My doctor says results are puzzling

[random222]

TSH 0.060

Thyroid Peroxidase 2319

T3 194

I took these test again, and their are aparently getting worse. I do not have those results yet. What the heck is wrong with me. I am soooooo tired!!!!

[Smilerdeb]

Lol bhoysbae.
Always here if you need some help guys :)
Rember no 2 people are alike but thyroid issue ARE lol.
All the best to you both.

[bhoysbabe]

These were exactly the symptoms I had, blood results showed hyper but
all my symptoms were hypo. I`m getting hyper symptoms now (horrible lol)
and was diagnosed with Graves last week though must say Smilerdebs
diagnosed me b4 doc :-).
Hope you feel better soon

[random222]

Never heard of t3 toxycosis until you mentioned it. Thanks!

This is the second time I have completed the blood work. The doctor wanted to see if I got any better. Results were worse on every test, but same amount of tiredness, not any worse or better. I still have not been given any sort of medication, but the doctor said she wanted to wait for the Endocrinologist.

I also did not know you could have hyper and hypo thyroid issues at the same time! (I really relate to the "being cold but sweating like a pig" part)

[HyperT77]

You defintely have the test results that would suggest Hyperthyroidism.  That's what I have.  I lost weight prior begin diagnosed.  Have heard of people who gain.  The Celexa could be playing a role in the weight gain and keeping the Hyper T symptoms hidden.

It's good that you're going to an Endocrinologist.  Very important.

[Smilerdeb]

In a lot of cases , there can be 'crossover' symptoms.
Both Hypo and Hyper BOTH at the same time.
This is usually where the FT3 is higher than normal and the FT4 lagging behind.
The FT3 causes the Hyper symptoms and the lower FT4 causes the hypo symptoms...hence the 'crossover symptoms'.
It is confusing as I have been through it myself where I couldve sworn I was hyper , only to find I was hypo.
The Free T3 does this and its so annoying as it gives the Pituatory Gland  'false signals' which in turn tries to make up for the over production of FT3 and the tsh goes lower.
You can sweat like a pig sometimes but yet be freezing cold and ache....get my drift?

There are a couple of reasons why this happens.
Usually the FT3 will go too high if the antibodies are high or going high again (viral, flu etc) or over-medication too fast.
Sometimes you can be on too high a dose and the FT4 'lags' behind the FT3.
Thats why I always recommend for everyone to take 'baby steps'.
Yes we can all be in a rush to 'be normal' as they say but most times it pays off to take baby steps with meds, and go it 'slow'.
A pain in the butt but a sure way of getting good results.

Jeni...I still say you have hyperthyroidism with T3 Toxycosis as the antibodies are firing your thyroid up to bring yr tsh down too low.
Others may think different but thats just my personal opinion.
Let us know how you go :)

[T25togo]

This is kinda me... I have a TSH at 0.2, normal FT4 and a high FT3 and have no typical hyper symptoms however I have all these hypo symptoms (memory prob and with the worst one extreme debilitating fatigue in the last few weeks...) I am on Armour 90mg (been on it since July 2008)... I was at TSH .069 and normal FT4 and FT3 when I was feeling OK (not great but OK).  I haven't been tested for antibodies since 2007... I have no idea what is wrong with me- the docs think I need antidepressents but I don't agree.  I don't have the answers yet but you are not alone...

[goolarra]

That was my first thought, too, as you can see above.  Before jeni1122 got her FT4 results, I don't even quite know why the doctor found her results puzzling except when viewed alongside her symptoms (which could be either hypo or hyper, but would most often be interpreted as hypo).

However, how do we explain the FT4?  

[Smilerdeb]

Personally I would say Graves with T3 Toxycosis from the Graves antibodies.
I have had both hypo and hyper symptoms whilst hyper AND gained 16kgs (roughly 34lbs).
Let us know how you go.

[goolarra]

Now, I would really like to see your FT3.  TT3 tells you the total amount of T3 in the blood.  However, some of that T3 is chemically bound and therefore unavailable to the cells.  FT3 actually shows what's usable.  I'd also be interest to see a FT3 and FT4 that were done at the same time.

I'm assuming your FT4 is 0.81?  Is that correct?

Are you on any thyroid meds?  Doubt the other meds are a concern since nothing's changed there.

Unfortunately, your FT4 doesn't make this any less puzzling.  I'm glad your doctor has referred you to an endo.

My only other thought is that this might be Hashi's.  Hashi's often makes people alternate between hyper and hypo.  Perhaps you were at one extreme when your TT3 was drawn and the other when your FT4 was drawn?  Just thinking out loud here.

I'd post another question now that you have your FT4 to add to the discussion.  Maybe your labs will strike a chord with another member.  I'm kind of running out of ideas.  Try to get your labs into the title line.  I'll watch your thread, and if you don't get a lot of response, I can PM some other members that I know do well with labs and ask them to take a look.

Sorry I can't be of more help.

[random222]

I sleep a lot and feel great when I wake up, however, a couple of hours later I am tired again.

I got my t4 yesterday 081 0.9 - 1.8 ng/dl (So Low t4, high t3, Thyroid Peroxidase AB very high, TSH very low.)

I have gain about 20 pounds, mostly, I think because all I do is sleep and eat. I have no energy for exercise. I try and exercise sometimes and I get so tired afterwards. I was a very athletic person and still not overweight with an extra 20 pounds, but closer than I have ever been before.

I have taken oral contraceptives for 6 years now. No childbirth or menopause (I am 27 years old)

I do take Celexa for depression, but I have taken this for a long time.

The doctor's office called today to say they put a referal in to an Endo.

[goolarra]

I'd definitely tell my doctor about the lymph nodes.  It may not be related, but it could be.  It's another piece of the puzzle and might help him to sort it all out.

How is your sleep?  Do you sleep well and a lot and are still fatigued?  Or are you fatigued because your sleep is disturbed and you don't get any rest?

How much weight have you gained, and is there any other possible explanation for it...eating habits, other meds you are taking, change in exercise habits, other recent illnesses/surgeries, menopause, childbirth, oral contraceptives, etc.?

[random222]

Thanks for the info. I am new to all of this. I also have very swollen lymph nodes on the lower head/upper back of neck area. They have been this way for a long time now. Should I tell my doctor?

[goolarra]

Your lab results don't look puzzling - they're pretty classic Grave's.

However, if all your symptoms are HYPO, then it IS puzzling.  

Your TSH is almost zero...very low.  T3, at 194, is above the normal range.  This all indicates that you are hyper.  TPOab is also consistent with Grave's.

Some people do experience fatigue, memory issues and even weight gain when hyper.  I'm not doubting your symptoms, but with your numbers, it's almost impossible for you to be hypo.  Even if we ignore the TSH (it often gets us into more trouble than not), your T3 is over the top.  Next time you have labs run, insist on free T3 rather that total T3.  It gives better information on what your thyroid is doing. Also, a free T4 couldn't hurt.

[random222]

70-170 ng/dl

[goolarra]

I should have also asked what the reference range is on your T3.

[random222]

No hyperthyroid system. All hypothyroid systems (memory issues, fatigue, weight gain)

[goolarra]

It looks like you have Grave's disease (hyperthyroid).

Do you have any other hyper symptoms...hand tremor, sleeplessness, intolerance of heat, inappropriate weight loss, etc.?  Google "graves disease symptoms" and check out the Mayo Clinic site for a more complete list.