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Need help with lab results
I have all the signs of hypothyroidism – freezing cold all the time, muscle cramps, brain fog, constipation, ridged nails, fatigue, poor exercise recovery, depression, mood swings, etc.
My labs over the years have been mixed here are a couple. I would love to hear some thoughts on what others think
Most recent: 5/8/13
TSH 1.59 (0.34-5.50 uIU/mL)
T4 Free 0.76 (0.58-1.64 ng/dl)
T3 Free 3.1 (2.3-4.2 pg/ml)
Previous 6/12/12
TSH 2.89 (0.4-5.0 uIU/mL)
T3 113 (60-181 nd/dl)
FT4 1.2 (0.9-1.8 ng/dl
Others 8-31-11
TSH 3.2 (.27-4.2 uIU/mL)
Free T4 1.2 (.93-1.7)
T3 123 (80-200 ng/dl)
My T3 total has been down to 73 on a blood test with 80-200 as the reference and my tsh was once a 5.2. I just don’t have those records in front of me at the moment. I’m also constantly slightly anemic, have low vitamin D. I’m 26, male, was an athlete :/ I have tons of food intolerances now. I’m eating paleo but cant tolerate any supplements, etc. been really hurting my quality of life. Would appreciate any and all thoughts/insights!
My labs over the years have been mixed here are a couple. I would love to hear some thoughts on what others think
Most recent: 5/8/13
TSH 1.59 (0.34-5.50 uIU/mL)
T4 Free 0.76 (0.58-1.64 ng/dl)
T3 Free 3.1 (2.3-4.2 pg/ml)
Previous 6/12/12
TSH 2.89 (0.4-5.0 uIU/mL)
T3 113 (60-181 nd/dl)
FT4 1.2 (0.9-1.8 ng/dl
Others 8-31-11
TSH 3.2 (.27-4.2 uIU/mL)
Free T4 1.2 (.93-1.7)
T3 123 (80-200 ng/dl)
My T3 total has been down to 73 on a blood test with 80-200 as the reference and my tsh was once a 5.2. I just don’t have those records in front of me at the moment. I’m also constantly slightly anemic, have low vitamin D. I’m 26, male, was an athlete :/ I have tons of food intolerances now. I’m eating paleo but cant tolerate any supplements, etc. been really hurting my quality of life. Would appreciate any and all thoughts/insights!
Hi Barb,
I'll get some updated bloodwork for you in the near future. I've been trying to up my dosage from 12.5 mcg to 25 mcg but everytime I do the severity of my depression increases. I've considered trying armour instead of T4 which my doctor is open to but I'm nervous about losing the mild benefits I've noticed on the small amount of t4. I've tried buspar in the past along with a million other antidepressants but never tolerated them well. I've read that armour can be more helpful because it has t3 as well. I'll be discussing this more with my doctor but thought I'd love your opinion as well.
I'll get some updated bloodwork for you in the near future. I've been trying to up my dosage from 12.5 mcg to 25 mcg but everytime I do the severity of my depression increases. I've considered trying armour instead of T4 which my doctor is open to but I'm nervous about losing the mild benefits I've noticed on the small amount of t4. I've tried buspar in the past along with a million other antidepressants but never tolerated them well. I've read that armour can be more helpful because it has t3 as well. I'll be discussing this more with my doctor but thought I'd love your opinion as well.
COMMUNITY LEADER
I'm happy to hear that you are seeing some improvements. Unfortunately, recovering from hypothyroidism doesn't happen overnight, as you can well see.
The body tends to heal the most important things first, which is why your digestion and migraines are getting better. Both depression and anxiety are symptoms of hypothyroidism.
I don't know that zoloft "messes with the thyroid", but it's not easy to get off, once on it. Maybe you could talk to your doctor about something a little less drastic... such as buspirone, which is what I was on for a while, for anxiety. A lot of the depression/anxiety comes from not feeling well.
The decision to start an anti-depressant, anti-anxiety med is one that you and your doctor will have to make, based on your particular situation.
What are your current thyroid hormone levels? You should be getting tested regularly for FT3, FT4 and TSH, every time you have labs.
