Thyroid Help

[always_sick]

I went to an endo and he ran more bloodwork and did an ultrasound. The ultrasound revealed several nodules, two of which look suspicious. I am now schedule for an FNA next week. Here is the results from my latest labs. Please provide your opinion about what I should expect/do. THANX

Tsh 1.08 ref range 0.40-4.50
Free T4 0.9 ref range 0.8-1.8
Free T3 3.1 ref range 2.3-4.2
ALT 39H ref range 6-29
Vitamin D 23L ref range 30-100

[flyingfool]

What symptoms are you having?

how you feel is more important than what the numbers are. however where your levels allows monitoring how medication adjustments are reflected.

You seem to convert well given your very low T4 level.  if you are having Hypo symptoms then Barb is right that it can be a combination of things.


Iron, Ferritin, Vit B12 and  Vit D are all important.  And as mentioned I think most people feel better with B-12 levels as stated above go all the way to 1,100. So 581 leaves plenty to increase.

Vit D I think should be generally about 60 which again is generally the top of the range.

If you are not feeling horribly, then I'd see what raising the vitamin levels can do after testing. If you are high in the ranges and still feel Hypo. THen by all means it makes sense to get a starter dose of thyroid.

On the other hand, if you currently feel horrible, with the FT4 level at the very bottom of the range, it may make sense to get a small dose of thryoid along with supplementing as necessary. Then get re-tested in about 6 weeks after starting the thyroid meds.

[Barb135]

Like thyroid hormones, vitamin B12 is one of those things that has to be fairly high in the range, for many of us.  I have to inject B12 weekly, in order to keep my levels high enough - which is right at the top of the range.  I would suggest that you start supplementing, then retest again in a couple months to make sure you're absorbing it adequately.  I have Pernicious Anemia, so I don't absorb it, which is why I have to inject.  Liquid or sublingual is, typically, better absorbed than swallowed pills.

[always_sick]

I just began to supplement with Vitamin D3 10,000 every other day. My Vitamin B12 level is 581 ref range 200-1100. i will start taking that as well. Thanks for the info. i will be sure to ask for the antibodies test on Monday!

[Barb135]

TSH is a pituitary hormone and, regardless of what the doctors say, it does not accurately reflect thyroid hormone levels. You have to go by the FT levels.

No, I don't think the nodules would be causing your low FT levels.  If they were high, I'd think differently.  Nodules sometimes leak hormones independently of the thyroid, causing levels to be too high; your levels are too low, which pretty much indicates that while your nodules might be causing some inflammation, they probably aren't affecting your levels. Many of us have nodules and they are nothing to worry about, unless their characteristics are unusual or if they change.

You need to have thyroid antibody tests done to determine whether or not you have Hashimoto's.  The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  You need them both to confirm/rule out Hashimoto's.

With Hashimoto's, it's not unusual for symptoms to show up long before regular labs indicate an issue.

Don't ignore that low vitamin D -- it can cause you to have thyroid like symptoms.  Are you supplementing that?  

Have you had vitamin B12 tested?

[always_sick]

Thanx Barb135 for your reply! No, I am not on any meds. Trying to get a diagnosis of what's wrong with me. Do you think the nodules could be causing the low Free's? I'm really not sure what to think being that I have the nodules but my TSH looks normal

[Barb135]

Are you on any type of thyroid medication?  Your TSH looks good, but both FT3 and FT4 are very low in their ranges, indicating hypothyroidism.

Your vitamin D is also very low.  Deficiency of vitamin D can cause some hypo-like symptoms.

High ALT indicates a liver issue.