Aa
Can you help me interpret?
I just had some blood tests done, anyone know how to interpret them at all?
I had my TSH tested 2 months ago, and it was 2.8, and 6 months before that was at 3.2
Thyroid Function
TSH 1.8 0.27-4.2 mU/L
T4 Free 14.1 10.5-20.0 pmol/L
T3 Free 4.2 3.5-6.5 pmol/L
Thyroperoxidase Ab 19 <35 IU/mL
Thyroglobulin Ab
Thyroglobulin Ab 14 <40 IU/mL
Thyroglobulin
Thyroglobulin 21.5 <60.0 ug/L
Thyroglobulin antibodies may cause
false reduction of this test result.
I had my TSH tested 2 months ago, and it was 2.8, and 6 months before that was at 3.2
Thyroid Function
TSH 1.8 0.27-4.2 mU/L
T4 Free 14.1 10.5-20.0 pmol/L
T3 Free 4.2 3.5-6.5 pmol/L
Thyroperoxidase Ab 19 <35 IU/mL
Thyroglobulin Ab
Thyroglobulin Ab 14 <40 IU/mL
Thyroglobulin
Thyroglobulin 21.5 <60.0 ug/L
Thyroglobulin antibodies may cause
false reduction of this test result.
COMMUNITY LEADER
I know you have a lot of money invested, but you don't really have to start completely over. You have these tests as "baseline", so if you can hang on a bit longer then retest FT3, FT4 and TSH to see if they've changed, you can go from there. You don't really have to do the antibody tests again, right away, but you should try to get a thyroid ultra sound to check for nodules, swelling and/or inflammation, as those, along with your low normal test results and symptoms, would be further basis for starting thyroid hormones.
Above all else, don't give up... I'm very sad to say, we've seen many others have to go through the very same thing.
Above all else, don't give up... I'm very sad to say, we've seen many others have to go through the very same thing.
Thanks. Yeah I will have to I guess :( I'm pretty disappointed. I will have to figure out where to go next. I have just already invested quite a bit of $ in all the consultations and tests with this one, so it is too bad that I'm going to have to start over...
COMMUNITY LEADER
I'm very sorry to hear that. I was hoping you wouldn't have to fight to get on med, but even naturopaths aren't predictable. Can you try a different doctor?
I wasn't able to get in to my NP for a few weeks, so I sent her an elaborate email about my results paired with my symptoms, and asked to talk with her further about going on a low dose NDT. I just got a phone message from the office simply saying : your results came back perfectly normal. I feel like crying.
COMMUNITY LEADER
I've been told that adult women should not eat less than 1200 calories/day. If you don't eat enough, that slows your metabolism even more, because your body is conserving stored fat. Not eating enough can contribute to your tiredness, as well.
I should note that the meds I changed/eliminated were not thyroid meds; one was a pain med for my peripheral neuropathy and the other was a blood pressure med.
It's important to know all the side effects of all the meds you take because they can cause side effects that mimic hypo symptoms, such as tiredness, weight gain, muscle aches/pains, etc. Even the "rare" side effects pop up now and then - I had one that my doctor thought was impossible, but when I stopped the med the symptom was relieved.
I should note that the meds I changed/eliminated were not thyroid meds; one was a pain med for my peripheral neuropathy and the other was a blood pressure med.
It's important to know all the side effects of all the meds you take because they can cause side effects that mimic hypo symptoms, such as tiredness, weight gain, muscle aches/pains, etc. Even the "rare" side effects pop up now and then - I had one that my doctor thought was impossible, but when I stopped the med the symptom was relieved.
Great! Thats promising at least. I have been working hard to lose weight, I eat less that 1200 cal a day, and try to excerise 3x a week. With being so tired it can be a real struggle sometimes though.
COMMUNITY LEADER
Most doctors will tell you that 5-10 lbs is the typical weight gain with hypothyroidism, however, I can vouch for that being totally incorrect... I gained about 30 lbs in less than 3 months just prior to being diagnosed.
