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Could you help look at my labs (Thyroiditis)
My Doctor has sent me for a ultrasound on my Thyroid and after she got the results she said she thinks I have Hashimoto's Disease. She sent me for lots of labs . Do the results look like it could be Hashimoto? I do have a lot of symptoms hair loss weight gain VERY tired .
vitamin D 14.7
TSH 3.3
T4 10.2
Phosphorus serum 5.2
T3 uptake 24%
TPO 8
Thyroglobulin Antibody 3.3
Triiodothyronine Free Serum 3.5
vitamin D 14.7
TSH 3.3
T4 10.2
Phosphorus serum 5.2
T3 uptake 24%
TPO 8
Thyroglobulin Antibody 3.3
Triiodothyronine Free Serum 3.5
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Your B12 would be much better for you if you raise it into the upper end of the range, say 800 or so. Your D was result was terribly low. Important to supplement to get it above 50. Also need to get the other tests done.
Your B12 would be much better for you if you raise it into the upper end of the range, say 800 or so. Your D was result was terribly low. Important to supplement to get it above 50. Also need to get the other tests done.
B12 should be in the upper end of its range. What was your level?
You don't necessarily need an Endo. Many of them specialize in diabetes, not thyroid. Also many of them have the "Immaculate TSH Belief' and think that TSH tells them all them need to know to diagnose and treat a hypothyroid patient. That is very wrong. Also, if they test beyond TSH, it is usually only Free T4 and then they use "Reference Range Endocrinology", by which they will tell you that a Free T4 test that falls anywhere within the range is adequate. That is also wrong. A good thyroid doctor will treat clinically, as described above. If you will tell us your location, perhaps we can suggest a doctor that has been recommended by other thyroid patients.
As I suggested I think you will need to be on thyroid med, based on symptoms and test results, but you need to get the recommended tests done to confirm, and also supplement as needed to optimize Vitamin D (should be 50 min.), B12 in the upper end of the range, and ferritin should be 70-100.
You don't necessarily need an Endo. Many of them specialize in diabetes, not thyroid. Also many of them have the "Immaculate TSH Belief' and think that TSH tells them all them need to know to diagnose and treat a hypothyroid patient. That is very wrong. Also, if they test beyond TSH, it is usually only Free T4 and then they use "Reference Range Endocrinology", by which they will tell you that a Free T4 test that falls anywhere within the range is adequate. That is also wrong. A good thyroid doctor will treat clinically, as described above. If you will tell us your location, perhaps we can suggest a doctor that has been recommended by other thyroid patients.
As I suggested I think you will need to be on thyroid med, based on symptoms and test results, but you need to get the recommended tests done to confirm, and also supplement as needed to optimize Vitamin D (should be 50 min.), B12 in the upper end of the range, and ferritin should be 70-100.
1 Comments
I live in Myrtle Beach SC
Vitamin B12 448 range 211-946 pg/ml
Vitamin B12 448 range 211-946 pg/ml
I am not sure why the doctor ordered Total T4, instead of Free T4. Only the T4 not bound to protein, thus called "free" is biologically active. You should make sure they always test for Free T4 along with the Free T3, each time you go in for tests. The T3 uptake test is outdated and not very useful. The TPO ab test was negative, but the TG ab test shows positive, so that indicates Hashimoto's Thyroiditis.
So far your available test results are not indicating a severe hypo condition. This could be due to being in the early stages of Hashimoto's, but that doesn't explain your symptoms, in view of those serum test results.
So this leads to another possibility. Serum thyroid hormone levels do not always accurately reflect what is more important, which is tissue thyroid hormone levels. Serum thyroid has to be transported into cells in order to be metabolized, as needed by the body. Researchers have concluded that the "biological effects of thyroid hormones at the peripheral tissues- and not TSH concentrations- reflect the clinical severity of hypothyroidism and the lack of euthyroidism". The transport function can be affected by many variables, as noted in the following quote.
" It is important to note that because this transport of thyroid hormones into the cell is energy dependent, any condition associated with reduced production of the cellular energy (mitochondrial dysfunction) will also be associated with reduced transport of thyroid into the cell, resulting in cellular hypothyroidism despite having standard blood tests in the “normal” range. Conditions associated with reduced mitochondrial function and impaired thyroid transport include: insulin resistance, diabetes and obesity (68,69,70,71,106); chronic and acute dieting (4,51,66,72,112,113,114,115,116,117,118); diabetes (69,73,74,75,76); depression (73,77,78,79); anxiety (73,80); bipolar depression (73,77,81,82); neurodegenerative diseases (73,83,84,85,86,87); aging (73,74,88-100); chronic fatigue syndrome (73,101,102); fibromyalgia (73,103,104); migraines (73); chronic infections (73); physiologic stress and anxiety (73,79); cardiovascular disease (73,99,104,105,108); inflammation and chronic illness (73,109,110,111); and those with high cholesterol and triglyceride levels (58,60,72,106,107). Thus, standard blood tests can be very unreliable if any of these commonly occurring conditions are present (1-107).
You have at least a couple of conditions listed: high cholesterol and high triglycerides, both of which can also be caused by hypothyroidism.
In order to assess the possibility of low tissue thyroid levels, the best test is a Reverse T3 test, along with a Free T3 test taken from the same blood draw, in order to calculate a Free T3 to Reverse T3 ratio. Along with that I would recommend testing for cortisol, and ferritin. You can read about the need for those tests in the following link. I highly recommend reading at least the first two pages, and further, if you want to understand the reasons behind the 6 suggestions on p. 2. Since fatigue is one of your symptoms I would add a test for B12 also.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
I highly recommend doing the additional tests. I also recommend talking to your doctor to find out if he is willing to treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. Also ask if he is willing to prescribe T3 type meds like Armour Thyroid and Cytomel. If either answer is no then you are going to need to find a doctor that will do so.
