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Thyroid lab results help
Hi everyone,
I am new to this forum. Was wondering if you could give opinions on my lab results:
TSH .06 (.46-3.59)
Free T4 .7 (.9-2.0)
Free T3 362 (180-420)
T3 Uptake 22 (24-39)
Reverse T3 12.6 (9.2-24.1)
I am new to this forum. Was wondering if you could give opinions on my lab results:
TSH .06 (.46-3.59)
Free T4 .7 (.9-2.0)
Free T3 362 (180-420)
T3 Uptake 22 (24-39)
Reverse T3 12.6 (9.2-24.1)
I noticed that my TSH level was mistated it is .6 not .06 (.46-3.59) . So it is in range, but on the lower end.
I did get a CBC, but I don't see serum iron, TIBC and % saturation unless it's listed as something else. :) And I definitely don't see B12 levels listed.
I will check out the cortisol test online...is there anywhere you recommend in particular?
Thank you so much for the advice!
I did get a CBC, but I don't see serum iron, TIBC and % saturation unless it's listed as something else. :) And I definitely don't see B12 levels listed.
I will check out the cortisol test online...is there anywhere you recommend in particular?
Thank you so much for the advice!
One thing that is very puzzling is that your TSH was very low, and you were not taking thyroid med, yet you still had thyroid hormone in your body. What is causing the production of the thyroid hormone? I think that is a question you should ask your doctor and maybe ask for an ultrasound of your thyroid gland. I want to think through the implications of this some more.
I would not suggest T4 med at that high dose without exploring a couple of other things first. The reason I say that is your Free T4 is actually below range, which obviously is way too low. However, your Free T3 is at 75% of its range. That tells me that something is causing your body to convert a lot of T4 to T3, but it doesn't seem to be getting into your cells as necessary to maintain body functions adequately. This could be related to several things, such as Low D, low cortisol, or high or low ferritin/iron. I am assuming that the other possibilities mentioned were not a factor, since you did not respond to any of those. You know your Vitamin D was low, so you need to supplement with about 4000IU of D3 daily to raise your level to about 55-60. The one cortisol test was on the low side. It would be much better to do a diurnal saliva cortisol test at 4 times during the day. Doctors are resistant to doing that test so you would have to order a kit from an online source and do it yourself. Cost is about $140 total.
So maybe the best approach is the cautious one. I would ask the doctor about starting on a lower dose for a few weeks to avoid any reaction to the high starting dose of 125 mcg. I would also ask the doctor about getting an ultrasound test and also a ferritin test, along with a full iron test panel of serum iron, TIBC, and % saturation. Also good to test for Vitamin B12. . Meanwhile supplement your Vitamin D and see about getting the diurnal cortisol tests.
I would not suggest T4 med at that high dose without exploring a couple of other things first. The reason I say that is your Free T4 is actually below range, which obviously is way too low. However, your Free T3 is at 75% of its range. That tells me that something is causing your body to convert a lot of T4 to T3, but it doesn't seem to be getting into your cells as necessary to maintain body functions adequately. This could be related to several things, such as Low D, low cortisol, or high or low ferritin/iron. I am assuming that the other possibilities mentioned were not a factor, since you did not respond to any of those. You know your Vitamin D was low, so you need to supplement with about 4000IU of D3 daily to raise your level to about 55-60. The one cortisol test was on the low side. It would be much better to do a diurnal saliva cortisol test at 4 times during the day. Doctors are resistant to doing that test so you would have to order a kit from an online source and do it yourself. Cost is about $140 total.
So maybe the best approach is the cautious one. I would ask the doctor about starting on a lower dose for a few weeks to avoid any reaction to the high starting dose of 125 mcg. I would also ask the doctor about getting an ultrasound test and also a ferritin test, along with a full iron test panel of serum iron, TIBC, and % saturation. Also good to test for Vitamin B12. . Meanwhile supplement your Vitamin D and see about getting the diurnal cortisol tests.
