Aa
Aa
A
A
A
Close
Avatar universal

Inrange T3 and T4, why do I feel so tired?

Hell!! This is my first post.  My TSH is less than 0.022 but Free T4 and T3 are in range. My US showed heterogeneous echotexture with no nodules/lesions but inflammed thyroid indicating thyroditis.  I am so tired, sweating crazily even in air conditioning, and just dont feel right.  Endo said my bloodwork was fine and has not responded as to what I can do to feel better.  I get good sleep ( 7-8hrs night) and eat well but just feel so off.  Any suggestions??
19 Responses
Sort by: Helpful Oldest Newest
Avatar universal


What causes silent thyroiditis?  I was told happens in postpartum women.  I am 56...just dont get it?
Helpful - 0
Avatar universal
thank u....

do you think its an issue that the left lobe is larger than the right or just my anatomy?  My endo asked me to have more bloodwork the end of October and go from there.
Helpful - 0
Avatar universal
Right lobe to be smaller in size than the left (not very common, most often the right lobe is larger than left)
6hr uptake was 9.5%     range 5-15%
24hr uptake was 14.2%   range 10-30%
the uptake is normal; when combined with low TSH AND high T4 it can be sign of silent thyroiditis (inflammation)
patchy labeling throughout the gland means some areas absorbed more isotope than others (common even in normal glands)
Helpful - 0
Avatar universal
good morning.  had an NM thyroid uptake and scan.  revieved oral I-123.  
6hr uptake was 9.5%     range 5-15%
24hr uptake was 14.2%   range 10-30%

thyroid scan demonstrates the right lobe to be smaller in size than the left. there is patchy labeling throughout the gland.  no discrete hot or cold nodules are demonstrated.  

Impression:  Euthyroid uptake .  scan suggests thyroiditis.  there is no evidence of hyperthyroidism by this technique.  thyroid ultrasound is recommended for futher evaluation of the size difference between right and left lobes if clinically indicated.

these are my results, please tell me what you think.  Thanks
Helpful - 0
Avatar universal
Thank u very much for all your help.  I will let you u know what happens at my followup appt  :)
Helpful - 0
Avatar universal
If you take a look at Table 1 in the following link I think you will see that thyroiditis is not the likely cause of your symptoms.  The most probable cause appears to be Graves', even though the TSI test did not exceed the reference range.    

http://www.niddk.nih.gov/health-information/health-topics/diagnostic-tests/thyroid-tests/Pages/default.aspx

While searching for info on the TSI test results, I also found this excerpt from an old thread from the Forum.


goolarra  
Jul 20, 2012
To: 8lu
Let me start with TSI.  Although the reference range for TSI is <140, the fact of the matter is that people who don't have Graves' (autoimmune hyperthyroidism) have TSI of <2.  140 is the level at which symptoms usually become apparent.  So, since your TSI is elevated above 2, it would indicate that you do have Graves', but it's not yet at the stage where you “should” have symptoms from it.


So from all this, your symptoms, and your test results, it appears that you are most likely in the early stages of Graves'.   I have no idea why your doctor did not react to your TSH being below range, and your Free T3 being over the range, consistent with being hyperthyroid and needing some treatment.  I expect that the doctor threw out the possibility of Thyroiditis just because the TSI was still within range; however, that does not preclude a diagnosis of Graves'.  So I think you should talk with the doctor and relate some of this information and request to be started on low dose of antithyroid meds to lower your Free T3 and Free T4 levels and relieve your hyper symptoms.  

Helpful - 0
Avatar universal
started noticing symptoms in June but waited to go to PCP til middle of July when they got worse
Helpful - 0
Avatar universal
This is exactly how the results look

Thyroid Stimulating Immunoglobulin   my result 108   range  <=122 %

Negative - 122 percent basal activity or less
Positive - 123 percent basal activity or greater
Positive results (123 percent or greater) are consistent
with Graves disease but do not always correlate with the presence and severity of hyperthyroidism.
Helpful - 0
Avatar universal
Also, when did you first start noticing those symptoms you mention?
Helpful - 0
Avatar universal
Sorry, I type TSH so much more often than TSI that I mistakenly asked for the  units of measure shown for the TSH test.  Please post the units of measure shown for the TSI test.  I am trying to compare to other ranges I have seen.  
Helpful - 0
Avatar universal

sorry, units of TSH are uIU/ml

free t3  pg/ml

free t4 ng/dl

Im not good at understanding the difference
Helpful - 0
Avatar universal
units of measurement IU/ml
Helpful - 0
Avatar universal
good morning

TSH done 7/28 was done by my PCP was <0.015 range 0.465-4.680
TSH 3rd generation ordered 9/1 by endo was <0.022  range 0.350-4.00

I was told by doctor its probably silent thyroiditis?  I'm 56 and feel like Im 80! No energy, aching body,sweating terribly, itchy skin, irritable(my son tells me everyday I need to relax)  Just wish there was something I could do.  I appreciate your advise.
Helpful - 0
Avatar universal
What were the measurement units attached to the TSH test result?
Helpful - 0
Avatar universal

Forgot to say I am not taking any thyroid medication
Helpful - 0
Avatar universal
I have my results from other testing.  Here they are:

Thyroglobulin AutoAb    <20      range <40 IU/ml

TPO AutoAb    <10      range <35 IU/ml

Thyroid Stimulating Immunoglobulin   108     range <122

Nurse today told me everything is ok.

What do you think?   and thanks
Helpful - 0
Avatar universal
I am amazed that your Endo would think that your bloodwork was fine.   TSH is affected by so many things that it is only an indicator of thyroid status, to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones; however, your TSH is suppressed even below range.  Also your Free T4 is high in the range, and your Free T3 was actually above its range.  With your symptoms, along with your test results, it should have been apparent to your Endo that you are hyperthyroid, and in need of further testing.  .  As the next step I think you should request to be tested for the possibility of Graves' Disease, which is the most common cause for being hyperthyroid.  The definitive step for that would be the TSI test (Thyroid Stimulating Immunoglobulin).  

Helpful - 0
Avatar universal
good morning.  here are my actual results and thank you


free T3          4.46            range 2.30-4.20
free T4          1.59            range 0.89-1.76
TSH 3rd generation   <0.022   range 0.350 -4.000
Helpful - 0
Avatar universal
Please post the actual T4 and T3 results, along with reference ranges shown on the lab report.  Are you taking any thyroid med currently?  
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.