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Old 11-14-2008, 08:12 AM   #2
mkgb
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Re: having thyroid symptoms, lab results inconclusive

Houseofglass21,

Hi, this is my first post here. I'm 25 years old and have been having what I consider possible thyroid related symptoms lately such as: heart palpitations (went to a cardiologist and he did an ekg and echocardiogram and said everything was fine), always feeling cold especially in my hands and feet, vertical ridges on nails and weak nails, hair has gone thin and started greying a bit in spots, panic and anxiety attacks, always feeling tired and weak, etc. Just an overall cacophony of symptoms. I've also been having throat problems. My voice has gone hoarse and I've had pain in the thyroid area and what feels like a small lump that is painful to the touch, also coughed up blood one time.

Welcome to our thyroid dysfunctional family. Your results are not inconclusive. You clearly have a thyroid issue.

I had some blood-work done last week and got the results back today. I'm making an appointment with an Endocronologist tomorrow. Do not give your MDs 100% faith. QUESTION everything and always get copies of your labs. Educate yourself on the latest levels and ranges and understand the difference between optimal and NORMAL in range. Being NORMAL in a statistical generated laboratory range that MAY or MAY not be up to current A A C E standards does not mean you are normal for YOU. YOUR symptoms are clear cut and indicate MANY things. You clearly have poor liver conversion of your T4 to RT3 versus active and useful T3 making you hypoT. Finding an MD to understands thyroid issues is the challenge. If you strick gold with your first swing of the MD pick.. well you are one lucky guy. Now let me dig into your numbers...

Here's the results:
3062 thyroid peroxidase autoabs | result - 17 | ref. range - <60

I am confused here. Is your TPOAB value 3062 or 17? If it is 3062 you have a whopper of an active case of Hashimoto's. The highest level of TPOAb I have documented is 1675. I felt like a blended cow patty at these levels, despite NORMAL Fts and TSH.

Reverse T3 | result - [H] 354 | ref. range 90-350

This is clear cut. You are not converting your T4 to active T3. Instead you are making the inactive useless RT3 component in your liver. The fix for this is to artificially supplement your T3 with cytomel or Armour/T4-T3 combination. Whether you need T4 supplementation depends on your T4 levels.

T3-Uptake | result - 40 | ref. range 32-48
This means that your taking up of T4 to be converted or moved about your body and used is normal in range. Almost perfect in level actually. This is a good result. It tells you nothing more.

Total T4 | result - 7.3 | ref. range 5.2-11.0 Your MD was showing his/her lack of knowledge here. There is a 20% error inherent in this test. It tends to be more accurate for males, because they should have less estrogen than females.. but all in all it is not the best test out there for getting accurate results. SO you have to take this result with a tablespoon of salt. You are 36.2% of normal range here. If this is artificially inflated as T4 levels tend to be.. you could be as low as 16.2% of normal. OPTIMAL T4 range is 50-80% of normal. YOU are clearly too low here.

T7 |result - 7.30 | ref. range 5.93-13.13 UH?! Why? *SNORT* Worthless test. Not even going to waste my time with number crunching on it.
TSH |result - 0.49 | ref. range 0.34-5.60 Hummm.. given the level of your T4 I would have expected this to be higher, especially since your RT3 is as high as it is.. you need a more detailed and accurate panel run. Plus you need some added biochemistry studies performed.

Your physical symptoms may be the result of malabsorption of some key nutrients: B12, vit D. You also need to get a baseline Ferritin and Magnesium level run. These are very important.

Now for a better look at your thyroid you need the most recent lowest error tests run:
TSH (Sensitive/3rd generation) Normal range by A A C E should be 0.35-2.5. Most labs have not adjusted this yet. Too much effort to fix their software probably.
FREE T3
FREE T4

TGAb
TSI
TRAb

You need to check into your adrenals too:
ACTH and cortisol 8 am blood serum fasting tests at the minimum. Add a DHEA if you are feeling froggy and get a willing MD. In the mean time I have 3 threads that I think you should read. I think they will help you out a bit. These are from my thyroid care and concerns series. Their URLs are:

[url]http://www.healthboards.com/boards/showthread.php?t=597479[/url]
[url]http://www.healthboards.com/boards/showthread.php?t=599141[/url]
[url]http://www.healthboards.com/boards/showthread.php?t=646472[/url]

Given your throat soreness and swallowing issues I think you also need to get an ENT on board and have a thyroid ultrasound run. Now I have another question, did you happen to have mono or a bad viral illness that seemed to hang on for ever sometime in the last 2-4 years? Maybe in college? This may have been the trigger to cause your thyroid issues. ESPECIALLY if you have Hashimoto's.

MG
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