The body tends to heal the most important things first, which is why your digestion and migraines are getting better. Both depression and anxiety are symptoms of hypothyroidism.
I don't know that zoloft "messes with the thyroid", but it's not easy to get off, once on it. Maybe you could talk to your doctor about something a little less drastic... such as buspirone, which is what I was on for a while, for anxiety. A lot of the depression/anxiety comes from not feeling well.
The decision to start an anti-depressant, anti-anxiety med is one that you and your doctor will have to make, based on your particular situation.
What are your current thyroid hormone levels? You should be getting tested regularly for FT3, FT4 and TSH, every time you have labs.
I'm definitely starting to notice some improvements. I had to start at 12.5 mcg and I am now working up to 25 mcg. My body is very sensitive. I am supplementing B12 and glutathione as well...the combination seems to be beneficial. My digestion is improving, migraines are becoming less, small overall improvements across the board I'd say. I still have a long way to go but my depression/anxiety is still very severe. I'm considering starting with a small amount of zoloft but am hesitant because I have heard things about it messing with your thyroid, etc. Anyways, thought I'd get your opinion as it would be nice to have something working to alleviate some of this depression.
COMMUNITY LEADER
While 25 mcg is quite a low dose, some people can't tolerate it; you can start out even lower than that, by splitting your 25 mcg levo tablet in 1/2 for 12.5 mcg; I've even known some people to quarter them, though that's pretty difficult because they're so small. If you make it for a couple weeks on the 12.5, you can go up to the full 25. Talk to your doctor about it.
Armour has T3 in it, which might tend to cause more anxiety, but you can do the same thing with it, if you want to try it again. Or try splitting the pill in 1/2 and take 1/2 in the morning, 1/2 around noon, so you aren't getting the full hit of T3 all at once. Most of us on T3 med, split our dose.
Talk to your doctor about it
Armour has T3 in it, which might tend to cause more anxiety, but you can do the same thing with it, if you want to try it again. Or try splitting the pill in 1/2 and take 1/2 in the morning, 1/2 around noon, so you aren't getting the full hit of T3 all at once. Most of us on T3 med, split our dose.
Talk to your doctor about it
they were very small doses armour 30mg after that seemed bothersome i instead tried levo 25 mcg. Maybe I'll try again.
COMMUNITY LEADER
I don't really see anything here that would indicate an adrenal issue, though your cortisol levels for the noon, evening and night saliva are all right at the very bottom of their ranges.
Unfortunately, it takes more than a few days for the levo to get into your system. It takes 4-6 weeks for the levo to reach full potential in your blood and it's not unusual for symptoms to worsen or new ones to appear, while the body adjusts to having the hormones again. What dosage did the doctor start you out at? You may have been started at too high a dosage.
Armour works faster, because it contains the T3, which is fast acting, but doesn't stay in your system very long. That too, may have been too high a dose. What was your dose on that?
Unfortunately, it takes more than a few days for the levo to get into your system. It takes 4-6 weeks for the levo to reach full potential in your blood and it's not unusual for symptoms to worsen or new ones to appear, while the body adjusts to having the hormones again. What dosage did the doctor start you out at? You may have been started at too high a dosage.
Armour works faster, because it contains the T3, which is fast acting, but doesn't stay in your system very long. That too, may have been too high a dose. What was your dose on that?
Update:
So I tried both armour and levo. Unfortunately within a few days of trying each they seemed to just make my anxiety significantly worse. I am working to reduce my stress in hopes that may be adding to my health issues. I also got a hormone salivary test as I have heard that poor adrenal function/fatigue can cause problems with thyroid medication. Here are the results from the adrenal/hormone panel
Hormone Test
Estradiol (saliva) < 0.5 L pg/ml Range: 0.5 - 2.2
Progesterone (saliva) 28 pg/ml Range: 12-100
Testosterone (saliva) 99 pg/ml Range: 44-148
DHEAS (saliva) 8.8 ng/ml Range: 2-23
Cortisol Morning (saliva) 7.2 ng/ml Range: 3.7-9.5
Cortisol Noon (saliva) 1.2 ng/ml Range: 1.2-3.0
Cortisol Evening (saliva) 0.9 ng/ml Range: 0.6 - 1.9
Cortisol Night (saliva) 0.5 ng/ml Range: 0.4-1.0
Any insight would be greatly appreciated!
