Need help with my test results!

[dragonhunter1]

Hi all -

New member to the site (though I have been using info on here for years!), so here is a brief synopsis of what is going on with me. For 9 years I have had an arsenal of seemingly unrelated issues that no doctor has been able to diagnose. I have seen Neuros, Gastros, Cardios, ENTs, GPs, and ERs for these issues that all cropped up at the same time. For years I was told my thyroid is fine but recently found out every single one of my symptoms could all be linked to hypothyroidism and the one test given in a "full blood panel" was not necessarily enough to say if I had a thyroid problem.

My new GP didn't want to do the test when I requested, but relented and finally ordered a handful of tests, though not the whole panel I wanted. The results finally came in and the nurse called to say "your thyroid is fine but get checked every six months because you have the Hashimoto's marker." That's it. No additional information for me. I got the copy of the results today and would like to ask if someone can give me a better idea of what this means and if I need to have more tests done or not...

TPO: 183 IU (in range is <9.0)
TSI: You value:<89 % baseline
T3 UPTAKE: 30% (low 35.0)
T4 FREE: 1.2 ng/dL (low 1.8)
TSH: 1.03 mIU/L (low 4.5)
T3 FREE: 3.0 pages/mL (low 4.2)

[gimel]

So your TPO ab test was over range, indicative of Hashimoto's Thyroiditis, with which your autoimmune system erroneously identifies your thyroid gland as foreign and develops antibodies to attack and eventually destroy the gland.  Along the path to destruction, the gland produces diminishing amounts of T4 and T3, and the TSH rises in a futile effort to stimulate more production.  You must be in the early stages of Hashi's because your TSH is still low in the range.  Or it could be that you also have a dysfunction in the hypothalamus/pituitary system that results in low TSH.  

At any rate, your Free T4 and Free T3 levels are too low and are causing you to have hypo symptoms.  In the words of a good thyroid doctor, "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."

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results and especially not just TSH results.  You can get some good insight from this link written by a good thyroid doctor.

http://www.hormonerestoration.com/Thyroid.html

So, I suggest that you make a copy of this following listing of typical hypothyroid symptoms, and mark those you have.  Then give the doctor a copy of the list of symptoms, and also the link above and ask him to start you on thyroid meds and gradually increase dosage as necessary to relieve symptoms.  

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

If the doctor is unwilling to treat clinically, as described, then you will need to find a good thyroid doctor that will do so.

[dragonhunter1]

Or not, because I apparently can't edit.

Looks like it was reading my greater than and less than signs as HTML and thus deleted that info. Sorry again!

T3 uptake: low (under) 22.0 --- in range 22-35 --- high (over) 35
T4 free: low (under) .8 --- in range .8-1.8 --- high (over) 1.8
TSH: low (under) .4 --- in range .4-4.5 --- high (over) 4.5
T3 free: low (under) 2.3 --- in range 2.3-4.2 --- high (over) 4.2

[dragonhunter1]

Oh, so weird. I actually wrote out the low, normal, and high for each result but for some reason they aren't showing up in my post. I'll go edit that now!

[gimel]

Before getting into a discussion of your test results, please check the reference ranges for Free T4 and Free T3.  They are usually shown with a low limit and a high limit.