Test Results

[metalchickphd]

Recently had results returned; note :results were read to doctor over phone by office assistant.. then I was told all is NORMAL.. so I went to get a copy myself.  Still fell like I could be hypo..but numbers don't add up; Any ideas: and these test ranges are not the range ratings I see in other posts.....

TEST                               Result             RANGE                   REfereance range
T4, Free calculated        1.88                      In                                  1.4-3.8

T4, Total                         4.4                       Low                                4.5-12.0MCG/DL

T3 Uptake                         42.8                     High                            22.0-35.0%

Ferritin                               11                         In                            10-154 NG/ML

TSH                                   1.80                   In                               0.40-4.50 mIU/L

Other notes Vitamin B12 is 365 out of 200-1100 but anything under 400 is realtive to low.
Vitmain D, 25-OH Total  is low at 29  range is 30-100

and Lipids
Cholesteral          152    range 125-200  MG/DL
HDL                        64    range  > or = 46 MG/DL
Choles/HDL Ratio   2.4  range  < or = 5.0
LDL   calculated       78  range   < 130 MG/DL

[goolarra]

Ranges vary lab to lab and have to come from your own lab report.  

That being said, your test DO have different ranges, mostly because your doctor ordered an impressive array of obsolete tests.

FT4 calculated is also called FTI (free T4 index).  It's been replaced by a direct FT4 test.  Rule of thumb for FT4 is that it should be midrange.  I don't know how that correlates with FTI, but you can see that FTI is far below midrange.

Total T4 is also considered a bit of a waste of money.  Much of the total T4 it measures is chemically bound and unavailable for use, FT4 (direct) has relaced it.  However, as you can see, it is below range, i.e. not "normal", especially if you apply the 50% rule to it.

T3 uptake has been deplaced by a direct free T3.  Higher T3 uptake indices lower functioning thyroid.  Once again, I don't know how anyone could say your result was "nomal".  Likewise, B-12 and D are in need of supplements.

If I were you, I'd either ask my doctor to run proper tests or find a new doctor who knows what to run.  You should be tested for FREE T3 and FREE T4 and TSH.  In addition, you might want to ask to have thyroid antibodies (TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies), tested to see if you have Hashimoto's thyroiditis, and autoimmune disease that is the most prevalent cause of hypo in the developed world.  

D, B-12 and ferritin deficiencies can all mimic thyroid symptoms. You need to start addressing those and, at the same time, get proper thyroid testing.

What are your symptoms?

Your ferritin needs work.  Adequate iron and ferritin are necessary for proper thyroid hormone metabolism.  You should discuss supplementing with your doctor.

[Red_Star]

The short answer: low/deficient vitamin B12, iron, vitamin D, hypocholesterolemia, and thyroid binding protein deficiency.

The long answer: :)

Vitamin B12 - 550pg/mL is the lowest acceptable level for Japan and many countries in Europe. This is not optimal by any means.

Ferritin - recommendation over 70ng/mL

Vitamin D - vitamin D council recommends between 50 - 80ng/mL year round

Hypocholesterolemia is classed as under 160mg/dL by the American Heart Association. Low cholesterol is associated with increased mortality (death) mainly due to depression, cancer, haemorrhagic stroke, aortic dissection, and respiratory diseases.  

From Wikipedia's article "Hypocholesterolemia":

"Possible causes of low cholesterol are:[citation needed]

statins
hyperthyroidism, or an overactive thyroid gland
adrenal insufficiency
liver disease
malabsorption (inadequate absorption of nutrients from the intestines), such as in celiac disease
malnutrition
abetalipoproteinemia - a rare genetic disease that causes cholesterol readings below 50 mg/dl. It is found mostly in Jewish populations.
hypobetalipoproteinemia - a genetic disease that causes cholesterol readings below 50 mg/dl
manganese deficiency
Smith-Lemli-Opitz syndrome
Marfan syndrome
leukemias and other hematological diseases[2]"

While T3 uptake is now considered an obsolete test, low T4 and high T3 uptake indicates low thyroid binding protein (TBG).

From Medscape article "Thyroid Binding Protein Deficiency"

"Causes of TBG deficiency include:

TBG gene defects - Partial deficiency (X linked) and complete deficiency (X linked)

Other genetic defects - Carbohydrate-deficient glycoprotein syndrome type 1 (CDG1), which is autosomal recessive

Acquired causes of TBG deficiency include the following:

Hyperthyroidism
Nephrotic syndrome[2]
Chronic renal failure
Chronic liver disease
Severe systemic illness (but not in human immunodeficiency virus/acquired immunodeficiency syndrome [HIV/AIDS] or acute intermittent porphyria)[3]
Malnutrition
Acromegaly (in very rare cases only)[4, 5]
Cushing syndrome
Drugs (eg, androgens, glucocorticoids, L-asparaginase)"

"Consultations

In cases of secondary thyroxine-binding globulin (TBG) deficiency, referral to consultants should be made as appropriate for the evaluation and treatment of the primary disorder.

A geneticist may be of value for selected cases of inherited TBG deficiency. Occasionally, referral to an endocrinologist is necessary, because concomitant disease (eg, euthyroid sick syndrome, glucocorticoid therapy, concurrent thyroidopathy) may complicate the laboratory test picture in TBG deficiency, rendering the establishment of the diagnosis almost impossible without expert subspecialty input. Follow-up evaluations with the endocrinologist may be necessary until the concurrent illness subsides."

[metalchickphd]

Note; Female 39 yrs. old,