So I tried both armour and levo. Unfortunately within a few days of trying each they seemed to just make my anxiety significantly worse. I am working to reduce my stress in hopes that may be adding to my health issues. I also got a hormone salivary test as I have heard that poor adrenal function/fatigue can cause problems with thyroid medication. Here are the results from the adrenal/hormone panel
Hormone Test
Estradiol (saliva) < 0.5 L pg/ml Range: 0.5 - 2.2
Progesterone (saliva) 28 pg/ml Range: 12-100
Testosterone (saliva) 99 pg/ml Range: 44-148
DHEAS (saliva) 8.8 ng/ml Range: 2-23
Cortisol Morning (saliva) 7.2 ng/ml Range: 3.7-9.5
Cortisol Noon (saliva) 1.2 ng/ml Range: 1.2-3.0
Cortisol Evening (saliva) 0.9 ng/ml Range: 0.6 - 1.9
Cortisol Night (saliva) 0.5 ng/ml Range: 0.4-1.0
Any insight would be greatly appreciated!
COMMUNITY LEADER
Congratulations!! Did he do any labs? Can you post them, with reference ranges, so we can follow your progress?
Got a great new Dr who agreed to try a starter dose of thyroid medication. Started on armour this morning 30mg. I'll let you know how it goes! Thanks for all the help.
COMMUNITY LEADER
When you get current labs, be sure to post them, with the reference ranges so we can assess them.
Let's just look at what you just posted and try to draw a conclusion.
You have multiple Hypo symptoms. But "they" don't know what is wrong with you.
Dah! Hellow! "earth to Dr brain dead".
if it walks like a duck and quacks like a duck.....well it might possibly be a duck don't you think???
If you look and feel hypo, well then maybe you are hypo.
This is NOT rocket science and you really don't need a degree on a wall to unravel that riddle!
You have multiple Hypo symptoms. But "they" don't know what is wrong with you.
Dah! Hellow! "earth to Dr brain dead".
if it walks like a duck and quacks like a duck.....well it might possibly be a duck don't you think???
If you look and feel hypo, well then maybe you are hypo.
This is NOT rocket science and you really don't need a degree on a wall to unravel that riddle!
Thanks for the quick response. Ya, I'll look into using a different lab and get some updated results
COMMUNITY LEADER
Your results still look hypo, in spite of being within the lab ranges. The ranges your lab is using, only takes in the bottom 1/2 of what we normally see, especially, the FT4 range. Typically, we see a range of 0.8-1.8...... is there a chance you can try a different lab?
Hey Barb and flying fool. Thanks for the help. I'm still kind of at a loss as to what to do. I met with my dr and got these results back
TSH: 1.27 uIU/mL Range: 0.40-4.50
Free T4: 0.95 ng/dL Range 0.54-1.24
Free T3: 3.22 pg/mL Range: 2.30-3.90
I certainly have all the symptoms of hypothyroid and have also looked into a myriad of other conditions with my dr's to see what could be causing all this but nothing seems to provide any answers. I'm pretty desperate at this point as feeling absolutely terrible for years has destroyed my quality of life and nothings offering much hope for there being an answer. I'd love you opinions on whether or not you think thyroid medication would still be worth a try given these results. Also, why would my results be significantly worse years prior and not as bad now but I still feel terrible? I have significantly changed my diet and eat primarily paleo per my nutritionists recommendation. Thanks in advance for your help.
P.S. I've tried vitamin supplements, antidepressants, etc. but my body cant seem to tolerate anything they all end up giving me excruciating migraines worse then the ones I already have to endure everyday.
