

Hello I just feel TERRIBLE I have felt like this for ages have loads of the symptoms of thyroid probs with nodules and goitre beginning to show but the standard tests come back as normal,,,I too have been given all sorts of medecines anti depressants because I am so low with all of it that I burst into tears people think Im imagining problems but why would one do that? I so badly want to feel well.I need advice as to any other test I could have that would show something….I cant lose weight whatever I do just feel a wreck and really unhappy Help someone please !!!!!!


bb May 26, 2015 at 12:13 AM

Me too. I don’t know what to do. And being this heavy, the heaviest I have ever been, is just making it worse. Like you I can not drop a single pound no matter what I do. I wish someone could help us.


Kristi June 24, 2015 at 2:48 PM

You guys are NOT alone. I’m so frustrated with my Dr and I’m feeling like I’m completely losing my mind. I recently started Armour and it was working, but it didn’t last long, but because my levels are ‘stable’ he won’t listen to me. He just says I have thyroiditis and to take tylenol. My surgeon found a mass on my thyroid during a MRI unrelated to why I went and personally called me. My Dr had ordered me an ultrasound already, so I told my surgeon I’d forward him the results as well. I heard back from my Dr., and the nurse tells me, my ultrasound came back normal and that there were no masses/nodules (grant you my surgeon, nor I told my Dr. about what he had found on the MRI). So, tell me how an MRI can pick up something on my thyroid, but I come back with a normal ultrasound? I still am waiting for my surgeon to tell me what he got from the ultrasound, but I’m wondering if I need to change Dr.’s?!? My Dr. office did also tell me my white blood cell count was high, but again, just to take tylenol! I’m in tears everyday because I feel sick and stuck and all these visits and labs have cost me. I can’t afford to start all over with a new Dr. But, again, just reading everyone’s frustration, I feel somewhat more normal when it comes to dealing with hypo!


Cindy May 5, 2015 at 7:22 PM

Hello everyone. I’m 26 weeks pregnant and my TSH came back abnormal. On 03/24/15 my tsh was 0.299
My regular doc sent me for a full blood drawn free
thyroxine index 1.7 1.2-4.9 1
t3 uptake 18 24-39 % LOW
thyroxine (t4) 9.4 4.5-12.0 ug/dL
tsh 0.480 0.450-4.500 uIU/mL
My doc says everything is fine.. but I feel shaky and rapid heart beats for almost 5 months and i’m not getting any answers. PLEASE HELP


Keely May 5, 2015 at 6:27 AM

I just found this link was wondering if anyone started levothyroxine and then their periods stopped! I’m trying to get pregnabt but since staring these tablets I haven’t had a period which is 3 months now?

Many thanks


mary March 20, 2015 at 10:50 PM

Hai, i feel the same, am on thyrox 100mg form the age of 10 and now am 26. my blood tests are normal but i feel very low, moreover, i forgot how to smile.please help me


Ricky yom March 6, 2015 at 5:54 AM

Same here tsh say I’m fine but I feel like I’m dying can’t sleep I have no bowl movement neck and chest hurt my head hurt all the time I so weak I’m depress because I don’t know what’s to do.


China May 29, 2015 at 6:35 AM

Wow, you just described me to a “T”!!! In a strange way I feel better, just knowing I am not alone.


Ricky yom March 6, 2015 at 5:52 AM

Same here tsh say I’m fine but I feel like I’m dying


marcy February 10, 2015 at 1:43 PM

In serious need of help. My daughter is 11 and weighs around 180. We have had her on special diets and had blood withdrawals to check her thyroid and for diabetes. She is a active child and we are cautious of what we let her eat and not eat. I’m so frustrated and ready for more answers, what can I tell my doctor in a nice way that we want more answers and more tests. What should I be aware of to tell my Dr. I’ve heard there are some thyroid issues that do not show up in blood tests so what can we do to seek help for more testing?


heather bryant June 12, 2014 at 2:51 PM

hi there i have just had an ultra scan and they couldn’t see anything wrong but i have some blood test to check the immune system but not heard yet probably hear when i go for my follow up appointment at the hospital.


