Thyroid test confused

[Sickandrired1220]

I have been having severe fatigue,weight gain loss of eyebrow hair brittle hair and nails for months and went for a blood test my t4 total was 14.4 my t3 uptake was18.4 and my tsh was 1.83. The doctor told me everything was fine but I have these symptoms. Could it be a thyroid issue?

[Barb135]

Your FT4 is right at mid range 2.6 (1.6-3.7), which is what we usually recommend.  You would need an FT3 to determine if you are converting the FT4 to FT3, adequately. If FT3 is adequate, you may have to look elsewhere for a diagnosis; but do be sure to get thyroid antibodies, as well, since symptoms can present, before labs reflect.

Your RDW is high, indicating that your red blood cells are larger than normal.  This is often an indication of a vitamin B12 issue.  Be sure to get B12 tested. Deficiency can cause absolutely, debilitating fatigue, and if left untreated, can cause a multitude of other symptoms.

[payton382]

What I started doing (I know this is weird) but I'd take a bath, wash my face, fish out all the eyebrows and lashes that I would lose (floating around me) and take a picture with them all together on the side of my tub with my cell phone.  One picture had 45 lashes and brows but around 15-25 on any given day was typical for me.  

I also did this with how much hair I was losing, up to and over 500 hairs each time I washed my hair.  

If I heard one more Dr tell me "Well, you look fine"...I was going to scream.  Once I started taking pictures in they listened more and began to realize that even though I wasn't bald or all my brows/lashes weren't gone that I was having a problem and I wasn't exaggerating.  

I had a lot of the same problems you describe, with weight gain or inability to lose weight, hair/brow/lash loss, and extreme fatigue.  Because I wasn't overweight and it's hard to prove fatigue it was really frustrating getting Dr's to pay attention.  A lot of them wanted to prescribe antidepressants.  I kept saying I was not depressed, I didn't feel sad, I felt frustrated and my body was tired....something is wrong.  

Anyhow, at your next Dr appt I would request the Free's, TSH, Antibodies, Ferritin, and B12.  Your H&H (Hemoglobin and Hematocrit) look fine, a little lowish, but you're not anemic yet.  Just make sure you look at B12 and Ferritin to ensure those aren't low and you don't have a deficiency.

How much Vitamin D are you taking?  I know it takes a while to build that back up.  Mine was originally in the 20's.  I took liquid Vitamin D for 3 months and it was well over 100 within that 3 months.  I think it usually takes longer though for Vitamin D to climb that high.  

Vitamin D is fat-soluble so your body cannot rid itself of excess Vitamin D, at which point it can become toxic.  It's important to watch your levels later with a blood draw and make sure you stop taking it or cut back to a maintenance dose (usually around 2,000 iU's per day) once you level out....or whatever your Dr tells you to do.    

There's very few things that cause the combination of symptoms you're having (especially taking the brow loss into consideration), unfortunately all of the causes have very screwed up ranges so it'll be important for you to research where in the ranges each one of your numbers fall into.  You can always come back here and post your ranges after your next appt.  

Lastly, the only other thing I think I found that causes those combination of symptoms is Lupus (but I can't honestly remember if it was eyelash loss only or lash and brow).  An ANA test can sometimes rule that in or out but would be the last thing I would suspect.  

[Sickandrired1220]

Thanks, my GP didn't seem to think it was a big deal but I will be sure to push the issue with the endo. I can be washing my face and have several eyebrow hairs on my hands when I am done

[Sickandrired1220]

Thanks for the advice. They did test for vitamin D and I was low so I have been taking vitamin D for about a week now. The other things they tested and the ranges were
White blood cell count 10.6 range of 3.8-10.8
Red blood cell count 4.62 range of 3.80-5.10
Hemoglobin 13.0 range of 11.7-15.5
Hematocrit 39.7 range of 35.0-45.0
Mcv 86 range 80-100
Mch 28.2 range 27-33
Mchc 32.8 range 32-36
Platelet count 302 range 140-400
RDW 15.1 range 11.0-15.0
Mpv 8.7 range 7.5-11.5

[Red_Star]

"The Sign of Hertoghe or Queen Anne's sign is a thinning or loss of the outer third of the eyebrows, and is a sign of hypothyroidism.

The sign is named for Eugene Hertoghe of Antwerp, a pioneer in thyroid function research.[1][2]" - Wikipedia: Sign of Hertoghe

Not everyone will have this sign but if you do it's a red flag sign.  My mother has this sign, along with other symptoms and clincial symptoms which is why i pushed for a full thyroid panel. She has high antibodies showing Hashimoto's thyroiditis.

[payton382]

Like Barb recommended, have the endo also test Free T3.

Low Ferritin also causes the exact same symptoms you listed.  Ferritin is your iron storage and is not a part of a standard iron panel.  I'd also request a CBC (just a normal blood panel) so you can see if your anemic, which will be identified by low Hemoglobin and Hematocrit levels.  Ferritin to see if you are anemic if it's being caused by iron deficiency.  You can be iron deficient without being anemic.  You can also be anemic but the cause could instead be a B12 deficiency.  

Sorry if that's confusing.  What I mean is there's anemia, iron deficient anemia, B12 deficient anemia, and iron deficiency only (with no anemia), B12 deficiency only (with no anemia).  All can cause symptoms you describe and if they are the cause you'd need to figure out what you have.    

This is what I'd want to look at first if I had your symptoms:

Ferritin
Iron Panel
CBC
TSH
Free T3
Free T4
Thyroid Antibodies
B12

And throw in Vitamin D for good measure since almost everyone is low.  

Then I'd come back here and post your results since a lot of the ranges for these tests are skewed.  They might say "within range" or "normal" or not flagged as high/low, when in fact you'd benefit from some treatment.  

[Sickandrired1220]

I should also add that they did test for free t4 and it was 2.6. The rage that the lab used was 1.6-3.7

[Sickandrired1220]

Thanks for your advice. The doctor I saw was a real jerk and didn't want to hear what I had to say and rushed me out as fast as he could. I made an appointment with an endocrinologist but I couldn't get in until July. I am just trying to gather as much info as I can before then

[Barb135]

Yes, it could be a thyroid issue.  Unfortunately, Total T4 and T3 Uptake are considered obsolete and of little value.  You really to get Free T3 and Free T4 - those are the actual thyroid hormones, with Free T3 being the most important, because that's the one used directly by the individual cells.

You should also be tested for thyroid antibodies to determine if you have an autoimmune thyroid disease. The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  These will determine if you have Hashimoto's Thyroiditis.  

With Hashimoto's, the body sees the thyroid as foreign and produces antibodies to destroy it. The destruction, typically, takes years, but doesn't have to.  As the destruction progresses, the thyroid produces less and less hormones.  Many people have severe symptoms, long before thyroid tests indicate a problem.

You may have to find a different doctor in order to get adequate testing/treatment.