Thyroid Disorders Community
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Avatar universal

Please Help me decipher TSH, T3,

I've posted on here a couple of times and I'm very thankful for the help and support that I've been given. I need to call on you again to help me decipher my tests results. I had my thyroid checked in Sept. because my hair was falling out rapidly and here are the results .... TSH 4.19 range 0.35-5.50...T3 Uptake 33.9 range 22.5-37.0 and Total T4 5.7 range 4.5-10.9...What does all this mean. My Gyno said I was on the high side of normal but my PCP said I was normal...(of course, I know that I'm not normal because of the way I feel). Anyways, I was retested about 2 weeks ago and my results are as follows: TSH 3.40 range 0.40-5.50 and Free T-4 0.9 range 0.8-1.8...Also, checked my total Testosterone and it was 45..there was no range on this....My glucose was 86 range 65-99...Creatinine was 1.0 range 0.5-1.2...DHEA sulfate was 191 range 40-325 and Ferritin was 27 range 10-154......I know I went a little crazy with the results but someone out there may know what all this means...Of course, dr. says all is normal but I know otherwise...Thanks for all your help.
13 Responses
Avatar universal
It means exactly what the doctor said, everything is in normal range.  Your thyroid is on the hypo side of Labs reference range, but you are not officially hypothyroid.  Redo test (TSH, FT-4 and FT-3) in 3 to 6 months and see how they stand by then. Go to an endo., internist, or regular  doctor. Mean while look for other conditions that could be causing your symptoms, they are not all exclusive to thyroid. For instance, you listed hair falling out, some of the conditions are:
Alopecia,  temporary problems  associated with pregnancy, unusual stress, chemotherapy, crash diets/anorexia,  major surgery, severe infection or high fever, anemia, poor diet and genetic factors. Influence of different factors on hair loss
- Age: Well, everyone ages -- there's just no getting around it. We produce less hair, and the individual hairs we do grow are thinner. Plus, older hair is more prone to dryness and breakage, so be sure to take that into account in your daily hair-care regime.
- Over-processing: Coloring, bleaching, perming and straightening, if done improperly, can cause hair to break off or fall out, and you'll have to wait for healthy hair to grow back in. Frequent relaxing using a hot comb can cause permanent hair loss.
- Traction: Tight ponytails or braids, weaves and extensions, heavy beads and too-tight curlers can all result in hair loss, particularly around the forehead. Fortunately, once you loosen up, your hair should grow right back.
- Clogged follicles: This is uncommon, but it can happen if you use a lot of very heavy, greasy products on your scalp and don't wash them off frequently. If you use a clarifying shampoo occasionally and cut back on the conditioners, you'll be fine.
- Other causes: There's a long list, but most of these are pretty rare: eating disorders; rapid weight loss; severe stress; alopecia areata (an autoimmune disorder); chemotherapy; overdoses of vitamin A, DHEA, or astralagus; thyroid disease; bacterial or fungal infection; syphilis; scarring; and side effects of some medications.
- Drugs: Certain drugs can also take their toll on once flourishing and healthy tresses. However, these conditions are usually temporary, and once the "trauma" is alleviated, the hair shedding stops and healthy re-growth occurs with time.
List of drugs that are known to cause hair loss
- Cholesterol-lowering drug:
clofibrate (Atromis-S) and gemfibrozil (Lopid)
- Parkinson Medications:
levodopa (Dopar, Larodopa)
- Ulcer drugs:
cimetidine (Tagamet), ranitidine (Zantac) and famotidine (Pepcid)
- Anticoagulents:
Coumarin and Heparin
- Agents for gout:
Allopurinol (Loporin, Zyloprim)
- Antiarthritics:
penicillamine, auranofin (Ridaura), indomethacin (i\Indocin), naproxen (Naprosyn), sulindac (Clinoril), and methotrexate (Folex)
- Drugs derived from vitamin-A:
isotretinoin (Accutane) and etretinate (Tegison)
- Anticonvulsants for epilepsy:
trimethadione (Tridione)
- Antidepressants:
tricyclics, amphetamines
- Beta blocker drugs for high blood pressure:
atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal) and timolol (Blocadren)
- Antithyroid agents:
carbimazole, Iodine, thiocyanate, thiouracil
- Others:
Blood thinners, male hormones (anabolic steroids)