Tracy May 14, 2014 at 12:09 PM

its so interesting reading everyones comments.I have been unwell for 1yr now with ,Tremor,aggitation,weak arms and legs,a feeling of a lump in my throat..the list is endless.my dr thought it was over active thyroid but tests came back normal.they then prescribed anti deppressants which made my symtoms worse.im at my wits end and feel so unwell i cant function properly.ive rapidly gained weight lately but not through over eating :-(


GG March 17, 2014 at 7:46 PM

Dear ladies! Hypothyroidism is very common. Unfortunately, a lot of doctors can’t diagnose it.
I’ve been on Levothyroxin for couple months, didn’t see any improvement. Doctor suggest to increase the dose. I found another doctor.
2 months on Armor my TSH drop from 6 to 1.4. Even when my TSH was 2.5, which is in the range, I still didn’t feel good. But in this case doctor will tell you that you are fine. Only with Armor dose adjustment my TSH drop and I felt the difference. I have more energy, I don’t take naps anymore, I’m productive, muscle cramps gone, depression moods gone.
I learn from Dr. Hotze. He has a clinic in Taxes.
Good luck to everyone to find the right doctor!


Angie March 3, 2014 at 9:51 AM

There’s has been something wrong with me for 6 months now.I have many symptoms of both hypo and hyper thyroidism.The most obvious signs I have are fatigue,my body feels like its on fire but I am always freezing and the golf ball in the throat feeling(you can feel the enlarged thyroid gland at the base of my neck).Also muscle weakness ,sore joints and the list goes on.My thyroid bloodwork came back normal.I asked for a thyroid ultra sound and the results were that my thyroid was mildly thickened.What does that mean and if there is nothing going on with my thyroid why was this swelling and thickening plus all my other symptoms not there 6 months ago?


Amber February 21, 2014 at 9:54 AM

My doctor wouldn’t refill my thyroid medicine until I had blood work done. I’m a very busy mom & I work so a month later I finally was able to make it in. Note: No medicine for 1 month++. The nurse called and stated my lab results are normal. I told her I’ve been off the medication & did I really need it- Note: I’m 5′ ,9 288 lbs, with Acne hair loss, facial hair, I could sleep all day, insomnia, memory loss, no libido, on Levox, Advise please!!!


Amy October 30, 2013 at 9:32 PM

I just had my blood work done and all tests came back normal. I had a spit test done once and it revealed a lot. I have not been to a Dr since that has done that. I have felt terrible for years and I always tell the drs that. I am tired all the time cannot lose weight no matter what. I don’t like feeling this way. I have thought I needed to go to an endo Dr but seeing these comments I am not sure. Oh the last Dr said they thought it was either my thyroid orig was depression.


beanny December 5, 2013 at 4:40 AM

amy i am in the same boat endo stage 4 stopped taking all hormones 9 months ago my hair is rapidly thinning and getting worse just got blood results today for full blood count and thyroid all came back normal even though i show all the symptoms??? dont know what to do next?


Tracy May 14, 2014 at 12:32 PM

This is so me..very frustrating :-(


Missy July 3, 2014 at 7:35 PM

I would like to know what happened later on?
I have been going through symptoms of hormonal inbalance and anybody refuses to take me seriously. if ur storu could help. I would be grateful. :(


Danial Garcia September 4, 2013 at 12:40 AM

I guess there should be natural remedies to the problem. Could you share some with us?


kennisha July 9, 2013 at 2:18 PM

I have been feeling horrible for a full year now, maybe longer. I have been to numerous doctors, every test you can name… nothing. However I do have lots of thyroid nodules and cyst….my inflammation level was sort of high, I’m just lost. My brain is always in a fog, I constantly feel tired even with lots of rest, sluggish forgetful and very depressed!! I am losing weight only because I am nearly killing myself to lose it. My tsh was 2.23 in April and recently it was 0.529 dr’s say its normal but I sure don’t feel normal!! What do I do now? I am tired of feeling this way I want my normal life back….


