Confusing blood results

[ashley4373]

I went to my doctor last month because I thought my neck was swollen. My mom had hyper when she was young so I have paid extra attention to my neck. My doctor ordered an ultrasound, which reported mildly enlarged, hypervascular thyroid gland. I also had some blood work done. My doctor told me in the phone that my numbers are okay. However, based on the research I did online, those numbers do look off normal and confusing to me. Here are the numbers:

anti-TPO: 238.0 (0.0-34.9)
aiti-thyroglobulin: 45.7 (0.0-39.9)
TSH: 3.95 (0.50-6.00)
Free T4: 1.51 (0.75-1.54)

My TSH and Free T4 are both in the "normal" range, that's probably why my doc said my results were ok. However, I know that the latest standard for TSH has a much tighter normal range and according to that my TSH would be classified as higher than normal. That is confusing given that my free T4 also lies on the high end. I don't know whether they imply a tendency of hypo or hyper now. I don't have obvious symptoms yet tho I often feel tiredness and difficulty waking up in the morning. How should I understand my results? Has anybody had a similar situation? Also, are the high antibody levels suggesting any explanation? Thanks ahead!

[ashley4373]

Thanks all you guys for the responses. I'm new to here but it makes me feel so much better to find people to discuss this with. I'm a graduate student in biology and often times I just can't help thinking about what's going on and looking for answers everywhere. It's just nice to find experienced people to talk with.

The doctor I'm seeing is a primary doc from the university health center. Maybe I should ask her to refer me to an endo. I'm seeing her this afternoon and I believe I'll get another blood test done. I'll post the results when I get them.

[Barb135]

You need to have another TSH and FT4 done, along with a Free T3; with both your TSH and FT4 elevated, I can't help wonder if you might be hypo, but not converting the FT4 to FT3.  

Your antibody tests indicate Hashimoto's but I'd ask for TSI, as well, to rule out Graves.

[armywife92]

PS, You can also have TED(thyroid eye disease) with hashimotos too. The bulging eyes are related to graves though.

[armywife92]

Your results are interesting, as your T4 indicates possibly hyper but TSH possibly hypo.  Graves can have elevated TPO, and the prescence of ATG. When both are elevated it's mostly hashi. In graves patients an elevated(higher than yours) ATG means their thyroid is about to die off. You need to have the TSI run. Also yes thyroid disease is hereditary but it doesn't mean that you inherit the exact same thyroid disorder, ie hashi, graves. You could wind up with the complete opposite. I'd search around for a new endo since this one is not educating you.

[LazyMoose]

Usually TPO and thyroglobulin both elrevated is generally Hashimoto.

TSI is Graves only, maybe get that tested, and free T3..

Autoimmune thyroid can be very confusing in the early stages, we see some weird labs here with new diagnosis on occasion.

[ashley4373]

Thanks for the reply, LazyMoose. My doc told me only briefly on the phone that I might have some kind of thyroiditis and wanted me to wait for a month and get checked again. I didn't feel eased with the vague answer so I ordered a copy of the results and did my own research. What I've been reading says that anti-TPO can be elevated in both Hashimoto's and Grave's disease. Given my Free T4 number, is it possible that what I'm having is Grave's? Another reason I suspect Grave's is that I've been having some eye discomfort, mainly pains in and around the eyes and a morning redness when I get up. I'm seeing my doc soon, shall I ask a test for anti-TSHr?

[LazyMoose]

"Also, are the high antibody levels suggesting any explanation?"

- Yes , Hashimoto. He did not tell you this, but ran the tests, .......odd.

The average case : The antibodies come first, with or with out symptoms, then in time , falling T4 and T3 with raised TSH.

I would suggest requesting Free T3 testing for available T3 hormone, which is supposed to be converted from T4 in a healthy body.

I would ask him why he did not mention Hashimoto with those high antibodies.

You might need a new doc, this is common for us unfortunately.