Help interpreting results thyroid results PLEASE.

[ammy111]

I feel like I am underactive thyroid, and have the symptoms weight gain, insomnia, fatigue etc. But my tsh shows that it is over active. Does anybody know what this means?

TSH 0.01 (.50-5.00)
fT4 12.2 (9.00-25.00)
fT3 3.7 (3.5-6.5)

Thankyou

[Smilerdeb]

I have answered your other post.
Your TSI shows Graves Antibodies.

[poodle25]

EndymionJkb please read my post.  I have exp many problems over the years with my thyroid, but always told it is leveling out.  Told I am a little hyper at times and a little hypo at times.  I am taking vit D right now.  Antibodies tested neg, but the graves antibodies seem to be a high normal.  Can the antibodies increase and decrease over the years? My children have tested positive for the antibodies. One very hypo with a TSH of 38 and TPO antibodies only at 36. He has been on med for two years. Always having to increase. My other child has a normal levels with a TPO close to 200. They started him on med to control the antibodies so he will not go hypo, but I worry about if he goes hyper.  I am so confused. This is the 4th doctor we have been to.  Has see two endos.  Who didn't even want to run a Free T3. Breaks my heart that my children have to deal with this at such a young age.  Please read my post and see what you think. Thank you.

[EndymionJkb]

These labs don't make a lot of sense! I wonder, along with the doctor, if there are lab errors. Maybe you need to use a different lab.

The one set where you had T4 > 60 looked like hyperactive thyroid (not hypo). High T3/T4 levels can indeed suppress TSH to levels like that, without suggesting any pituitary issues. 0.01 TSH is explainable with hyperactive T4, and only looks odd with "normal" or low T3/T4 levels.

I agree with targeting symptoms vs. lab results (especially when they're inconsistent), and with getting off all meds for a while to see where you are, which it seems like you've done. I think you need a good endocrinologist to sort all this out! There can also be mind-body factors here; make sure you're eating right, exercising, sleeping enough, and managing stress.

These hormones are so interrelated, and vary so much during the day, I wouldn't get too worked up about individual results -- especially if the lab is suspect. Pituitary tests that are reliable require measuring *relative* response, not just TSH levels. By itself, TSH isn't very informative. For instance, they give you metyrapone at night and test you in the morning (a normal pituitary would respond be secreting tons of ACTH). Given the whole picture, I wouldn't worry too much about the pituitary.

It's a complex system of interrelated glands (pituitary, adrenals, thyroid, etc.), and not reducible to a couple numbers on a lab report. As for switching between hyper- and hypoactive thyroid, Hashimoto's can do that -- but you said you tested negative for antibodies (presumably Hashimotos).

Hashimoto's is the most common cause of problems (it's what I have), and should be ruled out first. Triggers for it, if you're genetically susceptible, include "gluten intolerance, too much iodine ingestion, pregnancy, perimenopause, heavy metal toxicity, gastrointestinal disorders, polycystic ovarian syndrome, insulin resistance and deficiency of vitamin D..."

You might try eliminating gluten (lots of unexplained problems turn out to be unrecognized food allergies, gluten intolerance foremost among them), or taking a little extra vitamin D.

There is also the much rarer Graves disease, which leads to hyperthyroid. Antibody screens can pick up either one, and distinguish between them.

[ammy111]

OK so could the jump from being underactive to being overactive and now underactive damage the pituitary? Could this be a reason why my tsh is suppressed?  Iam not taking anything at the moment. Could this be a possible reason???

[ammy111]

the refrence range for TF4 is (9.00-25.00) and for the TSH (.50-5.00). It was at 62.4 now has droped to 12.2. The tsh is the same 0.01.

I definitely don't feel underactive. My main concern is tsh, I dont know if its like that because I was possibly overmedicated. Im not sure what pituitary dysfunction means? Is there anything that can correct that? sounds scary  

[Barb135]

If you don't take anything else, your levels should be "natural" in a couple of weeks.  

What was the reference range for that FT4 of 62.4?  

[ammy111]

Sorry tsh was 3.2.  FT4 was 16 and the FT3 was 4.9.

I just wanted to see if someone might have any idea why tsh is soo low at 0.01. And what are some possible reasons for this?

I will have them retested in a months time, hopefuly they will go back to what they were. Just not sure how long to wait for the levels to go natural again

[Barb135]

You don't say what the reference range for that FT4 at 62.4 and the TSH of 0.01; results like that don't sound under active; instead they sound like over active.  

You said:  "I am just so upset cause they were better at the beginning of the year with my tsh at 3.2, tsh 16 and ft3 4.9. And my doctor says it doesn’t matter what tsh is cause everything is normal, he thinks Im insane."   I don't understand your "3.2 tsh, tsh 16'; which was your TSH level?  Was it 3.2 or 16?  

I agree with gimel - you need to get off anything you are taking for a while to let your levels go natural again, then go to a good thyroid doctor for proper testing and treatment.  With a TSH of 3.2, you are most likely hypo, even if it's within the range your lab is using.  

