Test results

[liskess]

I have had hypo symptoms since 2014....weight gain (despite low carb, high protein diet and exercise), fatigue, anxiety, dry sky, constipation. Last year I had my labs run and found a dr and he wasn’t of much help.... last year my results were:
Tsh-2
Free t4- .9
Free t3- 2.9

It’s a year later and I had labs run again. I just got them back and would like some feedback. I found a new dr and have an apt in mid March but in the meantime any help would be appreciated. New results:
Tsh-2.64
Free t4- 1.0
Free t3- 3.3
Thyroid ab- <1

[gimel]

Good to hear.  As part of your tests, It would be good if you can get the doctor to test for Vitamin D, B12 and ferritin, and then supplement as needed to optimize.  Vitamin D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100.  All three are important for a hypothyroid patient.  And of  course you want to make sure the doctor treats you clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, rather than just based on test results. especially TSH results.  TSH should never be the basis for determining you med dosage.  You can read all about this in the following link.  I suggest reading at least the first two pages, and more, if you want to get into the discussion and scientific evidence for all that is recommended.  

http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf

Please keep us posted on your progress.  

[liskess]

Just wanted to give a follow up. I saw my doctor today, and while she wants to do a lot more lab work. She is willing to start me on 1/2 grain of Armour based on labs and symptoms. I finally feel like I’ve found a dr who is willing to listen.

[gimel]

I agree with Barb about medication.  It should not be based on biochemical tests only.  Symptoms should be the most important consideration.  When also looking at biochemical test results, note the following quote from an excellent thyroid doctor.  

"The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

[liskess]

Thank you for your feedback. I am supposed to see my new Dr on March 7. I am hopeful I will get some answers. As I have truly have felt awful lately. I’m really hoping this doctor is willing medicate as my prior doctor looked at insulin levels, vitamin levels, tested for Lymes disease. The practice was recommended through hypothyroid Mom, so we shall see.

[liskess]

Thank you for your feedback. I am supposed to see my new Dr on March 7. I am hopeful I will get some answers. As I have truly have felt awful lately. I’m really hoping this doctor is willing medicate as my prior doctor looked at insulin levels, vitamin levels, tested for Lymes disease. The practice was recommended through hypothyroid Mom, so we shall see.

[Barb135]

Sorry, I dropped the ball; if you're still here...yes I do think the Free T4 is low enough to medicate, but it's unlikely your doctor will think so.

Have you seen your doctor since the labs were done?

[liskess]

I should also mention that after having my daughter, I immediately lost 45 lbs without trying and without gaining that much during the pregnancy. A few months later it all came back despite healthy eating. I track calories on MyFitness pal.  Do you think the free T4 is low enough to medicate.  Also, is the tsh a bit high?

[Barb135]

It's likely your doctor will say your levels are fine because they're "in range", but your Free T4 is too low and indicates that your thyroid is not producing adequately.  For most of us to feel best, we need to have Free T4 at about mid-range; yours is only at 20% of its range.  You would most likely benefit from starting on replacement thyroid hormones.

There are 2 antibody tests you need to determine if you have Hashimoto's.  You've had the Thyroid Peroxidase Antibodies (TPOab), which is negative, indicating that you don't have Hashimoto's.  You should have the other antibody test done because some of us have one or the other, some have them both... The other test is Thyroglobulin Antibodies (TgAb) and will help confirm/rule out Hashimoto's.  A thyroid ultrasound will also help confirm/rule it out and will determine if you have nodules on your thyroid.

[Barb135]

What are the reference ranges for the Free T4 and Free T3, along with the TPOab?  Ranges vary from lab to lab, so they need to be posted with results for the best comparison.

Your symptoms certainly match those of hypothyroidism, but many doctors will refuse to treat if labs are within range, as it appears yours might be.

Once we know the reference ranges used by your lab, we'll be able to tell you more.

[liskess]

Thyroid peroxidase antibodies <1 (<9)
T4, free 1.0 (0.8-1.8 by/dL)
T3, free 3.3 (2.3-4.2 pg/ml)
Tsh 2.65 (.40-4.50)

[Barb135]

I'm sorry, I see them above.  For some reason, when I posted my request the previous posts were not showing, but they did after I posted.  Odd.

[gimel]

Thyroid related test results and associated reference ranges vary from lab to lab.  So you always need to compare results to ranges from the same lab.  Please post reference ranges for those test results.  

[liskess]

Thyroid peroxidase antibodies <1 (<9)
T4, free 1.0 (0.8-1.8 by/dL)
T3, free 3.3 (2.3-4.2 pg/ml)
Tsh 2.65 (.40-4.50)