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    Old 09-25-2007, 07:36 AM   #1
    Petra1979
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    Please help with these labs...

    Ok, so I just got the lab results back and I am so confused. My TSH and Free T4 are significantly higher than the last time they did them (about a month ago) and now I don't know what to think. Please give me your opinion on these:

    TSH - 1.190 (.350-5.5)
    FT4 - 1.01 (.89-1.76)
    Total T4 - 6.5 (4.5-10.9)
    T3 Uptake - 32.2 % (22.5-37)
    Ft4 Index - 2.1 (1.2-4.4)
    Antibodies - 1.0 (< 9.0 considered negative)

    What do you all think? I have thyroid nodules that are affecting my swallowing and my speech as well as a lot of hypoT symptoms. I am having an ulstrasound on Oct. 5th.

    Thanks in advance for an insight!

     
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    Old 09-25-2007, 09:30 AM   #2
    Petra1979
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    Re: Please help with these labs...

    Anyone have any thoughts? I am getting so frustrated, I feel like my endo. is going to blow me off because of these results, but something tells me they are not as great as she may try to get me to believe.

    Help!

     
    Old 09-25-2007, 09:30 AM   #3
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    Re: Please help with these labs...

    Quote:
    Originally Posted by Petra1979 View Post
    Please give me your opinion on these:

    TSH - 1.190 (.350-5.5)
    FT4 - 1.01 (.89-1.76)
    Total T4 - 6.5 (4.5-10.9)
    T3 Uptake - 32.2 % (22.5-37)
    Ft4 Index - 2.1 (1.2-4.4)
    Antibodies - 1.0 (< 9.0 considered negative)
    Well I am not an expert.. but your TSH is normal.. almost optimal. However your FT4, TT4, and FT4I are all low.. with a normal T3 Uptake. It would be nice to have had a TT3 or FT3 as well. Which Antibodies were run? TPOAb?

    From what I can dig up on these readings there are two things to look at..
    secondary hypothyroidism (Pituitary and hypothalamic diseases are causes of secondary hypothyroidism) and hypothyroxinemia (Just have low T4 for some unknown reason).

    Hypothyroidism may be caused by chronic autoimmune thyroiditis/Hashimoto's disease.. you are clear of antibodies there so it is unlikely this is your problem.. but 5% of Hashi's do not have positive Ab tests.
    Thyroid treatment with radioactive iodine, external radiation.. not a problem for you given your history.
    Defective iodine metabolism.. your uptake is pretty good.
    Iodine deficiency or excess.. it wouldn't hurt to check this...
    Lymphoma of the thyroid gland, and medications, such as antiT drugs, lithium, interferon, or goitrogenic chemicals.

    I am not saying you have any of this stuff.. just listing known causes.. I didn't include pregnancy or post partum thyroiditis.. thinking you would have mentioned if you were preggers..

    So we know your FT4, T4, and FT4I are low.. TSH is normal.. and you have hypo symptoms (this is actually a good thing.. cancer and such normally do not have symptoms just growth from what I have read until it has progressed significantly).. so I am betting on secondary hypothyroid. Maybe you can get blood work drawn and your TT3, FT3 tested. If these are low.. then you should push for a T3/T4 combo medication to get you at optimum.

    Best of luck on your scan. You are not imagining things and your results are off even if you have a normal TSH.

    Sincerely,
    MG
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    Last edited by mkgb; 09-25-2007 at 09:32 AM.

     
    Old 09-25-2007, 09:40 AM   #4
    Petra1979
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    Re: Please help with these labs...

    Thank you so much for the reply, I am thinking along the same lines, but I feel like I am crazy because the doctors just keep saying that I am "in the normal range" UGH! It is so nice to have a sounding board here to turn to.

    Anyone have any experience with Secondary HypoT and could you share your numbers? Thanks!

     
    Old 09-25-2007, 09:47 AM   #5
    mkgb
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    Re: Please help with these labs...

    Get the iodine tests and such run.. it may be iodine deficiency.. but if it isn't then something is keeping your blood T4 concentrations too low... and since you have symptoms ask to get your T4 and possibly T3 into optimal ranges. Make sure they test you T3 levels... many studies link symptoms to not enough T3 in your system.

    Desired FT4 range on the NACB website.. lots of digging and reading and searching involved.. is 1.33-1.55 for the lab ranges you presented what they can middle to middle high range. Same holds for the TT4 you would want a number between 7.7 - 9.3.. yours is too low.. aime for the middle to middle high range. Same holds for T3 or FT3 desired levels are 60-85% in the reference range.

    Best wishes.. make sure you leave all bats and clubs at home.. just incase your MD tempts you too much. I have ran into a few that made me want to knock sense into them.

    Sincerely,
    MG
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    Old 09-25-2007, 09:58 AM   #6
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    Re: Please help with these labs...

    Hi Petra, My numbers are all in the lower end of the range which might suggest secondary HypoT. I am awaiting an appt. with an endo for second week in Oct. as I just went to a new family doctor who immediately referred me after YEARS of trying to figure out if there is a problem or I am crazy. Here are my numbers....like yours but a little more off....still lower end of normal...

