Thyroid

Hello Doctor,
I was informed by my family doctor that I am a thyroid patient and I should take medicine. I was take proper medications for this and yesterday I got a test done and the results are as under:

Thyroid Profile
T3 (Total) (CLIA) - Result: 1.30 ng/ml - Biological Ref Interval: 0.4 - 1.8 ng/ml
T4 (Total) (CLIA) - Result: 5.06 ug/dl - Biological Ref Interval : 5.1 - 14.1 ug/dl
TSH (Ultrasensitive) (CLIA) - Result: 22.47 uIU/ml  Biological Ref Interval: 0.2 - 8.5 uIU/ml

Could you kindly let me know whether the readings are under control? Or still have a very bad Thyroid.
And what readings/numbers are ok for a good thyroid. Can this be controled, if I am on the higher side.

[goolarra]

Total T3 and total T4 measure the total amount of T3 and T4 in your blood.  However, much of that is chemically bound by protein and unavailable to your cells.  FREE T3 and FREE T4 measure the amount available and are preferable to total T3 and total T3.

Your total T4 is still very low.  It's below reference range, indicating that you are still hypo.  TSH is way above range, and this indicates hypo as well.  No, it is not under control yet.  It looks like you need your meds increased.

The rule of thumb for FT4 is middle of the range, and for FT3, it's the upper half of the range.  So, you have quite a way to go.

How do you feel?  Still hypo?

[FTB4]

I am not familiar with your lab results beacause the values and reference ranges are different than here in the US, but comparing them with your ranges, you have a very high TSH, your T3 and T4' are totals, which here we use Free T3 and Free T4, but again I would say they are a little low compared to the ranges. I would say you are not at an optimal level in regards to your lab results and may need an increase in the dose of your medication. I will explain how the thyroid works and what these lab results mean, this way when you get them, you can understand what they mean. Your thyroid is a gland shaped like a butterfly just below "The adams apple" The hormone that is secreted into your body by this gland is called  T4, Then your body converts this T4 to T3, It is the T3 that your body functios on, also controlling the body's metabolism. When the T3/T4 is low, another small gland(The Pituitary) in the brain senses this lack of hormone and sends a signal to the Thyroiud to produce more T4, This is called "Thyroid Stimulating Hormone"  "TSH"  So when the T4/T3 levels in your body are low, this TSH is high, and also works the opposit, when the T3/T4 levels are high, the TSH is low. This blood test is omly a rule of thumb to determine if a thyroid issue is present, the Free T3 and Free T4 should be used to determine dosage of medication along with your symptoms and how you feel, In the US they do not use Totals anymore, They use "Free" Free is the residual or floating hormone available for your body's use. I hope this response makes your lab results a little easier to understand. Good Luck FTB4

[rri_manju]

Thank you very much for your reply. In fact when I met a doctor here, she
too suggested me and increased the dosage.

Manju

[rri_manju]

Hello, Thanks for your reply. Yes, indeed I understand what is thyroid
from your brief note. The doctor with whom I had consultation has increased
my medicine dosage. Lets see after six weeks, how the test results will be..

Thanks once again,
Manju

[rri_manju]

Hello,
As per docs instructions I started taking the increased dose, but its very difficult for me for me withstand. I donot know its due to increased dose or due to some other prob. The BP is under control. Its been from three days 138/87, 140/90, 137/88. My tierdness is due to the increased dose or will it be alright after couple of days.. I drink lot of water..
Manju

[goolarra]

What was your previous dose, and what were you increased to?  How long ago did you increase?  Have you had new symptoms since the increase, or are these ongoing?

[rri_manju]

Since my TSH reading 22.47 uIU/ml on last Saturday, I have been informed
by the doctor to continue Thyronorm Tab from 50 to 100. and asked me to visit her after 6 weeks with a new TSH report.  

[goolarra]

That's a big increase all at once.  Many of us are sensitive to increases and have to move much more slowly.  12.5-25 mcg is more easily tolerated.  Perhaps you could tell your doctor that you are having problems tolerating the new dose and ask her to increase in several small steps instead of one huge one.

Also, next time you have labs, ask her to test FREE T3 and FREE T4 as well as TSH.  

[Jugabug]

What a great site!  It is a bit concerning or frustrating when you have two health professionals recommend a different line of action.  I recently had an ultra sound of thyroid. The radiologist said there was significant suspicion of neoplasm based on it grew and has microcalcification and ill-defined margins.  He suggests biopsy. My dr says let's wait and see and started me on synthryoid  I know in the big picture thyroid conditions aren't that big a deal even if there is cancer. I had a hysterectomy when I was 21. and thoracic surgery when I was 40 both  times I was given a "wait and see" approach by my doctors.  How long of a time should I wait to see if I need A biopsy.  If my TSH goes down will that mean no biopsy eequired

[goolarra]

No, your TSH level is in no way indicative of what your nodule is doing.  Nodules have to be monitored through imaging and/or FNA (biopsy).  How they are approached usually depends on size, growth characteristics and composition.  

Synthroid sometimes shrinks nodules.  

You might try posting a new thread so that your individual concerns can be addressed.  We have a member who is very good interpreting imaging.  Make it clear from your title that you're looking for help interpreting an ultrasound and post a complete report.  He's on a bit sporadically, so give it a little time.  

[Jugabug]

Thanks. I don't know how to start a new thread. The report was
Thyroid in normal size. Then gives size. Overall appearance has become more heterogeneous in echotexture. There is relativity increase in vascular of the gland. Mid portion of r lobe a relativity hyperechoic nodule w/ heterogenicity and has developed peripheral microcalcification and ill defined margin. Currently 8*8*7 mm was 6*5*6mm. An equivocal modularity in upper pole 9*3*7mm within left lope an equivocally demarcated area in the upper pole measures 6*7mm previously indicated 23mm area. No discrete nodules are otherwise identified. Two lymph nodes are noted inferior to the upper pole of the left lope the largest measures 1*6*4mm. What does inferior to the upper pole mean. They all seem pretty small but the radiologist considers sufficiently suspicious for neoplas

[goolarra]

Just go to the top of the page and click the orange "Post a Question" button.  You'll be prompted for responses.  You can copy the above and paste it into the new thread so you don't have to retype it.

As I said, we have people who are good with interpreting imagain, but I am not one of them.  Make sure your title says something like "Help interpreting ultrasound".  Wish I could help more, but this isn't my area.