Thyroid test results

[bellacoal]

I am a LCSW. My client is being treated by their primary MD for thyroid problems. Their resent test results are TSH 2.90   FT4 0.88 and Vit. D 16.8

They continue to be extremely exhausted, depressed and cold. The MD is saying the thyroid is normal. Your thoughts.
Thank you

[Barb135]

Thank you on the LCSW - there are too many abbreviations to keep up with these days....... lol

The range set by AACE about 9 yrs ago for TSH is 0.3-3.0, but most labs and doctors don't go by it.  At 2.90, the patient's TSH is near top of the range and there are doctors that treat anything above 2.0.  That said, TSH is merely an "indicator" as to actual thyroid status and is often totally irrelevant, as in my case.  My TSH stays at a lower than low < 0.01 all the time, and I've never been hyper since I've been on med, in fact, I'm still hypo.

The antibody tests for Hashimoto's are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  It is necessary to get both tests, as a person may have one or the other of the antibodies, and some people have them both.

I'd be interested in knowing if this patient is currently on thyroid medication, if so, what dosage, how long on the medication?

[bammity]

"LCSW" stands for licensed clinical social worker.

TSH of 2.9 is still low within the range of "normal." My endocrinologist likes my TSH to be at 1, or even a little lower. Your client might benefit from taking thyroid medication, and as long as her TSH is not in the hyperthyroid range, she should be okay. Is there any way for your client to get a second opinion? Or for you to talk directly with the doctor? Technically, your client is within the "normal" range, but that does not mean her thyroid is fully optimized.

Also, good idea on the thyroid antibody test. There are two antibody tests. Make sure your client has both of them. I have Hashimotos and tested negative for antibodies on one of the thyroid antibody tests -- but positive on the second test. Sorry I don't know the names of the tests. Maybe someone else can help...

B~

[Barb135]

What does LCSW stand for?

Do you have a reference range for the FT4?  If the range is what we normally see, the patient's level is right at the bottom of the range.  Since the new range for TSH is 0.3-3.0, even though a lot of labs and doctors don't go by it, the patient's TSH is near the of its range.  These 2 factors and symptoms noted, could indicate hypothyroidism.  We would need to see a Free T3 result, also. FT3 is the actual hormone used by the individual cells.  Many doctors refuse to test FT3.  It would also be good if the patient had antibody tests to confirm/rule out an autoimmune disease called Hashimoto's Thyroiditis.  In the early stages of Hashimoto's it's fairly common for patients to have so called "normal" thyroid labs, but still have symptoms.

The vitamin D level at 16.8 is very low.  Vitamin D deficiency can mimic hypothyroidism.  Has the patient been started on any type of vitamin D supplement?