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tigger67 06-02-2007 11:50 AM

Please help me interpret my lab results
My TSH is 0.018 and my T4 is 1.26. My doctor told me I had high levels and had hypothyroidism, but according to the limits on the lab results (0.350-5.00), my score is low. So what exactly does my score mean?

accessn12 06-02-2007 11:54 AM

Re: Please help me interpret my lab results
If you could post the range for the t4 too, we might be able to intrepret it. Usually a low tsh means hyperthyroid but it's hard to tell for sure without knowing where that t4 is sitting.

tigger67 06-02-2007 11:57 AM

Re: Please help me interpret my lab results
The range for T4, Free (Direct) is .61-1.76. My scores were 1.26. The nurse said hypo though, not hyper.

accessn12 06-02-2007 12:11 PM

Re: Please help me interpret my lab results
That's an interesting interpretation of those labs. Your tsh says hyper. Your ft4 says you are euthyroid (which just means neither hyper or hypo). Before any kind of diagnosis can be made you will need a ft3 done which might settle the question. The tsh should be repeated too. The chances of you being hypo with those labs is all but nil. Perhaps she misread the doctor's writing. I've been hyper almost forever now. The nurses still sometimes read the chickscratch as hypo and it keeps ending up on my insurance forms and referrals as that.

midwest1 06-02-2007 12:16 PM

Re: Please help me interpret my lab results
Tigger... it's not adding up. Your TSH indicates hyper, but your free T4 would be pretty normal for most people. Neither ones says "hypo". More testing is needed. If your free T3 isn't high either, perhaps your pituitary function should be checked.

tigger67 06-02-2007 12:18 PM

Re: Please help me interpret my lab results
I'm getting tested again in 7 weeks, and then the doctor said I may need a scan (uptake scan I assume).

So far my only symptoms are fatigue and dry skin on my neck. Should I be more worried if it's hyper and not hypo?

accessn12 06-02-2007 01:22 PM

Re: Please help me interpret my lab results
Retesting in 7 weeks is very reasonable. It should include a free t3 to make sure you do not have what's known as t3 toxicosis which can also lower the tsh. It would also be a good idea to have antibody testing done. A raiu scan should be reserved for if they can't figure out what's going on based on the labs. And they probably should wait to do that until after an ultrasound. Never have a raiu scan before antibody testing. It will skew the results for quite a period afterwards.

With a ft4 at that level, you probably don't have a lot to worry about if you aren't experiencing more than fatigue and dry skin. You've got time to get things figured out.

tigger67 06-02-2007 02:00 PM

Re: Please help me interpret my lab results
Now I'm really confused since it's not just cut and dry. Do I need to mention to my doctor about testing T3 or would this be an obvious thing to her? The nurse mentioned a 2 day scan if the next tests were "off", so I just assumed that was the uptake scan.

accessn12 06-02-2007 03:52 PM

Re: Please help me interpret my lab results
No, it's not always cut and dry. I just took a quick look at your other posts. I see you have some other issues going on too. I didn't read in depth but to further complicate things, thyroid function tests can sometimes be misleading when you have other medical issues.

Testing of FREE T3 is not always obvious to doctors. In my experience, very few doctors are really familiar with thyroid issues and even more are unfamiliar with hyperthyroidism or all the other various interactions of the various organ systems that do affect thyroid function. It's a very complex system and a situation that they don't run into very often.

When I first learned that I was hyper 16 years ago and finally found out why I had been ill for so long, I really didn't have any idea what a thyroid was or how it worked. I trusted the doctors to take care of it. I'm finally finding out how little the doctor's that I have seen about it actually do know. And I've seen a bunch of doctors.

tigger67 06-02-2007 04:23 PM

Re: Please help me interpret my lab results
Yes, I do have other health issues (asthma and osteoporosis). I've been reading that eating foods high in iodine can cause what they're calling subclinical hyperthyroidism (low tsh, normal t4). I have been eating a lot more processed and fast foods in the last couple years due to being too busy to cook (in school while working full time). I may call the nurse next week to clarify what she told me. Maybe I can get a better idea of what the doctor is thinking. I feel like I have symptoms of hypo (fatigue, dry skin, having a hard time focusing), but I guess these can be with both hyper and hypo?

tigger67 06-02-2007 04:39 PM

Re: Please help me interpret my lab results
I also found out with my lab results that I had low Vitamin D levels (30.3) normal is 32-100. I've read this can cause thyroid problems, so I guess I'll find out when I get retested again since my doctor is having me take 1600iu of vit D.

accessn12 06-02-2007 05:42 PM

Re: Please help me interpret my lab results
I think you're on the right track. You need to question, question, question. You also need to find out if any other medications you are taking can interfere with thyroid test results. There's also incidences where an illness itself can cause low tsh readings.

Fatigue, dry skin and trouble focusing can be signs of either hyper or hypo and also can be signs of other diseases or even side effects of medications. It's important when a diagnosis is not clear cut to look at all the possibilities.

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