[gimel]

I think that you need to get to a good thyroid doctor that will treat your symptoms by testing and adjusting your FT3 and FT4, without worrying about your TSH level, other than testing for pituitary function.  Do you know anyone that could recommend a good thyroid doctor, based on their experience?  What area do you live in?

[ammy111]

Thankyou to everyone here who has offered their thoughts !

I have been struggling for years  with thyroid like symptoms. And have supplement my self with iodine in the past which has helped me minimise them to a degree, but I still struggle with my health. My symptoms include, insomnia, weight gain, mental physical fatigue etc  

I had seen a homeopath back in May who gave me a homeopathic powder which was suppose to help my thyroid. I went to the doctor in June and results came back that I was under active with my  ft4 at 62.4 and tsh 0.01.  I went back to her and she gave me something to help them go back to normal and these are the results now
TSH 0.01 (.50-5.00)
fT4 12.2 (9.00-25.00)
fT3 3.7 (3.5-6.5)
My doctor thought it was just a lab error and homeopathy wouldn’t have been able to do that.

I am just so upset cause they were better at the beginning of the year with my tsh at 3.2, tsh 16 and ft3 4.9. And my doctor says it doesn’t matter what tsh is cause everything is normal, he thinks Im insane.

I have been doing a bit of research, and am thinking maybe the tsh is that low because the homeopathic stuff may have been too much for me. Perhaps I was overmedicated? I know that sounds crazy because it was just a homeopathic, but that’s the only explanation I can come up with.

The tsh being so low, is that the brain trying to work it all out? Will my numbers  go back to normal? Is it a danger to my health? I dont know what to do, will they adjust and go back to normal? Im hoping to  retest in a months time not sure how long to wait though. What do people think?

[Barb135]

I don't see whether or not you are currently on thyroid med or if you are just now trying to get diagnosed.  That would be very helpful to know.

[gimel]

I agree with Endy that your TSH result, considered along with the in-range results for FT3 and FT4, indicates a possible pituitary function problem.  Your doctor needs to do some testing in that area.  

Given your hypo symptoms, I think that your FT3 and FT4 results are too low in the range.  The current ranges for FT3 and FT4 are far too broad, because they have never been corrected like was done for TSH over 8 years ago.  As a result we hear from many members that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least the midpoint.  Symptom relief should be the objective., The current reference ranges should be considered as guidelines within which to adjust thyroid hormone levels as necessary to relieve symptoms.  

In my opinion the best way to treat a thyroid patient is to test and adjust levels of the actual, biologically active thyroid hormones, FT3 and FT4, with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH levels.  If your doctor is unwilling to treat you in this manner, then you will need to find a good thyroid doctor that will do so.  

I think you will get further insight on this from reading the article in this link.
http://www.hormonerestoration.com/Thyroid.html

[EndymionJkb]

Well, given that you are having symptoms, I would definitely ask about that specifically. I'm not a doctor, but I have Hashimoto's myself and studied this extensively after being diagnosed. I think that TSH value needs to be explained; it's possible your doctor just didn't notice it. (The units should be mIU/L; make sure the units are right or you can't compare the numbers.) Some medications can suppress these levels as well.

TSH levels vary widely throughout the day, and may lag thyroid problems by months, so many doctors ignore it and just look at T3 and T4 to diagnose hypo- or hyperthyroidism. Your thyroid is probably fine, given those T3 and T4 levels. If there's a problem based on those numbers, I would look to the pituitary.

Maybe your doctor will have you repeat the test (since TSH varies so much). At any rate, I would ask for an explanation. Your doctor would know all your medications, current symptoms, and history, and should be able to interpret it based on all that. (Make sure he/she does have all that information; medical records are often incomplete!) Good luck!

[ammy111]

MY doctor didn't say much about it, cause the other ft3 and ft4 are within range.

My autoantibodies are within normal range.

Should I be worried that my tsh is that low 0.01 ? Should I be on anything for that? or shouldn't I worry about it?

Thanks for your comments.

[EndymionJkb]

Low TSH with normal (albeit low range) T3 and T4 can signal subclinical hypothyroid. However, your TSH is **really** low. It would typically be normal or only slightly low in Grave's or similar conditions.

Assuming you didn't make a typo on that number, I'd wonder about the pituitary, as in hypothalamic-pituitary dysfunctions. The pituitary secretes lots of hormones, and if it's not functioning well it might also explain those symptoms. What does your doctor say?

[Barb135]

Your FT3 and FT4 are both very low in their ranges, indicating that you are hypo, which correlates with your symptoms.  Those are the results that tell what your thyroid is actually doing.  TSH is a pituitary hormone and should not be used to diagnose a thyroid problem.  It is merely an "indicator" of a possible problem.

Are you currently on any thyroid med(s)?  Often when we are on thyroid meds our TSH is suppressed.

Have you been tested for autoimmune thyroid diseases?