Need help understanding lab results

[LaurieAnn70]

Good Morning,

I recently had some labwork done after experiencing symptoms of hypothyroid for years.  I've had tests done before - just a very general one (TSH I think) and they always came back in normal range.  I insisted something was wrong and finally found a Dr. who made out a lab requisition for a more complete test.  My results came back high, not low so I am really confused.  If I have most of the symptoms of an underactive thyroid, how can my ranges be high?  The Dr. I saw said I needed to see an endocrinologist that he couldn't prescribe medicine to me  because my situation was a tricky one. Here are my results:

TSH  - 2.45                                             ( lab range is 0.4 - 4)
TOTAL T4  - 7.69                                    (lab range is 4.5 - 12.5)
FREE T3 - 4.8 (high)                                (lab range is 1.8 - 4.2)
FREE T4 - 1.43                                       (lab range is 0.8 - 1.9)
THYROID UPTAKE - 44.80 (high)             (lab range is 21-38)

Any help interpreting my results would be greatly appreciated!
Thanks!

[LaurieAnn70]

Thank you for responding to my post.  Hypothyroid runs in my family (maternal and paternal grandmothers) as do various autoimmune diseases ( i have Psoriasis, my dad has Vitiligo) I have no idea if those play any part - I know some thyroid conditions can be autoimmune related.  I have been feeling this way for 9 years.  It all happened after I had my son.  I couldn't loose any weight, and when I did try diets, it took me twice as long than the average person to loose anything.  Once I would stop a diet,the weight would come right back on in the blink of an eye.  I do have some symptoms of Hyperthryroid on occassion too,  the heart palpitations - thought I had a heart condition there for a while - and anxiety.  Overall, more symptoms of Hypothyroid but like Tamra it sems to go back and forth at time.  

[TamraW]

First of all, too bad the doctors only tested your TSH for all these years. TSH is a pituitary hormone. Measuring the active FT3 and FT4 tell us more about what the thyroid is doing. And if you've been feeling hypo for years, then docs should have given you the TGab and TPOab antibody tests to determine if Hashimoto's is behind it.

BTW - Your TSH is on the high end (indicating hypo) but the frees are on the high end (indicating hyper). There is a lag time between the message the pituitary sends out (TSH) and what the thyroid puts out (frees). I suggest a thyroid ultrasound to determine if you have leaky nodules causing your frees to rise. People with Hashimoto's, though commonly hypo, many times have nodules, rendering us hyper and then hypo again, depending on the week. This is why people with Hashi can have variable frees and TSH.

I had that before I was put on thyroid hormone and my nodules shrunk.I would be tired, depressed, constipated on week, then wired, anxious, diarrhea, the next. It was a wild roller coaster. I thought I was dying.

:) Tamra

[stella5349]

I can see why this was referred. You see, looking at the TSH - that is somewhat high for optimal thyroid screening. Even through most thyroid patients find looking at the TSH as a sole diagnoises isn't great - it is used quite often in general practice. The rule of thumb on the TSH is the lower the lab number the more hyperthyroid you are - the higher = the more hypo. The reference range you had on your sheet is outdated - it was changed to .3-3.0 a while back - so a doctor "could" be looking at that as a high(hypo) issue.

Now the tricky thing is your FT3 ( Free T3) that is high will usually indicate hyperthyroid when this is on the high end.

So in respect - the TSH seems hypothyroid - but the Free T3 read hyperthyroid - Question - what are you?

My thought before seeking an endo - if you are feeling OK - is... run those exact tests again with your doctor but run the FREE t4 and not the total T4 - talk more about your medication and supplements you used prior to the test and change the things that may have inteferred with that test.

It very unusual with your current labs and my opinion  to re trace the day and retest would be good.