Thyroid Profile- Test Results???

Would you interpret these test results as normal? I just got this back from my new doctor today and I am a little puzzled. The Free T4 and T3 seem borderline high to me. What does that mean????

TSH, 1.23 f            (ref range: 0.34-5.6)
Free T4, 0.9 f         (ref range: 0.6-1.2)
Free T3, 4.1 Hf       (ref range: 2.5-3.9)

By the way...I have never been on thyroid medication, nor have I ever been diagnosed with a thyroid disorder. I does run in my family though.

[gimel]

Assuming you are Euthyroid (have neither hypo nor hyper symptoms), then I would be very happy with those lab results.    As they say, "If it ain't broke, don't fix it".

Merry Christmas.

[goolarra]

Your TSH and FT4 look really good.  However, your FT3 is a bit on the high side.  This could indicate the beginning of a thyroid problem.

Since thyroid disorders do run in your family, have you had any antibody testing?  TPOab, TGab and TRab?  These would indicate if you have an autoimmune thyroid disease and would indicate the direction that any further testing should take.

[dustybrown]

I've been very sick for quite awhile. I have had many of the classic symptoms of thyroid disease. My uncle has Graves, grandmother has Hashi's and my father is borderline Hyper. My sister is also having issues with being hypo. I have had a lot of Hyper symptoms off and on throughout my life. I am just plain confused really.

I did have antibodies testing recently and one of the tests was slightly elevated, but not positive. That endo didn't even bother to do ALL of the tests that needed to be done, so I ditched him and found a new doctor who did the FT3, which to my surprise is slightly high. What does it mean when the FT3 is high? I feel horrible all of the time.

Also, my doctor found that I am severely low on Testosterone, Progesterone and DHEA. My adrenal gland is also not working right, but I am not so sure how I feel about Adrenal Fatigue at this point and can't see forking out money for supplements for that. I am however interested in the hormone replacements and very concerned about the life cycle of my thyroid due to my family history.

[gimel]

After Goolarra's post, I noticed in your profile that you are not symptom free, so she's correct, as usual.  Get the additional testing done.

[goolarra]

High FT3 usually indicates hyper.  However, early stages of Hashi's (hypo) can sometimes include a hyper phase before the thyroid goes permanently hypo.

Adrenal fatigue can make it very difficult to regulate thyroid hormones, and many find that until that is resolved, they don't have much luck stabilizing thyroid hormones.

Do you have the actual results of your antibody tests and their ranges?

Have you had anyother thyroid bloodwork, scans, etc.?

[TamraW]

You definitely need both antibodies tested and a thyroid ultrasound, especially with your symptoms and family history. Your FT3 is high and could be the beginning of a thyroid problem.
:) Tamra

[dustybrown]

I tested for the thyroglobulin antibody and the thyroid peroxidase and both were normal. The new doctor did say that even though the thyroglobulin antibody was normal it was a little elevated though. I can't remember what the level was though.

[goolarra]

TPOab can be associated with both Grave's and Hashi's.  TGab is most often associated with Hashi's.  

I think there are two things you can do.  1) Try to get your adrenals under control and retest thyroid hormones after that to see what effect it's had on them.  2) Get further thyroid testing to see what might be causing your high FT3.  I think you need to confirm or rule out Grave's with a TSI.  

Has your doctor suggested any medication or further testing?  Is he paying attention to your symptoms?

[dustybrown]

He has suggested adrenal supplements, but I feel kind of skeptical of these since they come with a big price tag. He has also prescribed hormone creams that I will be trying just to see if they help, but at this point he is not taking the high FT3 results seriously. I am so ill lately and thin (I wear a size two) and am on so many different prescription medications for all sorts of things it's just making me angry that I can't figure out what's going on with my body.  

I am curious about this TSI test. I am also wondering if it's possible for me to test negative for antibodies now, but develop them later on? Like I mentioned before my thyroglobulin antibody was elevated, but still normal. I am wondering if this level could still increase over time?

[corky21]

I may be wrong on this, but I seem to recall on another forum I belong to that the levels for Ft3 used to go as high as 6.0 and then it was changed and lowered. So maybe you need even higher level. Also if you do have some adrenal issues, that can also skew your results and cause symptoms. If you don't want to start adrenal hormone, at least support them with  3 grams a day of a good bioflavnoid Vitamin C, and Rhodiola, or American Ginseng are also helpful.

Another possible cause of the higher T3 is that you may have high Reverse T3. Your lab reading can be showing a larger number of T3 in the blood, but it could be pooling there because much of it is being reversed the other way and that will give you hypo symptoms. It can be pooling if you have low adrenal function.

If you can do so, order a saliva cortisol test kit from ZRT labs and do that before you start on any hormones and get a Reverse T3 test too.

How is your ferritin level, D level, B12?

[goolarra]

What other symptoms have you had besides weight loss?  Have you checked the side effects of your meds (usually the drug websites have good info on this) to see if any of them could be causing your FT3 to be high?

The fact of the matter is that if your adrenals are messed up, it's going to be really hard to both sort out and treat any thyroid problem you might have.

