Aa
Update to confusing blood results
Hi everyone! I had some confusing lab results last month and asked for help here. Last friday I got the results of my new blood work and here are the new numbers (For a quick reference I've put the numbers from one month ago in the brackets):
TSH (0.5-6): 2.6 [3.95]
FT4 (0.75-1.54): 1.66 [1.51]
FT3 (230-420): 297 [NA]
TPO (0-34.9): 154 [238]
ATG (0-39.9): 29.8 [45.7]
TSI (<140% baseline): <89 [NA]
Basically TSH, TPO and ATG all have moved in the "more normal" direction, but I have no idea about the fluctuation magnitude of the antibodies so don't know whether the decrease of TPO is significant or not.
As suggested by some of you on this forum, I asked for FT3 and TSI. FT3 turned out to be normal and TSI negative. So shall I understand the TSI result as ruling out Grave's?
My FT4 has increased further compared to last time. Given that my FT3 is normal, does it indicate a conversion problem or the number is not significantly off and I'm just an individual with T4 on the high end? Apparently my doctor doesn't think I have any problem and only wanted me to recheck after three months. But she's not a specialist and I really wanna hear more opinions.
I'm eager to obtain a good understanding of the situation because I'm planning to get pregnant in the near future. I had my first pregnancy last year which turned out to be a miscarriage at 10 weeks. I don't know if that had any connection with my thyroid but I know I need to make sure my thyroid's working properly before my next try.
Thanks again!
TSH (0.5-6): 2.6 [3.95]
FT4 (0.75-1.54): 1.66 [1.51]
FT3 (230-420): 297 [NA]
TPO (0-34.9): 154 [238]
ATG (0-39.9): 29.8 [45.7]
TSI (<140% baseline): <89 [NA]
Basically TSH, TPO and ATG all have moved in the "more normal" direction, but I have no idea about the fluctuation magnitude of the antibodies so don't know whether the decrease of TPO is significant or not.
As suggested by some of you on this forum, I asked for FT3 and TSI. FT3 turned out to be normal and TSI negative. So shall I understand the TSI result as ruling out Grave's?
My FT4 has increased further compared to last time. Given that my FT3 is normal, does it indicate a conversion problem or the number is not significantly off and I'm just an individual with T4 on the high end? Apparently my doctor doesn't think I have any problem and only wanted me to recheck after three months. But she's not a specialist and I really wanna hear more opinions.
I'm eager to obtain a good understanding of the situation because I'm planning to get pregnant in the near future. I had my first pregnancy last year which turned out to be a miscarriage at 10 weeks. I don't know if that had any connection with my thyroid but I know I need to make sure my thyroid's working properly before my next try.
Thanks again!
I forgot to add that a conversion problem can be related to low iron/ferritin or low selenium. So you might want to have those tested as well. As you go forward there are other tests that members will be happy to bring up. But, first things first.
Thanks for the detailed information, gimel! I haven't got very obvious symptoms yet as I stated in my previous post (http://www.medhelp.org/posts/Thyroid-Disorders/Confusing-blood-results/show/1468487), tho I do have a lot difficulties getting up in the morning and often feel a depression that could possibly due to the big stress in my life. I did gain some weight (5 lb) during my pregnancy last year but except for that my weight has been quite stable. What brought me to the doctor was a mildly enlarged thyroid, which was confirmed by an ultrasound.
My previous results confused me because my TSH was kinda high while FT4 was also on the high end. This time I asked for T3. According to your comment you think my FT3 is considered low? I think that makes my relatively high TSH more understandable. But again, why would I have high FT4 if I'm having Hashi's? My understanding is that T4 is made by the thyroid whereas T3 is converted from T4 at other parts of the body. If my T3 is low due to Hashi's thyroiditis, shouldn't the low T3 be secondary to a low level of T4?
Also thanks for the info about doctor. The one I'm seeing now is just a primary doc at my university's health center. She told me what I have is thyroiditis but since the numbers are getting improved and my hormone levels are quite normal there is nothing to be worried. But that doesn't give me peace of mind. From what I read here and there and like what you pointed out in your comment, my understanding is that once started it's gonna be a long-term trouble and I should not just expect that everything goes back to normal. I understand that if I'm not having symptoms there is probably nothing to done for treatment in any way, but I'm still eager to get a good evaluation plus necessary monitoring of the situation for the reason I mentioned in my original post. Do you think I should see a specialist for that?
