T3 results

[Deb5249]

In 2004 I had 1/2 of my thyroid removed because of a nodule, which was benign. I have been taking Levoxyl, 25 mcg, once per day. I had been going to an endocrinologist yearly for check ups, until I moved in 2010. I decided just to rely on my primary provider to do the yearly blood work. (TSH, T4, and T3) In July of 2010 my TSH and T4 were in normal range. TSH  0.500-8.900  Mine was 3.413.  T4 0.61-1.64  Mine was 0.93   For the T3 normal range is 100-215 and mine was 88. My doctor never mentioned it to me, and I just now realized it when I went back to check. What could cause the T3 to be low, and the others to be normal? I have gained 20 pounds in the time since then, could this be one of the reasons why? I am also very tired and run down, but I am also very anemic, and for that I will be seeing a hematologist. Thanks in advance for any answers.

[gimel]

Don't forget to insist on testing for Free T3 and free T4.    Also request testing for Vitamin D, B12, zinc and selenium.  Be aware that just being in the low end of the range for theseis frequently inadequate also.  The specific reason I suggested zinc and selenium is that, along with iron they play a role in the conversion of T4 to T3.  So it is very important to make sure those are adequate, and also for you to get your iron anemia taken care of, since that   also has some very unpleasant symptoms.

I do want to make you aware that just because you will be seeing an Endo does not mean that he will be a good thyroid doctor.  Many specialize in diabetes.  Many also rely heavily on their "Immaculate TSH Belief', by which they want to use TSH as the primary diagnostic to medicate a hypo patient. That doesn't work.   Also, many use "Reference Range Endocrinology", by which they will tell you that a thyroid test result that falls anywhere within the reference range is adequate for you.  That also doesn't work.

I described for you previously what a good thyroid doctor will do.  So after you request the above testing, and see how that goes, then you should also ask about being treated clinically.  If your doctor does not want to do the testing suggested, and does not want to treat clinically, then you will have to provide enough info and persuade him to change his mind, or you will have to find a doctor that will do so.

[flyingfool]

It is true different labs use different ranges.  But I've never seen a lab that has the high point of TSH over about 6 let alone almost 9.  MANY people feel symptomatic with a TSH over 3.  And TSH is at best a screening tool.

As gimel points out the true tests really are the FREE T3 and FREE T4.  Many people find they need to have their Free T4 in the MIDDLE of the range AND (that means in addition to) they need their FREE T3 to be in the UPPER 1/3 of the range.  Just being "somewhere" within the range is not sufficient for many people.  and both of your levels are below this higher target.

The free or unbound T3 hormone molecule is the ONLY thing your body actually uses at the cellular level.  T4 is a storage hormone that remains in the blood an awaits the body to convert it when needed into T3.  Again only the unbound or "free" hormone is able to be converted.  This is why it is so important to test for the "free" and not total hormones.  Testing for "total" is analogous to checking the fuel level in your automobile gas tank. Sure it provides some information but it does NOT tell you how much fuel is getting to your engine.  To do that you need to test the fuel flow rate at the engine.  This is what a "free" hormone test does.  It determines the amount of hormones that is available to be converted and how much is available for the cells to use.

Conversion issue would mean for whatever reason your body does not convert the T4 into T3 efficiently.  For this reason you may need to have a medication with a T3 component.  Also selenium can sometimes help with that as well.  Which is why gimel suggested getting your selenium levels checked.

I would tend to agree that your thyroid issue and your anemia may be unrelated to Thyroid.  But that does not mean that you don't need thyroid medication increase to help you feel better.  more than one person on the thyroid forum has pernicious anemia.  Not saying they go hand in hand.  But if you have this, you would not be the first person to have both thyroid issues and pernicious anemia.  

[Deb5249]

Hi, I requested a referral from my primary, to an Endo, and she gave it to me. This is a message that I received from her when I mentioned that the TSH range of 0.500-8.900 was incorrect.

    Deborah --

Different labs have different normal ranges for testing. The level you are at right now should be ok for you and should not be causing the anemia.

Sue will be contacting you in the next few days to see the endocrinologist.

Have a great week.