Avatar universal
Thanks for the very informative post. I have done several months of research on hair loss and have read all of this before. The reason I asked if it could be my thyroid is that I have also noticed the following sypmtoms: dry skin, dry eyes, stay cold, blurred vision, problems w/ swallowing, neck pain, stay tired, constipation, arthritis, headaches, forgetful, sweating, ringing in ears, skin laxity....I have also read that a TSH level of over 3 is now considered hypo. I have been referred to an endo. However, I do not go until Feb. 8th. I thought by posting my lab results that I could get an idea of what was going on. I have dealt w/ depression over my hair loss. It just seemed to happen overnite. At one point, I was losing up to 300 hairs a day. I am now losing about 1/2 that amount. However, my hair is difficult to deal w/ ...it doesnt stay in place, it's just not the same head of hair that I had just 5 mons ago...It's amazing how much it has changed.  Thanks for your comments.
Avatar universal
A good doctor, with or without levels, will or should, fully investigate the reasons for the symptoms.
Avatar universal
P.S. Thank you very much for the excellent summaries you have written of the information you have been finding. I think that my endocrinologist is an excellent doc, but I am glad for any evidence that confirms my impression. Reading the overviews you have provided, I am reassured to see evidence that my endocrinologist indeed is thinking in the ways in which a wise endocrinologist should be thinking (and encouraging me to think in those ways, too). The reassurance is good for my morale, which welcomes all the help it can get!
173351 tn?1201217657
I must specify I don't think iron is the answer to ALL your complaints/symptoms... just every little bit makes a difference when you are feeling under the weather...
Avatar universal

And as of March 2003, it is the official recommendation of the america Association of Endocrinologists that the normal range for TSH levels is .3 to 3.0 -- Read the information here. I know I feel terrible at a TSH level of 4 to 5, I also feel bad when it drops too low to .2, but I pretty best at a TSH of between 1 and 2.

(NOTE: TSH levels are usually kept lower than 1 to 2 for thyroid cancer survivors -- a process known as thyroid suppression -- to help prevent cancer recurrence.)

TSH Levels

TSH Less than .5/.7 -- This is considered hyperthyroid (too much thyroid hormone) at most labs in the U.S. You may be anxious, find it hard to sleep, hair falling out, diarrhea, and other symptoms

TSH 1 to 2 -- The optimal normal level for most people. This is the TSH range where the majority of people feel best. It is sometimes considered "too low" by less-informed doctors.

TSH 2 to 4.7/5.5 -- "Normal" range according to some lab standards, but the recommended top end of the range was changed as of March 2003 to 3.0 Some people feel well in this range, but many suffer low-grade hypothyroidism symptoms at this level.

TSH 4.7/5.5 to 10 -- Formerly considered "subclinical hypothyroidism" levels, but as of March 2003, above 3.0 is considered evidence of possible hypothyroidism. These levels show hypothyroidism, but amazingly, some doctors won't even treat these levels, and do not attribute hypothyroidism symptoms felt by patients at this level to the hypothyroidism itself. Many people have symptoms at these levels.

TSH Above 10 -- Considered hypothyroid that merits treatment by most doctors

The Need for T3

Some people do not feel well on a levothyroxine/T4 only drug (like Synthroid). I am one those people who feels far better taking T3. I take the drug Thyrolar, and it has worked far better for me than Synthroid. Others have had success adding T3, such as in the form of Cytomel or via compounded, time-released T3, to their levothyroxine. Finally, yet others have had success with Armour, the natural thyroid hormone replacement. For more information on the various thyroid drugs, see A Quick Look at Thyroid Hormone Replacement, and Armour Thyroid and Thyrolar: Alternatives to Synthroid and the Other T4-Only Drugs.

Surprisingly, It's still considered controversial to use T3 for people with hypothyroidism by the less innovative or accepting members of the medical world, despite research that clearly demonstrates the need for T3 in many thyroid patients. In February 11, 1999, the New England Journal of Medicine published a groundbreaking research report that says that many patients feel better on a combination of T4 and T3, not T4 (i.e., Synthroid) alone. Many people have a normal or even LOW-normal TSH level, yet still suffer continuing hypothyroidism symptoms. In these cases, the addition of T3 helped relieve depression, brain fog, fatigue and other symptoms. This information about T3 is quite revolutionary and has major implications for people who don't feel well on their current thyroid therapies!!! For more info, see my full report on this research.
Avatar universal
Well you have certainly done your home work.  Although it sounds like you took offense to my post. However, due to being around for 10 years I have already read these issues, but thank your for sharing anyway. But you need to convince your doctor, not me.

