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Old 01-25-2013, 01:26 PM   #1
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New lab results help please

I have not been diagnosed with hypothyroid or on any medication, but come from a long line of family members with Hashimoto's (men included!) on my mother's side. I have been tested for years because I am a textbook case of symptoms but blood work has always been fine in the past. I was hoping you all could help me out with my new labs. I see subclinical hypothyroidism as the diagnosis however the enternist does not see it that way. He is writing a letter to my primary doc about sending me to an endocrinologist after much debate in his office.

Here are the labs:

Free T4- 0.9 (0.8-2.0ng/dl)
TSH- 2.740 (0.300-5.000mcIU/mL)


I also had an ultrasound of my thyroid done because it looks enlarged. However, the enternist and primary doc do not see any enlargement.

Right lobe 4.2cm, left lobe 4.6cm
normal echogenicity and morphology, no masses

The enternist said that in order for me to be subclinical hypo I would have an enlarged thyroid and therefore he sees my lab results as normal.

Any thoughts/comments?

 
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Old 01-25-2013, 02:38 PM   #2
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Re: New lab results help please

I'm sorry you're struggling like this.
Can you consult with another doctor?

an enlarged thyroid is not a required criterium for subclinical hypoT.

Unfortunately your doctors are focussing way too much on TSH (which as you probably know is thyroid stimulating hormone produced by the pituitary gland and not an actual thyroid hormone, FT4 and FT3 are the actual thyroid hormone levels). tsh >2.5 is suspicious of hypoT although even that is not written in stone. TSh is not what causes symptoms, in a perfect scenario TSH will rise (end up elevated) when the actual thyroid levels drop too low for the body's needs, that does not happen for everybody as perfect though.

Tsh is not what causes symptoms, actual thyroid hormone levels being too low does. most healthy people will have their free levels (FT4 and FT3) abou 60-80% of the ranges. your FT4 is near bottom (we don't have FT3) so no doubt you're having symptoms and are hypoT.

When was your blood taken? TSH is supposedly highest in the morning, so if it was done later on during the day it's worth considering having it done in the morning (might make the difference to receive treatment).

Also worth considering is to have your antibodies done being antiTPO and antiTG, in case you have those it might be easier to receive treatment.

good luck and keep us informed!

 
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Old 01-26-2013, 08:24 AM   #3
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Re: New lab results help please

The enternist is going to recommend I visit an endocrinologist. I live in cincinnati, OH and plan on doing some research on the endo I want to see. I've heard that I should try to find a doctor that prescribes armour because they tend to look at the big picture not just TSH.
I did have the test taken late afternoon so my TSH was probably lower but in all honesty i want a doctor who looks at the big picture anyway so it's for the better.
Thank you for responding!

 
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Old 01-28-2013, 09:01 AM   #4
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Re: New lab results help please

Just got another test back from my doctor

My thyroglobulin AB <0.9 (0.0-4.0)

My TPO Ab-ARUP? 0.3 (0.0-9.0)

 
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Old 01-29-2013, 08:34 AM   #5
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Re: New lab results help please

Hi Mel,
Your labs do lean to the hypo side.

Your TSH 2.74 is higher than the median for normal women under 60 years of age of 1.3 to 1.4, indicating slightly hypo.

Your FT4 0.9 is lower the than normal median of 1.04 to 1.1, indicating hypo.

Next time, see if you can insist on getting a Free T3 test as well. Normal median for FT3 is 2.8 to 2.9 ng/dL.

If you do start taking something for it, I would suggest you might as well start taking Armour right from the get go.

The standard tip around here is for you to go to a compounding pharmacy in your city and ask the druggist if he would give you the names of any docs that he knows that prescribe Armour or slow release T3. Ask the druggist which one he would go to! Some Naturopathic Doctors are good at this thyroid stuff.

 
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Old 01-29-2013, 09:27 AM   #6
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Re: New lab results help please

My thyroid gland has never been enlarged. My mother was hypothyroid, and her gland was never enlarged. It isn't always so. That internist is not thyroid-knowledgeable. Keep looking for someone who knows better and who will treat you.
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Old 01-29-2013, 10:05 AM   #7
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Re: New lab results help please

Over a year ago (October 2011), I had my free t3, free t4, and tpoAb done. Here are those results

Free T3 3.10 (2.3-4.2)
Free T4 1.05 (0.89-1.76)
Tpo Ab 9 (0-34)

As you can see from the past results vs. current my free T4 decreased.

I am definitely going to be hunting around for doctors. I have even been looking for good thyroid doctors in the Columbus area which is an hour and half from me.

 
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Old 01-29-2013, 10:34 AM   #8
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Re: New lab results help please

Telus is right on about asking your pharmacist who prescribes Armour. I found a highly rated internist who thinks outside the box.

 
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