My previous results confused me because my TSH was kinda high while FT4 was also on the high end. This time I asked for T3. According to your comment you think my FT3 is considered low? I think that makes my relatively high TSH more understandable. But again, why would I have high FT4 if I'm having Hashi's? My understanding is that T4 is made by the thyroid whereas T3 is converted from T4 at other parts of the body. If my T3 is low due to Hashi's thyroiditis, shouldn't the low T3 be secondary to a low level of T4?
Also thanks for the info about doctor. The one I'm seeing now is just a primary doc at my university's health center. She told me what I have is thyroiditis but since the numbers are getting improved and my hormone levels are quite normal there is nothing to be worried. But that doesn't give me peace of mind. From what I read here and there and like what you pointed out in your comment, my understanding is that once started it's gonna be a long-term trouble and I should not just expect that everything goes back to normal. I understand that if I'm not having symptoms there is probably nothing to done for treatment in any way, but I'm still eager to get a good evaluation plus necessary monitoring of the situation for the reason I mentioned in my original post. Do you think I should see a specialist for that?
The antibodies tests and your FT3 level indicate to me that you have Hashimoto's Thyroiditis, which is the most common cause for hypothyroidism. The changes in test results from prior, for TPO ab and TG ab are insignificant, and do not change the diagnosis.
you didn't say anything in this post about symptoms, but I'd be surprised if you haven't started noticing hypo symptoms. If not, it may be that you are in the early stages of Hashi's. with time the antibodies will attack and destroy your thyroid glands, requiring you to supplement your natural thyroid hormone production with thyroid meds.
For info, TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a sole diagnostic for thyroid. At best it is an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, freeT3 and free T4. Of these FT3 is the most important because it largely regulates metabolism and many other body functions. Scientific studies have also shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not correlate very well at all.
Just having a FT3 test that is within the range is not assurance that all is okay. The range is too broad for that. I won't get into all the reasons why that is the case, but believe me when I say that members frequently report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range. Symptom relief should be all important to you, not test results.
I think it is important for you to know that a good thyroid doctor will treat you clinically, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. This is a good link on that.
http://hormonerestoration.com/files/ThyroidPMD.pdf
you didn't say anything in this post about symptoms, but I'd be surprised if you haven't started noticing hypo symptoms. If not, it may be that you are in the early stages of Hashi's. with time the antibodies will attack and destroy your thyroid glands, requiring you to supplement your natural thyroid hormone production with thyroid meds.
For info, TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a sole diagnostic for thyroid. At best it is an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, freeT3 and free T4. Of these FT3 is the most important because it largely regulates metabolism and many other body functions. Scientific studies have also shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not correlate very well at all.
Just having a FT3 test that is within the range is not assurance that all is okay. The range is too broad for that. I won't get into all the reasons why that is the case, but believe me when I say that members frequently report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range. Symptom relief should be all important to you, not test results.
I think it is important for you to know that a good thyroid doctor will treat you clinically, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. This is a good link on that.
http://hormonerestoration.com/files/ThyroidPMD.pdf
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
As to why your FT4 and fT3 are somewhat out of balance, that may be due to inadequate conversion of T4 to T3. This is what typically creates low-in-the-range FT3, while FT4 is on the higher end of the range. The low FT3 is what causes symptoms, even though it is within the so-called "normal" range. The range is far too broad because it has never been corrected like was done for TSH over 8 years ago. If the FT3 and FT4 reanges were similarly correct by purging from their data bases suspect hypo patient data, the ranges would be much closer to the upper half of the current ranges. That is why we hear from so many members that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 was adjusted to at least midpoint of its range.
The reference ranges should really be considered as guidelines within which to adjust as necessary to relieve symptoms. Symptom relief should be all important, not test results. In other words, treat the patient, not the test results.
Some doctors don't want to treat a Hashi's patient until the blood test results are out of whack, and by then symptoms are usually pretty bad. Other doctors will agree to starting treatment earlier, based on symptoms and an understanding that the ref. ranges should be used as guidelines, as I discussed. I think you can get some good ideas from this link.
http://thyroid.about.com/od/hypothyroidismhashimotos/a/preventative.htm
You don't necessarily need to see a specialist, just a good thyroid doctor, as I defined above. That does not necessarily mean an Endo. Frequently they specialize in diabetes, not thyroid. Other times they have the "Immaculate TSH Belief" and only want to go by TSH. Other times they only want to keep you somewhere within the reference ranges for T3 and T4. These approaches bring us many new members. LOL
If you find that you need a good thyroid doctor, then try posting a new message, asking members for recommendation for a good thyroid doctor in your area.