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Interpreting Lab Results

Hi, Everyone.

I need help interpreting my lab results.  I am Hashimoto positive.  Have been dealing with a multitude of symptoms related to that but endo says I am "normal".  Meanwhile I feel horrible.  

TSH is 2.92  Quest range is .40-4.50
T4 Free is 1.2  Quest range is .8-1.8
T3 Uptake is 26  Quest range is 22 - 35
T3 Total is 122  Quest range is 76 - 181

My primary care dr and endo are in the same practice.  Together they feel my symptoms can be managed by taking anti anxiety med (Cymbalta 30 mg/day then up to 60 mg/day after one week) and Belviq (2 x per day) to get the weight off that I have gained since feeling this way.

I am sitting on both scripts, terrified to take either meds.

What am I missing here?  I feel awful.  I started talking with a Nutritionist and she said to try grain & gluten free to help with the Hashi symptoms.  I started four weeks ago and it has helped with the stomach issues and managing the pain from inflammation but I am still dead tired.  Exhausted beyond beleif.  When I had nursing baby on a constant feeding schedule I wasn't this tired!

8 Responses
Avatar universal
Someone will assist you with labs shortly.  Do not accept normal for an answer.  To many physicians are lab happy, rarely ever listen to patients, believe psych meds are a cure all.  If you can avoid psych meds do so at all cost.  Most do more harm then good, and only mask the underlying condition.    

Avatar universal
My first impression based on your endo's comment of "you're normal" is to look for a new endo. As the previous posted mentioned, some of these doctors get tunnel vision with ONLY the lab tests.

From your description of symptoms and the Hashimotos, i would *think* trying synthroid would be a better choice than belviq and cymbalta. Not that these two meds don't have their place, but I would *think* stabilizing the hashi's and the thyroid levels first would make more sense. Then, additional adjuct meds like belviq and cymbalta could be added.

Hope this helps.
649848 tn?1534637300
I'm in total agreement that the first thing you need to do is look for a new endo and if necessary an new pcp, as well, since they are in agreement with each other...

First off, like many/most labs, Quest has failed to make the transition from the old range of 0.4-4.50 to the "new" range recommended by ATA and AACE 12 yrs ago of 0.3-3.0, so if we go by the "new" range, your TSH is right at the top of that range.

Looking further at your labs, T3 Uptake and Total T3 are both considered to be obsolete tests and of little value... Even at that, your T3 uptake is very low and so is your TT3...

A person can have Hashimoto's for years before it actually does enough damage to the thyroid for TSH, FT3 and FT4 to go out of range, but unfortunately, we feel the symptoms all too clearly, sometimes, years before this happens.  Doctors used to go ahead and treat the symptoms, but when it was decided back in 1979 that TSH would be the gold standard in thyroid testing/treatment that went out the window; now patients get treated with anti-depressants and weight loss medications when all they really need are thyroid hormones...

Both anxiety and weight gain are prime symptoms of hypothyroidism and treating them with with cymbalta and belviq are not the way to go... As far as I'm concerned both of these doctors should be up on malpractice charges, but unfortunately, this is the way doctors are being taught to treat thyroid conditions these days.  What a sad state of affairs we've come to!!

If at all possible, find another doctor who will test Free T3, along with the Free T4 and treat you according to symptoms - and not with anti-depressants and Belviq... They come with their own sets of side effects, which often are just as bad or worse than being hypo...

Avatar universal
Thank you, blee7926.  I haven't taken either the Cymbalta nor the Belviq.  I am not sure of the side effects and honestly I don't think that is treating what's really wrong with me.  I am searching for a new endo now.
Avatar universal
Thank you, Barb135.  I have also heard that the Quest lab ranges are older.  Unfortunately that is what I have here and where my insurance says I have to go.  I am searching for a new endo and will definetly get the T3 Free  and T4 Free testing.
649848 tn?1534637300
You can rest assured that Quest isn't the only lab that's still using the old range for TSH -- I think most of them do.  I'm not sure why they didn't change over when AACE and ATA made the recommendation.

Let us know when you have a new endo and can get the rest of the tests you need.
Avatar universal
Thanks.  They just requested an ran a test for prolactin.  Came back normal.  So now I am still arguing with my current endo about the belviq/cymbalta regimine.  Thanks again for all of your help.  
649848 tn?1534637300
Keep arguing - as they say "the squeaky wheel gets the grease"... hopefully, you'll win!!  

If we can help you by giving you scientific evidence that weight gain and anxiety/depression are hypo symptoms, let us know.
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