Hypothyroidism Test Results

[connie753]

TSH                 1.96
Free T4             1.0
Free T3              2.7


What do these results mean?

[connie753]

I really don't know What she will do as she is an endocrinologist and this is My first time seeing her.  I sure hope she will see that converting T3 to T4 is not happening

[Barb135]

I agree with flyingfool, that you might not be converting FT4 to FT3 adequately, and could probably benefit from an added T3 med, such as cytomel or generic T3.  That's not to say you're "out of whack", but you're certainly under treated and symptoms would certainly be understandable.

Is your doctor pretty open to med adjustment or does s/he simply go by whether or not your levels are "in range"?  

[connie753]

I actually went to the hospital lab from where I live here in state of Washington.  

Based on what I had told you about my results, does it sound like my hypothyroidism is 'out of wack' and that my dr would have to change my medication?

[Barb135]

Wow - your lab is holding a lot of people hostage with an FT4 range like that.  

Would you mind telling us what lab that is?  I've never seen a range that narrow or that low.  If my FT4 were that low, I'd be kept in hypo he!!...

I was thinking about questioning your FT3 range, because it's pretty low, as well, but I guess I won't.  I will say that your lab is something of an outrage as far as thyroid levels are concerned.  Most labs use a range of 0.8-1.8 for FT4 and 2.3-4.2 for FT3, so you can see that you're losing out on a lot of the upper ranges, which are the most important and where most of us feel the best...

Is there any way you can get these tests done at another lab?

At least you have the TgAb results coming... that's refreshing.  

The range my lab uses for B-12 is 200-1100 and I have to keep my level right (or slightly above) the 1100 mark, in order to feel right.

[connie753]

YES
                                   mY #
Free T4                        1.0               range 0.6-1.1

mY dr did order that other test---Thyroglobulin Antibodies (TgAb) but the results are not in as of yet;   Back in July 2013 the B12  my result was 950 and the standard range was 211-946.  

[Barb135]

Please verify the reference range for the FT4.

The Thyroid Peroxidase Antibody (TPOab) would tend to rule out Hashimoto's Thyroiditis; however, there's another antibody test that should have been done called Thyroglobulin Antibodies (TgAb) that's also needed in order to rule it out.  You should ask your doctor for it, unless you think it might have been done and you just don't have the result yet.

Since you have the extreme fatigue, I'd also suggest that you ask to have vitamin B12 levels tested.  

[connie753]

I just got my other test results in :

Thyroid Peroxidase Antibody   <0.3        Standard range 0.0-9.0


What do you think about this result?

[flyingfool]

That is the narrowest reference range I've seen for Free T4.  0.8 top 1.8 is closer to what we mostly see.  No big deal really but just something I noticed.

Given those ranges you are:

FT4 you are 80% of the range.  
FT3 you are only 14.3% of range

The rule of thumb for symnptomatic people on thyroid is to have BOTH of the following:

1) FT4 to be 50% of range or slighly higher  You are at 80%

AND

2) FT3 to be 50% to 66.7% (upper half to upper 1/3 of the range) you are ONLY testing out at 14.3%

What this really tells me is that you have a conversion problem. That is your body for whatever reason is not converting either efficiently or is converting it wrongly.

your body has to convert the FT4 and remove a iodine molecule away and making into Free T3. It is the free T3 that your body's cells use.

So with such a high level of FT4 and low level of FT3 shows that you are not converting.

Therefore what is generally recommended if you can convince your Dr and what you need is a source of T3 medication.  So that you can raise your FT3 level and have sufficeint available for your body's cells to utilize.

Raising your dosage of Levo (T4) you are taking will likely do very little or mnothing.

Given your balance you can do this (adding T3) one of two ways.

You can add in a 2nd medication of T3 such as Cytomel or the generic off brands.

The other way would be to switch from Levo to Natural dessicated thyroid (NDT) such as Armour or Nature Thyroid brand names.  NDT has a higher proportion of T3 in it than the human thyroid produces.  So it is a great source of T3.

Either one will work.  And personally (for whatever that's worth) given your low dosage of T4 and your blood lab balance, I would tend to lean to changing to NDT such as Armour.  But either way will work and you need to work it out with your Dr.

Also I want to make you aware of a real possible thing you may face.  

First is that your Dr may not want to add T3.  many do not believe in it and even more do not belive in NDT in particular.

Second if you are able to get a source of T3, it is probable if not likely that with a source of T3 it will suppress your TSH.  That is your TSh will go VERY low and your Dr will Freak out!  He will tell you that you are Hyper and reduce your medication even if you have no signs of being hyper at all.  And this can cause a roller coaster ride of hell.  So if you prepare for the possibility and even expect that your TSH may go very low ahead of time you may head off this problem.

You have to be your best advocate. Do NOT rely upon the DR's as being knowledgable. because unfortunately the average Dr has no clue as they are brainwashed in medical school about T4 only medication and TSH only testing.  The fact that you already have the FT4 and FT3 is huge as it shows that your Dr is at least willing to do the FT3 testing.  many people are not even that lucky.

Hope this helps

[connie753]

Yes these are  

TSH                            1.96     range 0.45-5.10
Free T4                        1.0      range 0.6-1.1
Free T3                        2.7      range 2.5-3.9

I am currently taking  Levothyroxine 75 mcg 1 tab every morning since March 2014.

My symptoms are extreme fatigue, intolerence to cold

[Barb135]

What are the reference ranges for the Free T4 and Free T3?  Ranges vary lab to lab and have to come from your own report.  Judging from what we normally see, your FT levels look quite low.

Do you have symptoms of hypothyroidism?

Are you on a thyroid replacement med?  If so, which one, what dosage and for how long have you been on it?