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Thyroid results - help!

Hi all - need help with some results on thyroid. Over the last few years I’ve had signs of a thyroid disorder that I thought would likely be hachimotos. Always cold, rapid weight gain, fatigue, hair thinning, etc.. I was did an thyroid US and can back that I had a 6mm nodule. The doctor had me complete idione uptake and some bloodwork which have me a little confused on my results. My ts3 free 3.17 ts4 free at .65 (at the “normal low” and tsh at 1.14 (near he normal low). My uptake is what is confusing as my results are increased uptake in both the 6 hour and 24 hour outside of the normal range. Is that a sign of Graves’ disease? Any insight would be helpful.
2 Responses
1756321 tn?1547095325
That looks like Hashitoxicosis. Usually due to leakage of active Hashimoto's thyroiditis but in some cases Graves antibodies can show up as well with Hashimoto's thyroiditis.

Thyroid Research and Practice - Hashitoxicosis: A clinical perspective...

"Chronic autoimmune thyroiditis is the most common cause of hypothyroidism worldwide. Sometimes, it is associated with a transient hyperthyroid phase. This hyperthyroid phase, called Hashitoxicosis (the term generally refers to a combination of thyrotoxicosis/hyperthyroidism in the setting of ongoing autoimmune thyroiditis), is self limiting, and lasts for a period of a few weeks to some months. During this time, classical symptoms of mild to moderate hyperthyroidism may co-exist with a diffuse, firm, painless goiter. Thyroid scintigraphy may show normal or a slightly increased uptake. Anti-thyroid antibodies are often positive, and ultrasound with Doppler is a useful test. A combination of clinical features, thyroid function tests, and appropriate radiology will help make the diagnosis."


649848 tn?1534633700
COMMUNITY LEADER
What are the reference ranges for the Free T4 and Free T3?  Reference ranges vary from lab to lab and have to come from your own report.  

Also, have you been tested for the actual thyroid antibodies to determine if you have Hashimoto's or Graves Disease?  

The antibodies to confirm Hashimoto's are Thyroid Peroxidase Antibodies (TPOab),  sometimes known as Microsomal Antibodies, and Thyroglobulin Antibodies (TgAb).  The definitive test for Graves Disease is Thyroid Stimulating Immunoglobulin (TSI).  

Your symptoms of cold intolerance, weight gain, fatigue, and hair loss are consistent with hypothyroidism.  We would expect your TSH to be higher with Free T4 as low as yours appears to be, but that will depend on the reference range.  

You may also have Central or Secondary hypothyroidism, which is a problem with the pituitary/hypothalamus axis in which there isn't enough TSH to adequately stimulate the thyroid.  But it might not matter if your thyroid is under attack and can't respond anyway.  We just don't your doctors to overlook the possibility since some of them are prone to concentrate on the TSH and yours is what most would consider "pristine"...
1 Comments
Thank you for the responses. The range for tsh is .49 -4.67, rage for t4 free is .61 -1.60 and t3 free is 2.50-3.9. I did recently receive the results for TPOab which was 3 and the range given was <10
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649848 tn?1534633700
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1756321 tn?1547095325
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