Medication has to be properly adjusted in order to be able to lose weight successfully. I've been on thyroid medication since early 2008 and it's just been in the past year that I've been able to lose any weight at all and I've had to really work at it. The past few months, I've managed to lose 20 lbs, but part of that was due to changing one of my medications and eliminating another. I find that adding more fat to my diet helps more than most things because it fills me up and I don't eat as much overall. For me, exercise is also a key ingredient to losing weight.
Medication has to be properly adjusted in order to be able to lose weight successfully. I've been on thyroid medication since early 2008 and it's just been in the past year that I've been able to lose any weight at all and I've had to really work at it. The past few months, I've managed to lose 20 lbs, but part of that was due to changing one of my medications and eliminating another. I find that adding more fat to my diet helps more than most things because it fills me up and I don't eat as much overall. For me, exercise is also a key ingredient to losing weight.
Thanks. I don't have another appt booked with the naturopath yet, but hope to get in one day this week.
I will for sure let you know what she says.
I know that "they" say that only a small amount of weight gain is actually caused by thyroid disease. But I am curious if many people have had more success with loss once they are on meds. I feel like I hardly eat anything, and am on a restrictive diet already, and have lost a wopping 1 lbs in 2 months :/
I will for sure let you know what she says.
I know that "they" say that only a small amount of weight gain is actually caused by thyroid disease. But I am curious if many people have had more success with loss once they are on meds. I feel like I hardly eat anything, and am on a restrictive diet already, and have lost a wopping 1 lbs in 2 months :/
COMMUNITY LEADER
If your endo is controlling your med, based on TSH, he's not doing you any favors, because TSH reacts to many things, other than thyroid hormones and it doesn't correlate with symptoms at all.
You're right that T4 is different from Free T4... T4 is total T4 and tells both the bound and unbound portions of T4 in your blood. We aren't so concerned with the bound portion, because that's not available for us. We want to know the unbound or Free portion because that's what's available to be converted to the active hormone, Free T3. Free T3 is the hormone that correlates best with symptoms.
You're correct that many people have nodules large enough to notice when swallowing or moving the head from side to side. Often they can be felt when palpating the thyroid. Many of us also have nodules that are too small to see when looking in the mirror or when palpating the thyroid. I have multiple nodules on my thyroid, but they're all small and could never be felt upon palpation - only via ultrasound. Nodules are very common with Hashimoto's, which is what it sounds like you have, like many of us on the forum.
You're right that T4 is different from Free T4... T4 is total T4 and tells both the bound and unbound portions of T4 in your blood. We aren't so concerned with the bound portion, because that's not available for us. We want to know the unbound or Free portion because that's what's available to be converted to the active hormone, Free T3. Free T3 is the hormone that correlates best with symptoms.
You're correct that many people have nodules large enough to notice when swallowing or moving the head from side to side. Often they can be felt when palpating the thyroid. Many of us also have nodules that are too small to see when looking in the mirror or when palpating the thyroid. I have multiple nodules on my thyroid, but they're all small and could never be felt upon palpation - only via ultrasound. Nodules are very common with Hashimoto's, which is what it sounds like you have, like many of us on the forum.
I can only go by the little I know about my experience. My levels would go up and down a lot! I also have an enlarged thyroid with nodules, found on an ultra sound. My thyroid is failing, I am currently on meds to keep my THS level between 1.0-.3, this is what my Endocrinologist wants. My T4 is 1.7, which I think is different than free T4. My level is slightly above normal. The biggest factor is how you feel and how that is impacting your day to day life. Make sure you let your doctor know that too. By the way, I found my nodule...watch your throat when you swallow. I could see the lump.
COMMUNITY LEADER
I can't say what your doctor will do. Naturopaths are, typically, more willing to start patients on thyroid medications, based on symptoms, even if labs are within normal ranges, than regular medical doctors are, due to guidelines set forth by your NHS. They tend to go mostly by TSH and yours is pristine, so that might be an issue. You might have to fight a little bit, but don't give up.
If I were you, I'd try to stay as much with the Naturopath as possible, but I think you do need to get an ultrasound on your thyroid to determine if you have nodules and/or swelling/inflammation that would indicate Hashimoto's. You should also get both antibodies tested again in a few months, in case they just haven't ramped up yet. It doesn't really matter if you have Hashimoto's or not - treatment won't change because hypo is hypo and you'll need replacement med, but it's nice to know because Hashi's is progressive so your meds have to be adjusted to keep up with thyroid destruction.