I understand  thyroid thyroid is the easiest and fastest diagnose for what might ail us,  but we just can't blame everything on thyroid, especially when levels are normal. After being diagnosed and treated for thyroid, symptoms certainly take their place in treatment. A good doctor, with  or without symptoms, will or should, fully  investigate the reasons.

Yes, and its just what it states, a "recommendation" (suggest as first diagnose with symptoms) but not a 100% law and most doctors/Labs are  not going by the "recommendation"! for many reason because there is a lot for a doctor to take into consideration. Its just not a matter of levels or symptoms, but how they related to each other (its the whole pie, not just pieces), which with all your research I am sure you already know, so I won't go into to them.

I am not gong to discuss the T-3 issue for its a matter of preference, although  I do have reputable sites that dispute the theory.  But hey, what ever it take for a person to feel their best whether it comes from the mind or a little pill.

I hope you get the help that you seek.
Avatar universal
Thanks again for your words of encouragement. It helps to talk to other people that are going thru the same thing. I have read a lot of posts on this forum and it appears to me that even with "normal" TSH levels, people are being treated for hyper/hypo. I realize that you can't put these symptoms in a "box" and self diagnose. I have also read the following:

In addition to hormonal imbalance, other conditions often cause or contribute to hypothyroidism. This is why it is so important to look at the body as a set of interconnected systems, rather than isolating the thyroid as a single entity.

There are so many symptoms of adrenal fatigue that are similar to thyroid disorders that this often leads to confusion in distinguishing between the two. There is speculation that adrenal stress impairs thyroid function because it causes overproduction of cortisol, blocking the efficient conversion and peripheral cellular use of the thyroid hormones at many levels. We don
Avatar universal
I am glad you are doing a lot of self-educating and that you are trusting what you are feeling as an accurate yardstick for whether or not you are normal. As you have found in the process of self-education, your Gyno. and PCP both are making judgment calls based on outdated information.

My information also was a little out of date, in that I did not know the endocrinologists' association has officially come down the scale again in their guidelines for the upper end of a "normal" TSH level. Something I read in a medical journal, when combined with my training in research methodology, instantly caused me to predict that someday, 2.0 officially will be seen as the upper end of normal for TSH.

I wonder why the field of endocrinology cannot move faster in looking for the research evidence to support or refute the current guidelines. It seems highly thought-provoking that most people feel their best when their TSH level is between 1 and 2. Common sense (that under-utilized ally) tells me that this is an area of research that should be very energetically pursued. By the way, during my first discussion with my endocrinologist, he mentioned the reports "out there" in the world that people feel their best with a TSH between 1 and 2, and then he said that he has found it to be true among his many patients over the years.

Back to your request for help, which I have drifted away from. I am writing to comment only about your TSH level (other members of the forum are much more expert than I am regarding the other results). Even though my experience is only one person's experience, it might be instructive for you. Here are my TSH levels over time, with the date of the blood draw, the value, and the reference range for each one:
Sept. '97   2.4   .4 - 5.6
Nov. '00   1.58   .3 - 6.0
Jan. '01   2.46   .6 - 6.0
Jan. '02   2.46   .3 - 6.0
April '03   3.32   .4 - 5.6
July '04   2.93   .32 - 5.0
Sept. '05   2.85   .32 - 5.0
June '06   4.11 .32 - 5.0
In hindsight, the first symptom that my thyroid gland was starting to struggle was in December of 2002. By April of 2003,  I was developing symptoms right and left, but it was an isolated symptom here and an isolated symptom there, so it was easy for my physicians to overlook the source.

What was starting to be the most bothersome of my hypothyroidism symptoms was a return of the sleep disturbances that had been well relieved by HRT. Whether estradiol and progesterone are making independent contributions to my ability to sleep remains to be seen, but as I edge closer to being established on the "right" dose of levothyroxine, it is becoming abundantly clear that sleep disturbances have been one of several "paradoxical" symptoms of hypothyroidism for me. Between April of 2003 and this past summer, this area of my symptomatology worsened slowly but steadily despite the up-and-down pattern of my TSH levels.

In short, just because your most recent TSH was 3.4 and the one before was 4.19, it probably does not change the underlying reality you are sensing. The endocrinologist will be the one to say for sure, but I would bet that hypothyroidism has become a fact of your life. I had BIG sympathetic vibrations to your comment "It's amazing how much it has changed." All by itself, that sort of perception is beginning to seem to me (as I read about more and more people's experiences with hypothyroidism) like a good informal indicator that a thyroid gland may be struggling. In addition, several of your symptoms ring big bells with me.