    Previous TSH .65 (1995) .87 (2003) 1.93 (2006) .793 (8/10/07)

    End of August:
    TSH 1.516 (.35-5.5)
    Free T3 2.5 (2.3-4.2)
    Free T4 .97 (.61-1.76)

    Total T4 5.7 (4.5-12)
    T3 Uptake 32 (24-39)
    Free Thyroxine Index 1.8 (1.2-4.9)

    TPO Ab 21 (0-34)
    Antithyroglobulin Ab (Tg Ab) 22 (0-40)

    Ferritin 24 (10-291)

    I think we may have a breakthrough of sorts. I suffered a post partum hemorrhage 20 years ago which may be causing this (Sheehan's Syndrome). It MAY NOT be this but I am sure the endo will look more into it. I am also having Estradiol, Vitamin D, Ferritin (again) and many other things checked and am waiting for results.

    I can't do much to help you but can certainly empathize with how you feel. Hoppy

     
    Old 09-25-2007, 10:03 AM   #7
    Petra1979
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    Re: Please help with these labs...

    Wow, our numbers are really similar. I am so curious as to whether my endo. is going to take my concerns seriously or not. When do you see your endo? I go October 15th after my ultrasound on the 5th. I hate all this waiting!

     
    Old 09-25-2007, 12:32 PM   #8
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    Re: Please help with these labs...

    I go back to the family doctor first on Oct.2nd. She wants me back to discuss blood test results from the extra tests I had done last week. I can't getthe results over the phone but I am hoping the lab will mail my copy before then. I guess there are some issues but nothing serious enough to go in before next Tuesday. Then I go to see the endo on Oct. 9th. Oh yeah, this new doc....bless her heart....was the first to actually feel my thyroid in years and said it is slightly enlarged and harder than she would have expected. Hoppy
    PS. I think it is mm that has similare numbers as well???

    Last edited by hopalong_too; 09-25-2007 at 12:33 PM.

     
    Old 09-25-2007, 02:09 PM   #9
    Petra1979
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    Re: Please help with these labs...

    I really hope that these doctors take our concerns seriously, because otherwise I am finding another one. But I really don't want to have to go through the whole process of finding another one and waiting for an appt.! The only good thing would be that I could just take all my test results to the new dr. to evaluate. How do I find an endo. that I know will look at the whole picture though? I just wouldn't even know where to begin. *Sigh.

    Any ideas?

     
    Old 09-25-2007, 05:16 PM   #10
    m. m.
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    Re: Please help with these labs...

    Yes, I'm the other one on the board right now with funky low labs. Several labs over past year show a decreasing FT4 with inappropriate TSH level. My doc agrees I have some kind of secondary thyroid dysfunction however he has been trying to kickstart my pituitary/hypothalamus with nutrition/supplements vs. thryoid meds as I was deficient in many things when he checked. But this approach doesn't seem to be working after 4 months as my FT4 has gone down and I continue to feel worse. I go back on 10/4 and will be having the "I think it's time for meds" discussion. My ferritin is 30 (too low) and I'm low in a handful of other hormones/vitamins/minerals. I have a chart that shows FT4 and TSH levels of people diagnosed with primary and secondary hypothyroidism and my levels are consistent with others who are secondary hypo. When you look at those with primary hypo-t, my FT4 levels are the same as people whose TSH levels were between 10 and 100. So, in my mind, if FT4 is the active hormone and others are diagnosed with FT4 levels higher than mine (they just have out of range TSH to go with it) what makes them any different from me in terms of there being enough FT4 hormone in my body just because their pituitary glands are working well and sending the TSH signal (vs. mine whose isn't working so well).

    9/06:
    TSH: .86 (.34-5.60)
    FT4: .90 (.58-1.64)

    2/07:
    TSH: .78 (.34-5.60)
    FT4: .76 (.5-1.5)

    4/07:
    TSH: .69 (.4-5.5)

    8/07:
    TSH: 1.29 (.34-5.60)
    FT4: .70 (.5-1.5)

    Looks like with the last lab my pit. gland is trying to send message to make more FT4 - but signal not strong enough????

    Lets keep each other posted on progress since it seems we are all going to doc in near future!

    Michelle

     
    Old 09-26-2007, 06:26 AM   #11
    Petra1979
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    Re: Please help with these labs...

    So your doctor definitely thinks it's secondary HypoT? Does he want to do any testing to see if you have any growths on the pituitary? I am curious as to whether my endo. will want to check this out or not.

    Thanks for sharing, I hope that you get started on meds and see an improvement!

     
    Old 09-27-2007, 08:50 AM   #12
    Petra1979
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    Re: Please help with these labs...

    Anyone else have any thoughts on these labs?

    TSH - 1.190 (.350-5.5)
    FT4 - 1.01 (.89-1.76)
    Total T4 - 6.5 (4.5-10.9)
    T3 Uptake - 32.2 % (22.5-37)
    Ft4 Index - 2.1 (1.2-4.4)
    Antibodies - 1.0 (< 9.0 considered negative)

    Thanks!

     
    Old 09-27-2007, 09:04 AM   #13
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    Re: Please help with these labs...

    This is just my lay opinion; your thyroid hormones are below median range, which may not be enough for your needs and could be causing symptoms and maybe even the nodules. The total T4 is particularly lacking. It would be extremely useful to have a free T3 test run.

    You're going to have a tough time, though, finding an MD willing to give you a trial of supplemental hormone... especially an endo. Most endos are notorious for going strictly by TSH and for ignoring low thyroid levels altogether.

    I wish I could be more positive for you. If you find a holistic-minded MD or DO, you may have better luck with being allowed a treatment trial.

     
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