Test indicates hyper, but I mostly have hypo symptoms.

[solu9]

Hey folks. I'm really glad I found this community.
I'm so sorry if I make stupid questions, I'm very curious because I got my lab results a few days ago and I have an appointment with my doctor in a week.

Anyways. Last year I did a general blood test and everything thyroid-wise was okay. I'm eighteen now, almost nineteen. I've been feeling very depressed, unmotivated and tired for quite a while now. I exercise and eat well to try and feel better, but to no use. I tend to lose weight very slowly. My mom has hypo and she is on levothyroxine, and my grandma had hyper. Just so you know. That and a few more reasons were the triggers to make me take a specific thyroid test. Cholesterol is normal, TSH looks normal, but both my T3 and free T4 are way high.
T3 - 8.70 ng/ml
free T4 - 14.70 ng/dl
anti-thyroid peroxidase antibodies - 180 UI/ml (nomal value: up to 60 UI/ml)

I took the test again just in case there was a mistake, and I'm getting my results in a few days. For now I wanted to know if somebody can interpret that combination...In terms of symptoms, I'm almost sure I have hypo.

Sorry for the nuisance.

[goolarra]

Okay, sorry to hear that.  If you're still having problems, you should contact MH and let them know, or if you prefer, contact me, and I'll contact them for you.  MH was having some problems last week, and this sounds related.  I can contact the same moderator (who is familiar with the problem).

Let me copy your current question into the other thread then (other thread has a lot more info in it).

Here's the link to that thread:

http://www.medhelp.org/posts/Thyroid-Disorders/Is-it-OK-to-Add-Cytomel-T3-but-NOT-adjust-Synthroid-T4-and-Hair-Loss---Breakage-Questions-Related-to-adding-Cytomel-T3/show/1624723#post_8411059

[Bella192]

For some reason, I'm unable submit a new thread/post...whenever I type in the new question and hit "post", nothing at all happens..I'm sorry!  Tried it several times.  

[goolarra]

Would you start your own, new thread?  Just go to the top of the page and hit the orange "Post a Question" button.  I know you posted labs, meds history, etc. in another thread, and it would be so helpful if we had all that information together in one thread.  If I remember correctly, you had some confusing labs (FT3 had gone down despite an increase in Cytomel).

[Bella192]

Goolarra,  In your opinion, if I am currently taking 112 mcg of Synthroid and blood tests show positive for the Thyroid Antibodies for Hashimoto's, what would be the new dosage of Sythroid I should try?

I have to hold my doctor's hand and tell her what to look into regarding Thyroid issues, so I want to be prepared with some idea what would be an ideal higher dose to discuss when I see her on Monday.

Thanks again in advance...

[goolarra]

No, it doesn't affect the antibody tests.  You're okay.

[Bella192]

Is it ok if I've already taken my Synthroid and Cytomel before my Thyroid Antibodies blood test that I have scheduled for today?  I took them about 2 hours ago, didn't realize until just now that it could affect the Antibodies test, ( anti-TPO and TgAb).  If so, I will reschedule blood test.

Thanks in advance for your help!

[solu9]

I agree, they should update the system immediately.
Maybe I should do a new test in a different lab, and compare results. Just in case.

Thank you both very much for your answers. You've been extremely helpful.

[goolarra]

I have to agree that it's still a little unusual.  I'd check that FT4 result one more time to make sure it isn't 1.47 rather than 0.14...at 0.14 I'd be surprised if you were walking.

That's a really grievous error on the lab's part.  Too many times, doctors who aren't really familiar with certain conditions just look at the result and the range and react.  I hope they sent out corrections promptly.

[solu9]

On my test, it only reads Triiodthyronine T3, so it must be the total T3.
I'm meeting with my doctor in a few days, and she'll probably tell me to take the test to an endocrinologist.

[flyingfool]

Still a little strange if you ask me.  The FT4 you report is SEVERELY low.  Yet the TSH which I don't hold a ton of value in is only 1.3.  Even my little faith and trust in TSH I would expect with you having almost zero FT4 would be severely Hypo and would anticipate a TSH much, much higher.

I want also to make sure that your T3 is in fact T3 and not Free T3.  As simply stated T3 is almost always the "total T3" test which measures both useful and useless variants of T3.  The Free T3 is the only thing your body uses at the cellular level.  Total T3 test is outdated and of little value since you have no idea how many of the total are Free and how many are attached to a protein making them biologically inactive and thus useless.

However saying that.  Your total T3 is also at the very bottom of the range. So considering a portion of those are useless, it would lend to the idea and likelihood that your Free T3 would also be low.

I believe and your symptoms you list are all consistent with being Hypo. And getting a starter dose of thyroid medication would seem to make sense.

However with the TSH being between the mythical and magical 1 and 2 you may find it hard to find a Dr to actually prescribe you medication.

[solu9]

I'm back again with news.
It seems like the lab went through an unit/method conversion, but the computer that prints the test results is still using the old units. That really messed up the results from the last test.

These are the real results, from the second test:

T3: 0.87 ng/ml (normal values 0.80 - 2.00)
TSH: 1.30 uUI/ml (normal values 0.40 - 4.00)
FT4: 0.14 ng/dl (normal values 0.93 - 1.70)
TPOab: still 180 UI/ml (normal value up to 60 UI/ml)

Well, I guess that makes more sense.
Thoughts?

