This Is MS Multiple Sclerosis Knowledge & Support Community

Hello. I am a 45-yo woman. I have been suffering from a variety of what are to me bizarre symptoms and until yesterday never thought about the possibility of having MS. I am planning to get a referral to a neurologist but wonder if there is any advice before I pursue testing for this disease. Here's my story: Please forgive the length.

For the last approximately six months (some symptoms longer), I have had unusal symptoms, some of which include: Sharp pain under both ribs (began only on the left), always in the same place; seeming inability to digest and absorb nutrients from food; BMs unformed, sinking en masse; at a.m doctor appointments, hyperactive bowel sounds; at afternoon visits, almost no active bowel sounds; weight loss; some loss of strength in left leg and left arm; shrinkage of the muscles in left arm compared to the right above the biceps and in a band around the arm; severe urinary frequency, which is getting worse; diminished vision, getting worse (with pain behind my left eye a few days ago that is better now); a band of pain seemingly on the skin but sometimes deeper from under left breast around to my back that is electrical in quality; heart palpitations (had EKG, diagnosed as benign premature atrial contractions); headaches; severe pain in left jaw that includes teeth (a dental visit showed no problems with my teeth); jaw tightness and tension; what feels like muscle spasms down the left side of my neck sometimes interfering with swallowing; pressure in my head with popping ears; intermittent inability to take a deep breath; shaking of left leg when taxed (yoga); mid back pain at end of day when fatigued; tightness along the sides of my abdominal muscles; depression; anxiety. These are the most bothersome symptoms, although there are others.

History: I grew up in Illinois, moved to Florida for 13 years as an adult and now live in the southern plains for the past 7 years. I have a medical history that includes (in adulthood) EBV and endometriosis that required hysterectomy at age 34. I've had one child, have been married to same wonderful man for over 26 years.

When these symptoms became bothersome, of course I went to my family doctor. I had a blood test, was diagnosed with H. pylori because of the GI issues. After a brutal 14-day course of antibiotics 4 times a day along with Bepto Bismol and Prevacid, I did feel better. After course finished, stool sample was negative for H. pylori. The pain was less but my general weakness, malaise, weight loss continued. Then the symtpoms began to return within about a month or two. I began to do my own research and thought I might have a yeast overgrowth and am on day 10 of a 14-day Candida cleanse. Some energy has returned but still weak and with pain and other symptoms. We have had a long, hot, dry summer here. Summer came early--starting really in about February or March with high temperatures, and that is when most of the symptoms started to be very bothersome.

Like I said, I am 45, about 5'6, weight 130 pounds. When I have the energy, I work out 6 days a week and have been an active person for most of my life. I eat right--lots of fruits and vegetables, rare chicken, fish, turkey, no other meat; I have cut gluten and dairy from my diet in an attempt to alleviate GI symptoms (which didn't really help). I do not consume alcohol or caffeine. I do, however, smoke. I recently quit for 3 months but stress from illness unfortunately made quitting so difficult at this time. I am planning to quit. I've always been a generally healthy person.

As I'm sure you can appreciate, when I began to tie my symptoms to MS, it was frightening. Since this is Labor Day weekend, I cannot contact my doctor until tomorrow and not sure how long I will have to wait for appointment. I am hoping for some replies from this forum. This sounds very much like it could be MS, doesn't it? Any advice on how to proceed, any similar symptoms to share or explanation for some of the symptoms? I would certainly appreciate any support and response.

Thank you!!

Addendum to my first post--forgot to mention also intermittent severe vertigo with room spinning and also left leg very restless, constantly jiggling. Also, in my history, I was in a car accident in 2008 or 2009 where I rolled my Chevy Blazer 3-4 times but after a concussion, didn't seem to have further problems. My eyes are pretty bad today, with pain behind them and difficulty focusing on computer screen. Being a holiday, I cannot get a hold of my family doctor until tomorrow and when I tried to call my eye doctor, his office has closed permanently! Any response to my post would be so appreciated.

Welcome to ThisIsMS, greenspark. I offer you my advice, as you sought in your first paragraph, my standard action plan recommendation:

First, you may not have MS at all; with the symptoms you described, there is always the possibility that it may be MS; it is a differential diagnosis – made by ruling out other possibilities, as you may know. Very often, it is not easy or quick to diagnose My first three MRIs, EMG, and evoked response tests were normal, and it was the fourth neurologist I saw before I got my MS diagnosis. IF you do have MS, you have found many supportive friends at this site. We come from diverse experiences and hold diverse ideas. We do not agree necessarily in our thoughts on MS; you will probably not agree with some of us either; we only ask for tolerance when we express unconventional ideas (as mine are).