TSH: 1.27 uIU/mL Range: 0.40-4.50
Free T4: 0.95 ng/dL Range 0.54-1.24
Free T3: 3.22 pg/mL Range: 2.30-3.90
I certainly have all the symptoms of hypothyroid and have also looked into a myriad of other conditions with my dr's to see what could be causing all this but nothing seems to provide any answers. I'm pretty desperate at this point as feeling absolutely terrible for years has destroyed my quality of life and nothings offering much hope for there being an answer. I'd love you opinions on whether or not you think thyroid medication would still be worth a try given these results. Also, why would my results be significantly worse years prior and not as bad now but I still feel terrible? I have significantly changed my diet and eat primarily paleo per my nutritionists recommendation. Thanks in advance for your help.
P.S. I've tried vitamin supplements, antidepressants, etc. but my body cant seem to tolerate anything they all end up giving me excruciating migraines worse then the ones I already have to endure everyday.
I am not currently taking any thyroid medication. I'm not sure what the reason for my anemia is... no one has ever given me a reason or diagnosis besides just telling me I'm anemic and they don't know why. I cant tolerate any supplements they just give me severe migraines so unfortunately, while I have tried, I can't take supplements at the moment. I'm hoping my body can someday tolerate things better again. I will look into vitamin b12 injections and trying to get into the sun more. I live in the northeast so the weather is getting nice again and I will do my best to get plenty of sunshine.
COMMUNITY LEADER
Are you currently on a thyroid hormone replacement? If so, which one, what dosage and for how long?
What antibody tests have you had? To test for autoimmune thyroid disease, you need Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). Either of those will diagnose Hashimoto's Thyroiditis, which is the # 1 cause of hypothyroidism in the developed world.
Are you supplementing for the low vitamin D or spending extra time outside with enough bare skin to absorb the rays that will allow your body to make it?
What about the B12? Your level is way too low, even if the range says > 250; that's not nearly enough, and B12 deficiency can cause the most horrendous fatigue. While most people inject monthly, I have to inject weekly, in order to keep my levels high enough to feel well.
What type of anemia do you have? Is it iron deficiency or because of the low B12?
Depression is a symptom of hypothyroidism and I agree that your actual thyroid hormones are low enough to cause symptoms.
When getting thyroid hormone tests, always make sure you get Free T3 (FT3), not total, because total is considered obsolete and of little value, because a portion of that is attached to proteins which make it unusable. You want to know how much is unattached, and Free to be used by the individual cells.
What antibody tests have you had? To test for autoimmune thyroid disease, you need Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). Either of those will diagnose Hashimoto's Thyroiditis, which is the # 1 cause of hypothyroidism in the developed world.
Are you supplementing for the low vitamin D or spending extra time outside with enough bare skin to absorb the rays that will allow your body to make it?
What about the B12? Your level is way too low, even if the range says > 250; that's not nearly enough, and B12 deficiency can cause the most horrendous fatigue. While most people inject monthly, I have to inject weekly, in order to keep my levels high enough to feel well.
What type of anemia do you have? Is it iron deficiency or because of the low B12?
Depression is a symptom of hypothyroidism and I agree that your actual thyroid hormones are low enough to cause symptoms.
When getting thyroid hormone tests, always make sure you get Free T3 (FT3), not total, because total is considered obsolete and of little value, because a portion of that is attached to proteins which make it unusable. You want to know how much is unattached, and Free to be used by the individual cells.
Thank you! Here are the other results you asked for
Vitamin D: 21 range (33-100)
B-12: 388 pg/dl range >250
Ferritin: 96 range 30-300
Hematocrit: 35.2 range 41-53
My immune system is also slightly low in a couple areas - not sure if that could be connected. Been tested for most autoimmune disorders all came back negative but have yet to be tested for hashimoto's.
IgA: 69 (70-400)
IgM: 44 (40-230)
IGG subclass 2: 243 (242-700)
One of my major problems now is that I can't tolerate much anymore. All supplements and many foods give me migraines or some sort of allergic reaction. Incredibly frustrating. My system and health got worse after being told I was just depressed and then given a myriad of about 12 different psych drugs over a couple years... needless to say they brought no relief and my body is significantly worse after. I'm hoping with my nutritionist/wellness/holistic dr and the right combination of quality clinical dr's (which I think I have finally found and set up appointments with) I can get back to full health. Thanks in advance for all the help and looking forward to more information from you and others!
