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New to this - tests and symptoms
I had a bunch of tests done that I'll paste in below. I was told that I have Hashi's and have started taking iron. My biggest concern right now is I have what I think is air hunger, I am easily fatigued, a lot of muscle tension, and I just feel so foggy mentally. I'm a sharp, motivated person and I feel like my brain and body cannot keep up. I can't do basic exercise like walking on the treadmill. I can't even read a book aloud to my daughter any longer because I get so winded. I'm slightly overweight according to BMI, but I don't think that has anything to do with it.
I called my endo to see if he would take more tests because of this breathlessness and so on since from reading it sounds like classic thyroid stuff. He told me I had to go to my PCP because it sounds like it could be lungs or heart. So I have an appointment with him tomorrow. I really don't think it is lungs or heart. I was in ER last summer and they checked me out pretty well so unless something has developed in the meantime I don't think that is it.
Sorry if TMI but I also spotted off and on this entire month and I've never done that. Ever. And I'm 47.
What tests should I push my doctor for? More detailed thyroid tests? Hormone levels?
Thank you for any help you can give me!
ACTH – 31 mg/ml
Thyroid Peroxidase Antibodies – 10.1 iu/ml
B12 – 563 pg/ml
Cortisol, Total – 21.9
Magnesium – 2.0
Ferritin – 29
Vitamin D 25-OH D2 =60 mL/min/1.73 m2
CALCIUM 9.7 mg/dl 8.6-10.4 mg/dL
I called my endo to see if he would take more tests because of this breathlessness and so on since from reading it sounds like classic thyroid stuff. He told me I had to go to my PCP because it sounds like it could be lungs or heart. So I have an appointment with him tomorrow. I really don't think it is lungs or heart. I was in ER last summer and they checked me out pretty well so unless something has developed in the meantime I don't think that is it.
Sorry if TMI but I also spotted off and on this entire month and I've never done that. Ever. And I'm 47.
What tests should I push my doctor for? More detailed thyroid tests? Hormone levels?
Thank you for any help you can give me!
ACTH – 31 mg/ml
Thyroid Peroxidase Antibodies – 10.1 iu/ml
B12 – 563 pg/ml
Cortisol, Total – 21.9
Magnesium – 2.0
Ferritin – 29
Vitamin D 25-OH D2 =60 mL/min/1.73 m2
CALCIUM 9.7 mg/dl 8.6-10.4 mg/dL
You do need the D so maybe try splitting your dose and taking half in the morning and the other half in the afternoon. You also need iron, so what kind were you taking?
I am really confused about why your doctor ran all those additional tests. They really don't add anything beyond the Free T3 and a Free T4 result. If your old Free T4 result, at the top of the range, is indicative of current level, and now your Free T3 is slightly below mid-range, it may be that your body is not adequately converting T4 to T3. Also, your Free T3, at 3.0, is too low in the range for many people. So, I think it is important that you find a way to get your iron level increased up to about 70. Then you can see if your thyroid hormone levels become adequate to help your symptoms.
I am really confused about why your doctor ran all those additional tests. They really don't add anything beyond the Free T3 and a Free T4 result. If your old Free T4 result, at the top of the range, is indicative of current level, and now your Free T3 is slightly below mid-range, it may be that your body is not adequately converting T4 to T3. Also, your Free T3, at 3.0, is too low in the range for many people. So, I think it is important that you find a way to get your iron level increased up to about 70. Then you can see if your thyroid hormone levels become adequate to help your symptoms.
I am still taking the B12.
I tried increasing the D and it made me sick.
I started on the iron and felt much worse so I wondered if was messing something up.
It's hard trying one new thing at a time and trying to discern what is impacting what. LOL!
I know I need the iron though because I have so much hair loss I had to start wearing a wig a few years ago. I've always had thin hair, but it became very bad. I'm just wondering if the iron will mess with any of my other numbers.
I was also reading about fluoride. My dentist wanted me to use a high fluoride prescription toothpaste because I had so many cavities. I put it off and put it off. I finally started using it after Christmas and shortly after that I felt the worst (when I started posting here in January). It is the kind of toothpaste you use for two minutes and then don't rinse so it stays on your teeth. I stopped using it.
I tried increasing the D and it made me sick.