Second, if your family doctor, a GP or internist, is someone with whom you are comfortable, who is compassionate and who enjoys being a "disease detective," work with him. I am not sure that a specialist, a neurologist, is necessary right at the beginning of your investigation. A GP can order the tests necessary to rule out some possibilities. You have compiled a great list of your symptoms; hand a copy to your physician for discussion and start at the beginning with a thorough physical, baseline examination including blood tests for your cortisol level (elevated with stress), glucose AND insulin levels (these are two DIFFERENT tests), thyroid hormone levels (TSH, Free T4, Free T3, Reserve T3, and antithyroid antibodies), even a liver profile, and CRP (C-reactive protein) test (indicating inflammation). Ask for a copy of all your test results for your own file. Since I suspect insulin involvement and insulin resistance in skeletal muscles, this could play into your muscle weakness, restless leg, "jiggling," or spasms. (By the way, the optimal result for a fasting blood insulin test is 3 UU/ML or lower.)

Third, if you like to read and if you do have MS, start your reading with two books: "Multiple Sclerosis: The History of a Disease" by T. Jock Murray, OC, MD, and I think "The Multiple Sclerosis Diet Book" by Roy Swank, MD, PhD and Barbara Dugan is a good second book to read or even have. You may be able to get these through your local library.

Fourth, you know the smoking has to go! And I encourage you to continue to eat a healthy diet. In my opinion, this means a low-carb diet -- removing all sugar (including beer, wine, etc. which have sugar – you are good here), all artificial sweeteners, including sugar alcohols like sorbitol, xylitol, etc. (These promote insulin production, too.), all trans fats (These also increase insulin.), and white flour, white bread, white potatoes, white rice (in fact, all carbs so far as possible) from your diet. My personal belief is that excess insulin plays a great part in MS. I suspect that Fatty Liver Disease is also involved for some, since visceral fat (belly fat) secretes cytokines (like poison to the internal organs), which lead to increased insulin, which leads to inflammation which leads to more visceral fat… And the cycle goes round and round. Even though your weight is ideal for your height, it is still possible to have internal fat around the organs; Dr. Mark Hyman has referred to this as being "skinny fat." You may find the account of Dr. Terry Wahls and her dramatic improvement interesting (http://www.TerryWahls.com).

By the way, I identified with your history: I also grew up in Illinois; I had one child; I had endometriosis which ultimately led to a hysterectomy. My husband is wonderful!

We are glad you found us.
All the best to you.

Lyndacarol, what can I say but thank you, thank you from my heart for replying to me and providing so much helpful and insightful information. I am like minded in diet issues--I agree with every diet thing you mentioned and have followed a similar type of diet pretty strictly for years.

I am a reader; I will find and read everything you suggested. I hope to be able to get all the tests you recommended, too. My doctor is not the best at listening to her patients, likes to do things her own way, but I can try or I can look for another doctor.

It's interesting that our histories are so similar. I'm glad you have a great husband, too.

Again, thank you. I appreciate you very much.

hi and welcome to the forum

ms patients have a known constellation of nutritional issues that are often ignored in the mainstream, and similarly are often addressed in complementary therapy. there are a variety of dietary and supplement approaches.

what i'm wondering is, if your exercise has had the potential to result in nutrient depletion, and whether your diet, although consisting of health whole foods, has any nutritional gaps that could lead to your symptoms.

symptom factors, re muscles, pain, and mood:

muscle and bone pain usually make me suspect magnesium and vitamin d3 first. you can connect both of these with mood, also. magnesium is important for energy also. it's pretty standard for everyone to have suboptimal d3 whether they have ms or not. it just manifests differently in different people. magnesium is readily lost via physical exertion and stress. given some of the background you describe sounds like there's a possible connection:

-Sharp pain under both ribs (began only on the left), always in the same place;
-a band of pain seemingly on the skin but sometimes deeper from under left breast around to my back that is electrical in quality;
-heart palpitations (had EKG, diagnosed as benign premature atrial contractions);
-headaches;
-severe pain in left jaw that includes teeth (a dental visit showed no problems with my teeth);
-jaw tightness and tension;
-what feels like muscle spasms down the left side of my neck sometimes interfering with swallowing;
-intermittent inability to take a deep breath;
-shaking of left leg when taxed (yoga);
-mid back pain at end of day when fatigued;
-tightness along the sides of my abdominal muscles;
-left leg very restless, constantly jiggling.
-depression;
-anxiety.

