Even though the TSH is within the lab's range, AACE recommended nearly 10 years ago that the range be change to 0.3-3.0. Labs, therefore, doctors, have been very slow to adopt this change. So, if we go by "our" range, your TSH is still too high. As noted in a previous post, TSH fluctuates considerably, even intraday. When it's all said and done, I barely give TSH a second thought, since it neither causes, nor alleviates, symptoms. At best, it's merely an "indicator" of thyroid status.
It seems that you might have hit the jackpot with the T3 and T4.... the result of the T4, does appear to be free (whenever getting verbal results, it's always a good idea to ask this). Based on ranges we normally see for FT, yes, that's in range, however, reference ranges do vary from lab to lab, so always have to come from your own report; again, it's always a good idea to ask ranges, when getting verbal results. That said, even though your FT4 is in range, it's quite low in the range. Rule of thumb is try to get FT4 at mid range. Depending on the actual range, yours is less than that.
The T3 is the clincher, here. I can't really tell if that's free or total, but either way, it's too low. If that's total, then we can assume that FT3 would most likely, be even further out of range, since some of the total would be bound by protein, and unusable. If it's Free, we simply know it's too low.
Since FT3 correlates best with symptoms, your symptoms are not a surprise, and it's quite likely that getting placed on a medication will go a long way toward alleviating them.
As for the subclinical hypothyroidism - I don't think so. With subclinical, FT3 and FT4 are usually in range, with a high TSH. Your FT3 is too low, which indicates an issue with the thyroid.
I'd strongly suggest that you ask your doctor to test you for the thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) to confirm/rule out Hashimoto's Thyroiditis. Hashimoto's is an autoimmune disease, in which the body sees the thyroid as foreign, and produces antibodies to destroy it. If you have Hashimoto's your thyroid function will continue to decline, until it no longer produces any hormones, at all, and you will be completely dependent on the replacement medication (there are worse things). The destruction process can take years or decades, or it can go quickly.
I'd also strongly suggest that you request a thyroid ultra sound, which will help confirm/rule out Hashimoto's and will determine whether or not you have nodules, which are common with Hashi's.
Also, since these numbers are raw data said to me by the nurse, I do not know if these are Free or a total unfortunately. Tomorrow I am calling the doctor to find out the particulars of the test and treatment options when he returns to the clinic. thanks again!
Also, since these numbers are raw data said to me by the nurse, I do not know if these are Free or a total unfortunately. Tomorrow I am calling the doctor to find out the particulars of the test and treatment options when he returns to the clinic. thanks again!
I called the doctors office today. The doctor is out until tomorrow so the results that I have to post today are from the nurse who is just reading raw data and here are the results.
TSH 4.47 (previous test was 5.7)
T3 74 (Normal range is 76-181) correct?
T4 1.1 (in Range for this test)
So there you have it. It appeared as tho my TSH is back under Normal range and but just barely. It seems that these numbers fluctuate. My T4 is below normal range, I assume that these numbers also fluctuate. And of course the T4 is in normal range. I am going to be skillfully insistent to still get on some kind of treatment for this because of the fact of my high cholesterol and fluctuating blood pressure could be solved by thyroid medicine to get those numbers lower. What do you think Barb135? With these numbers does it sound like (as it does to me) that Im Subclinical Hypo? and Meds will help bring it within normal ranges (even lower, Id like to see 1.0-2.0 personally). what are your thoughts?
I do hope those tests were for FREE T3 and FREE T4? If not specified "free", you will get for total T3 and total T4, which are both considered obsolete and of little value. When you get the results, please post them, here, along with the reference ranges, which vary lab to lab, so must come from your own report.
Yes, it's possible for TSH to fluctuate without meds. TSH varies greatly, even intraday, so whatever it is now, it could be different in a few hours. That's why it should never be used, alone, to diagnose or treat a thyroid condition.
Agree that some of your symptoms could be related to sleep apnea; be aware that sleep apnea often goes with hypothyroidism and the symptoms should go away once thyroid levels are optimal.
You have the right to take part in deciding your course of treatment; most of us have found that we have to be our own advocates and go in, not only informed, but ready to fight for what we need. I certainly think it would be appropriate to ask for thyroid replacement medication, rather than blood pressure med. Of course, I wouldn't recommend going in like block busters, but do stick to your guns.
I'll give you an example: When I was hypo, my cholesterol shot up. My doctor wanted to put me on Crestor and I refused. I told him that I'd start the thyroid med and if getting my levels right didn't bring my cholesterol down, I'd look at diet and exercise, and the Crestor would be the last resort. That was over 4 years ago and I still don't take Crestor, or any other cholesterol drug. I've since learned that my cholesterol goes up and down with thyroid levels. In all fairness, I also now have a different doctor!!
Nobody knows your body better than you do; sometimes, well informed doesn't cut it and we have to be insistent.
thanks for your helpfulness. Today I went to the doctor's again and he tested for T3 and T4. I should know the results tomorrow or the next day. So another concern I have is, is it possible for this high TSH (even tho its just elevated and not really high) to fluctuate without meds? For example the doctor said today (even tho he hasnt seen the results from teh T3 or T4 yet) that my slightly elevated blood pressure and headaches in the AM and low sex drive might be from Sleep Apnea. The concern is, if the results come back that im borderline or "subclinical hypothyroidism" and not full-on symptomatic that he will not prescribe meds to address the hypo but instead give high blood pressure meds since BP numbers are not consistently high. I am just anxious about the whole thing and waiting seems to be the hardest part right now. My worst fear is that the symptoms that I do exhibit, weight gain, over sleeping, lethargy, high cholesterol, high blood pressure, low libido will be overlooked and not addressed when id rather see if a low dose of synthroid type meds will work instead. Because from what ive read all these symptoms are associated with thyroid issues. would it be appropriate to tell me doctor these thoughts and have some part in the decision making process to get prescribed thyroid meds? your thoughts are appreciated! I dont want to come across as insistent about it with him but rather well informed. thank you!