Where to find easy explanation of test results?

[mamasue487]

I was told that my test are normal, and am not satisfied with that answer.  I am trying to find information on
understanding test results as a whole and have become more confused,  My TSH is 2.43,
my T4 is 1.0, and the T3 306.  I have many of the symptoms of low thyroid, and I just would like
some one to give me an insight to these test results.  Thank you Susan

[mamasue487]

Hello, I was just reading through some of these enteries and read one that you wrote back on and I am curious as you mentioned high cholesterol has something to do with thryoid.  If I were to give you my numbers would you comment on what you think?

Cholesterol 197
HDL   33 low
Tri   262 high
LDL  112

TSH  2.43 no understanding of if this is within norma;
T4 Free 1.0
T3 Free  306
ACTH  37 high

Thanks

[North48]

I can't thank you enough for sharing your experience with me.  So many of your symptoms are exactly what I have joint pain, carpal tunnel, numb fingers, sinus infections, skin tags, snoring, the bridge of my noise seems to be wider, my 2 front teeth have started to hurt like I've been pushing on them and they are getting loose.  My skin has gotten really rough and I thought this was severe dry skin,  it kind of looks like I've been in the bathtub too long but its hard and dry not soft.  I have rashes all over and I think it's hives in my armpits.  The first time they checked my IGF-1 it was 224 in April 08, 199 in May 08, 123 (?) April 09 so it seemed that it was coming down but maybe it is cycling.  Who Knows!!! But I do know that I'll keep plugging away at this and keep talking with others who have some experience with this.  I have started to have some TSH reading out of the norm so I've been trying to figure if some of these symptoms are thyroid related.  I keep looking at thyroid, growth and cortisol they all have some similar symptoms.

Thanks again and Happy Halloween and have a safe night.

Carrie

[mamasue487]

Hi there, you have to be your own best advocate.  With acromeagly there are so many symptoms.  I went 18 years befor being diagnosed, and that was only because a dermatologist that I had taken my son to, knew I had acromeagly from looking at me.  I had miscarriages, bone and joint pain, rheumatory arthritis, my husband would joke that every time I was pregnant my nose and feet grew.  My wedding ring size went from a 5 to a 10, but the changes occur very slowly and that is why its hard to recognize and not attribute the changes to growing older.  There were other signs that the body was off, I was diagnosed with corpal tunnel, had severe sinus infections, severe headackes ( attributed that to the sinuses), my vision was changing, skin tags, blotted skin, snoring, drooling on the pillow at night, swelling at the joints, my teeth hurt, my bite was off,  my spaciong between my teeth got bigger, my voice had grwon deeper, had carpal tunnel, skin variations, oily to dry to rough, it was a long road, and I kept thinking, maybe this is normal, and I am just not adjusting to who I am.  So when I was finally diagnosed, it was only a matter of 3 weeks till I had surgery.  And like I said it was a very long surgery, and I did not have the radiation that Dr. Simmeon suggested, he was very upset with me.  However, I still feel that it was a wise decision.  My biggest problem has been dealing with the DI.  And now that I have been off the DDAVP for all these months, I am started to reconize that the thyroid maybe where I need to concentrate.  Because now for the past four years I am suffering with, not being able to go to sleep, being tired, baggy circles, low libido, tremendous weight gain, fluid retention that really is shocking,
brittle chipping nails, my hair has thinned so much, and turned gray in the past six months, no appetite, that I am being to look at the thyroid.  Being off the DDAVP has set backs, frequent urination, and constant thrist, however, the blood pressure is stable, no heart palpatations like they were, I actually thought I was having heart attacks.  So I know that was the right decision regardless of what the endo thinks.  He said last week I could never do what your doing, lets put you back on the DDAVP and on a good stong BP med and lets get you to stop getting up 4 -5 times a night.  I said to him, are you serious.  Anyway, just monitor your IGF1 and keep checking on your other hormone levels.  But remember you know your body and you know what is unsettling to you.  I am going to begin the search now, for someone to take a good long hard look at me and lets get a game plan together.  Hope this has been of some help.

[North48]

Thank you for the support!  I have decided to start all over with a new doc.  They have not treated me for the pituitary tumor because they say it's to small 3x4 and what blood work they have done for cortisol, IGF-1, thyroid, prolactin have all come back as "normal".  But I have all the symptoms and I question the lab results.

49 is not old and I shouldn't feel this way nor should I be treated in this fashion!

[Barb135]

mamasue487 and north48            sounds like you both need to find new doctors who will work with you on your thyroid issues.  49 and 50 are not "old", even though I understand that you might FEEL that way.  

I'm 60 and my pcp tried to blame everything on my age, post menopause, you name it; he had a reason for everything -- except what it really was -- thyroid.  As I stated in my post above, I do have an endo who helps me handle the thyroid issues and I kicked my pcp to the curb and got a new one, who is looking into several different areas in effort to bring me back to normal health again.

