Help with lab results

[moooii]

Please could somebody help with these results? I have all the symptoms of hypothyroidism. Apologies, the labs were in Hungarian

Test                                                   Result                      Range
TSH receptor AT (TRAK)                0.406 IU/L F *1
ATPO                                               6.25 U/mL                 0.00-63.00 F
TSH Supersens.                              1.501 mU/L              0.350-4.940 F
T3 szabadfrakció meghat.                3.85 pmol/L               2.63-5.70 F
T4 szabadfrakció meghat.                10.80 pmol/L              9.00-23.20 F

Notes
*1
< 1 IU/L negative

[goolarra]

Based on where many of us have to be for symptom relief, we know that FT4 does not have to be below range, and TSH does not have to be above range for us to be hypo.  

How low was your vitamin D?  It is true that low D levels can cause similar symptoms.  Also, vitamin D must be present in sufficient levels (not just on the floor of the range, but well up into it) for the synthesis of thyroid hormones in the thyroid and later so that thyroid hormones can get into cells to do their work.  How much are you taking?

As long as we're at it, please post your ferritin and B-12 levels as well.  Have you followed up at all since you started supplementing to make sure your supplements are working?

[goolarra]

That's a significant drop in just six months.  I'd definitely pursue it further.

[moooii]

Thanks. I got this email from them today: Dear XXX, according to your results you do not have hypothyroidism. Your free T4 is in the lower part of the normal range but in the biology it is normal. In the case of hypothyroidism your fT4 has to be below the normal range and your TSh has to be above the normal range.
In May your vitamin D level was very low I don't know whether  you are taking any vitamin D supplementation but that can be important. The low vitmain D level can cause very similar symptomes.
Please start to take 2000 NE vitamin D every day (you can buy it without prescription).


I have already upped my D, B12 and Iron/Ferritin as I was deficient in all. Should I get a third opinion?!

[goolarra]

Has your FT4 dropped even further in the past few years?  Was FT3 run back then?

[moooii]

FT4 was 13.77 and FT3 was 4.45 back in May

[moooii]

Sorry I mean months not years!

[goolarra]

TGab (thyroglobulin antibody) is the other marker for Hashi's.  Only one of the two, TPOab or TGab, has to be elevated to confirm Hashi's, so both have to be tested to rule it out.  By far, most of us are TPOab positive, but you can't be sure until both are tested.

Your FT4 is only at 13% of range.  Thyroid test reference ranges are very flawed, and anyone falling in the lower half of the ranges is probably hypo.  For that reason, 50% of range is the guideline for FT4.  Your FT3 is at 40% of range, which is considerably low of the upper half to upper third recommended for FT3.  

Unfortunately, your TSH looks good.  I say "unfortunately" because although they may order FT3 and FT4, many doctors really pay attention to little besides TSH.  

I can certainly see where your low FT3 and FT4 levels could be causing symptoms.  Have you discussed treatment with your doctor?

[moooii]

thanks I will make appointment with endocrinologist. I decided to pay for  a thyroid panel at a clinic as I have been suspicious about being hypo for a few years and my doctor said I am normal. I just accepted these symptoms as normal. I looked a few years ago at a test and it was the same, i.e. low FT4, normal TSH, yet things seems to be getting worse.

[goolarra]

Are those FREE T3 and FREE T4?

Yes, the T4 is quite low.

TPOab is 6.25 (0.00-63.0), which is within reference range.  The lower, the better.  This is the antibody marker for Hashi's.  Did they test TGab, too?

[moooii]

I don't think they did. I had just these 5 done. What would a TGab do?

[moooii]

Sorry yes, they are Free T3 and T4 :)

[moooii]

The T4 is quite low isn't it? As is the TPO, yet the latter is supposed to be isn't it?