It's typical to start out on a T4 medication, but the Naturopath might be willing to start you on a desiccated med such as ERFA, the Canadian version of Armour, which is a T4/T3 combo.
When do you see your doctor again?
If I were you, I'd try to stay as much with the Naturopath as possible, but I think you do need to get an ultrasound on your thyroid to determine if you have nodules and/or swelling/inflammation that would indicate Hashimoto's. You should also get both antibodies tested again in a few months, in case they just haven't ramped up yet. It doesn't really matter if you have Hashimoto's or not - treatment won't change because hypo is hypo and you'll need replacement med, but it's nice to know because Hashi's is progressive so your meds have to be adjusted to keep up with thyroid destruction.
It's typical to start out on a T4 medication, but the Naturopath might be willing to start you on a desiccated med such as ERFA, the Canadian version of Armour, which is a T4/T3 combo.
When do you see your doctor again?
Ok great thanks :)
So will the doctor tell me that my levels are within the "normal" range? Am I going to have to fight to get meds, or do you think my levels show enough that I won't have to fight too hard?
So will the doctor tell me that my levels are within the "normal" range? Am I going to have to fight to get meds, or do you think my levels show enough that I won't have to fight too hard?
COMMUNITY LEADER
If you weren't diagnosed with PA, you won't be. Your tiredness is most likely from low iron and from being hypo, though there are other things that can cause it, too.
There's some controversy over the exact level ferritin should be to be optimal, but most sites agree that optimal is around 70.
Getting started on thyroid hormone replacement will help also.
There's some controversy over the exact level ferritin should be to be optimal, but most sites agree that optimal is around 70.
Getting started on thyroid hormone replacement will help also.
Thank you so much for taking the time to reply.
I don't currently have pernicious anemia, I have had low levels in the past, but not recently. My NP doctor suggested I try them to help with my energy levels. I noticed a slight improvement at first, but nothing recently.
I was also thinking I should be on an iron supplement, but the NP said my levels were fine. They are the highest I have ever tested, but thats after not having a menstrual cycle for 3yrs (Mirena).
I will definitely be following up with both a medical doctor as well as my naturopath, but I want to be sure that I go in "armed" with all the info I can get!
I don't currently have pernicious anemia, I have had low levels in the past, but not recently. My NP doctor suggested I try them to help with my energy levels. I noticed a slight improvement at first, but nothing recently.
I was also thinking I should be on an iron supplement, but the NP said my levels were fine. They are the highest I have ever tested, but thats after not having a menstrual cycle for 3yrs (Mirena).
I will definitely be following up with both a medical doctor as well as my naturopath, but I want to be sure that I go in "armed" with all the info I can get!
COMMUNITY LEADER
Both of your antibody tests are below the reference ranges, which indicates that you do not have an autoimmune disorder, however, some people have been diagnosed with Hashimoto's on the basis of an ultrasound, depending on the characteristics of the thyroid gland and whether or not there are nodules present, which are very typical with Hashimoto's. FNA has also be used to diagnose Hashimoto's. Hashimoto's is the most common cause of hypothyroidism in the developed world and many doctors simply "assume" that anyone who is hypo, has it, even without elevated antibodies.
I agree that your labs and symptoms indicate you are hypo and could use some thyroid replacement. Your FT4 is only at 38% of its range and your FT3 is at 23% of its range.
I see you're already taking weekly vitamin B-12 shots; do you know if you have Pernicious Anemia? That's another autoimmune disorder and when we have one autoimmune the chances of getting another are greater. Low levels of TPOab and TgAb, which are the antibody tests you had done are often seen in other autoimmune disorders. I have, both, Pernicious Anemia and Hashimoto's.
Vitamin B-12 deficiency also causes horrible fatigue and tiredness, so even though you're on weekly shots, that, too, could contribute to your tiredness.