I started on the iron and felt much worse so I wondered if was messing something up.
It's hard trying one new thing at a time and trying to discern what is impacting what. LOL!
I know I need the iron though because I have so much hair loss I had to start wearing a wig a few years ago. I've always had thin hair, but it became very bad. I'm just wondering if the iron will mess with any of my other numbers.
I was also reading about fluoride. My dentist wanted me to use a high fluoride prescription toothpaste because I had so many cavities. I put it off and put it off. I finally started using it after Christmas and shortly after that I felt the worst (when I started posting here in January). It is the kind of toothpaste you use for two minutes and then don't rinse so it stays on your teeth. I stopped using it.
FINALLY have my last results... I'm just going to type this up exactly the way it is on the sheet my doctor sent.
Free Thyroxine
Index (FTI), S
Thyroxine Binding
Capacity , S 1.0
TBI Reference
Range: 0.8 - 1.3
Thyroxine, Total, S
8.3 mcg/dL
Reference Range: 4.5
- 11.7
Free Thyroxine Index
8.3 mcg/dL
Reference Range: 4.8
- 12.7
Free Thyroxine
Index (FTI), S
Thyroxine Binding
Capacity , S 1.0
TBI Reference
Range: 0.8 - 1.3
Thyroxine, Total, S
8.3 mcg/dL
Reference Range: 4.5
- 11.7
Free Thyroxine Index
8.3 mcg/dL
Reference Range: 4.8
- 12.7
You mentioned the uptake one. Why would they run that? Could it be that the other test was for Reverse T3?
Are you still supplementing with iron and Vitamin D? If so what is the daily dosage of each?
With that Free T3 test, there is plenty of room to add some T3 med to raise your level as necessary to relieve hypo symptoms. Also, by raising your ferritin level that will help increase the conversion of T4 to T3.
Are you still supplementing with iron and Vitamin D? If so what is the daily dosage of each?
With that Free T3 test, there is plenty of room to add some T3 med to raise your level as necessary to relieve hypo symptoms. Also, by raising your ferritin level that will help increase the conversion of T4 to T3.
Well, long story short... I finally got the other two tests done today.
Free T3 is 3.0 pg/ml (2.2-3.9 pg/mL)
They did the uptake one, but I haven't received that result yet. It sounded like they were sending it to a different lab.
Free T3 is 3.0 pg/ml (2.2-3.9 pg/mL)
They did the uptake one, but I haven't received that result yet. It sounded like they were sending it to a different lab.
Hi gimel,
Thank you for your response. I can live with discomfort as long as I know there is no imminent danger. :-)
I'll see if I can get another doctor to order those tests next week. Hopefully my doctor's medical assistant is around. She knows me well and I think she could probably get another doctor to order them.
Thank you again for your generous help.
Thank you for your response. I can live with discomfort as long as I know there is no imminent danger. :-)
I'll see if I can get another doctor to order those tests next week. Hopefully my doctor's medical assistant is around. She knows me well and I think she could probably get another doctor to order them.
Thank you again for your generous help.
Danger no. Discomfort yes.
Before getting into discussion of the link you provided above, I'd like to take some more time to absorb it. Also, from your above test results, I think we do need to get the Free T3 and Reverse T3 tests done. Can you make that happen next week?
Yes, a therapeutic trial would be a starting dose of med to see how you respond to it.
Before getting into discussion of the link you provided above, I'd like to take some more time to absorb it. Also, from your above test results, I think we do need to get the Free T3 and Reverse T3 tests done. Can you make that happen next week?
Yes, a therapeutic trial would be a starting dose of med to see how you respond to it.
Can you also explain what you meany by therapeutic trial? I'm assuming you mean trying some to see if it makes me feel better symptom-wise?
What do you think of this?
http://chriskresser.com/low-t3-syndrome-i-its-not-about-the-thyroid
http://chriskresser.com/low-t3-syndrome-i-its-not-about-the-thyroid
gimel -
I have no idea who you are, but I am amazed at how generous you are with your time here. Thank you.
The way my tests were written up on the lab slip, the tech was confused and even called someone. I thought she was running the Free T3 so I'm a bit annoyed it didn't get done. I know my doctor wanted it so I'm as confused as you are.
