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Old 03-16-2011, 05:16 PM   #1
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Confusing Thyroid symptoms and results

Hi - I am new here but glad to have found such an active board!

I am a 38 yo female and since the beginning of the year have just felt ill - like when I had mono (tested and nagative). Feeling very fatigued and cold all the time. My thyroid was tested (among other things) and results came back that my TSH, Free t3 and free T4 were all normal but my T4 and T3 were high and T3 uptake low. Incidentally Vitamin D and Calcium were also very low. I then had a thyroid ultrasound which showed 2 12mm nodules on one side and a follow up nuclear thyroid uptake scan was "normal".

First, how can it be normal if there are nodules there? (I was told that the nodules are benign, but I am still curious as to how that can be considered "normal".) Second, I am unclear as to the significance of the blood work. Are these abnormal levels significant (I will post the actual numbers below) or do they basically mean nothing? I am not seeing an endo yet, but my regular docs suggested previously a brain CT to see if there are any problems with the pituitary gland, although I don't know if this is still necessary after these most recent tests (I have an appointment Monday, but I am sooo tired of all the waiting when I feel like utter crap!).

Results:
TSH 2.8 (range: 0.45 - 4.5)
T4, Free Direct 1.44 (range 0.82 - 1.77)
Thyroxine (T4) 15.0 (range 4.5 - 12.0) (this was tested again and second time was 16.1)
T3 Uptake 22 (range 24-39)
Free Thyroxine index 3.5 (range 1.2 - 4.9)
Triiodothyronine (T3) 189 (range 71 - 180)

I get the impression that my docs are a bit baffled, but perhaps there is just nothing in these results that would cause these symptoms and it's just the vitamin d levels (30 - range is 32-100) that were causing the fatigue part??

Can anyone with more experience than me shed any more light on this?

Thanks for reading!

 
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Old 03-16-2011, 05:50 PM   #2
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Re: Confusing Thyroid symptoms and results

Many people have thyroid nodules and don't know it until something brings them to that "area". Yours are very small so probably aren't affecting things much.

Your TSH > 2 is suspect for hypothyroidism.

Your FreeT4 level is good but might not be good enough for you (most people need their FreeT4 level in the upper third of the range or at the top of the range)

The other thyroid tests you had run are obsolete and really don't give the best information.....the "plain" T4 & T3 levels are often falsely elevated since they are affected by proteins and the T3 uptake and Free Thyroxine Index are calculations vs. accurate measurements.

It would be great if you could get a FreeT3 (triiodothyronine, free, serum) test. You see, the "free" test measures all the available T3 in your bloodstream.

T3 is our active hormone - the one we feel and the one that causes symptoms.....that's why it's very important to get that FreeT3 level done so you can get a complete picture.

You might want to Google hypothyroid symptoms and take a peek at the lists compiled from patient experiences - see if you have any of the other symptoms on the lists.
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Dx'd Graves' June 2007..used ATD's, achieved remission Nov '09....went hypo Mar '10

Last edited by cd37; 03-16-2011 at 05:53 PM. Reason: typos

 
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cyars08 (03-16-2011)
Old 03-16-2011, 07:35 PM   #3
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Re: Confusing Thyroid symptoms and results

Quote:
Originally Posted by cd37 View Post
Many people have thyroid nodules and don't know it until something brings them to that "area". Yours are very small so probably aren't affecting things much.

Your TSH > 2 is suspect for hypothyroidism.

Your FreeT4 level is good but might not be good enough for you (most people need their FreeT4 level in the upper third of the range or at the top of the range)

The other thyroid tests you had run are obsolete and really don't give the best information.....the "plain" T4 & T3 levels are often falsely elevated since they are affected by proteins and the T3 uptake and Free Thyroxine Index are calculations vs. accurate measurements.

It would be great if you could get a FreeT3 (triiodothyronine, free, serum) test. You see, the "free" test measures all the available T3 in your bloodstream.

T3 is our active hormone - the one we feel and the one that causes symptoms.....that's why it's very important to get that FreeT3 level done so you can get a complete picture.

You might want to Google hypothyroid symptoms and take a peek at the lists compiled from patient experiences - see if you have any of the other symptoms on the lists.

Thank you for your thorough response. I have Googled hypo and suffer from almost all of the listed symptoms, although my gastro symptoms are constant diarhea which seems contrary to almost everything I have read for hypo. Also my hair has become silky smooth, is not falling out and isn't dry and brittle either (although it previously WAS this way) so it seems I have a bit of a mix of symptoms. Indeed it was the gastro problems which brought me to the doctor in the first place. Thanks for the recommendation about the free T3. I will request that test next time.

I am wondering why the T3 and T4 tests are run if they don't provide useful information? I had also read somewhere that they are not very useful, but curious about why that T4 was high both times.

Can you explain why a TSH > 2 is suspect for hypo? And I am also curious about Hashimoto's as it seems I have possible symptoms of that also but since most of my blood tests fall within normal ranges I can't seem to come up with much good information.


You have been very helpful, I appreciate it!

 
Old 03-16-2011, 08:27 PM   #4
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Re: Confusing Thyroid symptoms and results

I've heard of people with hypothyroidism suffering from IBS-type symptoms so, diarrhea wouldn't be considered all-that-uncommon.

I wonder the same thing about those tests....perhaps it's an insurance thing? Or doctors going along with the standard (and less expensive) "thyroid profile" that some labs offer?

Since the "plain" T4 & T3 are often falsely elevated due to proteins in the blood, you don't really know why they were high - a hamburger, maybe?

The extensive and ongoing Nurses' Health Study has shown that healthy people have TSH around 1.0 (or even lower). There has been much discussion about the current TSH ranges to the extent that they might be too high.

That is why knowledgeable doctors will look at the thyroid hormone levels if TSH >2 and/or the patient presents with symptoms.

While there is no definitive test to confirm Hashi's - TPOab or anti-TPOab levels in the thousands can indicate Hashi's.....so can elevated TGab.

Glad I could help - it really takes the whole village to deal with thyroid disease 'cuz doctors just don't seem to make things easy.
__________________
Dx'd Graves' June 2007..used ATD's, achieved remission Nov '09....went hypo Mar '10

 
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cyars08 (03-16-2011)
Old 03-16-2011, 10:14 PM   #5
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Re: Confusing Thyroid symptoms and results

Thank you so much You have been super helpful

 
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