Andrea June 3, 2013 at 10:27 AM

My thyroid test has come back at 5.4 I’m taking 150 Levo dr says my result is fine, I thought this was to high, last yr it was 2.2 the yr before it was 1.3 and my hair is coming out in loads:(


Andrea June 3, 2013 at 10:14 AM

My thyroid test has come back at 5.4 I’m taking 150 Levo dr says my result is fine, I thought this was to high, last yr it was 2.2 the yr before it was 1.3


Jacqueline Briggs May 29, 2013 at 5:54 AM


Recently i have visited my new Doctor as my Dr. has retired i am a 55 year old lady looking after two Grandchildren and for some time have felt extremely unwell the usual dry itching spider crawling skin, exhausted, cat naps every 2hrs, horsey voice, alopecia 3 times, weight gain of 3 stone, awful muscle pains everywhere my joints are also sometimes unbearable unable to lift pots from the cooker etc, i have my blood test results which read my thyroid hormone is practically non existent and that some time in the future i will definitely be given Thyroxine so apparently it is now up to me to carry on with paracetamol as i am limited to little medication for pain with the added responsibility of regular blood test. To be honest i found my Doctor intimidating and she talk to me like i was a ten year old her patronising manner was something to be desired that i didn’t deserve to be in her company arrogant and rude she may of learned medicine but she lacked any understanding of a human being so may be would suit better in a pharmacy out the back somewhere out of sight!


Sibbie April 10, 2013 at 1:55 AM

I am 5 weeks pregnant. My blood tests reports showed I have hypothyroid(TSH 5.1)
Doctor advised to take 50mcg of thyroxine daily and to go for thyroid ultrasound. Today my ultrasounds results came and it shows thyroid levels are normal. Do I still need to have having medicine. Is there possibility there will be something wrong with my blood tests results. Should I repeat the tests.


Tanya Mentgen April 1, 2013 at 12:01 PM


I just had a thyroid test done my doctor says my levels are normal. But I have gained 12 pounds in 6 months and I am still tired all the time and have realy dry skin. I contacted a endocrinoligist but they told me that if my levels came back normal there was not much they could do for me. I am frustrated to say the least. Can you give me any ideas on where to turn next because I know something is not right.
Thank you


Janie April 1, 2013 at 3:07 PM

I have gained 50 in 4 months and have been on meds for years… Went to a new Endocrinologist today and said I basically have an eating problem. It was the worst visit I have ever had. Find a functional medicine doctor, or body logic MD. Mine wasn’t that great but they look at the entire picture.


Raza Wahab October 12, 2012 at 12:30 PM

Hi i have thyroid problim its come in my blood test the doctro give me Eltroxin tablets each 10 day after haif tablets more like 10 day 1 tablet than 1/5 than 2 what do you think i can be fine….. im very upset


Jackie May 20, 2012 at 12:18 PM

Hi, I appreciate your article so much! My thyroid is “dead” from radioactive iodine. After suffering for 8 years while on levothyroxine, I am finally taking Armour thyroid. I feel so much better…I truly believe my body needed the necessary T3 that levo did give me. I lost 20 lbs immediately after I began Armour one year ago. (Could not lose weight despite exercising and eating well on levo.) I have a question, please. Sometimes I get so swollen – hands, feet, face, etc. – if my dosage is not correct. Why is this and what is causing the swelling? I swelled on levo, also, so this is not an issue with Armour, of course. I was diagnosed with PCOS recently and also do not have regular menstrual cycles. I take compounded progesterone the last 14 days of my cycle and that give me a period, but I still do not ovulate. Do you know of anything that could help me? I am taking Vitex (day 13) currently and vitamins 2 times/day. Thank you for your website.


sean April 27, 2012 at 12:23 PM

Armour thyroid is “natural’ for pigs, not Humans, ask any endocrinologist, they will never prescribe it, its also not allowed to be prescribed in England and most european countries


JoAnn Goroshnik December 18, 2010 at 3:57 PM

I am a lot older than those of you writing, but I have had problems with my thyroid for about 50 yrs. I still do not think the docs know what they are doing. I went from taking 175mcg of Levothyroxine to 75mcg practically the same day after having my TSH done. I also have FM and suffer constantly with pain. I refuse to take strong pain meds because of the side effects, but have a great difficulty walking. Recently have had a problem with swelling of the leg from knee, ankle, & foot. The cardiologist tapped my leg and said it was nothing, but how can a person walk around with swollen feet, ankles and back of knee, but I supposedly have nothing wrong with me. I had an ultrasound for clots which was negative, everything lab wise is always negative except for the spinal stenosis of my lumbar and cervical spines. I truly do not want to go on because as I said I am perfectly fine except these docs don’t live in my body. However, I still don’t know shat to do. I am currently seeing a very good NP who comes to my home and seems to have a little more interest in my problems. Have a nive holiday to everyone and a healthy New Year. JoAnn


Nancy January 7, 2011 at 3:23 PM

Joanne, like you, once the TSH test became popular, my thyroid dosage of Synthroid went from 2 mg down to .75 mg. And I thought I was going to go into a coma.