Before considering thyroid hormone medication I think you need to get the additional tests done. That will enable a better idea of what needs to be done at present.
So far your available test results are not indicating a severe hypo condition. This could be due to being in the early stages of Hashimoto's, but that doesn't explain your symptoms, in view of those serum test results.
So this leads to another possibility. Serum thyroid hormone levels do not always accurately reflect what is more important, which is tissue thyroid hormone levels. Serum thyroid has to be transported into cells in order to be metabolized, as needed by the body. Researchers have concluded that the "biological effects of thyroid hormones at the peripheral tissues- and not TSH concentrations- reflect the clinical severity of hypothyroidism and the lack of euthyroidism". The transport function can be affected by many variables, as noted in the following quote.
" It is important to note that because this transport of thyroid hormones into the cell is energy dependent, any condition associated with reduced production of the cellular energy (mitochondrial dysfunction) will also be associated with reduced transport of thyroid into the cell, resulting in cellular hypothyroidism despite having standard blood tests in the “normal” range. Conditions associated with reduced mitochondrial function and impaired thyroid transport include: insulin resistance, diabetes and obesity (68,69,70,71,106); chronic and acute dieting (4,51,66,72,112,113,114,115,116,117,118); diabetes (69,73,74,75,76); depression (73,77,78,79); anxiety (73,80); bipolar depression (73,77,81,82); neurodegenerative diseases (73,83,84,85,86,87); aging (73,74,88-100); chronic fatigue syndrome (73,101,102); fibromyalgia (73,103,104); migraines (73); chronic infections (73); physiologic stress and anxiety (73,79); cardiovascular disease (73,99,104,105,108); inflammation and chronic illness (73,109,110,111); and those with high cholesterol and triglyceride levels (58,60,72,106,107). Thus, standard blood tests can be very unreliable if any of these commonly occurring conditions are present (1-107).
You have at least a couple of conditions listed: high cholesterol and high triglycerides, both of which can also be caused by hypothyroidism.
In order to assess the possibility of low tissue thyroid levels, the best test is a Reverse T3 test, along with a Free T3 test taken from the same blood draw, in order to calculate a Free T3 to Reverse T3 ratio. Along with that I would recommend testing for cortisol, and ferritin. You can read about the need for those tests in the following link. I highly recommend reading at least the first two pages, and further, if you want to understand the reasons behind the 6 suggestions on p. 2. Since fatigue is one of your symptoms I would add a test for B12 also.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
I highly recommend doing the additional tests. I also recommend talking to your doctor to find out if he is willing to treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. Also ask if he is willing to prescribe T3 type meds like Armour Thyroid and Cytomel. If either answer is no then you are going to need to find a doctor that will do so.
Before considering thyroid hormone medication I think you need to get the additional tests done. That will enable a better idea of what needs to be done at present.
1 Comments
Thank you I will definitely read all of the links you listed. I did have my vitamin B12 checked it was in normal range. I will make sure to ask about the other test you mentioned. In 2011 I was treated for hypothyroidism at that time I was taking 50 MCG of Synthroid I took that for probably 3 years. I wasn't able to go back to the doctor for about a year so when I did go back it was a new doctor and she didn't want to put me back on Synthroid until she did all the labs and that is the labs I listed above . I guess I'm confused should I be on medication for hypothyroidism or not? I also had the ultrasound done and she said I had significant amount of swelling around the thyroid. I'm currently waiting to go to an endocrinologist but that could take months to get in as a new patient.
lab results reference range
vitamin D 14.7 30.0-100.0ng/mL
TSH 3.390 0.450-4.500 uIU/mL
T4 10.2 4.5-12.0 ug/dL
Phosphorus serum 5.2 2.5-4.5mg/dL
T3 uptake 24% 24-39%
TPO Ab 8 0-34 IU/mL
Thyroglobulin Antibody 3.3 0.0-0.9 IU/mL
Triiodothyronine Free Serum 3.5 2.0-4.4 pg/mL
Cholesterol total 233 100-199 mg/dL
Triglycerides 363 0-149 mg/dL
HDl Cholesterol 35 >39 mg/dL
Ldl Cholesterol 125 0-99 mg/dL
T. Chol/Hdl Ratio 6.7 0.0-4.4 ratio units
Ldl/Hdl ratio 3.6 0.0-3.2 ratio units
vitamin D 14.7 30.0-100.0ng/mL
TSH 3.390 0.450-4.500 uIU/mL
T4 10.2 4.5-12.0 ug/dL
Phosphorus serum 5.2 2.5-4.5mg/dL
T3 uptake 24% 24-39%
TPO Ab 8 0-34 IU/mL
Thyroglobulin Antibody 3.3 0.0-0.9 IU/mL
Triiodothyronine Free Serum 3.5 2.0-4.4 pg/mL
Cholesterol total 233 100-199 mg/dL
Triglycerides 363 0-149 mg/dL
HDl Cholesterol 35 >39 mg/dL
Ldl Cholesterol 125 0-99 mg/dL
T. Chol/Hdl Ratio 6.7 0.0-4.4 ratio units
Ldl/Hdl ratio 3.6 0.0-3.2 ratio units
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