(consider b-complex for anxiety/depression too...)
symptom factors re GI/immune etc:

as for the GI, immune system, vision and infection issues, i'd look hard at zinc status. smoking and the associated cadmium toxicity has a big impact on ability to absorb zinc. (the body has trouble distinguishing the toxic cadmium from zinc, so cadmium can lock into and tie up your zinc receptors). childbearing places a huge demand on your body's zinc stores also. possibly related symptoms:

-the fact that seeming inability to digest and absorb nutrients from food;
-BMs unformed, sinking en masse;
-at a.m doctor appointments, hyperactive bowel sounds; at afternoon visits, almost no active bowel sounds;
-weight loss;
-severe urinary frequency, which is getting worse; (possible infection?)
-diminished vision, getting worse (with pain behind my left eye a few days ago that is better now);
-vertigo
-infections: EBV, H. pylori, possible candida
-Some energy has returned but still weak and with pain and other symptoms.

nutrient depletion factors:

-When I have the energy, I work out 6 days a week and have been an active person for most of my life.
-smoking

dietary factors:

-I eat right--lots of fruits and vegetables, rare chicken, fish, turkey, no other meat;
-I have cut gluten and dairy from my diet in an attempt to alleviate GI symptoms (which didn't really help).
-I do not consume alcohol or caffeine.

some of the best food sources of zinc are things like venison, beef, lamb and scallops. excellent sources of magnesium include spinach, and swiss chard. vitamin d3 doesn't tend to be adequately achieved through diet. unless you like cod liver oil, that is curious what sort of fish is typically on the menu, and how often, and also about nuts and seeds, eg good vit e sources like sunflower seeds and almonds? and lastly, whether you're balancing your omega 3 to omega 6 fatty acid ratio?

treatment factors:

14-day course of antibiotics 4 times a day .... The pain was less but my general weakness, malaise, weight loss continued.

question: did you take probiotics as well, to repopulate your beneficial gut flora?

thought I might have a yeast overgrowth and am on day 10 of a 14-day Candida cleanse.

question: what is the regimen for the candida cleanse?

possible next steps to consider:
serum zinc test, serum magnesium test. of course they'll likely come back 'normal', but the normal range includes both sick and healthy people. if your levels are poor, you can fix them up and see if anything on your symptom list improves.

that's all for now

Hi, jimmylegs. First of all, thank you for your in-depth response. You raise some compelling questions and I would appreciate more feedback as I answer them. I don't know how to do quotes as you did in your post, but I can find out how for the future. Right now, I can go point by point and answer the questions you posed.

First, my exercise: When I am strong enough, I usually work out 6 days a week, rotating or interspersing cardio, strength training and yoga. When I am feeling well, these workouts tend to make me feel better, stronger, not like I'm being depleted. I aim for 30-90 minutes daily, usually about 45. It may sound excessive, but keeping this regimen is when I feel the best.

My diet: I agree that there may be nutritional gaps, as I was a very strict vegan for awhile some time back. Normally, when not on the Candida cleanse (more about that below), my diet consists of plenty of fruits and vegetables, especially organic apples, citrus, bananas, melon, berries; broccoil, carrots, red potatoes, red and yellow onions, raw spinach, romaine, squash (yellow and zucchini), cucumbers and more.
Meats: Primarily just chicken, turkey, tuna and wild salmon (a lot of this lately, but don't like the idea of murcery), eggs lately.
No dairy. I try to get a little sun exposure every day for vitamin D production.
Nuts and seeds: Lots of walnuts, almonds, sometimes pistachios (sp?), sunflower seeds.
Beans and lentils.
Grains: No wheat lately, but eat brown rice, oats and am looking into buckwheat.
Oils: Extra-virgin olive oil, coconut oil and sunflower oil (looking into flax seed oil).
Honey for sweetener, never any sugar or sugar substitutes. No processed foods, pretty much ever. Vegetables and fruits raw when possible, organic when possible. I drink only water--6-8 large glasses a day.
Daily, I take a whole food supplement (although the label recommends 5 a day, I take only 1 a day) but it seems quite comprehensive (even excessive in some things, which is why I choose to only take 1). Also, daily, I consume a tsp. of raw garlic, 1 T organic cold-pressed coconut oil (helps wash down the large whole food supplement).

