Is everithing OK or is something wrong

[sstefan]

Hi
My wife had many symptoms pointing to thyroid problems. She gain weight and she cannot lose it although she tried lot of different diets and activities, she is fatigue, sleepy, she has back problems, depression, sometimes irregular period and hair loss.

She just tested her thyroid and these are the lab results

T3 total 90,6                                    acceptable range           81 - 178
T4 total (Тироксин) 8,67                   acceptable range           4.5 - 12.5
Free T3 (FT3) 4,00 l                         acceptable range           1.5 - 4.1
Free T4 (FT4) 1,05                          acceptable range          0.89 - 1.76
TSH (third generation) 2,242             acceptable range          0.4 - 4.0
Anti-TPO Ab 10,4                            acceptable range            < 35

All the results are in normal range but after reading about thyroid disorders I realized that normal range doesn’t mean that everything is OK.

Can someone tell me is everything Ok or is something wrong.

Thank you.

[goolarra]

I have to thank gimel for saying exactly what I was thinking.  

I would also suggest a thyroid ultrasound.  High FT3 levels can be caused by an autonomous nodule in the thyroid that produces T3 indiscriminately since it doesn't require TSH so isn't under pituitary control.  

[gimel]

Just thought this info from a good thyroid doctor might be of value in this discussion.  

"The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

So I would say that everything is not okay thyroid wise.  Also, I agree with goolarra that further testing is also needed.

[sstefan]

Thank you very much for your response.

Yes, the value of FT3 is correct (it is according for the lab result) and is at the top of the acceptable range.

[goolarra]

Total T3 and total T4 are considered obsolete tests.  So, let's forget those and concentrate on the FREE T3 and FREE T4, which are much more telling tests.  

Her FT4 is at 18% of range, which is low of the 50% target.  50% is based on where many of us had to be before symptoms were relieved.  

FT3 (please verify that this is correct), on the other hand, is almost at the top of the range.  Once you verify the number, I'll have more to say about this.

TSH, which is the least important of the thyroid tests, is in range, although many people have to have that much lower as well.  TSH is a pituitary hormone, and as such, a very indirect measure of thyroid status.

TPOab is negative for Hashi's, but there is another marker for Hashi's, TGab (thyroglobulin antibodies) that also has to be tested before Hashi's can be ruled out.