[mamasue487]

Good Morning,

I am so glad to hear from you, and I can appreciate where you are coming from.  However, we deserve too feel good, and healthy and heard.  So I am going to begin the search for someone to help me in discovering a solution.  I have always told my children the way I see life is simple, you can be part of the problem or part of the solution.  I chose the later, now I just need to find someone to help me with that journey.  Are they treating the pituitary tumor?  I had a a eight hour surgery and was really feeling good after surgery and then they realized that while surgery was a success it left me inspidious diabetic, that has been the hardest part of my life.  I took myself off the DDAVP10 months ago because of high blood pressure, against dr's advise and then was put on all types of blood pressure meds, then finally onto a diuertic, which I just stopped using because the bp was too low and I am using coffee to get me through the days because I don't sleep and I am exhausted.  I really believe that the water retention is the root cause, and believe you me, I am constantly going.  They did mention idopathic edema, but why?  Anyway, I pray that you will have complete healing, and live the rest of your life like you feel mentally.  I know I still feel 30 years old mentally now I just need to get the body to feel good.

[North48]

Hi - I just wanted to add that I have very similar numbers in April TSH 3.1, FT4 1.1, Oct TSH 2.14, FT4 1.1, FT3 3.12 and I also have a micro pituitary tumor 3x4 and I'm 49 yrs old and I'm tired of doctors treating me like I'm all washed up and not worth messing with because I'm just menopausal and to old too!!!!

Sorry to vent but we seem to have a few things in common :)

[Barb135]

Gimel has pretty much covered all the basics, so there's nothing more I can add.  I would like to back up his statement about low TSH causing many doctors to reduce med for fear of hyperthyroidism............My former pcp did that to me and I thought I was going to die.............

As soon as I started on med, my TSH hit rock bottom and my doctor began lowering my dosage in an effort to bring it back up, when I was still severely hypo.  Fortunately, I got sent to an ENT for what they thought was an unrelated issue and the ENT realized immediately what was happening.  HE in turn sent me to an endo, who began treating my FT3 and FT4 instead of TSH........my TSH is currently still in the basement (0.02 at last test on 10/12/09), but we don't worry about it as long as my symptoms are kept at bay.  I am currently almost exactly in the middle of both ranges (FT3/FT4) and content to stay there for the time being.  

So please take gimel's advice and find a good thyroid doctor who will treat your symptoms, instead of just your TSH -- you can save yourself a lot of grief.  

[gimel]

If you have been seeing that Endo for a while and nothing has been done to relieve your symptoms by now, then you are going to have to start using info like the above and discuss/pressure your doctor to change his treatment for you.  Or,  you may have to start looking for a good thyroid doctor that will test and adjust your FT3 and FT4 levels with whatever type of med is required to alleviate symptoms, without worrying about TSH if it is suppressed to low end of range, or below.  A low TSH causes many doctors to reduce meds, for fear of hyperthyroidism.  A low TSH doesn't mean hyper, only hyper symptoms make you hyper.   My own  TSH has been below .05 for over 20 years with no hyper symptoms.  In fact I continued to have slight hypo symptoms until I learned about the importance of FT3 and got my meds revised to increase FT3 and FT4 levels.  

If you do start looking for a good thyroid doctor, you might get some good input from Forum members.

[mamasue487]

Well I have been on that web site, not far from where I grew up.  He has some interesting articles, but I will need to wait till I get home to read them with understanding.
Thanks for all your input.  There is so much to learn and acknowledge about the body and how it works.  Nine years ago I had a huge pit tumor removed and I really believe that this is all connected.  The remains of that tumor have been in active and my blood work as far as IGF1 are good.  Now I just need to concentrate on what I know is not normal.  I believe that the endo that has been testing me every three months with blood test and brian scans, as just become to comfortable with the situation.  And I could be wrong, but that is what I sense.  Thanks again

[gimel]

Wilson's Temperature Syndrome was Dr. Wilson's explanation for patients having hypo symptoms even though their test results were "normal".  Dr. Broda Barnes had previously identified low body temperature as an indicator of hypothyroid.  Dr. Wilson used this , along with test results that were in range, yet patients still had hypo symptoms, and claimed this was a phenomenon that he named Wilson's Temperature Syndrome.  It has been largely discredited by the medical community.  

In my opinion, basal body temperature is a useful indicator, that needs to be followed up with lab testing, which is much more revealing.  BBT is inadequate as a diagnostic by which to determine med dosage, as Dr. Wilson advocated. I also think that the type of patients that prompted Dr. Wilson to decide that he had discovered a Syndrome, is really nothing more than those patients whose FT3 and FT4 levels fall into the lower end of the current ranges which I believe need to be adjusted, as was TSH.  That's why we hear from so many patients that fall into the lower end of these ranges, yet suffer from hypo symptoms.

[mamasue487]

Wow that was pretty amazing, I will have to read that again, just to make sure that iit all sinks in.  Have you heard of this Wilson's Temperature Syndrome?  Its interesting because I am always 97* temp.  Although I do swing durning the day from cold to hot, but the docs contribute the low temp to not being active enough and the swings to being menopause stage.  Its all so consuming, and the disappointment with the medical community I feel is overwhelming at this point in my life.  Thank you for all the information..