I did take probiotics along with the antibiotic course.

In looking at the whole food supplement label, though, I am seeing that by taking only 1 daily, the D3 value is only 80 IU (20% recommended daily value) and magnesium is only 50 mg (10% recommended). That's interesting. For zinc, I am getting 6 mg (40% recommended). So very possibly deficient in these things.

Candida cleanse includes the following along with a diet that does not include sugar, wheat, yeast-containing foods or fruits except grapefruit. I am on day 11 of 14 and will be glad to be done with it. Brand name Candida Clear by Nature's Sunshine. Contains Pau d' Arco (Brazilian Taheebo bark) 1000 mg 3 times a day; caprylic acid 600 mg 3 times a day as well as elecampane root, black walnut hulls, red raspberry leaves (totaling 200 mg) 3 times a day; yeast/antifunfal detox includes zinc 10 mg 3 times a day, selenium 20 mcg; cleanse enzymes include biotin 300 mcg 3 times a day, amylase, protease, bromelain, glucoamylase.
I take 2 probiotics daily with this as well (Probiotic Eleven-Nature's Sunshine).

You gave me a lot to think about. I have a call in to my doctor but not sure how soon she can see me. I'll find out today when I can get an appointment scheduled for complete physical and blood work. It would be a WONDERFUL thing if I could correct a lot of my problems by making sure I'm getting enough nutrients! Thanks so much for your feedback.

hi again

you just set off my nutrient depletion air horn alarm with

I was a very strict vegan for awhile some time back

... ditto. i am here today due to my time as a vegan, progressing to a 'whole food' vegan (BIG MISTAKE) with multiple deficiencies as a result. can you define 'awhile'?

there's not a doubt that exercise is beneficial and makes people feel better, but the underlying depletion problems are important. you have some time where you use up tissue stores nutrients, and when they get low enough, the wheels start to come off.

thanks for the detail on the diet! might be wise to look in detail at things like O3/O6 balance, pro- vs anti-inflammatory balance, cooked/raw balance (sometimes cooking can mitigate some of the anti-nutrient factors in certain foods like spinach/beans/lentils).

as for vit D, anyone living away from the equator can't rely on the sun to deliver enough energy to the skin to start converting 7-dehydrocholesterol to cholecalciferol in the skin. for example from research i know that i can only rely on sun to be strong enough between approximately april and october. and that's if it's not cloudy or hazy. doesn't sound like you're getting enough taking only one of the whole food supplement pills. salmon is a good source, tuna not so much. i rarely consume tuna but try to eat wild salmon once a week, with other white or pink fish in between. good to see those nuts and seeds, and very good to see you're considering flax (see if you can work in not just the oil (fabulous omega 3 ..although short-chain which your body then needs to convert to the long chain type found in fish, eggs and such)

what's excessive in the whole food supplement, by the way? and that's great re the probiotics

as for zinc. i strongly feel that the daily recommended amounts are WAY too low for the standard eater. your current diet is looking pretty good for keeping zinc depletion to a minimum, you'll just have to focus in on the phytates, exertion, and smoking.

on to the candida cleanse - the diet sounds like decent starvation measures, but if you can get into balance you shouldn't need to write things off 100%. i'm right into plant medicines academically, but i consider them first aid - not so much a fix for the underlying imbalances that create the conditions supporting bacterial, viral or fungal overgrowth. i remember trying olive leaf extract for the first time in australia, the reaction in my gut certainly seemed like something major was happening, but there was never anything so dramatic after that, so olive leaf extract didn't last in the regimen. same with things like oil of oregano. i don't need them any more because my antibacterial/antiviral/antifungal nutrition is up to a level that prevents overgrowth. finally :S what i use plants for nowadays are mostly just teaching.. eg crushed yarrow leaves to stop bleeding (have used it on myself and others here and there), jewelweed juice in case i touch poison ivy (definitely has saved myself and my co-workers on more than one occasion), or have an itchy mosquito bite (non-issue this year; it's so dry here!)

i like the 30mg zinc and the 60 mcg selenium in your detox product. you could even stand to get more! what forms are each of those (the zinc and selenium)? i take up to 50mg zinc citrate daily and 200mcg selenomethionine.

anyway. it would be great if you can get buy-in for a serum zinc test, and a serum magnesium test. vitamin d3 as a bonus would be awesome, but your ability to use vit d3 depends on both zinc and magnesium status, so they're more fundamental imho. if you want to read more about testing, labs, and desired results, there's some introductory info in the first post of my 'regimen' thread on ms nutrition.

you're welcome re feedback, and good luck with your appointment

Jimmylegs, just have a moment to reply, so I'll post this for now. What do you think of these amounts? Excessive values?

