Results Question

[ms_sally1974]

What do these results look like?
T4 12.7 (4.5-12.0)
t3 uptake 20 (24-39)
TSH 1.01 (.45-4.5)
Free Thyroxine Index 2.5 (1.2-4.9)

I've been referred to an endo for symptoms along with high T4 number and low uptake #.  What should I expect?  I've been having symptoms for approximately 4 years.  I was misdiagnosed with "depression" 3 years ago.... Was on anti-depressants for 18 months, no help... I have a new doctor that seems to think it's thyroid related. My symptoms run the gammot.

In no particular order, fatigue, body aches, joint pain, horse voice, weight gain, inability to lose weight, slow metabolism, constipation, white spots on my skin, no libido, no motivation, brain fog, moody, easily irritated, muscle weakness (used to be able to lift heavy weights, now I can't...) high cholesterol (despite a healthy diet and exercise)

[ms_sally1974]

Thank you for your help.  I don't know if this has anything to do with anything, but I took a closer look at my other labs and my WBC and platelets are elevated significantly from the last tests in 2013.  Still within range but WBC has gone from 5.4 to 7.2 (range 3.4 to 10.8) and platelets from 283 to 319 (range 150-379) could this be because my thyroid is slowly being killed? I've read somewhere that anything over 7 for WBC is elevated.  I;m definitely asking for all of the antibodies. I'm right in that there are two type of antibodies that need to be tested?

[Barb135]

Yes, that's what I was getting at, in my previous post... symptoms can often show up years ahead of the labs showing any sign of the actual hormone labs (FT3, FT4 and TSH) indicating a problem. That's why it's a good idea to test for the antibodies, because Hashimoto's is progressive and as time goes on, the antibodies would eventually cause hormone production to decline and FT3 and FT4 levels would decrease.  As FT3 and FT4 decrease, TSH would increase, since the pituitary gland would try to stimulate the thyroid into producing more hormones.

In the absence of elevated TSH, but low FT3 and FT4, the diagnosis would probably be Central Hypothyroidism, which is a problem with the pituitary gland vs the thyroid.  With Central Hypothyroidism, the pituitary gland fails to stimulate the thyroid enough to produce adequate thyroid hormones...This is often caused by a pituitary adenoma.

You do need to have new Free T3, Free T4 and TSH tests done, since your current tests are obsolete.  

If your new endo doesn't mention these possibilities, bring them up... don't let him skip over them, because many doctors will look at TSH only and decide you're fine, based only on that... if he tries to do that, or doesn't take suggestions from you, seriously, move on to a different doctor.

[ms_sally1974]

Sorry, I meant to ask is it possible in the early stages of Hashimoto's to have "normal" labs but still have symptoms?  I've never been tested for antibodies, but I've had symptoms for a LONG time and hypothyroid runs on both sides of my family.  In fact on my dad's side, my grandmother, two aunts and my father all have it that I know of.

[ms_sally1974]

Barb, I have never been tested for antibodies.

[ms_sally1974]

It's actually me not my daughter that has the issues. I attempted to stay off of the antidepressants for as long as possible and I couldn't deal anymore. So I went on them for 18 months but they never really helped my symptoms. So I went off of them. And now I'm back to being tested.

[gimel]

I noticed your comments about your daughter having depression and weight issues and trying to stay off meds.  Has she been tested for possible hypothyroidism?

[Barb135]

Your 2013 thyroid tests were about as pristine as they come... Rule of thumb (where most of us feel best) is for FT4 to be about range; yours was at 49%.  Rule of thumb is for FT3 to be in the upper half to upper third of its range; yours was at 75% of its range...

Have you been tested for anything else, such as thyroid antibodies to determine if you have Hashimoto's?  Hashimoto's is progressive and it's possible to have it for years before routine labs (FT3, FT4 and TSH) indicate a problem.  If you had the symptoms in 2013, the disease may have progressed enough since then to cause labs to go out of range, or at least, no longer be optimal.  

Deficiency in some vitamins/minerals, such as the Vitamin D, B-12 or ferritin that flyingfool mentioned?  can mimic hypothyroid symptoms, plus adequate Vitamin D and iron are necessary for the proper metabolism of thyroid hormones.

[ms_sally1974]

I took your advice and called the Endo and spoke to the nurse and told her what had happened before.  She said that their new patient appts are 40 mins long. And that they do test for other things and treat based on symptoms and labs... This made me feel so much better.

[ms_sally1974]

actually my TSH was .6 at this time.

[ms_sally1974]

Question, I'm sort of fuzzy about optimal limits....

These were the tests that I received in 2013
TSH 1.07 (.45-4.5)
FT4 1.25 (.82-1.77)
FT3 3.8 (2.0-4.4)

Would these test been indicative of anything at that point?  I had to fight to get these test only to be told that the symptoms were "all in my head' and that I had depressive disorder due to hormone imbalance.  At that time, they also did a blood cortisol (the one with the pill) which was below range at 2.2 (2.3-19.4) and a 24 hour test urinary and it was 34 (0-50).

[flyingfool]

Most of the tests run are outdated and obsolete.

Your symptoms are almost exactly low thyroid or otherwise known here as "hypo".

before you waste your time on go ing to the endo, I would get retested and make sure to get the following tests:

1) Free T4 - the test above that you had done is "total" which his different.  The body ONLy uses the hormone that is unattached (thus "free") from a protein.  Once a hormone is attached, it is bilogicaly inactive and thus useless.  Total count both the free and attached hormone molecules. But you have zero idea of what portion of that total is acutally available for use.

2) Free T3 - Again this is important because it is "free" from the protein making it available for use.  Most importantly this is the ONLY thyroid molecule that is ultimately used by your body at the cellular level.  Therefore you can see why it would be most important to test for the ACTUAL thyroid hormone that your body uses and sets metabolism.  (T4 must be coverted into T3 in order to be used.  T4 is a storage hormone and sits in reserve so to speak to be used on demand and converted. This is why it is important to have Free T4 (FT4) but it is NOT used directly.

I would recomend you also get the following tests as many people may be deficient in one or more of the following:

Vitamin D3
Vitamin B-12
Iron
Ferritin

Another recommendation I would make is to call your Endo. And ask a couple of questions, ask them:

1) Does the end routinely test for Free T4 AND Free T3?  Or if the Endo only uses TSH.

2)  if he/she has patients that the endo prescribes natrual dessicated thyroid medication such as 'Armour" and/or if they prescribe T3 medication generally referred to by brand name "Cytomel".

If the answer to question one is that they only uses TSH.  You may as well cancel the appointment. Chances are slim to non that they will be able to help you.

If the answer to question 2 is "no" the endo only prescribes T4 only medication.  I would also be tempted to cancel the appointment for the same reason.  

While some people can do well on T4 only medication. Others can't.  And if the Dr is set against using the other methods of treatment then they are too closed minded to potentially solve your problem IF you happen to be one of the people who need more than simple T4 only protocol.

Just my thoughts.