TSI result question

[lovely13]

I got my TSI bloodwork back today.  I have a question if anyone can answer.  
Test showed I was negative, it said result- 36   reference range - negative <140%
I have read online conflicting things.  Some say anything under a certain amount is negative, other sources say healthy people should not have any TSI in their blood.  So what do you think?  Also I am having some hyper symptoms.  I am fatigued, anxious, nervous, my hand shake when i have episodes of anxiety, and I think I have developed some heart palpitations.  My thyroglobulin antibody test was 2.0  reference 0.0-40.0  
If I am showing signs of hyper and hypo can both of these test still be considered normal even though i only have a small amount??

[Barb135]

Okay, thank you for checking on the TT3... it just looks quite odd, compared to what we normally see.  

As I noted, your FT4 and TT3 levels are very low in the ranges, indicating hypothyroidism.

Your symptoms also indicate hypothyroidism... you should talk to your doctor about central hypothyroidism, as that seems to be your problem more so, than an autoimmune issue.

In the case of central hypothyroidism, you should also ask to get other endocrine glands checked - those would be reproductive, adrenals, pancreas, parathyroids, etc - to make sure they are producing adequate amounts of hormones, since all of the endocrine hormones must work together...

[lovely13]

Yes that is the right TT3 reference range,

I have constipation, muscle/joint pains, swelling of legs and feet.  Also dry skin but i have always had dry skin.  

[Barb135]

I don't mean to question you, but could you verify the Total T3 result and reference range?  They look more like what we, typically, might see for and FT4.  

Rule of thumb (where most of us feel best) is for Free T4 to be about mid range - yours is only at 15% of the range, which falls very short of the recommended level.

Rule of thumb is for Free T3 to be in the upper half to upper third of its range.  You don't have a Free T3 and, unfortunately, Total T3 is considered obsolete, but yours is only at 37% of its range.  Considering that approximately 90-95% of that will be bound by protein and can't be used, we can safely assume that your Free T3 will be quite low as well.  

Low thyroid hormones indicate hypothyroidism, not hyper and since your symptoms can apply to either, I'd have to say you're hypo... The problem is that your TSH is also pretty low in the range, which is what we, typically, see with hyper, except in the case of Central Hypothyroidism, which is a problem with the pituitary gland, rather than the thyroid.  With Central hypothyroidism, the thyroid works just fine, but the pituitary gland doesn't produce enough TSH to stimulate the thyroid to produce adequate thyroid hormones.   This would also explain your lack of antibodies, because central hypothyroidism is not an autoimmune thyroid disease, like Hashimoto's and Graves are.  Central hypothyroidism is still hypothyroidism and does need to be treated with replacement thyroid hormones, though, in order to relieve symptoms.  Many doctors fail to recognize central hypothyroidism, because they place too much importance on the TSH and not enough on the FT4 and FT3 levels.

Are you having any other symptoms of hypothyroidism, such as weight gain, constipation, hair loss, facial puffiness, muscle/joint aches/pains, swelling of the feet/legs, dry skin, etc?

[lovely13]

TSH-  0.894    Reference- 0.340-5.6
free T4- 0.81   Reference-  0.66-1.65
TT3- 1.05        Reference- 0.60-1.81
TPO- 0
Throglobulin 0
Thyroglobulin Antibody-  2.0-    Reference 0-40.0

[Barb135]

Technically, your test result would be considered normal, since you're level is below the reference range, but you're right... normal people would not have any measurable TSI in their blood.  You would not be diagnosed with Graves Disease on the basis of that test.

Have you been tested for Thyroid Peroxidase Antibodies?  Even if you don't have Graves Disease, but are having hyper symptoms, you could be in a hyper phase of Hashimoto's, which is, also very common.  

Also, keep in mind that many symptoms can apply to, both/either, hyper and hypo, such as fatigue, anxiety, palpitations, etc.  I had them all when I was hypo.  It's not unusual for my hands to shake when I'm nervous or anxious.  

Do you have thyroid hormone test results you could post so we can see your actual status?  You should have been tested for Free T3, Free T4 and TSH, along with the antibody tests.  If you have results for those, please post them and be sure to include reference ranges, as ranges vary lab to lab and have to come from your own report.