[mamasue487]

Hi, I was on that web site and was reading on it.  I also read about this Wilson's Temperature Syndrome.  My normal basil temp is always 97, if it ever raises I have a fever.  There are many issues and I am tired of the doctors who attribute these symptoms to menopause.  I am 50, I am not ancient, nor do I need to be put out to pasture and wane away.  I am frustrated with the medical community in whole.  Thanks for getting back to me.

[gimel]

There is a lot to explain, but suffice to say that you are in the same position of many members of the Forum, in the past.  Test results supposedly "normal", but symptoms persist.  Here is a lengthy explanation that I've put together and used a number of times.  I'm sure you will have some questions after laboring through all this.  LOL






I can see from the results why many doctors would send you home as "normal; however,  there is more than ample reason to say that you are hypo and should be given at least a therapeutic trial dose of thyroid meds to evaluate the effect on your symptoms.  There are multiple reasons for saying this.  

First, the AACE recommended over 6 years ago that the ref. range for TSH should be lowered to .3-3.0.  Many thyroid authorities have stated that anything over 2.0 should be suspect.  In addition, TSH is a pituitary hormone that is only an indicator of thyroid hormone levels in the blood.  It is affected by many variables, including the time of day when the blood was drawn for the test.  Also, it does not correlate very well at all with hypo symptoms.  Why the medical community continues to use the old test range and rely predominantly on TSH as a diagnostic, when it is not, is a mystery to most of us on the Forum.

The most important tests are for FT3 and FT4, which are the actual, biologically active thyroid hormones.  Free T3 is actually four times as potent as free T4, and it correlates best with hypo symptoms.  Many patients with hypo symptoms have reported the best result by adjusting FT3 and FT4 into the upper part of their ranges.  Being in the reference ranges for FT3 and FT4  doesn't mean everything is okay.  The ranges should really be considered as guides within which to adjust levels as required to alleviate symptoms.



Sorry about the length, but here's another prior post that explains why I think the reference ranges for the "Frees" are too broad and result in patients not being properly medicated.



The reason the reference range for TSH is called "normal", is that it's based on a large population of patients' test results.  From that data base the decision was made that about 2.5 % of people would would fall out of this "normal" range because they were possibly hypo or hyper.  From this decision limits were placed at plus and minus two standard deviations (which correlates with plus or minus 2.5%) from the overall average and that was called the "normal" range, supposedly representing people who had no thyroid problems.  

After many years of bad experience with this "normal" range for TSH, they finally acknowledged 6 years ago that there were a lot more patients out there with hypo  and hyper problems, than previously accepted when they originally used their data base to established the range.  
After excluding from the data base those patients who were suspect for hypo and hyper, they again analyzed the remaining data base and established limits that included 95% of the total data base and called these new limits "normal".  This changed the reference range from .5-5.0  down to .3-3.0, which is a huge change.  Unfortunately this change hasn't yet been accepted or acknowledged by most labs and doctors, even though the change was recommended by the AACE over 6 years ago.

Also, realize that the reference ranges for the "Frees" were established the same basic way.  These ranges have never been reexamined and modified like the range for TSH.  I am absolutely convinced that this is the reason why so many hypo people fall into the lower end of the ranges for FT3 and FT4 and are still told they are "normal".

In one my past lives I had a lot of training and experience in statistical analysis.  Based on that experience, if I had to estimate what a revised range for FT3 would be if the data base were purged of suspect hypo and hyper people, like was done for TSH,then I would say the FT3 range should change from 2.3-4.2 pg/dl up to about 3.2-4.3.  And FT4 probably would change from .60-1.50ng/dl up to about 1.0-1.55. Quite a difference, huh?  Think maybe that is why we hear from so many people that have hypo symptoms, yet they are in the "normal" ranges for the "Frees"?  I'd bet my last dollar.

If you're not exhausted by now, you will benefit from reading this article by Dr. Lindner.

http://www.hormonerestoration.com/Thyroid.html

From all this I think you can see how all your test results can fall in the so-called "normal" ranges, yet suffer from hypo symptoms.  In my opinion the very best way to treat a thyroid patient is to test and adjust the actual, biologically active thyroid hormones (FT3 and FT4), with whatever meds are required to alleviate symptoms, without regard for the TSH level.  Relief of symptoms should be paramount.  The most difficult part of this is finding a doctor that will treat your symptoms in this manner.


  

[mamasue487]

Hi, thank you for getting back to me.  The TSH ref range >OR=20 yrs 0.40-4.50
T4 Free  ref range 0.8 1.8
T3 Free ref range 230-420
The doctor states all is normal, but it is not.  I am dragging and have stated to him for three years that the list of symptoms doesn't make sense to me, that something is off.  Thanks

[lwkerle]

There is a good book called Thyroid Power, which I was able to get at the public library.  There is also a thyroid power website.  This book does a good job explaining these tests and how the chemical processes take place in the thyroid.  I would recommend you see if that is available at your public library.

[gimel]

Different labs have slightly different reference ranges and sometimes express results in different units of measurement.  So, it would help if you would also list the reference ranges that go with the T4 and T3 results.  Also, are those for Total T4 and T3 or the Free T4 and T3?