O.K., this is my first post. I'm a little confused, and shouldn't be as I am in the medical field, and don't quite understand this whole thyroid thing myself. I have been doctoring with not feeling well for at least 2 years. I finally found a great doctor, who ordered the correct labs, thankfully. Anyway, any ideas on the results??? I'm just looking for verification, I think, in my head.
My cholesterol, triglycerides, and LDL were all high.
My TSH was 0.78 (0.34-5.60), my free T4 was .69, (normal range .8-2.4) and my free T3 was 3.21, (with normal being 2.5-3.9)
My ferritin level, which has never been checked, was 5.5 (7.0-238.0)
Vitamin D was low at 31.5 (32.-100.0), as was DHEA at 73 (143-1277). I also had thyroid antibodies, 26, but my thyroid ultrasound is o.k., thankfully.
My question is this-----I always thought your TSH had to be high, with your T3, T4 being low, to be hypothyroid. Any input.????????:
Last edited by besstmom3; 04-20-2008 at 05:21 PM.
Reason: ranges for T4, T3, TSH
Primary hypoT generally, but not always, presents with high TSH and low thyroid hormones (TH). When the hypoT is caused by auto-antibodies, TH can get too low for the body's needs before TSH rises out of range. In the case of low or low-normal TH, if TSH is above 2, TH supplementation can be started and symptoms caused by low thyroid will improve. Autoimmunity is the most frequent cause of hypoT in industrialized nations.
But secondary hypoT is caused by a malfunction of the pituitary gland. This presents with low TSH and also low TH. Your labs suggest this might be the case. (If you have the lab's reference ranges for your results, please amend your post to include them. We can't tell anything for sure without the context of the ranges.) It appears that your pituitary is not sending out more TSH to stimulate your thyroid into action, so your body is converting more of its stored T4 to T3 in order to compensate. That basement-level T4 is causing trouble, but for now, the T3 seems adequate to carry you by.
This cause of hypoT is far less common than autoimmune hypoT.
Dysfunction of the hypothalamus can also cause hypoT and skewed labs, but this is considered rare.
Most doctors look only at TSH to evaluate thyroid health and completely ignore TH. If yours sees the "normal" TSH and dismisses your complaints, don't go down without a fight. Ask him about secondary hypoT. If that gets pooh-poohed, look for a better doctor. Your FT4 level - if considered in the context of most typical ranges (please post it if you know it) - is too low for you.
Thanks so much for the input. I have ammended my information, to include the normal values. I know each hospital lab around here has different "normal" values, just to add to the confusion. I was started on quite a few new meds, mostly natural stuff like DHEA, Vitamin D, reacted iron, reacted Magnesium, Adren-All, Nature-Throid, and iodine drops. I'm on 1 grain of Nature-Throid, so far. The doctor I am seeing is an "integrative medicine" doctor, and seems to get the bottom of why I'm feeling this way. I was trying to get my symptoms across to I don't know how many doctors, but was dismissed as getting older!!!!! I'm 37!!!!!!!!!!!!!!! It really helps to read the stories on here of how others have been through what I have. Thanks for your input. Should I ask to have my pituitary checked????? I'm so "doctored out" by now, if you know what I mean?????
Oh good... Glad you are seeing an integrative doctor. Mine is as well, and I'm doing fine with him.
I have to warn you that if your hypoT is being caused by the autoimmune disease known as Hashimoto's thyroiditis, the iodine drops may make you feel far worse. When the thyroid gland is failing, it can't make use of all that extra iodine. It might be wise to be tested for TPO and Tg antibodies to see if you have Hashi's.
Were those labs done before you started taking Nature-throid? I assume so, unless you say otherwise. If they were done once you had already taken it for a few weeks, that is the likely cause of your lower TSH. Nature-throid and other drugs containing T3 tend to suppress TSH. If that's the case, you needn't worry about your pituitary.
Otherwise, I'm unsure what to do about the possibility of pituitary dysfunction because I don't have it. I think the treatment for hypoT is the same no matter the cause, but I don't know for sure about secondary hypoT.
HI Midwest & besstmom i am about to go and have my antibodies test this week so your post gave me an insight to things as my gp said i could have hashis i think once i have the results i will see how high they are what i s a good result and what is a bad result thanks kasskoo
You need to look into your adrenal function. Given those levels I am betting you may have Hashimoto's and AI inspired adrenal insufficiency. I am this way. Started with Hashimoto's then the adrenal's went out like a light. Low B12, Ferritin, vit D. It is classic. You need additional testing.
cortisol (saliva/urine 24 hour rhythm, and fasting blood serum 8AM), ACTH (fasthing blood serum (8AM)), and aldosterone and PTH. All are improtant and if you are adrenal insufficient you are going to need to replace your adrenal function with meds as well as supplement your thyroid.
This post has my search into my adrenal issues as well as MUCH MUCH more.
If we learn by our mistakes, I am working on one hell of an education.
Thanks so much for your input! I looked at my labs, and did have the TPO level drawn---it was 12. My Thyroglobulin antibody was 26. My doctor explained to me that your not supposed to have any antibodies, but that I don't have a huge number of them. I'll have eto ask about the iodine, as I would never have known that about it. I've learned so much about the thyroid, and thought I knew so much before, being a nurse. It's quite the evasive system, the endocrine system, isn't it???? It can be quite sneaky in it's symptoms. So, I think with these antibody levels, I don't have Hashi, right???? I'm just making sure I have it straight in my head. Thanks
You are not positigve for Hashimoto's, but you are not negative either. You do have some antibodies present. Not enough that should be an issue, but your system has proven it can and does make thyroid antibodies. As a result you are not classic Hashimoto's, but you could become so at anytime. It is worth a yearly check on the antibodies.
I haven't heard of TH, but she may have ment TG. I will leave that for her to correct though. I am interested in hearing it as well.
If we learn by our mistakes, I am working on one hell of an education.
Primary hypoT generally, but not always, presents with high TSH and low thyroid hormones (TH).
I meant both thyroid hormones, T4 and T3. I used the abbreviation 'TH' as a shortcut to avoid typing it over and over. I thought about using a plural abbreviation - THs - but considered that might be confused with TSH.
Guess I caused even more confusion... LOL
I just reread your original question and took note of your mention of high cholesterol. I will mention this - in case you don't know:
Low thyroid is the second leading cause of elevated LDL cholesterol and triglycerides, following poor diet. My LDL fell to within the recommended range, without any other dietary changes, once my thyroid was optimally treated. My triglycerides remain high... but then, I eat too much sugar and really hate exercise. That explains that.
Thanks for the cholestrol info. How long does it usually take for the thyroid meds to start kicking in????? This is truly a test in patience. Also, the iodine information you gave me---would there be a lab result for me to keep an eye on??? I'm continuing to take it, but I don't want to if it may make me feel even worse.
Thanks for your great information---you seem quite versed in this whole thing.
Hopefully my cholestrol will start to stabilize, as my diet is definitely not to blame. My new doctor seemed to think that it would go down with the thyroid being helped.
I know one thing, the Vitamin D3 that I am taking is helping w/ my mood, outlook, fogginess, etc. emmensely. Everyone should take this, I think.