Aa
Question about Lab Results
New here. Just got my labs back and am confused. I have hypo symproms and hyper symptoms. I have been Hypo before. My TSH is normally about 1.5 and when it gets over 2.0 I start feeling hypo symptoms. My lab results are
TSH..... 3.960 (.40 - 4.10)
FT3.......3.9 (2.2 - 4.2)
FT4.......6.4 (4.5 - 12.0)
Normally when hypo my TSH is high and my FT3 and FT4 are low. Well these labs show my TSH is high and my FT3 High and FT4 low. The FT3 being high is weird considering the TSH. Doc put me on meds (nature throid) but isn't this going to shoot my FT3 even higher? As it is I don't get but 2 hours sleep a night. what am I missing here? Thanks folks
TSH..... 3.960 (.40 - 4.10)
FT3.......3.9 (2.2 - 4.2)
FT4.......6.4 (4.5 - 12.0)
Normally when hypo my TSH is high and my FT3 and FT4 are low. Well these labs show my TSH is high and my FT3 High and FT4 low. The FT3 being high is weird considering the TSH. Doc put me on meds (nature throid) but isn't this going to shoot my FT3 even higher? As it is I don't get but 2 hours sleep a night. what am I missing here? Thanks folks
COMMUNITY LEADER
Are you getting the labs done at the same time of day? TSH can fluctuate as much as 75% over the course of a day, typically, being higher in the morning.
Wherever you're getting your thyroid panel done, may let your get the antibody tests, as well, otherwise, we can provide you with websites from which you can purchase them, then go to a lab, specified by the site for collection. That may be what you're doing?
I'm sure you'll need a doctor's order to get the ultrasound and/or other imaging tests, which would tell whether you have nodules and if they're toxic.
Remember that not all specialists (endocrinologists) are good thyroid doctors.
Be careful of the xanax, though as I've seen people have a hard time get off them. What happens when we have a thyroid issue is that the adrenals, often, come into play to help the thyroid (both part of the endocrine system), so you could have an abundance of cortisol, along with your high Free T3.
You might try researching a more natural approach for sleep, with melatonin or adaptogens, magnesium, B vitamins, etc - all of which can be calming. Just a thought.
Please post your new results with ranges, when you get them.
Wherever you're getting your thyroid panel done, may let your get the antibody tests, as well, otherwise, we can provide you with websites from which you can purchase them, then go to a lab, specified by the site for collection. That may be what you're doing?
I'm sure you'll need a doctor's order to get the ultrasound and/or other imaging tests, which would tell whether you have nodules and if they're toxic.
Remember that not all specialists (endocrinologists) are good thyroid doctors.
Be careful of the xanax, though as I've seen people have a hard time get off them. What happens when we have a thyroid issue is that the adrenals, often, come into play to help the thyroid (both part of the endocrine system), so you could have an abundance of cortisol, along with your high Free T3.
You might try researching a more natural approach for sleep, with melatonin or adaptogens, magnesium, B vitamins, etc - all of which can be calming. Just a thought.
Please post your new results with ranges, when you get them.
2 Comments
Thanks.I get my labs around 9 30 am every time. They have walk in labs here in San Antonio (no doctors order required) and a large menu of different labs you can order. I will check to see if they have the antibody tests also. I have been to a few endos here and they suck. Numbers readers. If you are within lab specs you are fine lol. When I get over 2. (TSH) I start feeling hypo symptoms. I'm very familiar with xanax and will not take on a regular basis. I should have my labs from yesterday sometime today and will post. thanks again :)
You're lucky you can get labs done that way... We can't do that, here, in Florida. I have to order them online, they send me a lab order and tell me which lab to go to. Fortunately, the lab they specify is not too far away. The cost for a Thyroid panel (Free T4, Free T3 and TSH) is less than $100 doing it that way, but if my doctor orders the labs, they charge my insurance/Medicare hundreds of $$$ for the very same thyroid panel... Crazy, isn't it?
That was my point - many endos are "numbers readers" and unfortunately, the main number they like to read is TSH and they tend not to pay much attention to Free T4 and Free T3, when those are the ones they need to be watching, since TSH neither causes nor alleviates symptoms, nor does it,often, even correlate with FT levels or symptoms.
I thought you must be familiar with xanax, but it's a habit to issue the caution... :-)
That was my point - many endos are "numbers readers" and unfortunately, the main number they like to read is TSH and they tend not to pay much attention to Free T4 and Free T3, when those are the ones they need to be watching, since TSH neither causes nor alleviates symptoms, nor does it,often, even correlate with FT levels or symptoms.
I thought you must be familiar with xanax, but it's a habit to issue the caution... :-)
COMMUNITY LEADER
Free T4 isn't used, directly; it's a storage hormone and has to be converted to Free T3, which is used by individual cells in the body. It's not unusual for Free T3 to remain higher, through conversion, once thyroid production actually declines. Your Free T4 is only at 25% of the range; it should be about mid range, while your Free T3 is at 84% of its range; it should be in the upper half to upper third, depending on where the patient feels best.
Have you had antibody tests to determine if you have Hashimoto's? The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb). You need them both, since some of us have one or the other and some have them both. You should also get the Thyroid Stimulating Immunoglobulin (TSI) test to rule out Graves, since some people do get them both.
It's also common, with Hashimoto's to swing from periods of hyper alternating with periods of hypo and normal before settling into permanent hypo. A hyper phase of Hashimoto's is also considered hashitoxicosis.
