Need help reading test results

[missreader]

After feeling unwell for two years my doctor finally did a complete thyroid test on me.  These are my results:
THS 1.36
Total T4 4.6
Free T4 .86
Total T3 .9
Free T3 2.6
TPO 11
I tested positive for an active Epstein Barr virus so my doctor said my thyroid was probably a little sluggish (but within normal ranges) from the virus and would get better once the virus was under control. Does that seem correct?  There aren't any other doctor's in my area covered by my insurance so I wanted to make sure if I really needed to get a second opinion before I have to drive 3 hours away for a new doc. Thanks in advance for any advice.  

[Barb135]

Your elevated  Thyroglobulin Antibody (TgAb) test result indicates Hashimoto's which is an autoimmune condition that causes hypothyroidism.  Apparently, your doctor missed that, or chose to ignore it because it’s not terribly high.


Epstein Barr Virus (EBV) is also known as mononucleosis, aka kissing disease, most commonly found in teenagers or young adults and  has been known to trigger Hashimoto's.  Once we've had EBV we carry antibodies for life.  Most of us have been exposed to EBV at one time or another and most of us carry the antibodies.  Do you have the results of the EBV test so we can see what was done?  

I find it appalling that your doctor can simply ignore the fact that your Free T4 of 0.86 is below the reference range (0.93-1.70).  It’s most likely he’s looking only at TSH, which many doctors do and yours is what most would consider “pristine”.  

Another issue is that when thyroid levels are as low as yours, we would expect TSH to be higher, which is a red “huge” flag in itself.  In your case, I’d also suspect Central or Secondary hypothyroidism.  With Central hypothyroidism the thyroid may, actually, work okay but there’s an issue with the pituitary gland in which is doesn’t produce enough TSH to stimulate the thyroid to produce adequate hormones.

The fact that your doctor is ignoring your below range Free T4, s/he ordered obsolete labs (Total T4 and Total T3) s/he is not up to date on thyroid diagnostics and/or treatment and it might be worth your while to get a second opinion.  Many doctors don’t “know” about the EBV/thyroid connection, nor do many of them think about Central/Secondary hypothyroidism.  Perhaps when presented with these suggestions, yours would be receptive to treatment… it’s hard to say.   Your symptoms will only continue to get worse without treatment.  If you think you can convince your current doctor to start treatment, it wouldn’t be necessary to go elsewhere, otherwise, I would say it would be worth driving 3 hrs to get well.  

[Alittleblues]

Would you be able to post the ranges for each test? Your Ft4 and FT3 would be low normal (not ideal) on my lab’s ranges but your lab may use different ranges. Optimum levels for Ft3 and Ft4 are generally the upper half of the normal ramge.

[missreader]

Oh ok. I didn't realize there were different ranges. Here are the ranges that were on my test:
TSH 0.27 - 4.2  (mine is 1.36)
Total T4 4.5 - 11.7  (4.6)
Free T4 0.93 - 1.70  (0.86)
Total T3 0.8 - 2.0  (0.9)
Free T3 2.0 - 4.4  (2.6)
TPO <40   (11)
I also tested for a Thyroglobulin Antibody of 1.1 IU/mL with the range of 0.0 - .09

[Alittleblues]

I would say that you are definitely hypothyroid. I don’t know how the virus would effect your thyroid but autoimmune diseases take a toll regardless. Some drs only evaluate by the TSH , and your TSH is “ok” so many won’t treat even though they should.  With your low ( or low normal) Ft3 and Ft4, taking thyroid would probably help. I have had a TSH of 2.5 and been severely ill. TSH can be worthless because it often doesn’t reflect the severity of hypo symptoms.   It would be worth it to get your iron and vitamin D checked to see if either is low. That can adversely effect thyroid.  I’m sorry I don’t know more,