Free T3 & Free T4 & TSH 3rd Generation

[joycekatherine]

I finally got my report from the doc...I wanted to run these by everyone, please let me know what you think...

TEST                                                IN RANGE                                                 REFERENCE RANGE

Free T4                                               1.0                                                                     0.8 - 1.8 ng/dl
TSH 3rd generation                              1.76                                                                    0.40-4.50 mIU/L
Free T3                                               308                                                                     230-420 pg/dl

Has anyone had results like these, but, still been symptomatic??  I appreciate any and all replies or suggestions!!

Thanks Guys

[joycekatherine]

I had all the columns set up nicely, but, when I clicked on submit, everything went kaflooey!!

Free T3   308 range 230-420 pg/dl
Free T4   1.0  range 0.8-1.8  ng/dl
TSH, 3rd generation  1.76  range 0.40-4.50 mIU/L
hope this one is better!!

[stella5349]

Yes I have been close to those labs in the past and for me - I fely bad with those results.

Really take a close look at the FT3. Your reference range is 230-420 and you only have a 308. Scaling that, it's low. In my opinion you're FT4 is great - there is conversion going on for you with those labs you may not be on enough meds though to rid the symptoms.

I would think you would still be symptomatic with that FT3 result. This is where many doctors will not treat through b/c the TSH is really close to "normal"

Right now - for me, my FT3 is near the top ( if not over) the max range. My TSH is much lower and I feel good. No major hypo symptoms to speak of.

I don't remember what meds you are on - but could suggest to your doctor a slight bump in meds or adding a small amount of T3 meds as a trial to see if that takes the issues away.

[Barb135]

Mine are close to that, except for my TSH, which is much lower.  My FT4 is 0.9; FT3 is 262, with TSH of 0.01.  My endo just lowered my cytomel because I've had very rapid heart rate and palp, but upped my levothyroxin (levothyroxine).

I am still symtomatic too, but the change was only made 2 weeks ago, so I'm still waiting ................. and waiting................

[joycekatherine]

Actually, I'm not on any thyroid meds!!  The Endo said that all my tests are normal!!  That's why, I wanted to run these numbers by some members...Stella, you said that I have "conversion" going on, what does that mean??
Barb, I know what you mean!!!  I call it, "Hurry up and wait!!"  ;)

[gimel]

You're already getting good info from a couple of the experts here, I just thought you might enjoy this excerpt from an article written by a doctor.

"Conventional endocrinologists deny that there is such a thing as hypothalamic-pituitary dysfunction without gross disease on an MRI scan, and they deny that free T4 and free T3 levels in the low end of the range can also cause hypothyroid symptoms and poor health. They are mistaken. While many do know enough to check a free T4 level with the TSH, they refuse to check the free T3 level, even though  T3 is the active thyroid hormone! T4 is just a prohormone and must be converted into T3 to become active. Indeed, hypothalamic-pituitary dysfunction with reduced TSH secretion is universal among aging adults (Carlé 2007). The fact
is that"central" thyroid insufficiency with low thyroid hormone levels within the reference ranges is common and is a frequent contributor to  depression, obesity, high cholesterol, chronic fatigue, and fibromyalgia. These problems should all be considered as due to thyroid insufficiency until proven otherwise. A doctor must always look at the free T4 and free T3 thyroid hormone levels. He should consider them significant when both are below the mid-point of their reference ranges in a symptomatic patient, and they certainly represent hypothyroidism when
both in the lower third of their population ranges, regardless of the TSH.
It is even more inappropriate to rely on the TSH to adjust thyroid hormone dosing, as the TSH may have been "wrong" to start with, and once-daily oral thyroid replacement produces unnatural spikes in serum thyroid hormone levels that over-suppress the TSH for many hours. Actually, it has been demonstrated that the TSH is of little use in adjusting thyroid hormone replacement. A landmark study was done where 4 experienced thyroidologists adjusted levothyroxine (T4) doses according to clinical criteria. The patients were then tested and the 95%-inclusive range for their TSH was from undetectable to 20mIU/L. The free T3 level correlated best with clinical
euthyroidism. (Fraser, 1986). Such a study has never been repeated. All other studies done start by assuming that a "normal" TSH means that the patient is well-treated, even though many studies show that TSH-normalizing treatment leaves many persons with residual signs and symptoms of thyroid insufficiency.(Saravan 2002, Samuels 2007) "  
This excerpt came from this link.     http://www.hormonerestoration.com/Thyroid.html

A copy of this for your doctor might help in convincing him to treat your symptoms and your relatively low FT3 and FT4 levels, in spite of the TSH level.

[joycekatherine]

Thank you so much for your comments and advice...I have a second appt set up for a different Endo and will bring the above excerpt with me!!  Will let you all know what happens... ;)