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16469579 tn?1448243049

Can someone help me decipher my thyroid results?

I have a family history of thyroid disease. For the past few years I've been developing more health symptoms that are interfering with my life. Chronic fatigue, no sex drive, digestive issues, chronic headaches, and extreme dry skin.

My new doctor ran a ton of blood tests and has ordered an ultrasound for my thyroid as well. I'm waiting for her to get back to me about her thoughts on my results but in the meantime I've been looking into thyroid resources and there's a lot! I just want to be able to advocate for myself but while looking through everything on the Web I'm having a hard time deciphering where I am actually sitting with things.

My results are as follows:

Free T3 4.2 pg/ml with reference range of 2.8-5.2
Free T4 0.9 ng/ml with reference range of 0.8-2.2
TSI <89 with reference range of 3.0 ng

Any help would be greatly appreciated!

8 Responses
Avatar universal
Not sure I understand the test result shown for TSI being shown as <89.  Please double check that and clarify if needed.  

I am surprised that no test was done for TSH.  Doctors always run that test, even though it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, Free T4 and Free T3.  

To assess your FT4 and FT3 results, here are the words of a good thyroid doctor. "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."   Of course the ranges for your test results are different, but I think the implication is clear, especially in view of your symptoms.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  So you are going to have to find out if your doctor is willing to treat clinically as described.  If not, then you will need to find a good thyroid doctor that will do so.  

Also, be aware that hypo patient are frequently too low in the ranges for Vitamin D, B12 and ferritin.  . Low levels can cause symptoms that mimic hypo symptoms.  Low D and low ferritin can also adversely affect metabolism of thyroid hormone.  D should be about 55-60, B12 in the very upper end of its range, and ferritin should be about 70 minimum.
4 Comments
I tried posting my TSH but it got cut off. My TSH level is 2.01 with a range of 0.300-0.500
And the TSI result is exactly as I mentioned before
My vitamin D level is said to be dangerously low and my ferritin is at 20 ng/ml. While my iron is at 85 mcg/dl with a saturation of 32%
My B12 is at 542 which is said to be normal/average
16469579 tn?1448243049
Seeing as I can't figure out how to edit my post, my tsi is <89 with a reference range of <140
Avatar universal
I am not really sure why the doctor tested for TSI which is a test for hypothyroidism.  Your symptoms and test results indicate central hypothyroidism, which is a dysfunction of the hypothalamus/pituitary system, resulting in relatively low TSH, which does not adequately stimulate the thyroid gland to produce T4 and T3.  

In view of your very low Vitamin D and ferritin, did the doctor say anything about those?  You may require D injections to get your level up faster.  You also need to supplement with B12 to get that up into the very upper end of its range, and also supplement with iron to get your ferritin up to 70.  To avoid stomach issues while taking it, the best iron supplement seems to be ferrous bisglycinate.  To raise my ferritin from 40 to 80, I started with 25 mg and gradually raised the dosage to 75 mg.

If your doctor does not accept that you are hypothyroid, and you need to find a good thyroid doctor, let us know and we will help locate one that has been recommended by other thyfoid patients.  
1 Comments
I just changed doctors, and she's new to my case so she ordered multiple labs to rule out or diagnose some possible issues. She started me on weekly doses of 50,000 units of vitamin D last week. I haven't heard from her yet because she wants to wait until I have the thyroid ultrasound before looking at the whole case. But with your input I'll be talking to her soon! Thank you
Avatar universal
Sorry, I meant to say that the TSI test is for hyperthyroidism, not hypothyroidism.  

Please let us know how it goes with the doctor.
1 Comments
Thank you! I will :)
16469579 tn?1448243049
Well my doctor has said the in her opinion everything is normal and I'm fine. So again I'm looking at starting a new antidepressant. This is not the news I wanted...
Avatar universal
Typical of so many doctors.  Due to their training and published Guidelines for Hypothyroidism, they think that as long as thyroid function tests fall within the so-called "normal" ranges that all is well.  Totally wrong for many reasons I won't go into.  

So the doctor knows about your symptoms but only pays attention to test results and declares that everything is normal and that your symptoms must be due to something else.   Instead of considering a therapeutic trial of thyroid med to see if that is the problem, the doctor offers antidepressant.  Terrible, but not atypical.  

I'd continue to get the injections of D.  I'd also ask the doctor about supplementing with B12 and ferritin to optimize those.  In the interim I am going to go through all my sources and see if there is a good thyroid doctor in your area.
1 Comments
Thank you so much! I had another question, what about having trouble swallowing... Like there's always a lump in my throat.
Avatar universal
There are numerous possibilities, but since you are hypothyroid, the first things that come to mind are a nodule on your thyroid gland, or inflammation of the gland.  It would probably be a good idea to get an ultrasound of the gland.  
Avatar universal
I just sent you a PM with info on doctors.  To access, just click on your name and then from your personal page, click on messages.  
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