Normal TSH, low T3, high T4, normal free T4?!?

[aubreya]

What the heck does it mean? My doctor is less than helpful. In fact, she just wants to give up and ignore how terrible I feel. :(

[gimel]

OMG  No wonder your daughter feels so bad.  Her thyroid hormone levels are very low.  Her symptoms are associated with being hypothyroid.  She is very much hypothyroid, not hyperthyroid.

It is good that she was started on replacement thyroid meds.  What dosage was prescribed?  When is she supposed to go back for followup tests?

As long as she is being adequately tested and treated, there is no need to see another doctor.  You should be aware that in Canada, with the NHS, our experience has been that members have difficulty getting adequately tested and treated.  The fact that she was tested for Free T3 and free T4 is a good sign.  Many doctors there only want to test and treat based on TSH.  That just doesn't work.  You should make sure that she is tested for Free T3 and Free T4 each time.  Also, since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin (as you found out),  she needs to be tested and treated for those to get to optimal levels.

I am not aware if the additional testing for Hashimoto's Thyroiditis, as mentioned by the doctor, costs you anything out of pocket.  If so, you can hold off on that, as well as the psychiatrist for her depression.  Depression is frequently associated with hypothyroidism.   She needs to get her Free T3 level increased as necessary to relieve symptoms, and her Free T4 level  around the middle of its range.  Then you can reassess her needs.  

So please answer the above questions and we'll go from there.  There are a lot of experienced and knowledgeable members on the Forum.  Please hang with us and we will support you and your daughter and provide all the help we can.  

[silvanap]

My daughter of 17yrs was recently diagnosed with hypothyroidism based on her CBC test:
TSH        95.20 ( 0.30-5.50)
T4 Free     7      (11 - 22)
T3 Free     4.8   ( 3.7 -  7.7)

Her physical symptoms are weakness, deep fatigue, depression, sleeping allot, cant focus....has not done any school work in year because cant focus. Used to be a B and A student now she cant even read a few pages without the symptoms interfering.

Went for an ultra sound because she has swelling of the thyroid, and clinic doctor says there is signs of Hashimotos Disease and he will recommend other testing and a psychiatrist for her depression

She was prescribed synthroid but she feels no different in energy or state of mind even though she has been on it for 6 weeks coming up this June2,2013.

She is also low on Ferriton 11   (<11) so she is taking FeraMax.

Her Hematology showed low on her MCHC 322 (33-365)

I am wondering if I should see a different doctor, but I have been out of work for over a year and my saving are almost exhausted, I will have to go on welfare to be able to get free medical care and prescriptions.

Either is the doctor correct in his diagnosis? Looks like hyperthyroidism but all her symptoms are for hypothyroidism?

What more steps do I need to take to ensure she has fruitful, energetic life, and productive life. Her life force and spirit has been slowly fading for almost 3yrs and only now I find out its her thyroid.

[rajivg53]

My mother is 80 years old. Her TSH is 2.27, FT3 1.14 and FT4 3.15, is it normal. Otherwise, what action do I take for her and what it means.

Kindly advise.
Rajiv Goyal

[aubreya]

Very good info to have. I will have my numbers checked again. (I am, by the way, on BC - nuva ring)

My numbers were:
TSH(3rd generation) - 2 weeks ago - 2.32 (range .4-4.5)
T3 UPTAKE- 1 week ago - 22% (range 22-35)
T4 - 1 week ago - 12.4 mcg/dL (range 4.5-12.5)
FT4 - 1 week ago - 2.7 (1.4-3.8)

Also, if it's important: my lipase levels are high (92, range 7-60). They tested this because my stomach has been in terrible pain for a few weeks. The doctors want to dismiss the thyroid problem and just say that I have IBS. The problem with this is that I've only been having stomach pains for 3-4 weeks but I've been having roughly 80%+ of the symptoms of hypothyroidism for years (about 7 for most symptoms).

So.. I should test my numbers again and check antibody levels. Should I also check cortisol/adrenals? Something is clearly wrong in my feedback loop (hypothalamus, pituitary, thyroid) and it's awkward to be pulling my doctor along by a leash. I'm frustrated that she isn't listening to my concerns and doesn't seem to give two honks about this long and pathetic list of symptoms.

[estrelinha]

"T4 is 99.9 percent bound to serum thyroxine binding proteins (TBP). The hormone is transported bound primarily to thyroxine binding globulin (TBG) and secondarily by thyroxine binding prealbumin (TBPA) and albumin. T4 levels may be elevated with increased concentrations of TBG, such as in pregnancy, administration of oral contraceptives or estrogen, etc......;" so it isn't a important lab value here. The free's are more important. T4 is converted in T3, so your total T3 is low (bound T3,  T3 is bound to thyroxine binding globulin (TBG), prealbumin and albumin. but in different %)., may be you're having a problem converting T4 to T3, so I would repeat the analyses to see if this is consistent, also test for thyroid antibodies.

[stella5349]

That's when you need to get yourself involved in your care and know what your labs mean.

It's then - you and your doctor will have more to share in getting you well if you know what is going on with you.

[gimel]

Please post the actual numbers and their ranges.