Thyroid

[Jenny1950]

Just had blood work done and had the thyroid came back normal . Had the TSH W/reflex to FT4 and results were normal 1.29 does this mean my thyroid was normal .  Have heart palpitations and feel sluggish should there but other tests done on thyroid ?

[gimel]

Those results are good, but you should always make sure they test for both of the biologically active thyroid hormones, which are Free T4 and Free T3.  Free T3 actually correlates best with hypo symptoms.  In addition, if not tested for Vitamin D, B12 and ferritin, I also suggest those.  Low levels can cause symptoms that mimic hypothyroidism.  Also, D and ferritin are important for proper thyroid hormone metabolization.  Since you also have palpitations, it might be god to test for magnesium.  

[Jenny1950]

Thyroid peroxidase (tpo) AB serum result 1 Ref range 9
T4 Free serum 1.3  (ref range 0.8-1.8
TSH 0.65 (0.40-4.50) ref range

[gimel]

Just because lab results fall within the so-called "normal' ranges does not mean they are adequate for you.  Please post your test results and reference ranges shown on the lab report, so we can better assess your status.  

[Jenny1950]

Had TSH ..t4 ...free ... Thyroid peroxidose(tpo) Arab serum and thyroglobulin tested and all are normal. Should I now see specialist?

[gimel]

Yes, I understood that your TSH was 1.29 and therefore, no additional tests were done.  But having a TSH at that level does not preclude hypothyroidism.   The doctor really should be  aware of central hypothyroidism, and consider your symptoms and your Free T4 and Free T3 levels as part of making a diagnosis.  That is why I suggested getting tested for Free T4 and Free T3.  And when you request those tests make sure you emphasize the symptoms you have that could be related to thyroid levels.  

[Jenny1950]

This is what a recent test showed ... TSH Wreflex to Ft4 result 1.29. Ref range 0.40-4.50 normal

[gimel]

The instruction "TSH w/reflex to FT4 only generates additional testing if the TSH is elevated over the reference range.  This is not really adequate for a thorough diagnosis.  TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator to be considered along with more important indicators such as symptoms and also the biologically active thyroid hormones, Free T4 and Free T3.  Also, that test protocol completely misses central hypothyroidism, which is characterized by relatively low TSH and Free T3 and Free T4 that are too low to prevent symptoms.  

So, I suggest that you should go back and request to be tested for both Free T4 and Free T3.  In fact you should make sure they always test for both whenever you go in for tests.  If the doctor resists just insist on it and don't take no for an answer.  

Also be aware that just being anywhere within the ranges does not mean that is adequate for you.  The ranges are far too broad.  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."

If you can get the Free T3 and free T4 tests done, then post results and reference ranges shown on the lab report, we will be glad to help interpret and advise further.