Test Results Normal, but so many symptoms

[phalangie]

Hello,  

I recently had blood work done and a ultrasound on my thyroid.  I've had many symptoms over the past year that lead me and my Dr to believe my thyroid has been the issue.  My nails peel, my hair has gotten really gray (I'm just 30) and more coarse, skin is always dry, constipation, sluggishness, I can't tolerate cold like I could before, I don't really sweat, I've gained 5 lbs over the last month with no change in diet, infact - the only time I've ever been able to loose weight is eating extremely low fat diet for a couple months before getting my gallbladder out.  I'm talking like no more than 2 grams of fat in a meal, no oils, anything.  I've had pretty irregular periods my whole life and needed clomid to get pregnant with my kids. Then there are other times where my heart just starts racing for no reason.  Lately at my dr appts it's been 94bps and blood pressure 113/60.  I feel like I'm having both hypo & hyper symptoms, and I'm wondering if something could still be up even though I got normal results.  

These are my results:

Thyroid Peroxidase AB    -   Not Available    
TSH W/ Reflex To FRT4   -   1.78 uU/mL      (35-4.94)
T3 Total                           -   146 uU/mL      (58-159)
Thyroglobulin                   -   8.0 NG/ML       (2.0-35.0)
Anti Thyroid Perox,lgg      -   .3 (IU)/ML         (0.0-34.9)
Anti Thyroglobulin lgg       -   4 (IU)/mL          (0-19)

Ultrasound shows no goiters or nodules.

Were the wrong tests done?  I know I've heard they don't always run the right tests to diagnose.

[goolarra]

Perhaps they didn't run the TPOab test because they ran the two IgG tests instead.  IgG is a subtype of TPOab and TGab.  I've never seen it done that way before.  Neither of the IgG's is elevated.  I have no idea why the TPOab test wasn't run as usual.  Perhaps it just isn't back yet?

TPOab is the primary antibody marker for Hashi's, so it's very important.

You can order your own labs online without a doctor's order.  If you're interested, I'll point you in the right direction.

[phalangie]

Thanks for taking a look.  I'm also not sure why the Thyroid Peroxidase AB test came back as Not Available???  Is that one not important?  

This is from just a regular PCP, so would I just ask her to retest?  I wish I could just order my own, seems like so many people have a problem getting the correct tests done.

[goolarra]

You're right; that's kind of an odd array of tests.  Notably missing is FREE T3 (FT3), which is a much better test than total T3.  FT3 tells you the amount of T3 in your blood that is available; TT3 tells the total amount, much of which is unusable.  FREE T4 is also missing.  The direction on your TSH test "w/ reflex to FT4" tells the lab to test TSH, and if it's normal, go no further.  If it's out of range, FT4 will be tested).  FT3, FT4 and TSH should be included in every blood draw if you have thyroid disease or suspect it.

Of the tests that were done, TSH looks good.  But, it's the least important of the tests.  As you can see, TT3 is close to the top of the range, so it certainly shouldn't be giving you hypo symptoms.

I'd retest and make sure FT3, FT4 and TSH are all included