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  • Help!! Confused by lab results.

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    Old 10-23-2008, 09:48 AM   #1
    kturk
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    Help!! Confused by lab results.

    I just got my lab results back and I am super confused!! My appointment with the endocrinologist is not until January so any input given would be greatly appreciated.

    TSH .1
    Free T4 1.05
    Free T3 3.0


    Cholesterol 215
    Tryglisorites 229

    Vitamin D deficient (told me to start a supplement right away)

    I have several symptoms of hypothyroidism. I have gained 15 pounds in a month, I have mental fog, fatigue, pain in joints, course hair, dry itchy patches of skin, etc..

    A have a few symptoms of hyperthyroidism as well. Loose stools, heat intolerance, and extremely dry eyes every morning.

    Based on my lab results my doctor diagnosed me as HYPER. I am wondering if it may be secondary hypothyroidism and am reluctant to start meds for hyperthyroidism until I have seen the endocrinologist.

    Any thoughts?

    Also, I had an ultrasound and it showed that my thyroid was swollen.

    Last edited by kturk; 10-23-2008 at 09:55 AM.

     
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    Old 10-23-2008, 10:11 AM   #2
    mkgb
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    Re: Help!! Confused by lab results.

    What were the ranges for your Fts. The Ft4 and Ft3 do not look hyperT in my book.. They actually would be suboptimal of HYPO given my lab ranges. Your MD may be going by your TSH alone. That is a BAD way to treat thyroid issues. I due believe you have an issue. I do not know if I would be jumping on the hyperT band wagon with out ruling out pituitary dysfunction and hashimoto's thyroiditis.

    Post the ranges to go with your FTs. I can assume a 2.3-4.2 range on the FT3.. that is the most common one. The FT4 ranges vary widely. My main ones are 0.8-1.8 and 0.61-1.76 dependent on the lab used. You would be at 25% of the normal range by the .8 FT4 range. Your FT3 level would be 36% of range according to my Ft3 range. These would both put you suboptimal in my opinion.

    You need Hashimoto's and Graves antibody testing (TPOAB, TGAB, TSI, TRAb) as well as a complete evaluation of your pituitary gland(ACTH). I would not take a PTU given the level of your FTs. Early in Hashimoto's you can have IBS, hyperT mimicry, anxiety and much more. You are not hyper according to your thyroid hormones. Your pituitary gland is however not producing an adequate TSH to tell your thyroid to make more hormone.

    MG
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    Old 10-23-2008, 10:15 AM   #3
    mkgb
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    Re: Help!! Confused by lab results.

    Oh and given your triglycerides have your Endo run a PCOS and insulin resistance profile on you. GTT, Insulin, Estrogen, testosterone, progesterone, LH, FSH, DHEA, cortisol, IGF. HE/She should know those names and lab codes.. if not the lab tech can look them up.

    MG
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    Old 10-23-2008, 10:27 AM   #4
    kturk
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    Re: Help!! Confused by lab results.

    Thanks so much for your reply.

    The nurse told me today that the normal levels according the lab are...

    T4 .71 - 1.85
    T3 .145 - 3.48

    She said mine where in normal range and not to worry. She again told me I was hyper. I told her that I thought my T4 would be higher if I was hyper. Her response was "everybody is different"

    I am so frustrated and January seems so far away.

     
    Old 10-23-2008, 11:05 AM   #5
    mkgb
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    Re: Help!! Confused by lab results.

    How old are you? Haave you been through menopause? Your Nurse is going by TSH as is your MD. I have a feeling you are dealing with TSH watchers.

    Free T4 1.05 .71 - 1.85
    Free T3 3.0 1.45 - 3.48

    You are 29% of the normal range in T4 there is NO way even if you were menopausal that you are hyperT in T4. 95% of the population with a normal functioning thyroid sits in the 50-80% range of normal. The NURSE needs to hit her books again and research more into thyroid issues.

    Now let us look at your FT3. You are at 76% of the normal range. This imbalance smacks of pituitary disfunction and adrenal issues in conjunction with thyroid issues. If your MD treats you as hyperT when you have adrenal induced T3 elevation he is going to send you into hypoT HADES!

    You need a fll antibody panel run:
    TPOAb
    TGAB
    TSI
    TRAb
    You also need your pituitary function checked (Prolactin and ACTH)
    You need a fasting 8 am blood cortisol test, ACTH Stim Test, ACA adrenal antibody test and saliva/urine cortisol rhythm test.

    Anything less would be insufficient care in my opinion. IN MY OPINION you are not hyperT. Your T3 levels are optimal.. your T4 levels are in the tank. The T4 T3 imbalance is a CLASSIC sign of low cortisol hypoadrenal effect on thyroid hormone conversion.

    How do I know? Been there done that. I have Hashimoto's, Graves, Hypoadrenalism, PCOS, Insulin resistance, and reactive hypoglycemia. I made my MDs do the tests and I helped them find all my issues. You can not trust your MD to take into account all your issues. On average they cling to the most OBVIOUS symptom.. your TSH in your case and refuse to find the source of your issue. MAKE them prove you are hyperthyroid by doing the right tests.

    MG
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    Old 10-23-2008, 04:39 PM   #6
    kturk
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    Re: Help!! Confused by lab results.

    Bless your heart. I did not know that you could have Graves and Hashimotos at the same time. I have been searching the web trying to educate myself on thyroid issues and feel pretty overwhelmed right now. My doctors office makes me feel so stupid when I call to ask questions.

    I am 34 and have not gone through menopause. Actually I have not been to the doctor (except OB) in over 10 years. We have 4 children and I just thought my symptoms were a result of being a busy mommy.

    I have always been a healthy weight although I must admit I do not follow the best diet.
    I do not overeat and keep snacks to a minimum.

    Thanks so much for your advice. Should I ask my MD (whom I have not been impressed with) to run these tests or should I wait and ask the endocrinologist?

     
    Old 10-23-2008, 05:24 PM   #7
    mkgb
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    Re: Help!! Confused by lab results.

    Any MD can write the order for the tests. I would ask the MD to run them so you had the data on hand for your first Endo visit. It will save time and you can get a copy of the results and check with us here about them. We can help you understand what we see due to our experience and you will be able to go into your Endo and know if they are worth their salt. I have researched and looked into 4 Endos in my town and one half way across the state. All of them failed to treat my issues well. My best luck was with an Internal Medicine MD that is part of an Integrative Medicine Clinic. SHe was up on the latest ranges and levels and willing to listen to me and my symptoms. Together we have done all the leg work. The last Endo I went to, asked me how I determined the need for adrenal testing. He is now looking at his patients blood work in a new light. ME? Well he told me that there was nothing he could do.. just keep doing what me and my IM had worked out. Well that is one more specialist I can avoid paying.

    But back to you. Given your 4 pregnancies and age you really need the antibody testing done. You also need to look over your T4 and T3 imbalance. I strongly suspect that it is hypoadrenal in nature. If your OB/GP will not test you.. they should for the thyroid AIs given they put you in the high risk pregnancy category.. look at other MDs around you and find one that is will to prescribe Armour of T3 supplementation. Those that prescribe T3 tend to be a little more forward thinking.

    I have some threads that you may find useful:

    These are basic threads on thyroid care and concerns.. what I consider the basics.
    [url]http://www.healthboards.com/boards/showthread.php?t=597479[/url]
    [url]http://www.healthboards.com/boards/showthread.php?t=599141[/url]

    This is a thread about hypothyroidism and pregnancy:
    [url]http://www.healthboards.com/boards/showthread.php?t=585150[/url]

    I truly hope you get help soon.
    MG
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