Vitamin D: 21 range (33-100)
B-12: 388 pg/dl range >250
Ferritin: 96 range 30-300
Hematocrit: 35.2 range 41-53
My immune system is also slightly low in a couple areas - not sure if that could be connected. Been tested for most autoimmune disorders all came back negative but have yet to be tested for hashimoto's.
IgA: 69 (70-400)
IgM: 44 (40-230)
IGG subclass 2: 243 (242-700)
One of my major problems now is that I can't tolerate much anymore. All supplements and many foods give me migraines or some sort of allergic reaction. Incredibly frustrating. My system and health got worse after being told I was just depressed and then given a myriad of about 12 different psych drugs over a couple years... needless to say they brought no relief and my body is significantly worse after. I'm hoping with my nutritionist/wellness/holistic dr and the right combination of quality clinical dr's (which I think I have finally found and set up appointments with) I can get back to full health. Thanks in advance for all the help and looking forward to more information from you and others!
Do you have the lab results for the Vit D.
Have you had a Vit B-12 test done?
Both of these vitamin deficiency's can cause high levels of fatigue.
You should also be tested for BOTH Hashimoto's antibody tests. These are; TPOab and TGab. Hashi't is the most common cause of Hypo. It is a autoimmune problem where your body thinks your thyroid gland is a foreign invader and so your immune system sends out antibodies to kill the thyroid.
In the early phases of Hashis it can cause a person to switch between Hyper and Hypo in some people.
ALWAYS, ALWAYS make sure you demand and they test for Both the FREE T4 and FREE T3. The "total" and uptake tests are obsolete and of little value.
Your lab tests show that you are only 16% of the range of your Free T4 and you are only 42% of the range for the Free T3.
This indicates that you are converting well.
However since you are symptomatic, many people found here that a MUCH better rule of thumb target to achieve are BOTH of the following:
1) Free T4 to be in the MIDDLE of the range (50%) or slightly higher
AND- means in addition to
2) Free T3 to be in the UPPER 1/3 (66.7%) of the range.
As you can see your FT4 is well below at 16% the rule of thumb 50%. Also your FT3 is low as well.
I would recommend that you discuss with your Dr about starting out on a T4 medication starter dose.
If your Dr is unwilling, it is most likely due to your TSH level. And any Dr who exclusively goes by TSH is NOT a good thyroid Dr and you are better served to go find another Dr. Any Dr who only uses TSH is almost guaranteed to keep you feeling like crap.
Many people end up on this forum site because of exactly this reason. They feel like crap but because their blood tests are within the normal range, they are unable to get medication. So you are not alone if this is your situation.
Have you had a Vit B-12 test done?
Both of these vitamin deficiency's can cause high levels of fatigue.
You should also be tested for BOTH Hashimoto's antibody tests. These are; TPOab and TGab. Hashi't is the most common cause of Hypo. It is a autoimmune problem where your body thinks your thyroid gland is a foreign invader and so your immune system sends out antibodies to kill the thyroid.
In the early phases of Hashis it can cause a person to switch between Hyper and Hypo in some people.
ALWAYS, ALWAYS make sure you demand and they test for Both the FREE T4 and FREE T3. The "total" and uptake tests are obsolete and of little value.
Your lab tests show that you are only 16% of the range of your Free T4 and you are only 42% of the range for the Free T3.
This indicates that you are converting well.
However since you are symptomatic, many people found here that a MUCH better rule of thumb target to achieve are BOTH of the following:
1) Free T4 to be in the MIDDLE of the range (50%) or slightly higher
AND- means in addition to
2) Free T3 to be in the UPPER 1/3 (66.7%) of the range.
As you can see your FT4 is well below at 16% the rule of thumb 50%. Also your FT3 is low as well.
I would recommend that you discuss with your Dr about starting out on a T4 medication starter dose.
If your Dr is unwilling, it is most likely due to your TSH level. And any Dr who exclusively goes by TSH is NOT a good thyroid Dr and you are better served to go find another Dr. Any Dr who only uses TSH is almost guaranteed to keep you feeling like crap.
Many people end up on this forum site because of exactly this reason. They feel like crap but because their blood tests are within the normal range, they are unable to get medication. So you are not alone if this is your situation.
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