Borderline results - should I pursue further??

[2littlebadgers]

Hi, there-

Just seeking some input on whether or not to keep pushing for additional testing regarding my thyroid labs.  As some background:  I saw my primary last fall for thinning hair, fatigue, and feeling cold all the time (my body temp is often 96.5-97.9 - rarely ever gets above 98).   Anyhow, my primary doc ran a bunch of labs and results showed a normal TSH but low normal free t3 and t4 as follows:

TSH:         1.614      (0.350 - 5.000 mcUnits/mL)
Free T3:    2.3  ( 2.2 - 4.0 pg/mL )
Free T4:   0.8    (0.8 - 1.5 ng/dL)

My RBC was also a little low at  3.85 mil/mcL 4.00 - 5.20 mil/mcL, so she thought that might explain some of my symptoms.   She did go back and check my thyroid antibodies, which were as follows:

THYROID PEROXIDASE A           47 Units/mL         ( <60 Units/mL)

Several months have passed since these tests and I've been taking an iron supplement, but don't feel any better.  My hair remains thin and seems to be shedding more by the day, I'm about 7 lbs. up from my normal weight despite the fact that I am a long distance runner and eat well & exercise regularly.    I'm not exactly a spring chicken at 43 and I do work with young, special needs children so I'm on my feet much of the day, but I just never expected to feel so tired all the time at this age - some nights, I beat my 11 year old to bed.  I'm starting to feel like a hypochondriac and am a bit embarrassed to go back and ask for more tests, or what tests I would even ask for at this point.   So anyhow, just wondering if anything about my labs looks troublesome, or should I drop the thyroid angle and move on?   Thanks for any thoughts.

[Barb135]

If those thyroid tests were done last fall, you should ask to have them repeated again, as the Free T4 and Free T3 were both on the floor of their ranges and could easily explain the way you feel.  Your levels could have decreased even more by now, so it's necessary to have them tested again.

In addition, there's another antibody test you should have had done to confirm/rule out Hashimoto's.  It's called the Thyroglobulin Antibody (TgAb) test.  Both, it and TPOab that you've already had done are markers for Hashimoto's, so without them both, you could be misdiagnosed.

Don't ever be embarrassed to ask for testing when it could help get to the bottom what makes you feel bad... If your doctor won't order the tests, you should either find a different doctor or we can tell you how to get them without a doctor's order, though they won't be covered by insurance.