This is my whole-food supplement label.

*ETA* Yikes!! Sorry about the size!!!

wow that's a lot of stuff! not keen on some of those forms. or where info on the forms is absent. other than that, no i don't think the full daily amount is excessive, except for the fact that i can't see the breakdown of retinol and beta carotene for the vitamin A. i think recommended daily values are often woefully underestimated, so the %DV can look scary when it's in fact appropriate.

here's mine: http://www.aor.ca/html/products.php?id=96

you're supposed to take 6 per day of this product, but i am working up to it while using up some of my older stuff. right now i'm on a two day rotation, ie day 1 i take 4 plus a couple other things, day 2 i take 2 plus a few more other things. for example, until now i was buying a separate e8 complex b/c my multi only used alpha tocopherol for vit E. also, until now i was buying a separate b-complex so that i could have one that used methylcobalamin for b12. now i won't have to do separate b-complex any more.

Greenspark-You seem to have an EXCELLENT eating plan!

Here is a little more reading for you on the fasting blood insulin test:

http://www.mercola.com/nutritionplan/index2.htm

Factor # 1 : Your Insulin Level
Insulin is absolutely essential to staying alive, but the sad fact is that most of you reading this have too much floating around, and it is pushing you towards chronic degenerative illness and increasing the rate at which you age.
Most adults have about one gallon of blood in their bodies and are quite surprised to learn that in that gallon, there is only one teaspoon of sugar! You only need one teaspoon of sugar at all times -- if that. If your blood sugar level were to rise to one tablespoon of sugar you would quickly go into a hyperglycemic coma and die.
Your body works very hard to prevent this by producing insulin to keep your blood sugar at the appropriate level. Any meal or snack high in grain and sugar carbohydrates typically generates a rapid rise in blood glucose. To compensate for this your pancreas secretes insulin into your bloodstream, which lowers your blood sugar to keep you from dying.
However, if you consume a diet consistently high in sugar and grains, over time your body becomes "sensitized" to insulin and requires more and more of it to get the job done. Eventually, you become insulin resistant, and then diabetic.
If you have high cholesterol, high blood pressure, type 2 diabetes, or are overweight, it is highly likely that you are eating too many grains -- yes, even unrefined whole grains -- as this is the most common culprit causing your insulin level to become abnormal.
Compounding the problem, when your insulin levels rise due to an excess of carbohydrates, they send your body a hormonal message telling it to store fat while holding on to the fat that is already there. So not only will excess carbohydrates make you overweight, they will effectively hamper your weight loss efforts too.
Your Fasting Blood Insulin Test
To find out your insulin levels, you need to get tested by your doctor. The test you need to ask for is a fasting blood insulin test, The test is done by just about every commercial laboratory and is relatively inexpensive.
Facts about Your Fasting Insulin Test:

• This test is profoundly useful. It's one of the least expensive tests in traditional medicine, yet it is one of the most powerful. A normal fasting blood insulin level is below 5, but ideally you'll want to be below 3.
• You can safely ignore the reference ranges from the lab as they are based on "normals" of a population that has highly-disturbed insulin levels.
• This is a great test to do BEFORE you start your program as you can use it to assess how well you are progressing in the program.
• If your level is above 5 you will want to consider significantly reducing most sugars and grains, even whole wheat grains, until you lower your level. Once you've normalized your insulin level you can reintroduce grains into your diet at a lower level to optimize your health.
• Exercise is of enormous benefit in improving the sensitivity of your insulin receptors, and help normalize your insulin level far more quickly.

I haven't been on the forum for awhile--I've been too sick. I lost approximately 85% of my vision a few days ago. Most has returned but vision still not normal. I have been insanely thirsty and urinating so much I can't believe it. My glucose, however, through this time ranged from 99-106. Possible diabetes insipidus. I have been to the doctor and right now can't even remember what all blood work they are doing. They are also retesting for H. pylori, though this seems a moot point right now. Most of the results are not back yet, but kidney function checked out okay preliminarily, I'm told. The only aberration in the blood work so far is an elevated sodium level, which is very strange because I don't eat salty foods and almost never add salt to any foods. I have had periods of intense muscle cramping followed by periods of muscle weakness and shaking. The cramping is better now but the weakness and shakiness remain. I have also had INTENSE anxiety. Since I am so rural, the only ophthalmologist I could find is a two-hour drive from me. I have an appointment tomorrow morning with him. It was the soonest (believe it or not) that I could get in. Obviously, I've been trying to get an appointment since my vision started to fail.

