Help interpreting my test results

[ill_at_ease]

I got my test results back from my last physical a week ago:

TSH W/REFLEX TO FT4    Result = 5.14  Flag = H
T4, FREE                         Result = 1.1    Flag = N  

I'm 24 and weigh 125.  I haven't noticed any weight gain, although after getting really unclear answers from my doctor I have been feeling depressed. Sometimes I feel fatigued after work when I don't get more than 5 hours sleep. But I'm way more anxious more than anything else. My doctor basically told me nothing about what these results mean, only that she will retest me in 6 months to see if it turns hypo. I am confused about what is going on since I have no family history of this and I read that it is rare and occurs in mostly post menopausal women. I guess I would just like some clarification and would like to know what my options are or what I should expect to happen and what exactly these test results mean.

[ill_at_ease]

Thank you for the advice I really appreciate it. I'll check around the local labs and see what I can do.

[goolarra]

We use the AACE range for TSH.  It's the FT4 range that i need to see.

WIth absolutely no health insurance, I'd guess that you could have FT3, FT4 and TSH and the antibodies (TPOab and TGab) done for about $250-$300.  You might "call around" to labs in your area and get prices.  Also, I hear that if you pay cash, some medical facilities are willing to "deal" these days.

It sounds like you may need a new doctor if this one is so flippant.  

Yes, you can have a normal life (whatever that is!).  My endo once told me he wanted to get me "normal" and I said, "No way!"  If you get on meds and they're adjusted properly, there's no reason why you should gain weight, nor will your hair fall out.  It's being hypo, not the meds, that causes all that (which is an argument for treating earlier rather than waiting for those symptoms to appear).  Don't be discouraged by what you read on the forum.  We're all here because we're not "textbook cases".  Many people take their pill every day and end of story.  One step at a time.

Check out local labs for prices.  Also, you can order tests on the internet...they'll send you to a local lab for the blood draw and send the results directly to you.  I don't think it's a lot cheaper than doing it locally, but it does eliminate the doctor visits on both sides of the labs.

There are a lot of us here, and we've all been there, so don't feel alone.  If there's any way you can swing those basic tests, they'll tell you an awful lot more than you know now.

[ill_at_ease]

The range for the TSH is .4 - 4.50. I've been depressed and anxious after talking to my doctor. She screwed up interpreting the results on some other lab test from my physical only to correct herself later, so I got stressed out for nothing. One time she sent me someone else's lab slip in the mail. I just am pissed off on how she has left me to just "figure it out for myself". I am sure that these are my correct lab results, she was just so nonchalant about it and rushed me off the phone. Now that I'm out of the military I have lost my Tricare health insurance and my current job doesn't give me health insurance so I feel stuck. I want to get all those tests done right away but can't because I'm sure it would cost a fortune.

Can I have a normal life if I get medication?  I just don't want to think that suddenly I am going to gain all this weight I can't lose. Or that my hair will fall out??? Or that my metabolism is just going to stop working? Right now I know I'm pretty ignorant on the subject and I will educate myself further. I guess right now I'm just really scared :( and feel alone.

[goolarra]

Your TSH is high (current range according to AACE is 0.3-3.0).  This indicates that you are hypo.  Do you have the range on your FT4?  Ranges are lab specific and have to come from your own lab report.

I wouldn't consider fatigue after less than five hours of sleep a hypo symptom.  That's pretty normal, and when hypo, people often get 10-12 hours of sleep and are still fatigued.  Depression can be a hypo symptom (I'm unclear if you're depressed because of your test results or depressed in general?).  The same for the anxiety...is it over the results or generalized anxiety?

You don't need a family history to be hypo, and sadly, it affects many young people (even children) and men.  Women are the vast majority, but we were all diagnosed at different ages.  It is not at all a "rare" condition, really quite prevalent.

I think how long you wait to be retested depends on whether you have hypo symptoms now or if you develop them in the near future.  If you can go for six months without symptoms, there's nothing wrong with a "wait and see" attitude.  When you do have bloodwork again, make sure they also test FT3.  T3 is the most biologically active of the thyroid hormones and correlates best with symptoms.

In addition, it would be a good idea to have thyroid antibodies tested at that point (TPOab and TGab - both are necessary) to rule out the possibility that you are in the early stages of autoimmune thyroid disease (Hashimoto's thyroiditis - the most prevalent cause of hypo in the U.S.).  It might be worthwhile to have antibodies checked sooner rather than later as there is a fair amount of controversy over when to start treatment for Hashi's (before or after symptoms appear).  But, that's a subject for a different day if or when you test positive for Hashi's.