Abnormal Thyroid Labs

[drkatzjr]

My labs results for the past 5 years are as follows:  I am 32/M


TSH 0.06  (below normal)   Note: 2 labs out of my 6 did show a very low, but slightly normal TSH.

T3: Always on the high-end of the normal range, but in normal range.
T4: Always nomal

Up-Take Scan: Results Interpreted by radiologist HYPOthroidism.  Low Uptake.   How can this be with
normal-high T3 and hardly functioning TSH?

Test for Hashimoto's: Negative  

MRI of pituitary gland:  Negative

My endo said that my dx was silent thyroiditis, and that the best course of action is "not to treat"
and that it should be "self-relenting.   What I have researched on silent thyroiditis is that it lasts for about
6mo, and the patient recovers (normal labs).  My labs have been the same for the last 5 years.

Thanks for any input you can provide.

[Mark Lupo, M.D.]

If it had not been a five year history of low TSH, I would have agreed w/ the endocrinologist on silent/painless thyroiditis which resolves on it's own.  The radiologist should not have interpreted the uptake as Hypothyroid -- this is a common mistake.  Hypo and Hyper are diagnosed on blood tests. If hyper, then the uptake can tell us why.  Low uptake - thyroiditis, normal/high - graves or hot nodules.

It is possible you had contamination with iodine (vitamins, diet, etc) - making the uptake look low.

So without evidence of pituitary disease (labs, MRI), with a history of low TSH for 5 years - this is either a toxic nodule or Graves disease.  If the ultrasound shows no nodule, it's Graves.   TSI and TBII lab test may help make the diagnosis.

Thyroiditis does not cause TSH to be low for 5 years.......

[drkatzjr]

My labs results for the past 5 years are as follows:  I am 32/M


TSH 0.06  (below normal)   Note: 2 labs out of my 6 did show a very low, but slightly normal TSH.

T3: Always on the high-end of the normal range, but in normal range.
T4: Always nomal   FT3/T4 Normal

Up-Take Scan: Results Interpreted by radiologist HYPOthroidism.  Low Uptake.   How can this be with normal-high T3 and hardly functioning TSH?

Test for Hashimoto's: Negative  

MRI of pituitary gland:  Negative

My endo said that my dx was silent thyroiditis, and that the best course of action is "not to treat" and that it should be "self-relenting.   What I have researched on silent thyroiditis is that it lasts for about 6mo, and the patient recovers (normal labs).  My labs have been the same for the last 5 years.

Thanks for any input you can provide, it would really mean a lot.