Thanks gimel!
Got the results back from the TRH test and definitely have low thyroid/hypothalamus problem. I have not asked for a B12 or Ferritin test yet...I know I need to do that!
He's starting me on 125mcg of Tirosint. I did just a bit of research and this appears to be a T4 only medication. I've read on stop the thyroid madness that a T3/T4 medicine is better. Or would that not be the case in my circumstance?
He's brining me back in two months to do follow up blood work.
Got the results back from the TRH test and definitely have low thyroid/hypothalamus problem. I have not asked for a B12 or Ferritin test yet...I know I need to do that!
He's starting me on 125mcg of Tirosint. I did just a bit of research and this appears to be a T4 only medication. I've read on stop the thyroid madness that a T3/T4 medicine is better. Or would that not be the case in my circumstance?
He's brining me back in two months to do follow up blood work.
Many times hypo patients taking thyroid med find that their levels of Free T4 and Free T3 don't really rise adequately until the TSH becomes suppressed to the low end of the range, or below. Then the serum levels are totally dependent on the meds. Many of our members say that relief from hypo symptoms required Free T4 at the middle of its range, and Free T3 in the upper third of its range. A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results and especially not just TSH results. You can get some good insight from this link written by a good thyroid doctor.
http://www.hormonerestoration.com/Thyroid.html
Just looking at your Free T4 it is actually below range. Your Free T3 is at about 76% of its range, which would be good, if your Free T4 was around the middle of its range. They need to be considered together. As mentioned above, sometimes the body will convert more T4 to T3 in an effort to maintain thyroid effect. Taken together, along with your symptoms, they indicate hypothyroidism to me.
Another possible contributor to your level of Free T3 is what is called "pooling of T3 in the blood", rather than getting to all areas of the body needing thyroid hormone. Here is some info on that subject.
How does T3 Pool? The cause of T-3 pooling can be any one of the following or a combination of the following:
High cortisol
Low cortisol
High iron
Low iron
Medications
beta blockers
Amiodarone
Iodinated contrast media
Lithium
Your serum cortisol test was low, but it would be better to do a diurnal saliva cortisol test panel of 4 tests taken at different times of day. Your Vitamin D is way too low, needs to be about 55-60. You also need to test for B12 and ferritin. Low ferritin can also cause hair loss.
So I would say it would be a good idea to get these additional tests done to see if you need to supplement to optimize levels. B12 should be in the high end of its range, and ferritin should be about 70 minimum. Since these can be affecting your thyroid status, it would be a good idea to find out results even before starting back on thyroid med. By the way thyroid meds are not drugs. They are hormones, which occur naturally in the body and are only being supplemented as needed.
http://www.hormonerestoration.com/Thyroid.html
Just looking at your Free T4 it is actually below range. Your Free T3 is at about 76% of its range, which would be good, if your Free T4 was around the middle of its range. They need to be considered together. As mentioned above, sometimes the body will convert more T4 to T3 in an effort to maintain thyroid effect. Taken together, along with your symptoms, they indicate hypothyroidism to me.
Another possible contributor to your level of Free T3 is what is called "pooling of T3 in the blood", rather than getting to all areas of the body needing thyroid hormone. Here is some info on that subject.
How does T3 Pool? The cause of T-3 pooling can be any one of the following or a combination of the following:
High cortisol
Low cortisol
High iron
Low iron
Medications
beta blockers
Amiodarone
Iodinated contrast media
Lithium
Your serum cortisol test was low, but it would be better to do a diurnal saliva cortisol test panel of 4 tests taken at different times of day. Your Vitamin D is way too low, needs to be about 55-60. You also need to test for B12 and ferritin. Low ferritin can also cause hair loss.