Wondering if you have any thoughts on the craziness that has become my life.

Thank you so much.

wowwww NO FUN! sorry to hear about all this will see what i can dig up. if you can test serum potassium (to get a sense of the sodium-potassium ratio) as well as zinc and magnesium tested, that would be good.

now this study is just looking at zinc in a rat model of diabetes, but it says that zinc supplementation helped with the polydipsia (excessive thirst):

Effect of zinc supplementation on type 2 diabetes parameters and liver metallothionein expressions in Wistar rats.
http://www.ncbi.nlm.nih.gov/pubmed/22585619
Zinc is a trace metal and acts as an active component of various enzymes. Zinc deficiency has been suggested to be associated with the development of diabetes. The present study investigated the role of zinc supplementation on prevention of diabetic conditions. A double-disease model mimicking hyperlipidemia and type 2 diabetes was created by applying high-fat diet and streptozotocin (STZ) to Wistar rats. We demonstrated that zinc supplementation improved symptoms of diabetes such as polydipsia and increased serum level of high-density lipoprotein cholesterol, indicating that zinc supplementation has a potential beneficial effect on diabetic conditions.

Just got copy of lab results. Any help on interpretation of "in normal range" appreciated. Some, however, not within normal range.

Positive H. pylori (by stool sample).

Magnesium--2.0 (normal 1.5-2.5)
Free T4--1.5 (0.8-1.8)
TSH --4.63, high (0.4-4.5)
Vitamin D, 25-OH--31 (normal 30-100)
Vitamin D, 25-OH, D3--31
Vitamin D, 25-OH, D2--<4
Vitamin B12--923 (normal 200-1100)
Folate, serum--17.1

NA--144.2, considered high normal (normal 136-145)
K--3.83 (normal 3.5-5.10)
CL--109.2, high (normal 98-107) This has me concerned--what causes this?
CO2--24.4 (23-29)
CA--9.6 (8.5-10.5)

ALT--27 (7-35)
AST--21 (5-34)
ALP--66 (35-123)
GLU--87 (70-105)
BUN--18, high normal (7-18) poor kidney function?

TBILI 0.6 (0-1)
TP--7.1 (6.4-8.3)
ALB--4.6 (3.5-5).
CREAT--0.94 (0.6-1.2)
BUN_CR 19.15

AG 1.84

WBC--6.5 (4.5-10.5)
LY--39.4 (20.5-51.1)
MO--4.6 (1.7-9.3)
GR--56 (42.2-75.2)
LY#--2.6 (1.2-3.4)
MO#--0.3 (0.1-0.6
GR#--3.6 (1.4-6.5)

RBC 4.15 (4-6)
Hgb 13.8 (11-18)
Hct 3902 (35-60)
MCV 94.5 (80-99.9)
MCH 33.2, high (27-31)
MCHC 35.1 (33-37)
RDW 11.7 (11.6-13.7)
Plt 238 (150-450
MPV 9 (7.8-11)

Some of these I know what they are about, some not. Please comment on highs--Na, Cl, TSH, BUN, MCH.

Thanks so much for any input.

Greenspark – In answer to your question about TSH… TSH is Thyroid Stimulating Hormone. If the thyroid gland is not functioning properly, is not producing the proper amount of hormones, is not managing metabolism properly, a gland in the brain sends out more TSH in an effort to "whip" the thyroid into shape.

To get the whole picture of the thyroid gland function is important to measure TSH and free T4, but also important to measure free T3, reverse T3, and antithyroid antibodies. If your GP is not comfortable in this area, perhaps a referral to an endocrinologist is in order. You might be able to convince an endocrinologist to do a fasting blood insulin test (Your fasting glucose can be normal, at 87, at the same time that your insulin level is elevated.).

i wrote you a massive response hours ago but didn't save properly before hitting 'submit'! came back to the computer and there it was gone. anyway, the web site labtestsonline is really useful when it comes to interpreting results. more info next time - sorry! short answer re high TSH and normal T4 - possibly subclinical hypothyroidism. bbl!