Since you had your iron level tested 2 months ago and it was 50, which is lower than recommended, are you supplementing? Iron is necessary for the conversion of Free T4 to the active Free T3, plus low iron reserves contribute to tiredness and fatigue, as well as hair loss.
Some of our Canadian members have a harder time getting adequate testing/treatment due to NHS guidelines, as do our U.K. members.
I agree that your labs and symptoms indicate you are hypo and could use some thyroid replacement. Your FT4 is only at 38% of its range and your FT3 is at 23% of its range.
I see you're already taking weekly vitamin B-12 shots; do you know if you have Pernicious Anemia? That's another autoimmune disorder and when we have one autoimmune the chances of getting another are greater. Low levels of TPOab and TgAb, which are the antibody tests you had done are often seen in other autoimmune disorders. I have, both, Pernicious Anemia and Hashimoto's.
Vitamin B-12 deficiency also causes horrible fatigue and tiredness, so even though you're on weekly shots, that, too, could contribute to your tiredness.
Since you had your iron level tested 2 months ago and it was 50, which is lower than recommended, are you supplementing? Iron is necessary for the conversion of Free T4 to the active Free T3, plus low iron reserves contribute to tiredness and fatigue, as well as hair loss.
Some of our Canadian members have a harder time getting adequate testing/treatment due to NHS guidelines, as do our U.K. members.
Great, I will discuss with a doctor for sure, thanks. Unfortunately I live in Canada where family doctors are at a serious shortage, so sometimes clinics aren't as helpful, which is why I have been going to the naturopath.
Do you (or anyone else), know anything about those antibodies??
Do you (or anyone else), know anything about those antibodies??
I think you need to talk to your doctor about a prescription for thyroid medication. You need a source of T3, wich you could get from an NDT type of thyroid med like Armour Thyroid or Naturethroid, which contains both T4 and T3. The alternative could be to try taking some T3 med like Cytomel, or a generic, to raise your Free T3 level toward the upper part of its range, or as necessary to relieve symptoms. You also need to get tested for B12, Vitamin D, ferritin and selenium to see where supplementation is required. It is important for these levels to be optimal, along with raising your Free T3 level.
I am currently getting B12 shots, once a week, and my ferritin was 38 and 50 the last two times I had it tested, the last was 2 months ago.
Thanks for the info on the T3 and T4, what about the antibodies? I thought I read that any anitibodies were an indication of some type of autoimmune disorder?
Thanks for the info on the T3 and T4, what about the antibodies? I thought I read that any anitibodies were an indication of some type of autoimmune disorder?
With those symptoms in mind, and your lab results, I'd say that your Free T4 is a bit low. More importantly your Free T3 is only at 23 % of its range. Members say that symptom relief required Free T4 at the middle of its range at minimum and Free T3 in the upper part of its range, as necessary to relieve symptoms. Free T3 largely regulates metabolism and many other body functions. Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.
Since hypo patients are also frequently too low in the ranges for Vitamin d and B12 those should be tested. Also since your FT4 and FT3 results indicate less than desired conversion of the T4 to T3, I also suggest tests for ferritin and selenium, both of which aid in that conversion. If you will get those done and post results and reference ranges, we can help interpret and advise further.
Since hypo patients are also frequently too low in the ranges for Vitamin d and B12 those should be tested. Also since your FT4 and FT3 results indicate less than desired conversion of the T4 to T3, I also suggest tests for ferritin and selenium, both of which aid in that conversion. If you will get those done and post results and reference ranges, we can help interpret and advise further.
Thanks for the reply gimel
I feel like I have a lot of thyroid symptoms-
hair was falling out, has slowed a bit now, fatigue, unexplained weight gain, anxiety, trouble sleeping, difficultly concentrating or remembering important things at work...
I have been seeing a naturopath for a few months and have been off of gluten,and been on a lower cal diet, but haven't noticed a change.
I feel like I have a lot of thyroid symptoms-
hair was falling out, has slowed a bit now, fatigue, unexplained weight gain, anxiety, trouble sleeping, difficultly concentrating or remembering important things at work...
I have been seeing a naturopath for a few months and have been off of gluten,and been on a lower cal diet, but haven't noticed a change.
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