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Thyroid Question(s)
For over six months I have been working out with a personal trainer monitoring my weight, calories, & exercises I do! I have not lost any weight! I scheduled a Doctors appointment for blood work to be done! I thought I was exhausted due to my exercise regiment, kids, work, ect.... Some of the symptoms I have experienced, exhaustion, constipation, hair loss, weight gain, depression, and moodiness.. Well, I received my blood lab work back and am confused! They test is based on ranges which I fall into however I feel that I am in the lower percentile range. My results were Free T4 (Range (0.6-1.6) NGO/dl. My score was 0.8. My TSH (3rd Gen). Range (0.34-3.00). My score was 0.85. These scores fall in the "normal range however if I don't have a thyroid problem what's going on with me??? If my husband would allow it I would sleep the day away...
Any advice would be greatly appreciated...
Any advice would be greatly appreciated...
Gimel's given you some excellent advice.
Let me just re-iterate that TSH is subject to many influences, other than thyroid hormone levels. So, except as a screening tool, in the absence of symptoms, it's pretty unreliable. FT3 and FT4 are much more important, and sympttoms are most important of all. However, TSH has been taught in medical schools for years as the gold standard in thyroid testing. As a result, many doctors pay attention to little else.
Your FT4 is too low in the range. It should be closer to 1.1 on your range (0.6-1.6). As gimel also pointed out, FT3 should be tested as well.
Secondary hypo is really a pituitary problem. Sometimes, even though your thyroid can work properly, the pituitary can't put out enough TSH to stimulate it to produce T4 and T3. Without TSH, your thyroid can't work. Since both your FT4 and TSH are on the low side, secondary hypo would be indicated.
"The lower the score the better.." is a huge oversimplification of the TSH test. Low TSH indicates hyper (if there is no pituitary problem), and high TSH indicates hypo. FT3, FT4 and TSH all have to be consistent, or the discrepancy has to be explained. When TSH is low, FT3 and FT4 should be high and vice versa.
I agree with gimel that your FT4 indicates hypo and your TSH indicates that it might be secondary hypo. If this doctor won't test further, you may have to shop for one who will. Don't put up with your symptoms just because your doctor is ignorant.
Let me just re-iterate that TSH is subject to many influences, other than thyroid hormone levels. So, except as a screening tool, in the absence of symptoms, it's pretty unreliable. FT3 and FT4 are much more important, and sympttoms are most important of all. However, TSH has been taught in medical schools for years as the gold standard in thyroid testing. As a result, many doctors pay attention to little else.
Your FT4 is too low in the range. It should be closer to 1.1 on your range (0.6-1.6). As gimel also pointed out, FT3 should be tested as well.
Secondary hypo is really a pituitary problem. Sometimes, even though your thyroid can work properly, the pituitary can't put out enough TSH to stimulate it to produce T4 and T3. Without TSH, your thyroid can't work. Since both your FT4 and TSH are on the low side, secondary hypo would be indicated.
"The lower the score the better.." is a huge oversimplification of the TSH test. Low TSH indicates hyper (if there is no pituitary problem), and high TSH indicates hypo. FT3, FT4 and TSH all have to be consistent, or the discrepancy has to be explained. When TSH is low, FT3 and FT4 should be high and vice versa.
I agree with gimel that your FT4 indicates hypo and your TSH indicates that it might be secondary hypo. If this doctor won't test further, you may have to shop for one who will. Don't put up with your symptoms just because your doctor is ignorant.
So I spoke to my Primary Physician and was told that my numbers are great! The lower the score the better and NOT to worry about anything! I asked for additional tests and a thyroid ultrasound and he stated "it's not necessary in my case." I am so confused & upset...
First, TSH is secreted by the pituitary, in response to serum levels of the actual thyroid hormones T4 and T3. When TSH increases, it signals the thyroid gland to produce more hormone. The thyroid gland produces mostly T4, and some T3 thyroid hormones. Most of the thyroid hormone becomes attached to protein. Only the unattached portions ( free ) are biologically active. As mentioned, Free T3 largely regulates metabolism and many other functions. The main function of Free T4 is for conversion to Free T3 when needed. So that is why it is important to make sure they test for Free T3 and Free T4, not Total T3 and T4.
No I do not think it is just you. Your testing so far is inadequate, but the Free T4 coupled with your symptoms, is a pretty clear indication that you are too low in thyroid hormone. Further testing will confirm that.
There is no need to be concerned. The most important thing for you is to get done the testing recommended above, and to find a good thyroid doctor that will treat clinically as described.
No I do not think it is just you. Your testing so far is inadequate, but the Free T4 coupled with your symptoms, is a pretty clear indication that you are too low in thyroid hormone. Further testing will confirm that.
There is no need to be concerned. The most important thing for you is to get done the testing recommended above, and to find a good thyroid doctor that will treat clinically as described.
Thank you for your time & response! This is all new to me. Something I did not think of telling my doctor was about forgetting things and dizziness.. What are all these tests: T4, T3, and a TSH? I am confused. Should I be worried with my symptoms and should I be worried that I have a low T4 result? So it's not me but you also feel the score is low?
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Even though your TSH fell well within the range, there are different types of hypothyroidism. Primary, associated with Hashimoto's Thyroiditis, is typified by high TSH results, as the thyroid gland is gradually destroyed by thyroid antibodies. Central hypothyroidism is typified by normal, or somewhat low TSH results due to malfunctioning of the hypothalamus/pituitary system, resulting in associated low Free T4 and Free T3. This looks to be more likely for your case.
I suggest that you should request to be tested for Free T3, along with the Free T4 and TSH each time you go in for testing. If your Free T3 is in the lower half of its range, then that would be consistent with being hypo. I also suggest that you should request to be tested for Vitamin D, B12, and ferritin.
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 when you see your doctor next you might give him a copy of the letter and ask if he is going to be willing to treat clinically, as described. If not, then you will ultimately need to find a good thyroid doctor that will do so.