Need help de-coing lab results

Question

I have classic hypothyroid conditions and have for years. I've had blood tests and every time I get the. "your levels are within normal ranges" answer and the issue is dropped. I finally got my hands on my lab results and I have NO idea what I'm even looking at. Looking up the info on the interwebs did NOT help, in fact I'm now more confused than when I started.

Here are the results

T4, free, direct, s  0.96 HH:mm:ss         ng/dL  0.82-1.77
T3, free, serum 2.9 HH:mm:ss               pg/mL 2.0-4.4
TSH 1.640 HH:mm:ss                            uIU/mL 0.450-4.500

Thanks in advance for the help!

gimel · Answer

Don't know of course what options you have for going to other doctors, but I did locate one in your general area that sounds like the kind of thyroid doctor that you need.  Sending PM with info.

twolilbeans · Answer

I just got back from my appointment and it was a disaster. Apparently I don't have any thyroid issues, I have major depression and need to go on meds right away /sarcasm. Stupid. The doctor actually wanted to argue with me when I said I refuse to believe I have depression and I won't be taking any medication for that. She then treated me like a child by saying, "you know, sometimes there are chemical imbalances in the brain, and its not because of something you've done, you're just born that way and medication can help fill in the gaps where the imbalances are." Really? Wow, a whole knew world of knowledge has just been opened up to me (annoyed). She then refused to send me a referral to a specialist because my numbers are normal. I tried to show her that yes, my numbers are within the "normal" range, but they're still on the low end of normal. I was then informed that there is no "range" it's normal or not. She then explained that going on thyroid meds can give me osteoperosis and something else that I can't pronounce. She eventually sent in a referral to a specialist, but made sure I knew it would be denied as she quickly typed in the notes section. I'm sure she was noting that I was crazy. I find it really hard to take advice from a doctor that uses a computer screen to diagnose conditions. Since when did doctors stop listening to their patients and instead just click on symptoms as they talk? She seriously spent the entire time clicking on symptoms as I explained them to her and when I was done she clicked on results and ta da! This is really sad. I guess it's time to buy some books on thyroid issues.

twolilbeans · Answer

I'm located in Victorville, CA. So far my first doctor says I'm normal...so onto the next doctor. I'll be seeing her tomorrow and hopefully I can get her to actually listen to me rather than my lab results.

Barb135 · Answer

Reference ranges vary from lab to lab, depending on the methodology used for the analysis, along with other criteria.  It will also depend on the units being measured.

mandiful86 · Answer

I don't know if this helps or if it is accurate. I have never seen my hormone results and do not know how to read them. The information below was from about.com and I do believe if the information is correct, then your TSH is normal, T3 is on the low side of normal  and T4 is kind of mid range, but on the lower side of normal. 

If your doctor ran a test called Free T4, or Free Thyroxine, normal range is approximately 0.7 to 2.0. If your result was less than 0.7, your doctor might consider that indicative of hypothyroidism.

If your doctor ran a test called Free T3, normal range is approximately 2.3 to 4.2. If your result was less than 2.3, your doctor might consider that indicative of hypothyroidism

Note the level of your Thyroid Stimulating Hormone (TSH). At most labs in the U.S., the normal range is from around 0.5 to 5.5. However, as of spring 2003, some experts are recommending that labs revise the range from .3 to 3.0.

gimel · Answer

I agree with Barb.  Plus, you need a good thyroid doctor.  By that I mean one that will treat you 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 from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf


So, you are either going to have to take info we can give you and make copies and give to doctor and try to get him to change his mind or, more likely, you are going to have to find a good thyroid doctor elsewhere.   If you will tell us your location, perhaps some member might be able to provide a doctor recommendation based on personal experience.

Barb135 · Answer

Off the top of my head, I'd say your doctor is looking only at the TSH, which many of them do.... shame, shame, shame.

While your Free T3 and Free T4 are "in range", they are very low in their ranges and with those levels, it's very possible to have hypo symptoms. The ranges are far to broad and because of this most of us find that we feel best with FT4 at about mid range, and FT3 in the upper 1/3 of its range; you have a long way to go to get there. 

I'd also wonder if you have been tested for thyroid antibodies to determine if you have the autoimmune disease, Hashimoto's Thyroiditis. With Hashimoto's, the body sees the thyroid as foreign and produces antibodies to attack and destroy it.  This is usually a gradual process and in the beginning it's not unusual to have "normal" thyroid levels.  

You might also request a thyroid ultra sound to determine whether or not you have swelling (goiter) or inflammation in your thyroid, and if you have  nodules.