[solu9]

I have thought of that possibility, too, and that's why I'm eager to see tomorrow's results. Those are the numbers on the lab test, though. The transcription could be wrong...or maybe the unit is.

I'll write tomorrow with the new results. Thank you.

P.S. I didn't get tested for Reverse T3 so I'm not sure about that.

[flyingfool]

The only way I could see you not being raging Hyper with those levels is if your Revers T3 is also through the roof!

Something doesn't make sense.  Is it possible there is a conversion issue where the decimal point is in the wrong position?  (divide by 10)

in other words,

Your T3 is really 0.87 (normal values 0.80 - 2.00) instead of 8.70 as you report

And your FT4 is really 1.47 (normal values 0.93 - 1.70) instead of 14.70

That would then show your FT4 to be 70% of the range but your T3 would be very low in the range. Which would indicate a conversion problem.  Your pituitary would pick up the T4 levels and think you're just fine. But at the cellular level with low T3 available would be Hypo.

This would then be consistent with what you are feeling and also not out of line for someone with Hashi's.

Just a total off the wall guess!

[solu9]

Yes, both lab test were done at the same lab, with the same reference ranges, and at the same time of the year. Tomorrow i'm getting the results of a more recent lab test I did just to verify that those values are correct. I'm going to post them on this topic as soon as I can.

And yes, the symptoms indicate hypo, which is why i'm so puzzled.
Thank you so much for your input.

[goolarra]

Hashi's is diagnosed by elevated TPOab and/or TGab antibody counts.  It's possible to have high antibody counts with normal TSH if you haven't had the antibodies long enough to destroy enough thyroid function.  On diagnosis of Hashi's, we often see TPOab counts in the high hundreds or even thousands.  TPOab can be somewhat elevated in other conditions as well...other autoimmune diseases, Graves' disease, etc.  So, I wouldn't hazard a firm diagnosis of Hashi's.

Were those results from a year ago and current done at the same lab?  Are you absolutely positive they both have the same reference ranges?  With your current labs, you should be raging hypER.  However, your pituitary seems to think your levels are just fine (TSH is excellent).  It's possible you're in a hyper "swing" of Hashi's, which is actually quite common, especially in early stages of the disease, but if that were the case, I'd expect you to be feeling hypER, too.

[solu9]

I thought that Hashimoto's was determined by an abnormal value of the TSH hormone, not the antibodies. Thank you for that info.

My symptoms are depression, lack of motivation, fatigue, difficulty to lose weight, increased cold intolerance (a few years back it used to be the opposite, actually), dry skin.

I repeat the results of the lab test, and I add the ones from last year so you can compare:

THIS YEAR
T3: 8.70 ng/ml (normal values 0.80 - 2.00)
TSH: 1.30 uUI/ml (normal values 0.40 - 4.00)
FT4: 14.70 ng/dl (normal values 0.93 - 1.70)
anti-thyroid peroxidase antibodies - 180 UI/ml (nomal value: up to 60 UI/ml)

LAST YEAR
T3: 1.12 ng/ml (normal values 0.80 - 2.00) much lower than this year
TSH: 2.58 uUI/ml (normal values 0.40 - 4.00) higher than this year
FT4: 1.20 ng/dl (normal values 0.93 - 1.70) much lower than this year

Like I said, my cholesterol levels are perfect. Luckily from last year to this year I could drop 10kg, slowly and with a lot of bumps along the road, but surely. Still, now it's getting pretty darn difficult for me to break my plateau.

Thank you.

[flyingfool]

The antibody test would indicate you have Hashimoto's.  This is an autoimmune disease and the most common cause for Hypo in the industrialized world.  The anti-bidies believe that your thyroid gland is a foreign invader and like a good immune system does. It systematically goes about killing or trying to kill the invader. So the result is that your thyroid is  under attack by your own body.  This results in the thyroid gland being unable to produce thyroid. And as the disease progresses the less and less thyroid hormone it is able to produce. So you get more and more Hypo.  

The only way to make up for the loss of thyroid is medicine.  And over time you can expect the dosage to increase as the thyroid gets less and less effective so you have to keep up  with that loss with more and more medicine.

Initial stages of Hashi's people can swing from hyper to hypo.  Ultimately however it will stay hypo.

I too would like to know your symptoms and test reference ranges.

TSH while almost always tested is the LEAST reliable of the thyroid tests. Although the medical industry at least in the USA and other places use TSH almost exclusively.

Many people have found that in order to feel well they need their Free T4 and Free T3 WELL up into the range.  In fact the better target seems to be having BOTH of the following as a target.

1) Free T4 in the MIDDLE (50%) of the range if not slightly higher

AND- that means in addition to

2) Free T3 in the UPPER 1/3 (66.7%) of the range

Notice just being "somewhere" within the range is NOT good enough from many people.

[goolarra]

What are the ranges for your T3 and FT4?  Ranges vary lab to lab, so you have to post them with results, and they have to come from your own lab report.

What's your TSH?

What are your symptoms?