My doctor is a caring man and I have no doubt he will want to help me find an answer. He most definitely will not blow me off or play this down. Unfortunately he is on vacation next week and I'm naturally feeling anxious about all this, especially since I haven't felt very well at all the past week or so.
Am I in any kind of danger with these numbers? I really don't want to see another doctor there, but given how crummy I've felt I'm concerned I have to wait probably two weeks before I will be able to get in and see my PCP again.
I did get some 5000 IU B12 chewable tablets and started on those today.
I have no idea who you are, but I am amazed at how generous you are with your time here. Thank you.
The way my tests were written up on the lab slip, the tech was confused and even called someone. I thought she was running the Free T3 so I'm a bit annoyed it didn't get done. I know my doctor wanted it so I'm as confused as you are.
My doctor is a caring man and I have no doubt he will want to help me find an answer. He most definitely will not blow me off or play this down. Unfortunately he is on vacation next week and I'm naturally feeling anxious about all this, especially since I haven't felt very well at all the past week or so.
Am I in any kind of danger with these numbers? I really don't want to see another doctor there, but given how crummy I've felt I'm concerned I have to wait probably two weeks before I will be able to get in and see my PCP again.
I did get some 5000 IU B12 chewable tablets and started on those today.
Why did they run a Total T3, instead of Free T3? Did the doctor refuse, or did the lab do as they usually do and run Total T3?
I am a bit surprised that your Free T4 is at the top of the range, yet your Total T3 is near the bottom of its range. Based on the Total T3 result, I would expect that your Free T3 is also in the bottom of its range, which is consistent with having hypothyroid symptoms.
As you can see in the following link, the scientific study concluded that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.
http://informahealthcare.com/doi/abs/10.1080/13590840050043521
Looking further at your TSH, along with the FT4 and TT3 results, I would say that you have central hypothyroidism. This is a quote from the link following. "The TSH level is not a measure of thyroid hormone levels--only the free T4 and free T3 are. TSH is a measure of how
much the hypothalamic-pituitary system is attempting to stimulate the thyroid gland. A "normal" TSH tells us only that the
person doesn't have failure of the thyroid gland. It does not tell us that they have sufficient levels of thyroid
hormone. A normal TSH does not "rule out" hypothyroidism. Many, and possibly most people with various degrees of
hypothyroidism have normal TSH levels. Their hypothalamic-pituitary system is dysfunctional and not making sufficient TSH to give
them optimal thyroid levels. The hypothalamic-pituitary secretion of TSH is every bit as fallible as the secretion of any other
pituitary hormone or neurotransmitter. Indeed, the hypothalamus is part of the brain and is affected by its connections to all parts
of the brain. It can be dysfunctional due to genetic alterations, neurotransmitter imbalances, toxins, stress, aging, drugs, etc. A
person who has symptoms of hypothyroidism with freeT4 (FT4) and/or free T3 (FT3) levels in the low end of the laboratory
reference ranges and a "normal" TSH has, by definition, central hypothyroidism."
http://www.hormonerestoration.com/Thyroid.html
So, in summary, your Vitamin D was okay, your B12 could be a bit higher in the range, your ferritin was low so you are supplementing that. The main thing that you need now is for your doctor to accept that you are hypothyroid and prescribe you some T3 med and gradually raise the level of your Free T3 as necessary to relieve symptoms. Do you think there is any chance your PCP will at least give you a therapeutic trial of T3 med?
I am a bit surprised that your Free T4 is at the top of the range, yet your Total T3 is near the bottom of its range. Based on the Total T3 result, I would expect that your Free T3 is also in the bottom of its range, which is consistent with having hypothyroid symptoms.