So I would say it would be a good idea to get these additional tests done to see if you need to supplement to optimize levels. B12 should be in the high end of its range, and ferritin should be about 70 minimum. Since these can be affecting your thyroid status, it would be a good idea to find out results even before starting back on thyroid med. By the way thyroid meds are not drugs. They are hormones, which occur naturally in the body and are only being supplemented as needed.
Thank you for replying!
I went to a health and wellness doctor a few years ago with hypo symptoms. He said my TSH was a little low, so put me on 60mg of Armour. I asked for additional tests (based on what I researched online), but he did not feel it was necessary. I did not notice any difference on 60 mg dosage so he bumped it up to 120mg. Again, I did not seem to notice my symptoms going away (VERY difficult to lose weight, tired, losing hair).
I stopped taking Armour about a year ago because I did not want to put drugs in my body if not necessary. I am currently not on any medication.
Fast foward to now. I decided I needed to go to someone who specialized in thyroid since I am still having the same issues (most frustrated with inability to lose weight and hair loss). I went a couple of weeks ago and the above were the test results. He said my FT4 was low but everything else looked good so he wanted to do additional TRH test...which I did this morning.
I didn't ask why to be honest. Do you treat all hypo the same (Low FT4, normal TSH). Is my FT3 considered low even though it's in range? It looks high in the range to me.
I went to a health and wellness doctor a few years ago with hypo symptoms. He said my TSH was a little low, so put me on 60mg of Armour. I asked for additional tests (based on what I researched online), but he did not feel it was necessary. I did not notice any difference on 60 mg dosage so he bumped it up to 120mg. Again, I did not seem to notice my symptoms going away (VERY difficult to lose weight, tired, losing hair).
I stopped taking Armour about a year ago because I did not want to put drugs in my body if not necessary. I am currently not on any medication.
Fast foward to now. I decided I needed to go to someone who specialized in thyroid since I am still having the same issues (most frustrated with inability to lose weight and hair loss). I went a couple of weeks ago and the above were the test results. He said my FT4 was low but everything else looked good so he wanted to do additional TRH test...which I did this morning.
I didn't ask why to be honest. Do you treat all hypo the same (Low FT4, normal TSH). Is my FT3 considered low even though it's in range? It looks high in the range to me.
From those test results it is most likely that you have central hypothyroidism. Central hypothyroidism is a dysfunction in the hypothalamus/pituitary system that results inTSH that is relatively low in the range and and Free T4 and Free T3 that are too low, with resultant hypo symptoms.
Not really sure what further information is to be learned from a TRH test, Note the following.
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."
A few questions before going further. What was the diagnosed cause when you were originally placed on thyroid meds? How did you feel on the 120mg of Armour Thyroid? What med and dosage are you taking now? What symptoms do you have?
Not really sure what further information is to be learned from a TRH test, Note the following.
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."
A few questions before going further. What was the diagnosed cause when you were originally placed on thyroid meds? How did you feel on the 120mg of Armour Thyroid? What med and dosage are you taking now? What symptoms do you have?
My endo said he wanted to do a TRH test before medicating. I am just so new to all of this that I really don't understand my results and I'm a little anxious. I have gone through pages and pages of this forum to look for someone that had similar results and I haven't really found anything.
I was treated previously from a doctor that only tested TSH. I was on 120mg of Armour.
What do my results say to you? Should I have anything else tested?
If it is a pituatary issue, how is it treated? Sorry so many questions, just don't know what to think right now.
I was treated previously from a doctor that only tested TSH. I was on 120mg of Armour.
What do my results say to you? Should I have anything else tested?
If it is a pituatary issue, how is it treated? Sorry so many questions, just don't know what to think right now.
Oh and not sure if this helps, but:
Total T4 5.9 (4.5-12)
Vitamin D 28 (30-100)
Cortisol 5.1 (4-20)
Prolactin 2.8 (0-15)
Total T4 5.9 (4.5-12)
Vitamin D 28 (30-100)
Cortisol 5.1 (4-20)
Prolactin 2.8 (0-15)
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