Do the above test results explain anything?

[EmpatheticJenny]

On December 28th, kdono posted a question. Instead of posting it as a new question, though, she clicked on "post a comment" and added her new question to an existing thread. I understand, I think. Some of us struggle to use today's technological gadgets correctly, even if the procedures seem straightforward to the rest of you. I am concerned that because kdono did not post her question correctly, it has gone without an answer, so I am reposting the question on her behalf. Here is what she said:

TSH = 4.220
FSH = 2.7
Total T3 = 201
Free T4 = 1.03
LH = 1.4

I am VERY tired - all the time.
Have had consistant menstrual bleeding for 4 straight weeks - never had this before. Checked by GYN. No cysts, or anything unusual - internal ultrasound used for exam. Appt. to see gyn. speccialist Jan. 3, 2007.

Do the above test results explain anything - sluggish thyroid?


kdono on 12/28

[EmpatheticJenny]

Now, to reply to the question I reposted for you, kdono: Although you did not mention what the laboratory's reference range is for TSH, I think it is safe to say that a value of 4.22, along with your symptoms, is ample reason to have an endocrinologist assess your situation.

I am curious about whether anything helpful came out of your visit to a gynecological specialist on January 3rd. Maybe he or she recommended your seeing an endocrinologist?

If not, you would be wise to pursue an endocrinological consultation anyway. The thinking among endocrinologists about what TSH value should be considered the upper end of "normal" has undergone a LOT of change in relatively recent years.

Note: A reproductive endocrinologist is a gynecologist with special training in the endocrinological aspect of reproduction. That is not quite the sort of specialist you need to see. What you need is a general endocrinologist and--as GravesLady wisely has reminded all of us in recent days--you should see an endocrinologist who deals a lot with thyroid problems (not mostly with diabetes).

My comments are coming from hindsight insights. I have mild hypothyroidism that--for three years--flew right under the radar screen of no fewer than four highly competent, hard-working, and caring physicians. They are not endocrinologists, and they were not "up" on the latest thinking about TSH levels, for which they should not be blamed. As new research findings and related thinking pour forth in torrents, it is an enormous challenge for any physician to stay up-to-date in his or her area of expertise, never mind keeping up with what is going on in other areas.

For that reason, it is good to be a patient advocate for yourself. If you have a solid reason to think that you should be assessed by a certain specialist such as an endocrinologist (and I think that you clearly do), I advise you to ask for the assessment or push for it, if you need to, no matter what another physician might say.

[EmpatheticJenny]

P.S. About my mild case of hypothyroidism: A few weeks after a blood test showed a TSH level of "only" 4.11, I began to be strikingly unwell in all sorts of ways, all of them related to a thyroid gland that was struggling to keep up with its workload, as has become obvious over time. On the other hand, it is possible to have a routine blood test reveal an amazingly high TSH level (more than 10.0, for example) in someone who is feeling entirely well. The test results you describe do not necessarily explain anything, but I am sure it will seem to my fellow thyroid forum "lay practitioners" ;o) that your lab results and you should be looked at by someone with the appropriate expertise.

[GravesLady]

Re: levels.  What is your Labs reference ranges?

Are you taking dessicated thyroid? Or are you pregnant?

The high T-3 might be a concern and can be a risk for dangerous situations.  

I'd have an endo. retest, making sure the TSH, both FTs and all five antibodies are done.  Make sure the endo. deals with a lot of thyroid patients per year.  The endo. will know what other test will need to be done, if any.

Good Luck!