Yes, you can develop antibodies at any time...few of us were born with them (if any), so they had to start at some point.  But, you have to understand that it's usually the antibodies that cause the thyroid dysfunction.  It takes them a while to dsetroy thyroid function, so you can be in range on tests and feel well for quite a while after you develop them.  However, they eventually take their toll.

[dustybrown]

Lately, my symptoms are more Hypo than Hyper related which confuses me. I am cold all of the time. My body temp is low and always has been. I have aches and pains in my shoulders and neck, ear pain, sinus issues and allergies, I have IBS and irritable bladder, my eye doctor told me I should get my thyroid tested when I had my last eye exam because of some eye complaints I had. There are many other symptoms. When I was younger I had severe panic attacks and agoraphobia and I was hospitalized twice for atrial fibrillation. I get heart palpitations- not so much anymore, but there was a point in my life where it was very frequent- when I used to smoke cigarettes (I quit almost 5 years ago).  

I had my saliva cortisol levels tested and that is how I know my adrenals are not quite right, but I know from an ACTH stim test that I don't have Addison's, so I am not too worried. My ferritin level is low. My vitamin D level is on the low side of normal. I don't have a test to reflect my B12.

My uncle and grandmother didn't develop Grave's and Hashi's until they were in their 40's and 50's (or at least it wasn't discovered until then). On top of this my grandmother on the other side of my family had Rheumatoid Arthritis and her mom had Pernicious Anemia. I have degenerative discs, spinal nerve damage and osteoarthritis in my spine already at age 33. My employer can't believe I am still working full time. I feel like a ticking time bomb.

[goolarra]

You have a lot of autoimmune disease in your family, and with both Grave's and Hashi's in ancestors, I think it would be a really good idea to try to pin down what might be going on with further testing.  Since both TPOab and TGab were negative, it doesn't look like Hashi's.  Remember, we wouldn't expect to see sympotms until some time AFTER you tested positive for antibodies...sometimes antibodies can take decades to destroy enough thyroid function to cause problems, but they can also go like gangbusters).  Have you had an ultrasound?

Personally, I'd do the TSI to rule out Grave's.  I'd also do what I had to do and spend what I had to spend (easy for me to say) to get the adrenals under control.  Until they're stabilized, any thyroid treatment you attempt is probably going to be derailed.  Also, work on your D and ferritin and check on that B12, especially with your mom having PA.

I think it's really important for you to decide what direction you want to take this in, define a treatment regimine and timeline with your doctor, and take this all piece by piece and see what symptoms you're left with after each issue is brought under control.  If your current doctor isn't sympathetic to your symptoms, it may be time to find someone who is.  

Did you have tachycardia with your palps?

[dustybrown]

You are very helpful. Thank you for your responses. Because I've been so sick and have mounting medical bills, I am starting with hormone replacements and vitamin d for beginners. This doctor does seem sympathetic compared to the last 500 doctors I've seen, so I think he will be willing to help me as long as I am willing to trust him. He did want me to take the adrenal supplements, but I was a little skeptical and with all of the Fibro, DDD, and arthritis medication I am already on and now the hormones....my gosh I am spending a lot.

You are right about picking apart my issues piece by piece and dealing with them in that fashion. It's just taken me so long to "piece" together the puzzle and the picture is still fuzzy. I will be seeing my doctor again in a month and will probably ask to begin the adrenal supplements, and I will mention the TSI test. I don't think he will have an issue testing me for it with my family history.  

Yes, I did have tachycardia with my heart issues I believe if I understand the meaning correctly- when I go into afib, but that hasn't happened to that degree in a long time. My father also suffers from the same heart issues and is borderline hyperthyroid. When I was in the hospital my heart would not keep a steady beat. It was all over the place. Up and down. They kept me until it came under control. One time I was even hooked up to a defibrillator. Most of the time if I have any heart issues nowadays it's just a mild palpitation where it skips a beat or two, but nothing that severe. It used to wake me up in the middle of the night. Crazy eh?  

Do you have any idea how to get your Ferritin levels under control? I take B12 now, but could probably ask for a test for that.

[goolarra]

I know it doesn't help in the short run, but I'm willing to bet that once you get your hormones under control, you won't need the meds for the fibro and the arthritis.  I think thyroid problems are often misdiagnosed as fibro.  I have arthritis in my back.  When I was really hypo, I got to a point where I could hardly walk.  I literally had to stop between the bed and the coffee pot in the morning...and, no, I do not live in a mansion.  Now, the arthritis is obviously still there, but my muscles are so much stronger that my back bothers me much less.

I asked about the tachycardia (rapid hearr beat) because I have a congenital heart defect that gives me tachycardia.  It runs rampant on my father's side of the family although he didn't have it.  It was under control without meds until I started taking levo, and that made it so much worse.  When I started on levo, it was at its worst between when I went to bed and when I fell asleep...hard to doze off with that going on!

I don't know about ferritin...sorry.  You should have B12 tested.  I have a friend with PA, and she has to take monthly B12 injections since she can't absorb B12 through the gut.