I am glad you are going to see an endocrinologist soon. I hope that he or she turns out to be a good physician for you, but if not, you seem like the sort of person who would not hesitate to fire your endocrinologist and look for another. Please keep us posted. For the moment, let me say that no, you did NOT go a little crazy with your latest lab results. Hypothyroidism is a crazy-making experience anyway, so if you were to go crazy over anything or everything, it would be undestandable. You are simply wanting to understand your own situation, though, which I think is the ideal way to cope.
Avatar universal
You are entirely welcome for my words of encouragement, truly. I know exactly what you mean when you say that it helps to talk to other people in the same situation. I am 56, and like you, I am somewhat new to all of this (since last June, for me).  Hypothyroidism can be SUCH an oddly behaving affliction. It can help to see from other people's comments that oddity often is normal, in a way.

In addition, other people's comments also caution a person that--as you said--you cannot put your symptoms into a "box" and diagnose yourself.  That is true two times over when the symptoms may not be typical at all, as has been my case.  It seems to me, though, that the complexity of the endocrine system is all the more reason to try to understand as much about your own situation as possible.  I think it is wise to be an equal partner in every major decision that is made about your own health care, which makes a solid layperson's knowledge base essential.

With that thought in mind, I hope that someone who is more knowledgable than I am about T3 will answer your question about your T3 and T4 numbers. As for your comment, "I guess I should have made myself more clear": How I do identify! If only I could see my own clarity lacks as easily while I am writing as I see them in hindsight (sigh...).
173351 tn?1201217657
Hi two42

I have enjoyed reading through all the posts on this thread!  I love it when people are pro-active about their health and find out as much as they can!!! It helps me feel empowered to learn about my health, instead of feeling victim to it.

It sounds like you might actually want confirmation about what you already realise about your TSH, freeT3 and freeT4?  All your logic looks good to me - but I am only a 'professional patient' (to steal someone else's term, utahmomma I think?).

Anyway one thing in your results did stand out to me.  Your Ferritin is within normal limits but on the low side.  With such a large reference range for 'normal' (10 - 154) personally I wouldn't hesitate to begin supplementing.  There is lots of room to move, and you may feel better at a higher level, especially if you have heavy periods.

An article I kept indicates the same...

" Iron supplementation may benefit fatigued women of childbearing age even if their haemoglobin level is within the normal range, a primary care study shows.

However, the study indicated that the effect may be confined to those women with serum ferritin concentrations at 50 microgram/L or lower. "

If you choose to take iron supplements to be safe make sure you take it 4-6hrs after your thyroid medication to avoid interfering with absorbtion.  Also iron is better absorbed by the body when taken with Vitamin C.  Don't be surprised if your stools go darker or are a green colour while taking iron supplements - this is normal.  Some people find they get a bit constipated when taking iron so make sure you keep up the fluids, fresh fruit and veges to keep regular.  

Best wishes and wellness
Avatar universal
I had strong sympathetic vibrations to jenipeni's comment "I love it when people are pro-active about their health and find out as much as they can!!!" When I worked in hospitals as a nurse's aide, I was still very young. Seeing what happened when people passively turned themselves over to a physician with a "You know what's best" attitude caused me to develop an activist-patient approach to my health care from that point onward. No matter how skilled your physician might be, a pro-active approach to your health will get you far, far better care than you otherwise would get, I am convinced.
Avatar universal
I have been suffering for about a two years now.  I had thyroid cancer last year and had my thyroid removed in May of 2006.  I am on 150 mcg of Levoxyl.  My TSH level is 0.1 and I am still experiencing all of the  same symptoms of before.... tired, over eating, can't concentrate on things, don't want to be social, dry skin, hair falling out, no sex drive, forget what I am talking about in the middle of a sentence.  I am having crying spells where I will cry all day that sometimes last for 3 days, and also headaches.  My doctor told me to see a psychiatrist that it isn't my thyroid, which is a bunch of ****.  I have been taking antidepressants for about a year and just up'd the dosage myself to 225mg of effexxor and felt happy for 3 days for the first time in months.  The last 2 days I am back feeling very tired and depressed.  I am wondering if anybody has read about adding T3 to my treatment if that might help?  Does anyone know of a cure...... to help.  I am so tired of feeling this way.  This is affecting my job and my marriage.  I recently just got married May 2007.
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