Thyroid Disorders Community
High TSH and Thyroid Peroxidase Antibodies, but normal T3 and T4
About This Community:

This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

High TSH and Thyroid Peroxidase Antibodies, but normal T3 and T4

I'm a little confused about my test results, and I'm hoping that I can get some insight from the community.
Here are my results

TSH is 5.76
FT3 is 3.0
FT4 is 1.1
Thyroblobulin Auto Antibody is 27.9
Thyroid Peroxidase Auto Antibody is 453
Thyroid is enlarged, but I hadn't noticed until my Dr. discovered this (and sent me for an ultrasound to confirm).

What does this mean?  Since my T3 and T4 are in normal range, putting me on replacement therapy wouldn't really do anything would it?
Also, my blood test revealed a vitamin D deficiency.  If was 17.
Blank
Avatar_m_tn
You really do need to supplement your Vitamin D level to get it up over the middle of its range.  

Beyond that, a test result like yours, for TPO ab, almost always means Hashimoto's Thyroiditis, which is the most common cause for diagnosed hypothyroidism.  If I assume that the ranges for your Free T3 and Free T4 are similar to those seen so often, then your Free T3 and Free T4 are within the so-called "normal' range, but your Free T3 is in the lower half of its range, which frequently is accompanied by hypothyroid symptoms.   The range is too broad to really be a functional range, due to the erroneous way it was established.  Your Free T4 would be considered as adequate.  

So first, please post the reference ranges for the Free T3 and Free T4, as shown on the lab report.  Second, please tell us about any symptoms you are having.  Third, I suggest that when you go for testing again, you should also request to be tested for Vitamin B12, and ferritin.  Even though men are usually assumed to have adequate iron levels, ferritin is so important for someone that is treated for hypothyroidism, you need to make sure your level is adequate.

  



.  
13 Comments Post a Comment
Blank
Avatar_m_tn
You really do need to supplement your Vitamin D level to get it up over the middle of its range.  

Beyond that, a test result like yours, for TPO ab, almost always means Hashimoto's Thyroiditis, which is the most common cause for diagnosed hypothyroidism.  If I assume that the ranges for your Free T3 and Free T4 are similar to those seen so often, then your Free T3 and Free T4 are within the so-called "normal' range, but your Free T3 is in the lower half of its range, which frequently is accompanied by hypothyroid symptoms.   The range is too broad to really be a functional range, due to the erroneous way it was established.  Your Free T4 would be considered as adequate.  

So first, please post the reference ranges for the Free T3 and Free T4, as shown on the lab report.  Second, please tell us about any symptoms you are having.  Third, I suggest that when you go for testing again, you should also request to be tested for Vitamin B12, and ferritin.  Even though men are usually assumed to have adequate iron levels, ferritin is so important for someone that is treated for hypothyroidism, you need to make sure your level is adequate.

  



.  
Blank
Avatar_m_tn
Thanks for the additional info.

The ranges on the lab report are as follows.
FT3 - (2.3-4.2) pg/ml  Mine was 3.0
FT4 - (0.7-1.5) pg/dl   Mine was 1.1

I'm not sure about the symptoms.  Once the Dr. did the initial test for TSH, and said that I probably had Hashimoto's Thyroiditis, I did some research, and in hindsight, have some of the symptoms.  Inability to concentrate, callused heels, varying emotional levels (depression/mania/anger), low energy.
I never noticed the inflammation of the thyroid though.

Again, thanks for the info.
Blank
1204245_tn?1356904325
Your TSH is above the new limit 3.3 and even above old limit 5.0
So this condition can be considered as subclinical hypo (rare among the males)
Blank
Avatar_m_tn
Just because thyroid test results are in the so-called "normal" ranges does not mean that is adequate for YOU.  First, everyone is different and react differently to thyroid hormone levels.  Second, the ranges are far too broad due to the erroneous way they were established.  As a result, many members, myself included, say that relief from hypo symptoms required Free T3 in the upper third of its range and Free T4 around the middle of its range.  

So, with Hashi's as the probable cause it is only a matter  of time until your levels drop further and you start having even more severe hypo symptoms.  Many doctors like to wait until a Hashi's patient gets to that situation before prescribing thyroid meds.  Other doctors like to start earlier in order to try and maintain the patient's thyroid hormone levels and prevent symptoms.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So you need to take care of the Vitamin D problem.  You need to make sure your B12 and ferritin levels are well up in their ranges.  And you need to find out if your doctor is going to be willing to treat you clinically as described above.  If not, then you will need to find a good thyroid doctor that will do so.
Blank
Avatar_m_tn
Here were the results of my additional blood tests.  These seem to be in normal ranges.

FERRITIN - 101 ng/ml
VITAMIN B12 - 413 pg/ml
Blank
Avatar_m_tn
Glad to see that your ferritin and Vitamin B12 are adequate.  Now your efforts need to be focused on the Hashi's.  There are two basic approaches to treatment.  Some doctors like to wait until test results are exceed range limits (especially TSH), and symptoms are overt, before starting the patient on meds.  Other doctors will start the patient on thyroid meds earlier in order to avoid the worst of hypo symptoms.  I know which one I would prefer.

