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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.
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.
It's funny about the iron with me, a Dr told me years ago that I need to donate blood because my iron was high. I found out later all they ever checked was my hemoglobin levels and it was always on high side so they assumed my iron was high. It's sad that I had donated for several years and I had finally got to the point of being really sick and not knowing why. So another Dr checked my complete iron levels and it come back that it was 2 and my hemoglobin was 16.1. He put me on an alert, that was about 8 months ago.
The B12 is higher than needed. If supplementing, reduce the dosage. D is a bit lower than optimal, so you could supplement with 1000 IU of D3 daily. The worst is your ferritin. It needs to be 70 minimum, so you need to supplement with a good form of iron to optimize. Here is a quote on that.
"Iron deficiency
Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone (238-242). Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present."
So, in addition to supplementing as mentioned, you need to further increase your thyroid dosage to get your Free T4 up to middle of its range, and Free T3 in the upper end of its range. By the way, to avoid false high results when taking T3 meds it is best to defer the morning dose until after the blood draw for tests.
"Iron deficiency
Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone (238-242). Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present."
So, in addition to supplementing as mentioned, you need to further increase your thyroid dosage to get your Free T4 up to middle of its range, and Free T3 in the upper end of its range. By the way, to avoid false high results when taking T3 meds it is best to defer the morning dose until after the blood draw for tests.
TSH is basically a useless test when already taking thyroid hormone. So ignore TSJH. The TPO test is meaningless when you don't have a thyroid gland. So ignore that. The important tests are the biologically active thyroid hormones, Free T4 and Free T3. The following is a quote from the good thyroid doctor.
"in tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range. The higher FT3 level compensates for the lower FT4 levels on NDT."
In addition since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, those need to be optimized also. D should be 55-60, B12 in the very upper end of its range and ferritin should be 70 minimum. How do your results compare to those levels?
"in tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range. The higher FT3 level compensates for the lower FT4 levels on NDT."
In addition since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, those need to be optimized also. D should be 55-60, B12 in the very upper end of its range and ferritin should be 70 minimum. How do your results compare to those levels?
What is a good range for the tsh, tpo, ft4, ft3 in order to drop the 40lbs I have gained in about the last 2-3 months
Please post the actual results for D, B12 and iron.
From your test results you are still hypothyroid. Even though the results are within the so called "normal" ranges that does not mean they are optimal for you. The ranges are far too broad due to the erroneous methods by which they are established.
A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T3 and free T4 as necessary to relieve symptoms without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can get some good insight from this link written by a good thyroid doctor.
http://www.hormonerestoration.com/Thyroid.html
In the link note the following. "Thyroid tests must be interpreted in relation to the patient's symptoms. The FT4 and FT3 tests must be interpreted in relation to each other. A relatively high FT3 may compensate for a relatively low FT4. If the FT4 is below the middle of the 1 to 1.6ng/dL range, the FT3 should usually be greater than 3.5pg/ml to assure thyroid sufficiency (range 2 to 4.4pg/ml)." Clearly your results are less than optimal, so you are having hypothyroid symptoms.
From your test results you are still hypothyroid. Even though the results are within the so called "normal" ranges that does not mean they are optimal for you. The ranges are far too broad due to the erroneous methods by which they are established.
A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T3 and free T4 as necessary to relieve symptoms without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can get some good insight from this link written by a good thyroid doctor.
http://www.hormonerestoration.com/Thyroid.html
In the link note the following. "Thyroid tests must be interpreted in relation to the patient's symptoms. The FT4 and FT3 tests must be interpreted in relation to each other. A relatively high FT3 may compensate for a relatively low FT4. If the FT4 is below the middle of the 1 to 1.6ng/dL range, the FT3 should usually be greater than 3.5pg/ml to assure thyroid sufficiency (range 2 to 4.4pg/ml)." Clearly your results are less than optimal, so you are having hypothyroid symptoms.
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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.
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