As you can see in the following link, the scientific study concluded that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.
http://informahealthcare.com/doi/abs/10.1080/13590840050043521
Looking further at your TSH, along with the FT4 and TT3 results, I would say that you have central hypothyroidism. This is a quote from the link following. "The TSH level is not a measure of thyroid hormone levels--only the free T4 and free T3 are. TSH is a measure of how
much the hypothalamic-pituitary system is attempting to stimulate the thyroid gland. A "normal" TSH tells us only that the
person doesn't have failure of the thyroid gland. It does not tell us that they have sufficient levels of thyroid
hormone. A normal TSH does not "rule out" hypothyroidism. Many, and possibly most people with various degrees of
hypothyroidism have normal TSH levels. Their hypothalamic-pituitary system is dysfunctional and not making sufficient TSH to give
them optimal thyroid levels. The hypothalamic-pituitary secretion of TSH is every bit as fallible as the secretion of any other
pituitary hormone or neurotransmitter. Indeed, the hypothalamus is part of the brain and is affected by its connections to all parts
of the brain. It can be dysfunctional due to genetic alterations, neurotransmitter imbalances, toxins, stress, aging, drugs, etc. A
person who has symptoms of hypothyroidism with freeT4 (FT4) and/or free T3 (FT3) levels in the low end of the laboratory
reference ranges and a "normal" TSH has, by definition, central hypothyroidism."
http://www.hormonerestoration.com/Thyroid.html
So, in summary, your Vitamin D was okay, your B12 could be a bit higher in the range, your ferritin was low so you are supplementing that. The main thing that you need now is for your doctor to accept that you are hypothyroid and prescribe you some T3 med and gradually raise the level of your Free T3 as necessary to relieve symptoms. Do you think there is any chance your PCP will at least give you a therapeutic trial of T3 med?
Okay, test results:
TSH = 0.72 (range 0.3-5)
T4 Free = 1.6 (range 0.6 - 1.6)
T3 Total = 97 (range 80-220)
Folate = 17.5 (range 5.9-24.8)
B12 - 637 (range 180-900)
Thoughts?
TSH = 0.72 (range 0.3-5)
T4 Free = 1.6 (range 0.6 - 1.6)
T3 Total = 97 (range 80-220)
Folate = 17.5 (range 5.9-24.8)
B12 - 637 (range 180-900)
Thoughts?
You have already had the antibodies test, so no need to repeat. Problems with Reverse T3 are not very common. Since you are paying out of pocket, as I recommended previously, I would just do the TSH, Free T3 and Free T4 as a start.
After doing some reading on Stop the Thyroid Madness, I am wondering if I should also ask for a couple of other tests. Based on what that site says, I came up with this list:
TSH
Free T4
Free T3
antibodies
Reverse T3
I have to pay for all the tests so I only want to do what I have to at this point. I've already had a TSH test. Should I get it redone so it is done at the same time as the others? Same thing with the antibodies. I had them done once. Should I ask for them to be redone? Do you think I should ask for the Reverse T3 or wait to see how the others come back?
Thank you!
TSH
Free T4
Free T3
antibodies
Reverse T3
I have to pay for all the tests so I only want to do what I have to at this point. I've already had a TSH test. Should I get it redone so it is done at the same time as the others? Same thing with the antibodies. I had them done once. Should I ask for them to be redone? Do you think I should ask for the Reverse T3 or wait to see how the others come back?
Thank you!
If your last Vitamin D tests are indicative of you already taking 1000 IU daily, then yes, increase by 1000.
I already do take a chewable 1000 IU of D3 each day. Are you saying take another one every day?
You are very welcome. Looking back, I think I misread your Vitamin D. At 39, you could stand to add about 1000 IU of D3 daily, in addition to the iron, and some B12.
Thank you for your reply!
The range for the Thyroid Peroxidase antibodies test was 0.0-8.9 IU/mL and my result was a 10.1.
I've started on Feosol Complete for the iron. I've never had success with iron, but so far this one hasn't bothered me. I'm on Pepcid and Prevacid once a day each for another health issue and I've read that those are bad for iron absorption which probably explains that low number.
My PCP is pretty good about working with me so I'll insist on the Free T3, Free T4, and TSH tests tomorrow. If you think I should ask for any other tests, feel free to suggest them!
My endo's unwillingness to order any more tests after everything I've read online really ticks me off. I also don't understand why he would tell me I have Hashi's and come back in nine months. Not impressed and that wasn't at all how he struck me in our first meeting. I was expecting much better.
Thank you for your help! :-)
The range for the Thyroid Peroxidase antibodies test was 0.0-8.9 IU/mL and my result was a 10.1.
I've started on Feosol Complete for the iron. I've never had success with iron, but so far this one hasn't bothered me. I'm on Pepcid and Prevacid once a day each for another health issue and I've read that those are bad for iron absorption which probably explains that low number.
