Thyroid

My TSH is '0'    and my T3T4 is '14' .   This seems to be an imbalance....What should I be doing to correct this?
  
    My medical advisor does not seem to be  concerned....

                                                                     Mary Jane Eichler

[AR-10]

Your T3 and your T4 are two different things. Your statement that your T3T4 is "14" is confusing.

You need to get a second opinion. Ask for a Free T4 test and a Free T3 test along with a TSH test. A free T4 test and a Free T3 test will tell you exactly how much available hormones you have.

Ask for a copy of the report. The lab ranges are broad, and you can test "within lab limits", and still need treatment.

Your TSH should be around 1.0 or 1.5. That's not very far away from 0.0, but there is a big difference between 1.0 and 0.0.

And TSH can be measured to 0.001, so "zero" is not a very informative result. Another reason to try a different doctor. If your TSH was 0.000, you would be very ill indeed.

[MJEIchler]

Thank you..

Will get a copy of my lab report......

  T4 is  '14'.....and TSH is '0'....that is what my M.D. told me......and also that testing for T3 is not done since it is part of the T4 test.....

[MJEIchler]

Will get the lab report and get back to you.

                                               Mary Jane......

[AR-10]

The Free T3 is often not run because the doctor feels it will be the same as the Free T4 test. It's common practice. I haven't had a Free T3 run in over a year.

That said, they are two seperate tests, and the Free T3 is actually more important. But standard practice is to only run it "if required".

If you can post a copy of your labs with the lab limits we will help you decipher them.

[MJEIchler]

Hi!


     Will be able to pickup my copy of the lab report/test on Thursday or Friday  (18th, 19th).

                                                                          Mary Jane......

[MJEIchler]

Here are my test results:

TSH          0.00           Ref. range 0.4-4.2    mU/L

FREE-T4        14.0                 ref.range  9.7-25.7

KEY: L:Low


Time of test   Dec. 3/2008   10:39

Test of Sept. 5/2008

TSH  0.03

FREE-T4     13.7

                                                                         Mary Jane......


                                                                      

[MJEIchler]

Please check the above test reading.....

[AR-10]

You weren't kidding, were you?

They can measure your TSH to thousandths, so there must be something behind those two zeros.

Ok. Your Free T4 is acceptable, although it is a little low.
Your TSH should be registering higher. It should be around 1.0 or 0.8 or 1.3. Maybe even higher.

That's a problem.

You need the same tests run again along with a Free T3. Either your Free T3 is WAY out of line, or you have a pituitary problem, or possibly an adrenal problem.

Your TSH of 0.00(?) shows you to be extremely hyperthyroid. Your Free T4 should be closer to 23 or 26 for your TSH to be that low. You Free T3 would also be at the top of range or above limit.

I don't think your Free T4 result is anywhere near high enough to reflect your TSH result or support a diagnosis of hyperthyroidism. It's possible your Free T3 may be high, but normally your Free T4 would be in the upper range of the limit as well.

If the Free T3 test confirms hyperthyroidism, then you need antibody testing, TSI, TPOab, and TGab.

If the Free T3 test does not confirm hyperthyroidism, then you should ask for pituitary testing to see why your TSH is so low.

The Pituitary gland produces TSH based on chemical signals from the Hypothalimus. Perhaps you are not producing TSH properly.

If that is what is going on, it must have started recently, or your Free T4 would be lower.

Sorry to make it sound so confusing. It is.
You need more tests run.

[MJEIchler]

Hi!

Thank you....

Was  in Wpg.last week (husband had a meeting)....We stayed at the Viscount Hotel and that night had to sleep sitting up due to a choking feeling. (felt like something was tight around the base of my neck)   I decided to go to the 'walk-in clinic' half a block from the hotel......Saw Dr. Ricrodon who checked my neck and pulse....asked if I ever had seen an endocrinologist or had a MRI done for thyroid.....answer Never....

Yesterday received, in the mail, an appointment to see Dr H. Lee in Wpg. January 6, 2009.

I have had for years a low TSH....0.09 the doctor cut back on my thyroid medication....and with a 0.03 the new doctor increased my dosage from 120mg to 125mg..   ( I am on Desiccated Thyroid 125mg)

This is truly confusing to me.....

Thank you for your help......and if there is anything else, please write.....will keep in touch.

                                                                   Mary Jane......

[AR-10]

Well...the fact that you are on Armour (or another brand of desicated thyroid) changes things.

It sounds like you are over-medicated. The question is, how high is your Free T3? Testing and regulation of medication is different for desiccated thyroid hormone than it is for synthetic hormone replacement.

Your TSH and Free T4 will be lower and your Free T3 will be higher. You really need to have your Free T3 checked each time your other tests are run if you are on desiccated thyroid.

Still, your TSH should not be lower than 0.05 or so unless you are having a problem converting T4 to T3.

Hopefully the Endo you are going to see can straighten things out.

[MJEIchler]

Thank you for your help........

From my test (TSH) of 0.03 the doctor upped my med. from 120mg to 125mg..and maybe this caused my reading to be 0.00.

It is pretty confusing.....I have bought several books: "Thyroid Solution" and also one "Living Well With Graves' Disease and Hyperthroidism by Mary J. Shomon.

                                                        Mary Jane.....

[MJEIchler]

Hi!                                                                      January 8.2009..

back from Wpg.  met with Endo Dr. H. Lee.....he is concerned.....I mentioned that I have been talking with you and the last response from you  was that you felt I might be over medicated......and he told me he is of the same opinion.....but he ordered a T3 and 3 other test......also had an ultrasound done on the thyroid..... also adjusted my medication from 120mg to 100mg. for now.....Will meet with him on the 27th of January.

   Will keep you informed...                      

                                                                             Mary Jane.....

[MJEIchler]

Hi!


   Lab results   08/10/2009

    TSH                         4.81   H

    Free-T4                     7.4       L
    Free-T4                      7.4      

    Free-T3                      5.8      L


    Free-T3                     5.8


    Will see  Dr. Lee.....November 12, 2009.

                                                 Mary Jane