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Help! High TSH, Normal T3/T4
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Help! High TSH, Normal T3/T4

Need help in understanding these lab results. Thanks in advance.

Condition: Non-fasting at around 9 a.m.


TSH - 5.2 (0.45-5)
TSI - 60 (0-139)
T4 - 8.2 (4.5-12)
FT4 - 1.1 (0.82-1.77)
T3 - 157 (71-180)
FT3 - 3.5 (2-4.4)
TPO Ab - 7 (0-34)
Antithyroglobulin Ab - <20 (0-40)
Testosterone - 248 (348-1197)
Insulin - 42.4 (2.6-24.9)
Glucose - 88 (65-99)


I have several of the hypothyroidism symptoms: Inexplicable weight gain (From 180 to 203 lb in 4 months), extreme fatigue, unfounded depression, some constipation, increased sensitivity to cold, dry skin and general body weakness.

The doctor didn't know why TSH could be high; I was asked to take idoine supplement (iodoral) and be re-tested in 6 months. He said I could be having fatigue and depression from Low Testosterone and asked me to consider Testosterone Replacement Threapy.

Do I really have hypothyrodism? Is idoine supplements enough to bring down TSH?
10 Comments Post a Comment
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Avatar_m_tn
Have you had Ferritin, Iron and Vitamin
test done? I understand Low Iron and Ferritin levels can cause Hypo like symptoms.  Your percentage of range with Free T3 looks good at 68.75%
But your Free T4 is a little Low at 18.94% , this is just comparing the two, since The portion of T4 that is unbound to protein is Free T4 is then converted mostly by the liver to T3 then what is not bound to protein is Free T3, Free T4 is more like a storage hormone and Free T3 is the active hormone that controls metabolism and your body functions. TSH is only a Pituitary hormone that is sent by the Pituitary located in the brain, It is Thyroid Stimulating hormone, and when the active thyroid hormone Free T3
is low, this TSH gets higher to bump or stimulate the thyroid into more secreting more T4 into the system, and the opposite, when the Free T3 is high, the TSH is low. You can have a thyroid condition without it being caused by autoimmune, and their are other things that can cause Hypo like symptoms like vitamin deficiencies and a lack nutrition or the ability to absorb some of the nutrition through the normal process, Your MD needs to do more blood work, I know low testosterone can affect metabolism and cause muscle and joint pain, although testosterone supplements have their risks in prostrate issues, it is natural for men as aging progresses to decline in testosterone levels, treatment is fine as long as prostrate levels are watched closely.  Best Wishes FTB4
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Avatar_m_tn
I found this pertaining to taking Iodine intake causing Hypo like symptoms,


Excessive dietary iodine intake can actually reduce T3 and T4 production if you already have sufficient stores of iodine in your body. As your thyroid hormone levels fall, your pituitary produces more TSH to stimulate increased production of T3 and T4, but your thyroid is impaired by iodine excess and cannot respond normally to TSH. Worsening hypothyroidism ensues, despite your high intake of iodine. This situation can occur when you have adequate stores of iodine and you increase your daily iodine intake to around 1,700 mcg per day.



Read more: http://www.livestrong.com/article/488723-excessive-dietary-intake-of-iodine-hyperthyroid-tsh-levels/#ixzz2JfbvwHuB

Best Regards FTB4
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1756321_tn?1377771734
Elevated insulin levels are a listed cause of elevated reverse T3. Elevated reverse T3 blocks the effects of free T3 causing hypothyroid symptoms. If you have low testosterone you invariably have an insulin resistant state. However if testosterone is increased, insulin levels will typically decline.

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Avatar_m_tn
Thanks for the response.

FTB4, here are the test results for vitamins,ferritin and Iron:

Ferritin, Serum 144 ng/mL (30-400)
Iron, Serum         62 ug/dL (40-155)
Iron Saturation 17 %         (15-55)
Iron Bind.Cap. 357 ug/dL (250-450)

Vitamin D,25        29.0 ng/mL (30-100)
Vitamin B12        344 pg/mL (211-946)

Should I ask for anything else in particular?

BTW, some info about me: Male, 37 years old, Vegetarian.

I'm hesitant to go with Testostrone threapy without knowing the cause of it.  Would going to an endocrinologist help?
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649848_tn?1357751184
Your vitamin B12 and vitamin D levels are way too low.  Vitamin D is actually below range and B12 is barely within.  I find that I have to keep my B12 levels right at the top of the range (my range is 200-1100), in order to feel well.

Are you supplementing either?

Iron levels look okay, though a bit low in the range.  You might benefit from a small dosage of iron supplement.  

Talk to your doctor the vitamin B12 and D, as well as iron.
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Avatar_m_tn
I'm supplementing both.

Vitamin D3 - 10,000 UI (4 days a week)
Vitamin B12 - 1000 mcg (4 days a week)

B12 used to be severely low (~200) before I started supplementing. It's now at least within the range.

I have been taking D3 for a year now /w relatively high dose, but it has barely inched up (started at 26, went to in the summer 33, now at 29). Not sure what more I can do. I live in Atlanta, which is warm and sunny 10 months out of 12.
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1756321_tn?1377771734
Take magnesium to help increase vitamin D levels. Magnesium is the boss of vitamin D and without it you can say hello to vitamin D resistance. High vitamin D doses can cause magnesium deficiency as the body uses magnesium to convert vitamin D into active vitamin D.

In Europe and Japan you are still classed as having vitamin B12 deficiency. Labs start around the 550 pg/mL range. That is still not high enough but you want to be past the range where B12 deficiency is found in spinal fluid.
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649848_tn?1357751184
I understand the vitamin D only 4 days/week at the 10,000 UI, but why only 4 days/week on the B12?  IMO, your level is low enough to warrant taking on a daily basis.
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Avatar_m_tn
Thanks for the responses, Red_Star and Barb135.

@Red_Star: I'll try some magnesium supplements and see if it helps with D.

@Barb135: I take the vitamins (all of them) only on the week days, so it's 5 days a week. Some times, I miss taking one of the days; that's why I said 4 days a week. I'll start taking B12 every day.
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649848_tn?1357751184
How long have you  been supplementing the B12?

I agree about the iodine; it's often contraindicated.

It's not unusual for thyroid symptoms to appear before labs show a definite problem; however, since your TSH is high and your FT4 relatively low, that would indicate that FT's just haven't caught up yet.  I'd suggest you ask the doctor for a low dose of thyroid replacement, to see if that will alleviate some of your symptoms, but you also need to work on the low vitamins and testosterone levels, as well.
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