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Help with test results for thyroid
My free T3 is 2.82, free T4 is 1.01, TSH 4.5808, thyroid peroxidase AB 26, thyroglobulin AB 6.5 which is believe is way high. Please help me determine the best next step.
Your Thyroglobulin antibodies test indicates primary hypothyroidism due to Hashimoto's Thyroiditis. With Hashi's the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland. As this proceeds, the TSH level rises in an effort to stimulate more output of thyroid hormone. You are likely in the early stages of Hashi's based on your test results, but you are already suffering with symptoms that are frequently related to being hypothyroid.
Even though your FT4 and FT3 results are within range, that does not preclude having hypo symptoms. Most doctors like to think that hypothyroidism is just inadequate serum thyroid hormone, correctly sensed by the pituitary gland, which then secretes TSH. So they really only pay attention to TSH for diagnosis and treatment. This is very wrong and results in most hypo patients being dissatisfied with their diagnosis and treatment. The correct definition of hypothyroidism is "insufficient T3 effect in tissues throughout the body due to inadequate supply of, or response to, thyroid hormone". This definition takes into account the additional processes and variables that affect what is called T3 effect. Inadequate T3 effect equates to being hypothyroid.
A good thyroid doctor will take an integrated approach to diagnosis and treatment starting with a full medical history, evaluation to identify signs/symptoms that occur more frequently with hypothyroidism (such as you have), and extended biochemical testing. In your case the tests the additional that should be done are for Reverse T3 and Free T3 (done from same blood draw), cortisol, Vitamin D, B12 and ferritin. Also, with your TG ab result you should have an ultrasound of the thyroid gland to assess its physical condition. With all this in hand your doctor should be willing to render a diagnosis of hypothyroidism and initiate a therapeutic trial of thyroid medication adequate to raise your FT4 and FT3 and determine the effect on symptoms. If symptoms improve, further increases in thyroid med should be adequate to relieve hypo symptoms without creating any signs/symptoms of becoming hyperthyroid. Note that a patient's thyroid hormone dosage should not be based on resultant TSH levels.
If your doctor disagrees with this, you will need to either provide enough information to get him to revise his position, or else find a good thyroid doctor that will test and treat as described. If you need information to persuade your doctor, I highly recommend reading the first two pages of the following link, and more, if you want to get into the discussion and scientific evidence for all that is recommended.
http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf
Even though your FT4 and FT3 results are within range, that does not preclude having hypo symptoms. Most doctors like to think that hypothyroidism is just inadequate serum thyroid hormone, correctly sensed by the pituitary gland, which then secretes TSH. So they really only pay attention to TSH for diagnosis and treatment. This is very wrong and results in most hypo patients being dissatisfied with their diagnosis and treatment. The correct definition of hypothyroidism is "insufficient T3 effect in tissues throughout the body due to inadequate supply of, or response to, thyroid hormone". This definition takes into account the additional processes and variables that affect what is called T3 effect. Inadequate T3 effect equates to being hypothyroid.
A good thyroid doctor will take an integrated approach to diagnosis and treatment starting with a full medical history, evaluation to identify signs/symptoms that occur more frequently with hypothyroidism (such as you have), and extended biochemical testing. In your case the tests the additional that should be done are for Reverse T3 and Free T3 (done from same blood draw), cortisol, Vitamin D, B12 and ferritin. Also, with your TG ab result you should have an ultrasound of the thyroid gland to assess its physical condition. With all this in hand your doctor should be willing to render a diagnosis of hypothyroidism and initiate a therapeutic trial of thyroid medication adequate to raise your FT4 and FT3 and determine the effect on symptoms. If symptoms improve, further increases in thyroid med should be adequate to relieve hypo symptoms without creating any signs/symptoms of becoming hyperthyroid. Note that a patient's thyroid hormone dosage should not be based on resultant TSH levels.
If your doctor disagrees with this, you will need to either provide enough information to get him to revise his position, or else find a good thyroid doctor that will test and treat as described. If you need information to persuade your doctor, I highly recommend reading the first two pages of the following link, and more, if you want to get into the discussion and scientific evidence for all that is recommended.
http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf
1 Comments
what a wonderful blessing you are!!! may you be blessed 10 fold for your goodness.
Thank you so much for your reply:
Thyroid Peroxidase AB: my result 26, reference 0-34 IU/ML
Thyroglobulin AB: my result 6.5, reference 0.0 - 0.9 IU/ML
Free T3: my result 2.82, reference 1.71 - 3.71 pg/ml
Free T4: My result 1.01, reference 0.70-1.48 ng/dl
TSH: my result 4.5808, reference 0.35-4.94 uTU/ml
Those are my results. I was told in December that it felt like I had a nodule on my Thyroid. Since waiting to see an endocrinologist I asked my general practitioner to order the test so I would be ahead of the game when I finally got in with the specialist. I am exhausted all the time. I don't sleep much. Acid reflux is a major problem. I do have a gallstone and will be having my gallbladder out soon. I am overweight and I am considering the gastric sleeve. I have recently been on antibiotics, flonase for respitory infection. I take over the counter meds all the time for acid. I also have psoriasis and have started taking otezla. In finding the gallstone, they also looked at kidney and liver on the sonogram and they look fine.
Thank you again.
Thyroid Peroxidase AB: my result 26, reference 0-34 IU/ML
Thyroglobulin AB: my result 6.5, reference 0.0 - 0.9 IU/ML
Free T3: my result 2.82, reference 1.71 - 3.71 pg/ml
Free T4: My result 1.01, reference 0.70-1.48 ng/dl
TSH: my result 4.5808, reference 0.35-4.94 uTU/ml
Those are my results. I was told in December that it felt like I had a nodule on my Thyroid. Since waiting to see an endocrinologist I asked my general practitioner to order the test so I would be ahead of the game when I finally got in with the specialist. I am exhausted all the time. I don't sleep much. Acid reflux is a major problem. I do have a gallstone and will be having my gallbladder out soon. I am overweight and I am considering the gastric sleeve. I have recently been on antibiotics, flonase for respitory infection. I take over the counter meds all the time for acid. I also have psoriasis and have started taking otezla. In finding the gallstone, they also looked at kidney and liver on the sonogram and they look fine.
Thank you again.
4 Comments
I have had a full hystorectomy. Between nausea which i think may be gall sludge, hot flashes and acid reflux I don't sleep long at all. I have been told I don't sleep more than 10 minutes at a time unless i take something to knock me out which i do not like to do. I just think my whole body is out of whack.
Also not sure if it make any difference I had the blood pulled first thing in the morning before I had eaten anything.
also poor memory and brain fog
my stool lately (2 weeks) has been very soft to diarhea but I was assuming it was because of all of this flem, etc.
There is a lot to discuss, but first please post the reference ranges shown on the lab report for those tests. Also, even more important is symptoms. So please tell us about any symptoms you have.
1 Comments
I am a new user and replied in the answers section instead of hear under your question. Forgive my ignorance.
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