Thyroid Disorders Community
lab question
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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lab question

I have seen an endocrinologist who wants to see me back in four months.  When you have thyroid symptoms (mine include weight gain, hair loss, dry skin, cold all the time, low temp, low heart rate, fatigue, brain fog) is it normal for it to take a long time to be diagnosed?  Do you normally need to have labs that are out of normal range more than once?
My labs:
TSH 3.87 range 0.27-4.20
vit d 22.6 range 10-30 insufficiency
iron 46 range 37-145
iron saturation 12.4 range 15-50
ferritin 12 range 10-291
free t4 2.0 range 0.8-2.7
tsh 1.34 range 0.4-4.50
total t3 76 range 76-181

Any advice would be regular doctor could care less about any of these labs, I have been told over and over that I am fine everything is close enough to normal.  But I don't feel normal!!  SO frustrating.

Just because your labs fall within the so-called "normal" ranges does not mean they are adequate for you.  First the ranges are far too broad, and second patients are not all the same.  Some require higher levels of thyroid hormones to achieve symptom relief.  Many of our members say that symptom relief required Free T3 in the upper third of the range and Free T4 around the middle of the range.  

TSH is pituitary hormone that is affected by so many variables that it is cannot be shown to correlate well with either Free T3 or Free T4, much less with symptoms, which are the most important.  Free T3 is the most important thyroid test because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  This is very logical since Free T3 largely regulates metabolism and many other body functions.

Your Free T4 is adequate, but you are missing a Free T3 test.  If we assume that the Total T3 is indicative of your Free T3 level, then it will be way too low to relieve hypo symptoms.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

So, you are going to have to discuss all this with your doctor and persuade him to change his diagnosis and treatment, or else you will have to find a good thyroid doctor that will treat clinically as described above.  

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