Aa
Ultra Sound & Blood work result question
I have had raging fatigue problem for over a year. After an appt with Family MD they found a nodule in or around my thyroid. So I went in to see endocrinologist for more blood work & ultra sound last year. He said same thing except he called it a mass in my thyroid that we could or could not biopsy. Did not look suspicious to him but wanted a recheck with Family MD in a year. Which I did! I got a copy of actual report with just a OK written on it. But I am confused!!
My TSH Sensitive-May is 3.4, My T4 Free-Mayo is 1.3, My T3 Total-Mayo is 149. He also check my glucose, cholesterol etc The only other thing that looks out of range is my Creatinine is 0.5 & my Potassium is 5.0. Not sure of the relevance or not.
My Ultra Sound showed a 5mm heterogeneous hypoechoic mass involving mid section of right lobe & 1.6 x 0.7 cm heterogeneous area in mid range of left lobe. Normal blood flow etc
Should I have a biopsy? And although it's still in normal range can any of these numbers cause fatigue???
My TSH Sensitive-May is 3.4, My T4 Free-Mayo is 1.3, My T3 Total-Mayo is 149. He also check my glucose, cholesterol etc The only other thing that looks out of range is my Creatinine is 0.5 & my Potassium is 5.0. Not sure of the relevance or not.
My Ultra Sound showed a 5mm heterogeneous hypoechoic mass involving mid section of right lobe & 1.6 x 0.7 cm heterogeneous area in mid range of left lobe. Normal blood flow etc
Should I have a biopsy? And although it's still in normal range can any of these numbers cause fatigue???
Just an aside, small nodules like that are very common (I think 50% of adults over 50 have them) and hard to do a proper biopsy on. Since thyroid cancer is notorious for being slow growing very low grade just watching is appropriate for small nodules.
I got 0.8-2.0 from Mayo's website for FT4, so let's work with that.
Your FT4 is at 42% of range. The guideline for FT4 is 50%, so you're a little bit low, but nothing terrible.
Unfortunately, your doctor ordered total T3, instead of FREE T3. Total T3 includes all the T3 in your blood, but much of that is chemically bound and unavailable for use. FT3 tells what's available. TT3 and FT3 do not always correlate. That being said, your TT3 is at 63% of range, and the guideline here is upper half of range. So, that looks really good.
Over 10 years ago, AACE recommended that TSH range be changed to 0.3-3.0. As you can see, labs have been very slow to acknowledge that change. According to the "new" range, your TSH is a bit on the high side, which indicates your pituitary wants FT3 and/or FT4 levels higher.
Elevated cholesterol can be a hypo symptom.
Your thyroid really looks to be in pretty good shape. If you want to explore it further, you might ask for TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies) to be tested. If either is elevated, you could be in the initial stages of Hashi's.
Have you had vitamins and minerals tested? Deficiencies of vitamin D and B-12 can both cause fatigue, and D deficiency is rampant, especially in higher latitudes. Iron/ferritin deficiency can also cause fatigue. Magnesium deficiency can cause heart arrhythmia. In addition, all of these, except possibly B-12, can make you hypo at the cellular level because they have to be present in sufficient quantity for thyroid hormones to get into cells and do their work. All we can test is blood thyroid hormone levels, but that tells us little about what happens later to thyroid hormones.
Keep in mind that if you have vitamins and minerals tested, their reference ranges are every bit as unreliable as thyroid reference ranges, i.e. it's not good enough to be on the bottom of the range.
Your FT4 is at 42% of range. The guideline for FT4 is 50%, so you're a little bit low, but nothing terrible.
Unfortunately, your doctor ordered total T3, instead of FREE T3. Total T3 includes all the T3 in your blood, but much of that is chemically bound and unavailable for use. FT3 tells what's available. TT3 and FT3 do not always correlate. That being said, your TT3 is at 63% of range, and the guideline here is upper half of range. So, that looks really good.
Over 10 years ago, AACE recommended that TSH range be changed to 0.3-3.0. As you can see, labs have been very slow to acknowledge that change. According to the "new" range, your TSH is a bit on the high side, which indicates your pituitary wants FT3 and/or FT4 levels higher.
Elevated cholesterol can be a hypo symptom.
Your thyroid really looks to be in pretty good shape. If you want to explore it further, you might ask for TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies) to be tested. If either is elevated, you could be in the initial stages of Hashi's.
Have you had vitamins and minerals tested? Deficiencies of vitamin D and B-12 can both cause fatigue, and D deficiency is rampant, especially in higher latitudes. Iron/ferritin deficiency can also cause fatigue. Magnesium deficiency can cause heart arrhythmia. In addition, all of these, except possibly B-12, can make you hypo at the cellular level because they have to be present in sufficient quantity for thyroid hormones to get into cells and do their work. All we can test is blood thyroid hormone levels, but that tells us little about what happens later to thyroid hormones.
Keep in mind that if you have vitamins and minerals tested, their reference ranges are every bit as unreliable as thyroid reference ranges, i.e. it's not good enough to be on the bottom of the range.
TSH Sensitive-May 3.4 (0.3-5.0)
T4 Free Mayo- 1.3 (Doesn't have a normal range)
T3 Total-Mayo 149 (80-190)
I have 3 pages of #'s for things I have no idea what there for.
The only numbers that appear out of range is..
Creatinine (L) 0.5 (0.7-1.2)
Potassium Lvl (H) 5.0 (3.5-4.8)
Cholesterol (H) 208 (0-200) Never had this problem
LDL Calculated (H) 133 (0-100)
I have just recently put on 15 pds (in a month) but I just quit smoking!
I have other strange random things going on, that Im not sure if there related. Off & On rash, heart races every once in while etc
Family Doctor seems unconcerned!! And I'm just making sure if I need to be. I am not good about going to the Doctor when I should
Please post the reference ranges for your blood work. Ranges vary lab to lab, so they have to come from your own lab report. A good way to post is:
Test Result (Range)
For example:
FT4 1.3 (0.8-1.8)
Test Result (Range)
For example:
FT4 1.3 (0.8-1.8)
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
