Need help understanding my labs

[Tholmes22371]

I recently had blood work done and was told I have a severely under active thyroid. Found out over the phone and a prescription was called in for me to start 50mg of levothyroxine. I'm on day 4. I'm 44 years old, mother of two. I don't have the best diet but I don't really eat all that bad either. I thought my weight gain was just part of getting older. I logged into my patient portal today and printed out my lab results. I was curious what "severely" under-active looked like. But I don't really know how to read them. Can anyone help?

Free thyroxine
Value = .32ng/dL
Reference range is 0.76-1.46

TSH
Value = 90.500 u[iU]/ml
Reference range is 0.358-3.740

Anti-Thyroid Peroxidase
Value = >1300 U/mL
Reference range is 0-60

Thyroglobulin Antibody
Value = 193 U/mL
Reference range is 0-60

[goolarra]

Be sure to ask for FREE T3.  Otherwise, you'll get total T3, which isn't as useful.

[Tholmes22371]

The CT scan is for my eye. I will ask to have T3 test at Endo appointment.

Thank you for all your help.

[goolarra]

There's something called TED (thyroid eye disease) which people with Graves' often have.  It's caused by the Graves' antibodies and results in the characteristic "buggy" eyes that Graves' patients often have.  You may have had Graves' at one time; you could be tested for TSI (thyroid stimulating immunoglobulin), which is the marker for Graves'.  However, antibodies can go into remission, so even if you don't have them now, you might have at one time.  Is your eye problem a recent symptom?    

What is your CT going to scan?

FT3 won't tell you a lot right at the moment that we don't already know.  However, what it's doing may be important down the road.  T4 is produced by the thyroid as kind of a storage form of the hormone.  However, before it can be used by cells, it has to be converted to the active T3 form.  This conversion process happens throughout the body.  Perhaps the most prevalent complaint we encounter on this forum is from people who don't convert well, i.e. they are taking T4-only meds (levo), and as their T4 rises, they're T3 doesn't follow it up, leaving them still hypo despite adequate, or even too high, T4 levels.  So, it's important to establish a history of it.      

[Tholmes22371]

Thank you. I appreciate you time. I found out about all this bc I went to my PCP with pain above my right eye. During the examination he doctor noticed that my right eye was slightly more closed than my left. He is saying that at some point I may have had Graves' disease which can lead to eye disease...?  I'm scheduled for a CT scan in 3 weeks. I'm also goin to call and make an appointment with an endocrinologist to get s better understanding of this new diagnosis.  I will ask for the T3 test. What can that tell me that we don't already know?

[goolarra]

I agree that I'd call you "severely" hypothyroid.

The reference range ("normal" range) on your FT4 (free thyroxine) is 0.76-1.46.  Your result is well below the range at 0.32.  Many of us found that we had to be closer to the middle of the range for our symptoms to stay at bay.  

TSH is well above range.  TSH is counterintuitive.  When it's high, you are hypothyroid (underactive), and when it's low, you are hyperthyroid (overactive).  So, your TSH confirms your FT4 level.  As you can see, it's very high.

The is one other test, FT3, and from now on, you should ask your doctor to add that to your lab order.  

TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies) are the two markers for Hashimoto's thyroiditis.  Since both of yours are elevated, it seems you have Hashi's.  Hashi's is an autoimmune disease and is the most prevalent cause of hypothyroidism.  So, you have lots of company, myself included.  When you have Hashi's, your immune system sees your thyroid as foreign protein and sets out to destroy it.