Opinions on labs?

[sapoho]

TSH: 0.67  (0.40-4.50)  *my TSH is ALWAYS low, and I am def not hyper)
FT4: 1.1  (0.8-1.8)
FT3: 3.1  (2.3-4.3)

TPO: 1  (<9)
TGAB: 5  (< or = 1)  H

Thyroglobulin: 3.4  (2.8-40.9)

I have fibromyalgia. I suffer fatigue, muscle aches & pains. I have been gaining stubborn weight. This last year has been terrible.

Anyone have any opinions on these numbers? My appt isn't for another week.

[goolarra]

Your FT4 is now at 40% of range, so closer to target than it was in the previous test.  FT3, however, has now dropped to 32% of range.  

Your new GP seems to know which thyroid tests to order, which is a good sign.  

Sorry it took me so long to get back; I've been away for a few days.  I still think a trial dose to see if you feel better is what you want to do.

[sapoho]

I just got some more results in...

I had some other labs run the following day by a new GP I am switching to, and he also ran thyroid labs, including the TSI.
Very surprised he ran these!! I like him even better!

T4, FREE 1.2   (0.8-1.8 ng/dL IG)
T3, FREE 2.9   (2.3-4.2 pg/mL IG)

THYROGLOBULIN ANTIBODIES   4 H   (< or = 1 IU/mL IG)
THYROID PEROXIDASE IG ANTIBODIES 1   (<9 IU/mL)

TSI (THYROID STIMULATING EZ IMMUNOGLOBULIN)
TSI <89  (<140 % baseline)

[sapoho]

I am so sorry, brain fart.
Yes, he tested the TGab in 2012.
Looking at it again, he didn't test TPO's, only the TGab's.

I appreciate your insight, it has really helped me!

[goolarra]

Yes, I understand your TGab was 233 in 2007.  I just wanted to make sure that it was TGab that was tested in 2012, when none were found.

You have a nice balance of FT3 to FT4 which indicates that you convert well.  Tirosint contains only T4; NT has both T3 and T4 in it.  Since at the moment it doesn't look like you need T3, I'd lean toward the Tirosint.  

TSH blocking antibodies attach to TSH receptors in the thyroid and block TSH from attaching.  However, your TSH is low long before it tries to attach.  I don't see the TRab blocking connection here at all.

[sapoho]

It was the TGab that was positive back then, a level of 233 with anything over 40 being positive.

I appreciate your help. The doc mentioned Nature-Thyroid or Tirosint when I was there, and I'm hopeful she won't have any issues with a trial.

I'll look into secondary hypo. Someone also mentioned a TSH blocking antibody too.
I hate my body being such a mystery! My labs are always borderline so no one can really get a good feel of what the heck is wrong!

[goolarra]

Do you know which antibodies they tested for in 2012?  Your TPOab is negative now, so there's a good possibility that it would have been then, too.  Once we have antibodies, we usually have them for life, unless the thyroid is removed.  Often, TPOab is the only antibody tested, which is okay if it comes back positive since it confirms Hashi's.  However, if it's negative, TGab has to be tested, too.  You can't rule it out without testing both.

Your TSH is low.  That could indicate secondary hypothyroidism.  Secondary is when the pituitary doesn't put out enough TSH to stimulate the thyroid to produce hormone.  It's actually a pituitary issue, and combined with Hashi's, it's kind of a double whammy.  

Do you think you could persuade your doctor to start you on a trial dose of thyroid meds to get your FT4 up closer to 50%?  

[sapoho]

It's measured in "< or = 1 IU/mL" and was performed by Quest Diagnostics.

I do have some kind of autoimmune issue, Lupus and Sjogren's has been ruled out. I have one doc who is convinced it is RA, but I have no symptoms of RA... no stiffness, no swelling, xrays show no damage. I have a Rheumatoid Factor that is negative, then barely positive, and some inflammation markers that are always just borderline elevated. The Anti-CCP for RA is always negative. He just keeps pushing very expensive infusions and other treatments on me that are just really harsh meds to be taken for something he seems to be 'guessing' at.

I had a sonogram of my thyroid last year and it showed it's slightly enlarged. It is firm to the touch.
I was positive for the TGab's several years ago, but the doctor wouldn't medicate me because of my TSH.
In 2007:
Thyroglobulin AB: 233.0 (<40)
TSH was .25

But fast forward to 2012, I was tested for antibodies again, and none were found.

It's just so confusing and frustrating.

[goolarra]

TPOab and TGab are the two markers for Hashi's.  Some of us are TPOab positive, some TGab positive and some both.  Yours is elevated, but thyroid antibodies can be somewhat elevated with other autoimmune diseases as well.  What are the units your TGab is in?  That's a bit of an unusual range for TGab.  

[sapoho]

My vit D level is low (supplementing), my sleep is crap... every now & then I break out in a flare of dermagraphism/hives/skin writing.
My thyroid gland is "slightly enlarged and firm-feeling".

[sapoho]

I'm not on any meds.

My hair feels more course, terrible fatigue, aches & pains, weight gain and difficulty losing any, I had some slightly elevated inflammation markers (SED rate, CH50).

Does a TGAB of 5 indicate hashi's?

[goolarra]

Your FT4 is only 30% of range, so short of the 50% recommendation.

FT3 is 40% of range, and the target for FT3 is 50+%.  Your balance of FT3 to FT4 looks good.  FT3 is higher in its range than FT4 is in its.  So, it looks like you are converting well.

Which meds are you on?

Any other hypo symptoms?