thyroid issue

[grammyro]

I had a thyroid panel done because I am showing all the symptoms of hypothyroidism...hair falling out, extremely dry skin, sluggish colon with constipation, to name a few.  I had half of my thyroid removed 20+ years ago.  I currently take .2 mg levothyroxine daily.  The test results indicate, however, that I have low TSH with high T4 which, according to all I've read, indicates hyperthyroidism.  I don't go back to my doctor for over a month.  Any insight on this?  Thank you.

[jacrjacr]

you can go online to privatemdlabs .com and sign up for their emails. they will send you a discount of 15 percent. you can get your free t4 free t3 and tsh test for around 70.00 out of pocket . you pay with a credit card, they email you a sheet to print out to take to a local labcorp. you walk in and give them the sheet, they take your blood and you get your results usually emailed the next day. print off and you can take that to any doctor and it also shows the reference ranges to you know if you are hyper or hypo.that helps when you have a high deductible or your dr will not pull the correct test because of lack of knowledge.

[Barb135]

You don't really need an endocrinologist - some of them are horrible thyroid doctors.... Actually, though, if you have an endo that's 20 miles away, you're lucky -- I travel further than that to get to my endo.

There are a lot of family doctors who manage thyroid issues and do well with it... the thing is whether they are willing to listen and learn.

I agree that you should probably not wait until the end of April to see your doctor again.  When you see him, you can ask for the Free T3, Free T4, TSH and antibody tests.  The antibody tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).

[grammyro]

No, I haven't.  Unfortunately I live in a rural area and there are no endocrinologists within 20 miles.  My family doctor is excellent, but he is not a thyroid specialist.  I will discuss this issue with him at my next visit which I think I will reschedule to sooner rather than later.  My blood pressure (systolic) is running very high, also, even though I'm on 2 different blood pressure pills.  My pulse is at 78, which is normal.  But the combination of the thyroid symptoms and blood pressure indicates to me that I should not wait until the end of April to see him.

I thank you, Barb35, for taking the time to answer my question.

[Barb135]

Unfortunately, most of the tests performed are considered obsolete and don't really tell a lot.

The thyroxine is total T4... of the Total T4 in your blood, most is attached to a protein, so is unavailable.  The unbound (Free) portion of T4 is what we need to know.  T4 can't be used directly; it must be converted to T3.

As with T4, most of the T3 in your blood is bound by protein and unavailable for use.  Therefore, we need to know the unbound (Free) portion.  

Both T3 uptake and Free thyroxine index are obsolete, round about ways to calculate Free T4 and T3.

The tests you need to have are Free T4 and Free T3.  Both are readily available at most labs; your doctor has only to mark the right things on the lab order.

Looking at the results you have posted, though, I'd guess that your FT4 is being driven up by the levo and you aren't converting to FT3 adequately.  Free T3 is the hormone that correlates with symptoms and too low levels will produce the symptoms you noted in your original post.

Next time you get tested, ask your doctor for Free T3, Free T4 and the TSH.

Have you been tested for thyroid antibodies?

[grammyro]

Thank you for your reply.  My test results are as follows:

THYROID PANEL WITH TSH:

TSH:  Result 0.137 (Low), ref range 0.450 - 4.500
Thyroxine (T4):  Result 12.3 (High), ref range 4.5 - 12.0
T3 Uptake:  Result 26, ref range 24 - 39
Free Thyroxine Index 3.2, ref range 1.2 - 4.9

[Barb135]

Please post the actual test results, so we can better assess your situation.  Be sure to include reference ranges, which vary lab to lab and have to come from your own report.  

Was that T4 test Free or Total?  Did you  have a Free T3 test done?  There's a good chance that your FT4 is being driven up by the levo, but you may not be converting it to Free T3 adequately.  TSH is a pituitary hormone and often (most of the time) becomes irrelevant when one is on thyroid replacement hormones.  TSH does neither causes, nor alleviates symptoms.