Hope you don't become too exasperated with me, and start to become convinced I must be dense! I've been TRYING to learn. But I'm taking crash courses in more than one medical subject at a time, with no real scientific inclination (I'm a musician and a "professional mom", chief cook and bottle washer, for crying out loud!). I'm way out of my league. So.... I decided to post Trav's latest (Sept. 7) thyroid labs here for your purusal and comment:
T3 UPTAKE 38 Range (24-35)
TSH 1.31 Range (0.35 - 5.50
T4 (THYROXINE) 10.5 Range (4.5 - 12.5)
To little ole me, his T3 and T4 look rather high, which would indicate hyperthyroidism. Yet, if that were true, why isn't his TSH very LOW? And this is confusing from a different aspect, as on his prior tests (from 2002 - 2004) his TSH kept going UP. We started at .7, went to 1.27 and then to 1.927. I thought I would see it up even higher on this last test, but it went back down instead! I'm sure we have different amounts of TSH on different days, but this blew MY theory that he might be becoming hyPOthyroid. His antibodies were not measured this time around, but in May 2004 they were 30 out of a range whose upper limit was 34. So he was within range for these, but toward the higher end. Anyone vote for Hashimoto's? Is that the one where you an go from hyper to hypo? This might explain the varying results. But the endo didn't think much of these results, seeing that the T3 uptake was the only number out of range. (To his defense, he didn't have the old labs in hand; we got slipped in suddendly to a cancellation slot, so didn't have time to do the necessary preparation we usually would have done.). Was tested by ACTH stim test for adrenal difficulties. Will find out sometime within the next two weeks. Thanks much for anything you can say. I own and am reading two or three thyroid books, but sometimes I cannot find the answers to my questions, even though they may be burried somewhere in the texts!
First of all, TSH can vary more than that over the course of a 24 hour period, so there isn't really a difference between .7 and 1.9. Just having labs done at different times of the day or when his sleep patterns are different could make that much of a difference or even more without there being evidence of a thyroid problem.
T4 is high in its range, but not over the top, so there is not really a fear of hyperthyroidism. Nothing to be alarmed about, here. I would prefer to see a Free T4 test here, but that can be approximated as I'll do below.
T3 Uptake is NOT a T3 test as the name misleads us to believe. (T3 from other sources is added from a test tube to come about the results, thus the misleading name) It is a test of the level of certain thyroid binding proteins (Thyroid Binding Globulins) in the blood. The main purpose of this test is to approximate Free T4 through a calculation using the T4 and T3 uptake scores. This lab result IS abnormal and is often seen when a patient is hypOthyroid or when thyroid antibodies are attacking Thyroid Binding Globulin in the blood as often happens with Hashimoto's.
Calculated Free T4 (also known as Free Thyroxine Index or FTI or "T7") is as follows: His calcualted result is 3.99 in a range of 1.71-4.75 by my calculations...Stll in range, and nothing to be worried about at this point in time.
I would still be interested in seeing Total T4, Free T4, Free T3 and Antibody tests all taken at the same time. To get a more accurate assessment of the above.
My diagnosis: For the time being, the levels are good and it would be hard to get even the most agressive doctor to treat him at this point. I would guess that there are thyroid antibodies that have been attacking Thyroid Binding Globulins in the blood and in the thyroid gland and that your son may well have some thyroid problems in the future, but right now it might be possible to treat him nutritionally. Make sure he is eating right and getting proper nutrition to support the thyroid gland. This includes making sure he is getting plenty of Selenium (up to, but not more than 200mcg a day), which can help reduce antibody counts and the symptoms associated with them. A good book to read that covers the subject of nourishing your thyroid gland would be Solved: The Riddle of Illness by Dr. Stephen Langer.
I am not a doctor, nor have I ever played one on TV...
Thanks very much for your appraisal of the situation. I think the doctors agree with you, only they don't give me as much info and explanation!! Thanks again. I was HOPING he DID look like he had a thyroid problem from his labs, because then we could get some meds and be on the road to recovery. But finding the WRONG diagnosis and treating IT just because we want to blame something and start meds, is a bit like accusing the wrong person of a crime and taking them to jail, just because we want to blame someONE! It doesn't do a bit of good, in the long run. We'll keep searching. And we are awaiting the results of Trav's ACTH test, too. ~ Tracy