After that, I was diagnosed with FM. Two years ago, someone suggested I start taking Armour Thyroid. It’s natural rather than synthetic and contains both T4 and T3. I’m still tired, but I think that’s because I still have FM. But at least I no longer think I’m never going to wake up if I lie down!


Amy December 13, 2010 at 10:57 PM

Thank you for posting this article! I was just told today that my thyroid was “normal” after having all four T’s tested along with insulin resistance and some other things. Everything came back “normal” except for my cholesterol which was slightly high. I’ve had my thyroid tested twice before (blood test and ultrasound) but it always showed normal. But never before have I had such a combination of symptoms. For years I’ve dealt with depression and fatigue. But in the past couple of years my acne has gotten much worse (I’m 25 years old), my menstral cycle more out of whack (I just started having periods again this past summer after a two year hiatus), thick black whiskers on my chin and neck, the hair on my head is thinning and has completely changed structure, and my neck looks puffy (one person even told me my neck looks “sick”). Something is NOT right. For a while I was convinced I had too much testosterone or PCOS…both of which are still possibilities. But I’ve been thinking lately that it’s more likely thyroid because of my neck and family history. My mom and both her parents have thyroid issues.
What next step should I take? My insurance isn’t very good and I can’t afford any out of pocket expense. The lady that ruled me “normal” was a nurse practitioner. Should I go to a thyroid specialist and see what they say? I have to admit, it’s comforting to see that thyroid is often misdiagnosed, even when the test results come back normal. I definitely don’t feel like my body is “normal” at this point.


Amy December 13, 2010 at 11:03 PM

I meant to also list with my symptoms “brain fog”. I feel like I can never concentrate or remember anything any more. A lot of times, my mind feels as if it’s going in slow motion, or when I try to think of something it goes completely blank for a little while and it takes a lot of effort to remember what I was even trying to think of in the first place. I’ve never had that before and I find myself getting overwhelmed easily.


Brandi May 6, 2013 at 5:07 PM

Did you ever get any of this resolved? I feel like I just wrote what you said. All the same symptoms to a ‘T’. I just received my blood work back today and everyting was normal with slightly elevated high cholesterol. Dr. told me probably cause I dont eat well. Well, news for him…I do!

Desperate for answers. I hate not feeling like myself!


Heather December 3, 2010 at 11:11 PM

Ok….BUT what is this information from a book that my MD, Naturopath, Osteopath, Acupuncturist, Chiropractor, Chinese Doctor need to learn or are you saying that your DIM is the answer?

“If they would simply pick up a book, stop learning “medicine” from the cute little pharmaceutical sales rep pushing a drug, and actually learn something new that wasn’t standard practice in the 1970s that has been handed down from teacher to student for forty years maybe people can get some relief.”


West Conner December 8, 2010 at 12:40 AM


Most doctors simply get their information from drug companies once they leave medical school. The only knowledge they gain is skewed towards prescription drugs. In order to grasp new understanding and research, they have to go outside the disease/drug model and learn on their own.

DIM will help remove excess estrogen from the body. Excess estrogen can lead to elevated TGB which presents as hypothyroid even though TSH is normal. It is one of many therapies that may help.


heather bryant February 20, 2013 at 6:52 AM

i had a blood test for thyroids and they said that my thyroids r normal and full blood count but i am still always tired


Jennifer Lindsay December 2, 2010 at 8:38 AM

Thank you so much for posting this article. I love how it is written in plain english that everyone can understand. I was told that my thyroid was “normal” even though it was definitely NOT. It wasn’t until I found a doctor practicing integrative medicine that I was helped. So refreshing to hear!


West Conner December 2, 2010 at 11:32 PM

You’re welcome Jennifer. Thyroid can be pretty complex at times. There is more to it than simply prescribing a drug based on one hormone level.


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