Interoperating lab results.

[EmilyXOrange]

My enocrinologist suspected I might have Hashimoto's, but from going over the lab work myself, I don't think so. Some input would be great, thanks.
T4- 4.35 (4.5-12.0)
Free T4- 0.73 (0.60-1.70)
T3- 125.28 (87.0-178.0)
Free T3- 2.90 (2.50-3.90)
TSH- 0.970 (0.46-4.98) *My TSH has slowly been climbing from low to normal ranges
Thyroglobulin Ab- <20 (0-40)
TSI- 24 (0-139)
TPO- 6 (0-20)
Thyroglobulin Quantitative: 7.9 (0.5-55.0) *They used the adult range for this one, not the 13-18, so I'm going to ask the doctor about the that*
ANA- Negative <1:80

[flyingfool]

Both the free hormone levels are low.  So that must be caused for some reason.

From what I understand the adrenal test for cortisol is best to be a 24 hour urine or 24 hour saliva test. Where samples are collected a few times over 24 hours. The single snapshot blood test is not the best since cortisol varies so much throughout a 24 hour day.

One possible reason why your adrenals would have to work extra hard is because you are Hypo and your adrenals try to make up for that fact.

[EmilyXOrange]

Thank you so much everyone, my mom talked to my endocrinologist this morning, and she thinks it has to do more with my adrenal gland, and not my thyroid.

[898_1]

The TSH at 0.34 is NOT a sign of hyper (it must be lower then 0.1 for a some period of time ; 0.34 is rather a fluke)
If the size of your thyroid (according to the ultrasound) is normal and there are no signs of inflammation present (such as uneven echotexture and uneven blood flow) I could not understand why you have been diagnosed with Hashimoto's!

[Barb135]

Thyroglobulin is used as a marker for cancer; not sure why they did the thyroglobulin quanitative.  I don't think it tells much in your case, because you've not got/had cancer.  Also not sure if the age is really that much of an issue.  

This is a good question to talk to your doctor about.

[EmilyXOrange]

The test was TPOab. Does anyone know why they would use the adult range instead of the 13-18 year old range for the Thyroglobulin Quantitative?

[Barb135]

Was the TPO, the antibody test?  Or was it the actual TPO?  They are different.  TPO is an enzyme used in the production of thyroid hormones; TPOab is to test for antibodies that attack the thyroid.

I agree that your FT3 and FT4 are both very low in their ranges, indicating that you might be hypo. Since your levels are so low, along with low TSH, it's very possible you're coming out of a hyper phase.

Even if your antibody tests are negative, you could still have Hashimoto's, as I've read/been told that Hashimoto's can be present without measurable antibodies, or that antibodies may develop later.

[EmilyXOrange]

The main reason I went to the endocrinologist was because my TSH was 0.370. The doctor thought that it might be Hashimoto’s and I was just getting out of the hyperthyroidism phase. The main symptoms that I have are migraines, joint pain, fast and slow heart beat, and fatigue.

[flyingfool]

First off you are EXTREMELY fortunate to have a Dr who performed all those tests. Many people are not that lucky.

From what I've learned here.  Hashi's would be indicated if you have an elevated result in either the TPO or TG results.  Graves would be indicated if you had and elevated result in TSI.

Your test results for these listed above are:

Thyroglobulin Ab- <20 (0-40)      (This is TGab)
TSI- 24 (0-139)
TPO- 6 (0-20)

Your test results show that NONE of them are elevated above the ranges.  So I'm a little confused why the Dr is suggesting that you have Hashi's.  he must have other information or something he's taking into consideration.

That being said, your Free T3 and Free T4 are quite low in the range and many people would feel hypo with those numbers even though they are within the range.  Many people here have found that in order for them to feel well they need their FT4 in the MIDDLE of the range, AND (that means in addition to) their FT3 to be in the UPPER 1/3 of the range. Your results show that there is plenty of room for improvement to get to that target.

Problem is many Dr's won't want to treat a patient with the TSH, FT3 and FT4 "SOMEWHERE" within the range.

Probably the most important thing to consider is how you are feeling.  What symptoms are you having that made you go to an endo and get these tests performed?

[Red_Star]

Tests to help diagnose Hashimoto's thyroiditis:

TPOAb and TgAb antibodies (approximately 10-15% may be antibody negative)
Fine needle aspiration (FNA) biopsy
Radioactive iodine uptake (RAIU)
Ultrasound

Autoimmune thyroid disease (either Graves' disease or Hashimoto's thyroiditis) may show up with a positive or negative ANA titer.  One study on Hashimoto's thyroiditis found 47% were ANA positive. Of them, 60% showed a titer of 1:40.