plshelpmyfatique, It is wonderful that you have found a very engaged and caring rheumatologist! I hope he can expedite your sleep study to find out about narcolepsy or other sleep issues. You mentioned acne and weight gain, which rang a bell. Have you been evaluated for Polycystic Ovarian Syndrome (POS)? It is an endocrine disorder that can cause weight gain, acne, hirsutism (excess hair), menstrual issues, and a whole host of other symptoms. I was diagnosed at age 19, and was told to lose 5-10 pounds to "control" the POS symptoms. With the help of a high fiber and hypoglycemic diet--I lost the weight and the excess hair on my fingers, toes, back and stomach; my acne gradually disappeared. However, I continued to have terrible "hormonal" migraines cyclically, and after many years, they began occurring daily.

Seeking help for the daily headaches, I was eventually diagnosed with hashimotos thyroiditis with Hypothyroidism by an endocrinologist (can also cause symptoms such as weight gain. tiredness, dry skin, depression and possibly other symptoms, if untreated). My gynecologist and internist had noted before this diagnosis, that my TSH was slightly elevated, but did not feel the need to treat it. I paid out of pocket to see the endocrinologist who did the Antigen tests (both lab results were extremely HIGH). He immediately prescribed Synthroid, and worked closely with me for months to titrate to an effective dose. My "chronic" headaches became less intense and less frequent. My tiredness resolved, and the awful "fluid retention" and carpal tunnel syndrome resolved. I don't recall if the T3 and T4 tests were done by my "regular" MDs prior to seeing the Endo.

About your "normal" TSH, T3, T4: I don't know anything about the "reverse T3" test. I'm guessing your MD's as of yet, have not felt it necessary to test for Thyroid Antigens (which are tests for autoimmune thyroiditis, which CAN look similar to hypothyroidism even if TSH is normal). I hope this Rheumatologist will consider sending you for a consultation with an Endocrinologist who can investigate not only thyroid function, but also functioning of the pituitary gland and other endocrine systems. Hoping your health will soon be improving by leaps and bounds!