So your issue becomes one of getting your current doctor to treat you clinically, as described above, or finding a doctor that will do so.  You need a doctor that treats patients, not lab test results.
Blank
Avatar_n_tn
my wife recently detected with thyroid problem her T3 value is 3.29  pg/ml   and T4 value is 0.69  ng/dl    and TSH value is 25.21 microIU/ml  is there any problem with this value, some time she is suffring from back pain, weakness, bone pain and breathing problem weather this is because of high TSH value ,  weather any remidy on this deseases at present she is taking LETHYROX 50 Tablet once before breakfast , weather this tablet is sufficent to recover this problem. please guide which diet should we follow.
Blank
Avatar_n_tn
my sons T3 VALUE IS 162 ng/dl   range is 60-200  and  T4  value is 13.3  range is  4.5 -12   micro gm / dl     TSH is 2.31 micro I U /ml   range is 0.3  -5.5  let me know weather he is having any problem with this reading
Blank
Avatar_m_tn
It would be very helpful if you can give us the reference ranges  for the Free t3 and Free T4 tests results for your wife.  Since she is having some symptoms that can relate to thyroid issues, I expect that both Free T3 and free T4 may be too low in the range for her.  TSH is a pituitary hormone that is affected by many things, such that it is totally inadequate as a diagnostic by which to medicate a hypothyroid patient.  Also, be aware that TSH does not cause symptoms.  It is only a poor indicator of thyroid status.  Free T3 is the most important test, since Free T3 largely regulates metabolism and many other body functions.  Also, Free T3 has been shown to correlate best with hypo symptoms, while Free T4 and TSH did not correlate at all.

Also, since hypothyroid patients also are frequently  too low in the range for Vitamin D, B12 and ferritin, I suggest that she should be tested for those as well.

The whole point of thyroid treatment is to relieve symptoms.  A good thyroid doctor will test and adjust Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  

It was not clear if your wife's test results were from before starting the medication,  or after.   At any rate, her meds will need to be adjusted to relieve symptoms.  So you will need to get the doctor to agree with clinical treatment for symptoms, rather than just based on test results.

Each time she goes in for tests, you should make sure it includes Free T3 and Free T4.  Also should find out her levels for Vitamin D, B12 and ferritin.  If you will get those done and post here, along with their reference ranges shown on the lab report, members will be glad to help interpret and advise further.  
Blank
Avatar_m_tn
As for your son, I see nothing in those test results to be concerned about.  Was he having symptoms that caused you to get him tested?
Blank
Avatar_n_tn
regarding my son he studing in std 3rd and his weight is 35kg but i never seen him complaining about tirdness or bones paining and i not realise any change in his sound because of T4 value is 13.3 and range is 4.5 - 12 micro gm /dl i think this value is slightly higher i would like to know weather this value affect for his weight gaining or he is normal doctor says not to worry, my wife thyroid report are as follows    free T3 3.29     RANGE  1.4 -4.4 pg/ml, free T4  0.69  RANGE  0.8 -1.8 NG/DL  ,  TSH  25.21  RANGE  0.45 - 4.5 micro IU/ml  i would like to know  weather above  value affect to her body symptoms which i already explained on my previous question and let me know LETHYROX 50 tablet is sufficient  for solved out this problem  or should i think about homeophathy medecine please guide me in this connection
Blank
Avatar_m_tn
I agree with your doctor regarding your son.  Your wife's Free T4 level needs to be increased to around the middle of the range.  The Lethyrox 50 is a step in the right direction.  After she has been on that dosage for about 6-8 weeks, it would be good to go back and test again to see the result, and see if she needs to increase dosage.  While there I would also recommend that she should be tested for Vitamin D, B12, magnesium, ferritin, and a full iron test panel.  

When test results are available, please post them along with reference ranges, and members will be glad to help interpret and advise further.  
Blank
Avatar_n_tn
thanks for your valuable guidence for me , i definatly send my wifes test result after 6 - 8 weeks
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Thyroid Disorders Community Resources
RSS Expert Activity
242532_tn?1269553979
Blank
How to Silence Your Inner Critic an...
Apr 16 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eaters: How to Silence Yo...
Mar 26 by Roger Gould, M.D.Blank
1344197_tn?1392822771
Blank
Vaginal vs. Laparoscopic Hysterecto...
Feb 19 by J. Kyle Mathews, MD, DVMBlank
Top Thyroid Answerers
168348_tn?1379360675
Blank
ChitChatNine
Avatar_f_tn
Blank
goolarra
Sisters, OR
1756321_tn?1377771734
Blank
Red_Star
Queensland, Australia
Avatar_m_tn
Blank
gimel
MI
649848_tn?1357751184
Blank
Barb135
FL
1204245_tn?1356904325
Blank
898_1
Long Beach