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Thyroid Disorders Community
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Thyroid Question

I recently went to the doctor to complain about a few symptoms... extremely tired all of the time, forgetful, foggy , weight gain despite daily workouts, dry skin/psoriasis, brittle hair and so on...I told her that I assumed these were all things that came with aging but I also was feeling some discomfort at the top of my neck under my chin that radiated downward.  My doctor agreed to check my thyroid based on my symptoms.  My ultrasound came back negative and my blood work all came back within normal range:

TSH 1.07
T4 Free 0.9
T3 Free 2.8
Thyroglobulin Antibodies <1
Thyroid Peroxidase Antibodies <1

Should I request additional testing?  I still don't feel like myself?!?
14 Responses
649848 tn?1534637300
COMMUNITY LEADER
What are reference ranges for the Free T3 and Free T4?  Ranges vary lab to lab and have to come from your own report.

What do mean when you say your ultra sound came back negative?  Do you mean normal?  Were there nodules or anything?
649848 tn?1534637300
COMMUNITY LEADER
Are you currently on a thyroid hormone replacement?
Avatar universal
Thank you so much for responding so quickly!!!

The lab ranges were as follows:
T4 Free 0.8-1.8 ng/dl
T3 Free 2.3-4.2 pg/ml
TSH 0.40-4.50

When I said negative ultrasound yes, I meant normal.

No, I am not on any medication.
649848 tn?1534637300
COMMUNITY LEADER
Your FT3 and FT4 are very low in the ranges and your symptoms would indicate hypothyroidism, but I'd suspect that you might have a hard time finding a doctor who would treat you because your labs are "in range".

Have you talked to your doctor about these results yet?  I'd hope that s/he would be receptive to giving you a trial dose of thyroid replacement hormones.  If not, you should start looking for another doctor.
Avatar universal
Yes, I thought so too although they fall under "normal" range.  I have read a few articles about low t3 and it's relation to the pituitary gland instead of the thyroid.  Do you know anything about that?  
I have a follow up visit scheduled for the 25th of this month.  
649848 tn?1534637300
COMMUNITY LEADER
Often if you have just low T3, the problem can lie with the conversion factor i.e. not converting Free T4 to Free T3.  Yes, you could have central hypothyroidism, which is when the thyroid works fine, but the pituitary doesn't stimulate it enough. Central hypothyroidism is rare.  Other pituitary hormones would need to be tested, if central hypothyroidism is suspected.

You should specifically ask to have your reproductive hormones tested, as weight gain, dry skin, etc do come with aging.  Vitamin B-12 deficiency causes horrible fatigue, brain fog and forgetfulness; vitamin D deficiency causes many hypo-like symptoms.  Iron is necessary for thyroid hormone production, so you might ask for ferritin test and/or an iron panel to determine if your iron stores are adequate.
Avatar universal
Thanks again for all of your insight!  It's really great to hear your opinions & recommendations.  I will see how it goes with my follow-up on the 25th.  

649848 tn?1534637300
COMMUNITY LEADER
Let us know.
Avatar universal
Well, I went to my follow-up visit and just as you suspected, my levels, since they fell within normal range, did not even phase the PA.  The doctore has yet to see me on either visit.  She suggested other labs that might give us insight into why I just don't feel right... Everything looks to be in normal range except:

ALT 31 with a range of 6-29
Leukocyte Esterase Trace
Vitamin D 25-OH, Total 22 with a range of 30-100

With that said, I didn't mention in my original post to you that 2 years ago,  I had a benign tumor removed.  It was suspected to be in my lung and after a 5 hour surgery, it was found to actually be embedded in my diaphragm.  As a result, about a quarter of my diaphragm was removed.  I had a long recovery because of the size of it and it could not be done laproscopically. Around January of this year (1 1/2 years post-op), my current symptoms began and my pulmonologist saw me and did an xray in his office and said my lung looked fine and that a shadow he saw was probably just the mesh  where they reconstructed my diaphragm.  I never did anything about it just like I ignored the original tumor since I was initially told it was a calcification and that it was not something I had to worry about but just to keep an eye on it.  Now, I know I might sound paranoid but given these new lab results, should I be worried?  The Dr.'s office hasn't called me but I went and requested a copy of the labs and have a follow-up on Friday.  
Avatar universal
by the way, my TSH went from 1.07 to 0.79 in 2 weeks.  It still falls within normal range...
Avatar universal
by the way, my TSH went from 1.07 to 0.79 in 2 weeks.  It still falls within normal range...
10709826 tn?1412177997
I had my thyroid removed a couple years ago and have been taking thyroid pills. Everything was fine until a few months ago when I started feeling weak,light headed, heart palpitations,  tremors, tingly heat sensations. Ive been in and out of the doctors constantly. Ive had EKG test, blood tests including veneral disease,lyme,WNV.,24hr urine.I have seen a neuroligist had a CT scan with dye of the head and neck. Im now going to an internist. Every test has come back normal. Im ready to give up. Ive also been on effexor for the last 5 years. No one has any idea.Im thinking of going to a Mayo clinic in the U.S. Does anybody have any idea or suggestions? Ive been told it could be my medication levels but all the DR.s say there fine?? Im at my wits end.

Sincerely Need help desperately.
649848 tn?1534637300
COMMUNITY LEADER
At 22 your Vitamin D level is way too low and you should be supplementing.  Low vitamin D affects the way your body metabolizes thyroid hormones.

IMO, your issue is thyroid related because your FT3 and FT4 levels are way too low, but with your TSH as low as it is, your thyroid just isn't producing much of anything.  

Would you consider finding a different doctor?  Or insist on seeing the doctor, not the PA.
649848 tn?1534637300
COMMUNITY LEADER
You should post your thyroid related blood tests so we can see what your levels are.  It's possible that you simply need an adjustment in your thyroid hormone dosage.

If you'll post your latest thyroid test results and include reference ranges, we can better assess your testing and treatment.  

Your situation might get better attention, if you start your own thread, by clicking on the orange Post a Question button at the top of this page, type your questions, including lab results and reference ranges, then click the green Post at comment button.
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649848 tn?1534637300
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