So based upon these results, do I look Hypo or Hyper? The endo seems confused about how I could have a low TSH, T4 and T3. Is my understanding correct that if you're hyper you have a low TSH and high T4/T3 and if your hypo you have a high TSH and low T4/T3? What does it mean to be low with all of them?
TSH 0.05 range 0.40-4.0
Ft4 0.67 range 0.5-1.50
Ft3 2.7 range 2.3-4.2
I know Ts and T4 aren't out of range yet, but symptoms have been bad this week -insomnia, hand tremors, heart palpitations, exhaustion, body fatigue, irritability, alternating quickly between hot and cold. Endo wants me on 100/mg of Levothyroxine a day. What do you all think? thanks.
Based on those results, you definitely look hypo to me. You could have what's called "secondary hypothyroidism". This is a condition in which your thyroid is capable of producing T3 and T4, but your pituitary isn't putting out enough TSH to stimulate it to do so. It's really a pituitary condition, but the result is that you feel hypo.
How old are you? Do you think you've been hypo for more than a few months (thinking back to when symptoms began)? Any history of heart arrhythmia?
Levo has to build up in your system. It takes 4-6 weeks for it to reach its full potential in your blood. Often, the dose they've started us on has to be adjusted at that point after retesting and re-evaluating symptoms. That can take more than one adjustment. FT4 often has to be about midrange (1.0 in your case), and FT3 at least upper half of range (over 3.6 on your range) before symptoms are relieved. However, you should start to see some relief of symptoms along the way. It can take a while, once labs are where they should be, for your body to heal.
"Is my understanding correct that if you're hyper you have a low TSH and high T4/T3 and if your hypo you have a high TSH and low T4/T3?" I should have answered that question directly. Yes, you are correct.
Thanks for answering, I'm 26 yrs old and 15 weeks pregnant with #2. I have definitely had hypo symptoms and high positive antibodies for over 3 yrs, but didn't get a diagnoses until three months ago when my TSH finally went hyper and they said I had graves. I go back and forth between hypo and hyper symptoms, but at this point I definitely feel hypo. NO history of heart issues. My labs go from one end to the other between months -it will be very interesting to see what meds do.
How was your Graves' diagnosed? Did you have a TSI (thyroid stimulating immunoglobulin)? The reason I ask is that Graves' is almost exclusively hypER. In fact, I think the "almost" could probably be removed from that sentence.
Which antibodies were positive? Though rare, it is possible to have both Graves' and Hashi's. Furthermore, initial stages of Hashi's can be characterized by swings from hypo to hyper and back again. So, if you haven't had a TSI test, I'd definitely request that. Are they still saying Graves' now that your FT3 and FT4 look hypo?
Yes, I had a positive TSI test done a couple of months ago. However, I've had positive TPOab and Tgab tests for years and they've skyrocketed in the past 2 yrs. Please look at previous post for labs, they're all there. IN the past three yrs of having symptoms, the past 6 months is the first time I've had hyper symptoms, and the first time my TSH, T4 and T3 finally reached abnormal levels. I've always struggled with extreme exhaustion, fatigue, mind fog, sensitivity to cold, etc. Right now? I feel like I am doing just that, swinging back and forth. What I don't understand is, IF I DO have both graves and Hashi's, is levo going to help me, or just swing me the wrong way? I'm curious to know what you think of the labs. thanks!
I think of TSH as, at best, a screening tool. It's a pituitary hormone, not a thyroid hormone, like T3 and T4, so it's subject to the influence of a multitude of factors in the hypothalamus/pituitary/thyroid axis. Too often, it doesn't accurately reflect FT3 and FT4 levels. So, now that my prejudice is out in the open...LOL
Your FT4 is at 17% of range. Midrange is the rule of thumb for FT4. SO, you're quite low there.
FT3 is at 21% of raange, and the rule here is upper half to upper third.
So, your numbers are pretty far out of whack. Since you're pregnant, I think you want to try to get those numbers into line fairly quickly.
"IF I DO have both graves and Hashi's, is levo going to help me, or just swing me the wrong way?" That's the $64,000 question. The interaction of the two diseases is very unpredictable. IF, indeed, you do have both. It's just the only way "I" can explain your going hypo. Hashi's can contain swings, as I said, but people virtually never go hypo with Graves'. One technique used to treat the combination of Hashi's and Graves' is "block and replace". You might do some research on that. The patient is given ATMs (anti-thyroid meds) to, in effect, make them chemically hypo. Then thyroid hormones are given at the same time to make them euthyroid.
What does your doctor think of your labs? Has he addressed at all why you are hypo with Graves'?
Hi like to jump into to this thread found you because I am having the same lab results symptoms and confusion, please help!!
Let me start by saying I am definitely not pregnant lol!
I am 46 years old my family doc discovered a large nodule during my physical a little over a year ago. I was sent for a sonogram which showed a large solid nodule 3 cm and 5 other smaller ones. Was sent to an endo who did blood work and looked over my sonogram and eventually biopsies on 3 of the smaller nodules.
The blood work showed
Free t4 1.20
Throglobulin 106 - High
Anti-tpo 37.6 - High
Anti-tg <20 - Low
He said I have Hosimotos but my counts were still in range
My largest nodule was said to be non cancerious with findings of chronic inflammatory cells (with focal areas of hyperplasia) admixed with occasional follicular cells and few onocytes moderate colloid is seen
Afrima test recommended (haven't done that) follow closely
Subsequent sonogram last week
It is now 4.0 cm
My new blood work
Thyroid peroxidase antibodies 135 - high
Thyroglobulin 63.7 - high
T4 free 1.1
T3 free 2.9
I also have the same symptoms as catlien h
Hypo and hyper
And the same questions (what is going on here and how do I make it stop!!)
Dr says now he suspects I'm going hyper and may have graves
Or a rare form of hoshimotos that causes hyper instead of hypo
He is sending me for a radioactive iodine uptake scan this Thursday to
See if the nodule is hot and over producing thyroid hormones (but that's not what my blood work shows?) or cold then he will re biopsy but either
Way my numbers don't make sense like the previous post
And I keep being told they can't give me anything because me number are in range and my favorite MY SYMPTOMS CANT BE FROM ALL OF THIS BECAUSE MY NUMBERS ARE STILL IN RANGE!! That makes me want to scream and cry at the same time : (
He said one way or the other will have to either remove or destroy with rai to avoid the hypo or deal with cancer if that is found
It is large and also causing me difficulty swallowing and strain on my vocal cords
I also wonder could my pituitary be causing all of this?
I don't know need help understanding all this so I can ask the right questions start advocating for myself and make informed decisions about future treatment plans
Any advice would be beyond appreciated!!
What are the reference ranges for your FT3 and FT4? Ranges vary lab to lab, so if the different sets of labs were done by different labs, you might have more than one range. Also for TPOab, TGab and TSI. When were those two labs (how far apart approximately)?
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