Best of luck to you, semo990, I knew Barb would be able to help you. Never hesitate to go to a different doctor if one ignores obvious of results in your lab work. I hope you get clear answers from your pituitary imaging and are feeling better soon.
Oh my - it looks like you’ve had Hashimoto’s since 2017, since you had positive thyroid antibodies even then. What prompted those tests? At that time, it looks like you might have been a bit hypo.
Although Hashimoto’s is, typically, associated with hypothyroidism (not enough hormones), it can often, start out by alternating between hypo and hyper and/or normal. Many of us have Hashimoto’s for years before it does enough damage to prevent the thyroid from producing adequate hormones. I was not tested for it prior to my thyroid “dying”, but knowing what I know now, I believe I had Hashimoto’s for approximately 15 yrs before my thyroid stopped working. I went through periods of hypo, hyper and normal during that time. Of course, my TSH was always “normal” so further testing was never done.
So we know you have Hashimoto’s but you’ll probably need a doctor’s diagnosis (I’m not a doctor - just know how to read labs). Your thyroid seems to still be working fine - your Free T4 is 51% of its range, which is right where we’d want it. Your Free T3 is at 65% of its range, which is also right where we’d want it.
Although, Hashimoto’s can cause some symptoms, those would mostly be symptoms of hypothyroidism that you don’t have, so I’m going to think the thyroid isn’t your major problem at this point.
You Vitamin D is too low, so I’ll recommend that you start supplementing. 1000-2000 IU/day should help bring your levels up where they need to be. Ferritin is the iron storage hormone and your level s pretty good, plus your hemoglobin level is really good, indicating you have plenty of iron.
I don’t see a Vitamin B12 result. Did you get that checked? Vitamin D, iron and B-12 are all necessary for our body to metabolize thyroid hormones properly.
So - that would take care of the thyroid-related issues. There’s still that high prolactin result that needs to be dealt with. I’m thinking that’s your biggest problem right now and needs to be explored further. If I were you, I’d start out with my primary care physician and let him/her refer me to an endocrinologist. The problem I have with that, in your case, is that you’ve already seen an endo and they’ve missed that key result (high prolactin).
If you like the endo you saw, you can go back and point out the prolactin issue (along with the Hashimoto’s) and see if the doctor will work with you. If not, I’d recommend trying a different doctor. These are all endocrine hormones and the pituitary gland is part of the endocrine system, so at some point, you’re probably going to need and endo to deal with it. You need pituitary imaging to rule out (or confirm) a tumor.
Hello there... I assume this is all the tests you've had up to now? Does your endocrinologist believe you're "fine" with these test results?
"Thyroiditis" is inflammation of the thyroid. The most common cause is Hashimoto's, but that's not the only cause.
With a Free T4 at 56% of its range, we'd expect your TSH to be lower since TSH is counter-intuitive (when thyroid hormone levels are high TSH should be low and when thyroid hormone levels are low, TSH should be high). That said, your Free T4 level actually right about where we'd want it to be, though your TSH could/should be lower, even though it's "in range". These levels would bring your doctor to the conclusion that your thyroid function is "normal", even though it may not be normal for you.
If you can get another set of thyroid tests, including TSH, Free T4 and Free T3, that would be good. Free T3 is the actual hormone that our individual cells actually use, whereas Free T4 is considered a storage hormone that much be converted to Free T3 before it can be used.
Your vitamin D is also too low. Please note your report indicates that levels between 50-75 are "insufficient". Your level is 53.9, indicating you should be supplementing.
Your high prolactin level (713.43) is concerning. High prolactin can cause a variety of symptoms, including ED. Men's reproduction isn't my forte', but there's a direct relationship between testosterone and prolactin.
As noted previously, you should try to get another set of thyroid function tests (TSH, Free T4 and Free T3). I'd also suggest you get thyroid antibody tests - Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb) to rule out Hashimoto's. Depending on your results, you could have a condition called secondary hypothyroidism, which is when the thyroid works fine, but there's an issue in the pituitary gland.
I'd also recommend Vitamin B12 and Ferritin tests as both are necessary for proper thyroid function.
With your high prolactin level, I think you should talk to your doctor and ask about a pituitary CT or MRI. High prolactin could indicate prolactinoma, which is a tumor of the pituitary gland that's producing prolactin on its own. Prolactinoma is, benign (non cancerous) and can often be treated with medication.
I don't click on links people post. Could you mention if either of the blood tests was for Free T3, Free T4 or antibodies that suggest Hashimoto's? You mention thyroiditis, but don't say what test told you it was a possibility.