My PCP is pretty good about working with me so I'll insist on the Free T3, Free T4, and TSH tests tomorrow. If you think I should ask for any other tests, feel free to suggest them!
My endo's unwillingness to order any more tests after everything I've read online really ticks me off. I also don't understand why he would tell me I have Hashi's and come back in nine months. Not impressed and that wasn't at all how he struck me in our first meeting. I was expecting much better.
Thank you for your help! :-)
What was the reference range shown for the Thyroid Peroxidase antibodies test?
I can't believe that an Endo would do all those tests and say that you have Hashi's, and not do a single thyroid related test. So tomorrow when you see your PCP you should request to be tested for Free T3, Free T4, and TSH. If the doctor resists just insist and don't take no for an answer. Also, you should always make sure they test you for those every time you go in for tests.
To best assess the above results we would need to see their reference ranges shown on the lab report. Results and ranges very from lab to lab so it is important to always compare results to the reference ranges on the lab report. I can see that your Vitamin D is adequate. Your B12 is a bit lower than recommended, which is the upper part of its range. Your ferritin is way too low. For women it is recommended to be at least 60. Ferritin is very important for a hypo patient.
When you have results from your tests tomorrow, please post, with ranges and we will be happy to help interpret and advise further.
I can't believe that an Endo would do all those tests and say that you have Hashi's, and not do a single thyroid related test. So tomorrow when you see your PCP you should request to be tested for Free T3, Free T4, and TSH. If the doctor resists just insist and don't take no for an answer. Also, you should always make sure they test you for those every time you go in for tests.
To best assess the above results we would need to see their reference ranges shown on the lab report. Results and ranges very from lab to lab so it is important to always compare results to the reference ranges on the lab report. I can see that your Vitamin D is adequate. Your B12 is a bit lower than recommended, which is the upper part of its range. Your ferritin is way too low. For women it is recommended to be at least 60. Ferritin is very important for a hypo patient.
When you have results from your tests tomorrow, please post, with ranges and we will be happy to help interpret and advise further.
The post cut off my test results. Here they are:
ACTH – 31 mg/ml
Thyroid Peroxidase Antibodies – 10.1 iu/ml
B12 – 563 pg/ml
Cortisol, Total – 21.9
Magnesium – 2.0
Ferritin – 29
Vitamin D 25-OH D2 <4 ng/ml
Vitamin D 25-OH D3 39 ng/ml
Vitamin D 25-OH Total 39 ng/ml
PROLACTIN 19.2 ng/ml
Phosphorus 3.3 mg/dl
SODIUM 144 mmol/l
Protein, Total 6.9 g/dl
ALBUMIN 3.9 g/dl
BILIRUBIN, TOTAL 0.4 mg/dl
ALKALINE PHOSPHATASE 45 iu/l
ALT 12 iu/l
AST 15 iu/l
Anion Gap 13 mmol/l
POTASSIUM 4.6 mmol/l
CHLORIDE 103 mmol/l
HCO3 28 mmol/l
GLUCOSE 96 mg/dl
BUN 12 mg/dl
CREATININE 1.03 mg/dl
ACTH – 31 mg/ml
Thyroid Peroxidase Antibodies – 10.1 iu/ml
B12 – 563 pg/ml
Cortisol, Total – 21.9
Magnesium – 2.0
Ferritin – 29
Vitamin D 25-OH D2 <4 ng/ml
Vitamin D 25-OH D3 39 ng/ml
Vitamin D 25-OH Total 39 ng/ml
PROLACTIN 19.2 ng/ml
Phosphorus 3.3 mg/dl
SODIUM 144 mmol/l
Protein, Total 6.9 g/dl
ALBUMIN 3.9 g/dl
BILIRUBIN, TOTAL 0.4 mg/dl
ALKALINE PHOSPHATASE 45 iu/l
ALT 12 iu/l
AST 15 iu/l
Anion Gap 13 mmol/l
POTASSIUM 4.6 mmol/l
CHLORIDE 103 mmol/l
HCO3 28 mmol/l
GLUCOSE 96 mg/dl
BUN 12 mg/dl
CREATININE 1.03 mg/dl
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