Thyroid Disorders Community
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Could it be hypothyroid?

Hello all! I am new to all of the thyroid tests and terminology. I have been experiencing most of the hypothyroid symptoms for quite awhile. Thyroid issues also run in my family. I had my primary Doctor run a free T4 and TSH, as well as the antibody tests. My numbers seem to fall under the normal ranges. My free T4 is 0.92, TSH 1.8, TPO 90 and Tg 0.06. I cannot seem to find any standard ranges for the antibodies. I am not sure if my levels are normal or not. I know I feel bad all the time, tired, anxious, depressed, erratic menstrual cycles, and headaches. I also had the free T4 and TSH last year, and my free number went down and my TSH went up. My doctor would not run the antibody test last year. I am just trying to find a reason why I feel bad. Any advice/suggestions/info is greatly appreciated! Thanks!
6 Responses
Avatar universal
There is much to discuss, but before doing that, please post the reference ranges shown on the lab report for those test results.  
Avatar universal
There were no ranges given with the results on the antibody tests. The TSH range was 0.4-4.0 and T4 is 0.8-1.8. When I asked my doctor, she said there is nothing wrong with my thyroid, and put me on metformin to try and stop the weight gain. I have quit taking the metformin.
Avatar universal
In 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."   Obviously your Free T4 result is much too low in the range, and you weren't even tested for Free T3.  They are the biologically active thyroid hormones.  TSH is a pituitary hormone that is only an indicator, to be considered along with more important indicators such as symptoms, and levels of Free T4 and Free T3.   I am not sure about the TPO and TG you reported.  Were those TPO ab and TG ab tests, as I expect?

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and free T3 levels as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  Many members say that symptom relief required Free T4 at the middle of its range, at minimum, and Free T3 in the upper third of its range, as needed ot relieve symptoms.  You can get some good info from this link written by a good thyroid doctor.  

Based on your experience with that doctor so far, I don't have much hope that you can get her to recognize that her diagnosis is wrong and get clinical treatment as described.  If you will tell us your location, perhaps we can suggest a doctor that has been recommended by other thyroid patients.  

Avatar universal
Yes, the TPO and TG were antibody tests. Thank you for all of the information. I am in Dayton, Ohio.
Avatar universal
Looking through various references it appears that the TPO ab test result exceeds reference ranges and would be indicative of Hashimoto's Thyroiditis; however, that is inconsistent with the relatively low TSH result, so somewhat confusing.  That said it is clear that your Free T4 is way too low in the range, consistent with being hypothyroid.  It is unfortunate that the doctor did not run a Free T3 test also.  Free T3 has been shown to correlate best with hypo symptoms.  I expect that you would find your Free T3 in the lower part of its range as well.

So you need a good thyroid doctor that will treat clinically, as previously described, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms.  Also, be aware that hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  Low levels can cause symptoms that mimic hypothyroidism.  Low D and ferritin can adversely affect metabolism of thyroid hormone.  So you should get those tested and supplement as needed to optimize.  D should be about 55-60, B12 in the upper end of its range, and ferritin should be about 70 minimum.

To help with your search for a good thyroid doctor, I have sent you a PM with info.  To access, just click on your name and then from your personal page, click on messages.  
Avatar universal
Thank you! Your help is much appreciated!
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