Aa
Aa
A
A
A
Close
Avatar universal

hashimotos but unusual t3/t4 levels

I have had Hashimotos disease for over 12 years. I have been taking synthroid. I recently had new blood work since I have gained over 40 lbs in a year.  My TSH level was .01.  T4 was in normal range of 1.6 but T3 was high at 4.4.  Thyroglobulin antibodies was high at 23 and thyroid roxidase antibodies waa high at 900.  The doctor said it seemed weird and said he would recheck in 3 months since he was raising my synthroid dosage.  He mentioned it seemed like I waa in thyroid storm and sent me home.  Should I be concerned?.  
6 Responses
Sort by: Helpful Oldest Newest
649848 tn?1534633700
COMMUNITY LEADER
It really isn't that confusing.  The Thyroid Peroxidase Antibodies (TPOab) are the antibodies that are attacking your thyroid, because for whatever reason, your body determined that your thyroid was "foreign".  Eventually the antibodies will destroy it.  Apparently, your doctor is of the believe that Synthroid can lower antibody counts and that lowering the antibody count will do some good... wrong on both counts.  

Once a patient has tested positive for Hashimoto's, antibodies need not be tested again, because Hashimoto's is for life, no matter what the antibody count is.

Thyroid 101:  The Free T4 and Free T3 are the actual thyroid hormones.  The thyroid makes them both, but mostly T4.  Of the Total T4 in your body, most is bound by protein and can't be used; that's why we measure "free" (unbound) T4, which shows the amount available for use.  Free T4 can't be used directly; it must first be converted to T3.  

Most of the T3 in your body is converted from T4 by the liver, but some is also converted by other organs and even cells, themselves.  As with T4, most of the T3 is bound by protein and can't be used, so we measure the "free" (unbound) portion, which is what's used by the individual cells.

Rule of thumb is for FT4 to be around mid range... your FT4 is at 80% of the range - higher than need be.  Rule of thumb is for FT3 to be in the upper half to upper third of its range.  Yours is obviously higher than necessary.

Apparently, your doctor is trying to use thyroid medication to cure what ails you, when it's not all thyroid related.  He also makes me very nervous, in that he's trying to pass things off as "age related" when age doesn't really have much to do with anything.  Too many doctors try to pass things off as "that's normal for your age", when that couldn't be further from the truth".   I've known people much older than either of us not have near the medical issues we do.

Insulin resistance can be caused by different things.  I have it and I've never been over medicated.  Typically,genes and lifestyle (diet and exercise) play a bigger role than age does.  Admittedly, I've often eaten too many processed foods (simple carbs) that spike the blood sugar quickly, causing, in turn, an insulin spike.  Insulin is called "the fat storage hormone"... it's not a simple process, but to put it simply, when we eat a lot of foods that increase blood sugar, then don't use that sugar for energy/exercise, insulin shuttles it right into fat cells to be used at a later time.  If we just keep adding to it, and never use it, we end up over weight and eventually with too much insulin or our cells are insulin resistant or our pancreas can't produce enough insulin (at which point we become diabetic).  

Cholesterol can be another of those lifestyle (diet/exercise) issues and by watching what/how much we eat and getting plenty of exercise, we can bring it back into control.  My cholesterol varies between winter and summer -- I have a winter neighbor that I walk with most days and my cholesterol drops.  In summer, I'm on my own and it nearly always goes back up.

Some of us are more prone to these things (genetic) and if we aren't diligent with our lifestyles (diet and exercise), we end up paying with our health.  

In your case, I do believe that a second opinion is definitely in order.
Helpful - 0
1756321 tn?1547095325
Hyperthyroidism worsened my insulin resistance and caused pre diabetes. Beware taking too much thyroxine.
Helpful - 0
Avatar universal
Thank you for all the info.  My T4 free range from lab is 0.8-1.8 with mine at 1.6.  The t3free range is 2.3-4.2 and mine is 4.4.  Thyroid peroxidase antibodies range  900.  Thyroglobulin antibodies range < or = 1 and mine is 23.  This is so confusing to have such strange results.  I have never had any issues like this and all he could tell me about the cholesterol and hemoglobin alc and HS CRP is it could be my age and as we get older these problems arise.  I have been following a high protein (lean) low fat 1,000 calorie a day diet for over a month now and have only lost 5 lbs.  I have been trying to increase exercise by walking every evening but not much luck with weight loss.  The blood work has just surprised me.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
What are the reference ranges for the Free T3 and Free T4?  Ranges vary lab to lab and have to come from your own lab report, but your results seem very high compared to what we normally see.

None of the issues you mention are cause to increase syntthroid, with FT levels already as high as yours and risk sending you into hyper he!!  

The A1c does indicate pre-diabetes, otherwise known as insulin resistance, which is another major cause for weight gain/inability to lose.  Proper diet and exercise should help, considerably with that.  Pre-diabetes, high cholesterol, overweight are all symptoms of metabolic syndrome.

Vitamin D should be supplemented to get levels up to between 50 and 80.  

If he thinks you are risk for heart disease the dumbest thing in the world is to increase your thyroid med and risk rapid heart rate, heart palps, irregular heart beats, etc...

Elevated cholesterol can be a sign of hypothyroidism, but since you aren't hypo, I don't think that's your problem.  Some people are just prone to it.  My husband is far from hypo and his cholesterol is much higher than mine.

With levels like yours, there's no way I would increase my thyroid med; in fact, if it were me, I'd be insisting on a decrease, instead.  Increasing Synthroid is not going to decrease the antibody count; nothing will.  If he doesn't know that, he's not a good thyroid doctor.

I wouldn't be comfortable just waiting to retest either.

You have to do what you think is best... I'll be off for the evening soon, but I want you to know that if you have any adverse symptoms of over medication (wouldn't be true thyroid storm), you should decrease/stop taking your medication and go to the ER.  
Helpful - 0
Avatar universal
He raised the synthroid because the antibody levels were so high.  I went from 100 mcg to 125 mcg.   He did a lot of blood work on me and I am postmenopausal according to all my hormone levels.  A lot of things were higher than I ever have had.  My hemoglobin alc was 5.9 which he said was pre diabetic.  I have never had a problem with that.  Vitamin d level was low at 24.  He also did an HS CRP which my level was high at 5.0 and it could be caused from inflammation of heart but am at risk for cardiovascular disease.   I have never had any issues other than the Hashimotos so this was kind of alarming for me.  Also have elevated cholesterol levels.  I may take my results to get another opinion.  I am not feeling comfortable with just waiting to retest
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Yes, you should be concerned.  Why is your doctor raising your synthroid when your levels are that high?  He should be lowering the synthroid in order to bring your levels down.  

If he's trying to bring antibody levels down by increasing synthroid, that's not going to happen..

Likewise, there are other things that could have caused the weight gain, besides thyroid, such as insulin resistance, metabolic syndrome, etc.  Thyroid medication is not a weight loss aid.  If the weight gain is truly thyroid related, it will come off with adequate thyroid levels.

Thyroid storm is a very dangerous, possibly life threatening condition.  If you have any serious medical issues, such as rapid heart rate, heart palps, severe anxiety, tremors, etc, either call 911 or have someone take you to the nearest ER asap...
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.