How to interpret my test results?

[Sleepy82]

Hi!
I am a 26 year old male form Denmark. Last year I found out through lab tests that I have stage III adrenal fatigue.  I have been addressing this issue for a while - however I got to suspect that I also might be slightly hypothyroid since many of my symptoms seems to match (low energy, proneness to weight gain, depression, diffuse joint pains, lowered tolerance to physical exercise, a general thinning of my hair, low resting pulse (40-50) and high cholesterol (6,3 mmol/L))

I try to take good care of myself nutrition and exercise- wise (my sister doesn’t and she’s hypothyroid). But my doctor refuses to test me, since I look healthy at first glance.

However I paid an endocrinologist to run some tests on me anyway. Unfortunately he wouldn’t give me the free T3 test, since he liked the total T3 test for reasons unknown. But my results are:

Free T4: 13,4 pmol/L
Total T3: 2,3 nmol/L
TSH: 3 (didn’t get the units, but I think it’s the same as all other TSH tests)
TPO antibodies: 21 (didn’t get the units)

The endocrinologist says that I’m “within range”. What do you say?

[goolarra]

I would strongly recommend that you find a doctor to help you manage this and not do it in your own.  Even a phone/internet/fax consultation would be reasonable if Danish doctors are really that terrible.  When I see my endo, he reviews my labwork and we discuss symptoms, but there is really not a lot of reason for me to see him.  We could accomplish this on the phone (and sometimes wish we did so I don't have to pay him!).

You are absolutely right that adrenal fatigue can sabotage thyroid treatment.  This complicates your condition and makes self-treatment more risky than it usually is.  I'd really try very hard to consult with someone on this.

Your TPOab count is good, so it doesn't look like Hashi's.  However, if you want to be sure, you should also have TGab tested since some of us with Hashi's have elevated TPOab, some TGab, and some both.

Why do you suspect adrenal fatigue?  

[Sleepy82]

Thanks for you input. My antibody test said "21" so I guess it's not that... ?

[Sleepy82]

Thanks for your comments and the info you send. It is really helpful. It’s nice to feel like I’m not all alone with this :)

I very much agree with you in that I might be slightly hypo. The Danish doctors are not very... well good (there has been a fuss in the Danish medias  many times over the fact that, if Danish doctors get seriously sick, many of them seek abroad to get treatment)... But fortunately for me, I can get Armour thyroid from a UK supplier of the internet, and I guess I'll just try out a low dose and see how I feel using that... :)

Only problem is, that I've heard that folks with adrenal fatigue aren't always able to handle thyroid medication, since it raises the body's energy turnover while the adrenals aren't really able to handle it yet. Hence I risk getting a hyper-like reaction on thyroid meds, although in reality being hypo.

http://www.stopthethyroidmadness.com/adrenal-info/

I think it would be prudent of me to get on a very low dose of hydrocortisone or Isocort, while using the Armour meds (more on safety and benefits of small doses hydrocortisone in the links below):

http://www.intlhormonesociety.org/ref_cons/Ref_cons_3_mild_glucocorti...
http://www.stopthethyroidmadness.com/adrenal-info/how-to-treat/
http://featherstone.bravehost.com/thyroid/peatfieldadrenal.html

Unfortunately I haven’t been able to find an Internet supplier within Europe yet (overseas shipments without prescriptions gets snatched right up by the customs). But I’m thinking of finding a doc on the internet that will be willing to have mail or phone consultations, so that it can be prescribed to me.

[Super_sally888]

Just to add to what Goolara said, it may be useful to get tested for antibodies.  IF these are higher than range it would also indicate autoimmune damage to thyroid and support a low dose of meds to see if helps how you feel.

[goolarra]

My lab uses 0.6-2.0 for FT4 and 98-215 for TT3.  As I said, these numbers are lab-specific, so you should still get yours from your doctor.  Your FT4 is just at the top of the bottom third of the range.  TT3 is considered an obsolete test and pretty much a waste of money.  TT3 is in the lower part of the middle third (for what it's worth).  The currently accepted range for TSH is 0.3 to 3.0.  Many labs still use an obsolete range (something in the vicinity of 0.5-5.0).  So according to the new range, you are very close to being hypo.

Many of us do not feel our best with FT4 so low in the range.  Many people have to get their numbers into the top half to top third of the range before feeling well.  I think you are slightly hypo and could benefit from a low dose of meds.  Perhaps you could talk your doctor into a trial dose.  If it relieves your symptoms, that's wonderful, if not, you can always discontinue with no harm done.  Your symptoms do sound hypo, also.  I'd definitely push for a low dose of meds.

[Sleepy82]

Hi. Thank you for your answer. The endocrinologist didn't bother to tell me the reference ranges (he called me and told me about the results and just said everything was dandy).

And thanks for pointing out that the units are not the same as the ones people usually deal with. I’ve looked up how to convert it to conventional units
So anyway, now the results are :)

Free T4: 1,05 ng/dl
Total T3: 149 ng/dl

I hope that's better :)

[goolarra]

Please post the ranges on your FT4 and TT3...these are different units than we're used to looking at and ranges are lab-specific.