With your Free T4 as low as it is, it's apparent that your thyroid is not producing much thyroid hormones, since T4 is the main hormone produced. There are a couple of possibilities as to what's happening since your Free T3 is so high - 1 is that most of the Free T4 being converted to Free T3, as has already been mentioned.
The other possibility is that you could have nodules that are producing hormones independently of your thyroid. This is called toxic nodules. You would need a thyroid ultrasound to help determine this. An ultrasound will determine if you have nodules and if they are hot or cold. Further testing may be needed to determine if the nodules (if present) are producing hormones on their own.
Have you had antibody tests to determine if you have Hashimoto's? The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb). You need them both, since some of us have one or the other and some have them both. You should also get the Thyroid Stimulating Immunoglobulin (TSI) test to rule out Graves, since some people do get them both.
It's also common, with Hashimoto's to swing from periods of hyper alternating with periods of hypo and normal before settling into permanent hypo. A hyper phase of Hashimoto's is also considered hashitoxicosis.
With your Free T4 as low as it is, it's apparent that your thyroid is not producing much thyroid hormones, since T4 is the main hormone produced. There are a couple of possibilities as to what's happening since your Free T3 is so high - 1 is that most of the Free T4 being converted to Free T3, as has already been mentioned.
The other possibility is that you could have nodules that are producing hormones independently of your thyroid. This is called toxic nodules. You would need a thyroid ultrasound to help determine this. An ultrasound will determine if you have nodules and if they are hot or cold. Further testing may be needed to determine if the nodules (if present) are producing hormones on their own.
2 Comments
Thanks barb. I will get more tests. I'm afraid to take the nature throid as I am already operating on 2 hours sleep a day and am afraid to put more t3 in my body. Maybe I'm wrong? Your answer sounds very logical...more than a regular doctor would offer up. I generally get independent lab work and go from there...maybe need to see a specialist and have him order these labs you suggest. I have xanax and will probablyy take one at night to sleep...I hate taking them but might need to until I can get labs done and solid answers. My mind is frenzied from lack of sleep but my body is not tired. thank you so much :)
I also re ran the labs yesterday to make sure the FT3 from the labs a few days ago wasn't a mistake. Hopefully have those back today. :)
"High levels of free T3 is evident early on in cases of hyperthyroidism (overactive thyroid). While the concentration may be normal for a long time in cases of hypothyroidism (underactive thyroid) however, concentration of T3 may be normal for a long time due to the increase in conversion from T4."
- Werlabs - Free T3 (triiodothyronine)
***
"It should be pointed out that, especially in the US literature, the term ‘hashitoxicosis’ is sometimes used to describe an autoimmune thyroid disease overlap syndrome of Graves’ and Hashimoto’s disease.2 In this article the term is strictly limited to the ‘leakage’ symptoms of active Hashimoto’s disease.
Hashitoxicosis is most likely to present in the early stages of autoimmune hypothyroidism."
Touch Endocrinology -
Hashitoxicosis – Three Cases and a Review of the Literature
- Werlabs - Free T3 (triiodothyronine)
***
"It should be pointed out that, especially in the US literature, the term ‘hashitoxicosis’ is sometimes used to describe an autoimmune thyroid disease overlap syndrome of Graves’ and Hashimoto’s disease.2 In this article the term is strictly limited to the ‘leakage’ symptoms of active Hashimoto’s disease.
Hashitoxicosis is most likely to present in the early stages of autoimmune hypothyroidism."
Touch Endocrinology -
Hashitoxicosis – Three Cases and a Review of the Literature
1 Comments
Thank you Red_Star :)
COMMUNITY LEADER
Hi and welcome...
What's the dosage of your NatureThroid and how long have you been on it? It's not unusual for those on desiccated hormones to have higher Free T3 and lower Free T4 levels, because of all the T3 in the desiccated hormones. The fact that your TSH is as high as it is, indicates that your dosage might need to be increased.
Were you on another medication prior to starting the NatureThroid? What medication and what dosage, for how long?
Can you tell us, exactly, what symptoms you have? There are some symptoms that "cross over" (apply to either/both hyper and hypo)...
What's the dosage of your NatureThroid and how long have you been on it? It's not unusual for those on desiccated hormones to have higher Free T3 and lower Free T4 levels, because of all the T3 in the desiccated hormones. The fact that your TSH is as high as it is, indicates that your dosage might need to be increased.
Were you on another medication prior to starting the NatureThroid? What medication and what dosage, for how long?
Can you tell us, exactly, what symptoms you have? There are some symptoms that "cross over" (apply to either/both hyper and hypo)...
1 Comments
Hi and thanks. I am not on any thyroid meds right now. I have a prescription to fill though. has been a year since I was on them briefly and everything went back to normal and I tapered off. all my labs have been fine for a year or so...normal TSH for me being. 1.5 until about 2 months ago i started feeling hypo symptoms. Typical for me is dry hands ..skin hair (and losing hair). declined vision. feeling colder than usual...lethargig...brain fog...sleep disorder...weight gain 9 I eat clean and exercise). So I finally got labs done 3 days ago and the results are the ones posted in my first post. I expected the higher TSH (and normally with low FT3 FT4)...I did not expect the high FT3...higher than it has ever been in any labs ever. So I have a high TSH and a high FT3. this I am confused about. Currently I sleep 1 to 2 hours a night and have pounding heart problems when waking and on and off throughout the day. I have had a stress test and echo test a year ago and apparently have a very strong heart.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
