Help With Reading My Thyroid Test Results

[silverqueen0819]

I'm hoping someone can help me read my thyroid test results. I've been on levothyroxine since 2011 for hypothyroidism. Right now, I'm taking 50 mcg. I've been experiencing a ton of symptoms for the last ten months, like fatigue, hair loss, hands & feet are always super cold, brain fog, severe headaches, dry scalp, dry skin, acne, constipation, diminished sense of taste, no appetite, the list goes on & on. Over the past year, I've been diagnosed with obstructive & central sleep apnea & carpal tunnel in both hands. All I want is to feel normal again!!! Here are my latest blood test results:

TSH: 1.740 uIU/mL --Ref range (0.450-4.5)
T4: 7.8 ug/dL --Ref range (4.5-12.0)
T3 Uptake: 30 % --Ref range (24-39)
Free Thyroxine Index: 2.3 --Ref range (1.2-4.9)

T4 Free, Direct: 1.41 ng/dL --Ref range (0.82-1.77)

Reverse T3: 18.2 ng/dL -- Ref range (9.2-24.1)

Free T3: 3.1 pg/mL -- Ref range (2.0-4.4)

[gimel]

You are very welcome.

Sorry for the typo in paragraph two.  It should read as follows,  "A good thyroid doctor  will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed ..........

[gimel]

The tests for T3 Uptake and Free Thyroxine Index are outdated and not very useful.  When already taking thyroid med, TSH is also not very useful, since in the majority of cases it becomes suppressed when taking adequate thyroid med.  Your Free T4 level is above mid-range which is good.  Your Free T3 is right a mid-range, which is lower than needed by many people.  You need a source of T3 in your med in order to raise your Free T3 level as needed to relieve symptoms.  Your Reverse T3 is okay and the ratio of Free T3 to Reverse T3 is 1.7. which is a bit low, consistent with what I said about needing to increase your Free T3 level.  

A good thyroid doctor  will treat a hypothyroid patient clinically by testing and adjusting Free T3 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  

You can confirm what I say by reading the first two pages of the following link, and more if you want to get into the discussion and scientific evidence for all the recommendations in the paper.  Note especially Fig. 1 on page 7 of the link.  That will provide a clear picture of all the processes and variables involved with achieving adequate tissue thyroid effects.   It totally blows up the idea of the one doctor that TSH tells her all she needs to know.

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

Hypothyroid patients are frequently low in stomach acid and thus don't adequately absorb vitamins and nutrients.  For that reason they are typically low in Vitamin D, B12 and ferritin.  So you need to get those tested and then supplement as needed to optimize.  D should be at least 50, B12 in the upper end of its range, and ferritin should be at least 70, and some sources say 100.  In addition, cortisol is an antagonist of thyroid hormone, so it would be good to test for that.  

When you see the new doctor on Thursday, if you run into resistance in getting the tests done, you can give the doctor  a copy of the entire paper in the link above and ask him to read and reconsider.  it  will also be important to find out if the doctor is willing to treat clinically, as described, and also if willing to prescribe T3 type meds.  If either answer is no, then you will need to locate a good thyroid doctor that will do both

Please keep us tuned in on your progress.

[silverqueen0819]

Thank you so much for your help!

[gimel]

Before discussing further, if possible please post your thyroid related test results from the time you were first diagnosed as hypothyroid.  If not available, can you tell us if you were diagnosed as having Hashimoto's Thyroiditis or not?  Also, at that time were your symptoms any different from current?  Have you been tested for Reverse T3, Vitamin D, B12, ferritin, or cortisol?  

[silverqueen0819]

In 2011 my doctor diagnosed me, she just said that I was hypo. My TSH in 2011 was 4.7. The most that I can remember about my symptoms was poor memory, poor attention span, extremely tired and weight gain. I couldnt lose weight no matter what I did. However at that time, I was also very uneducated about hypo and the related symptoms. I dont know if this helps at all, but I believe that I inherited it from my mom, who is also hypo. My doctor ran some other tests, but the only test that she would run for my thyroid is the TSH. I asked her a month ago to run other thyroid related tests and she said that the TSH will tell her everything she needs to know and that because Im already on medicine that my insurance wouldnt cover it anyway. Im really getting sick of doctors treating my symptoms but not trying to investigate the actual problem. Last November I finally got in to see a dermatologist for my acne, hairloss, dry scalp, dry brittle straw-like hair, he didnt even look at my head! He just prescribed me some medicine and sent me on my way. I tried using the medicine, and it helped at first, but then it stopped working. I also feel like my immune system isnt working right. The test results I gave in my question were done because I went somewhere else and paid out of pocket. Im going to see a different doctor on Thursday and Im hoping that he will be able to help me. The only reverse T3 test that I had done was the one from above. And no theyve never checked vitamin d, b12, ferritin, or cortisol. Im going to ask the doctor on Thursday if he will check those.