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Husband's Thyroid Labs

Hello, I have hypothyroidism and I've noticed my husband is having the same symptoms. His mom has hypothyroidism, lupus and fibromyalgia. He got some blood work done at his GP and the GP said his thyroid is normal. I just looked at the labs and I think they are definitely NOT normal. He has an appointment with an endocrinologist next month. Would y'all be so kind to look at his labs below?

FT3:  2.7  pg/ml (2.2-4.2)
T4 (thyroxine):  4.6  ug/dl  (4.5-10.5)
TSH, 3rd Generation: 3.210 UIU/ML  (0.400-4.100)

Thanks!!
3 Responses
Avatar universal
The correct definition of hypothyroidism is "insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone".  So it is not just the level of thyroid hormones, but the response to them, which is affected by a number of variables.   As a result TSH has only a weak correlation with even the levels of thyroid hormones Free T4 and Free T3, and a negligible correlation with TISSUE T3 EFFECT, which determines a person's thyroid status.  Even individual Free T4 and Free T3 results have only  weak correlation with with TISSUE T3 EFFECT.   So there is no blood test that is a reliable diagnostic for thyroid status.    The best indicator of potential hypothyroidism is an evaluation for  symptoms that occur more frequently with hypothyroidism.  

So before discussing your husband's test results please tell us about all symptoms that he has.   And while you are at it,  please tell us about the symptoms you have as well, along with your test results and thyroid medication and daily dosage.  .
Avatar universal
My husband's symptoms are primarily extreme fatigue, body aches esp in joints, brain fog and weight gain. These symptoms have been going on for months. I am well medicated now and feel good (daily 100mcg Synthyroid, felt horrible on Levo but everything improved on Synthroid). My symptoms consisted of extreme fatigue, depression, hair loss, dry skin and nails, brain fog, joint pain. I still have some symptoms now and then but for the most part I feel good. The patient portal at my doctors office is down so I cant get my most current results, but here is some from a post I did a while ago.

Labs June 28, 2016:
TSH: 1.82 (0.47-4.68)
FT4: 0.94 (0.60-1.80)
FT3: 2.91 (2.00-5.27)

Labs Feb 2016:
TSH: 1.32 (0.47-4.68)
FT4: 0.94 (0.60-1.80)
FT3: 3.40 (2.00-5.27)
Avatar universal
Your husband has a number of symptoms that are typical of hypothyroidism.   Along with that his Free T3 of 2.7 is only at 26% of the range, which is too low for many people.    He was not tested for Free T4, as should always be done,  but instead tested for Total T4, which was near the very bottom of its range.  TSH is inadequate as a diagnostic for thyroid status, unless it is at extreme levels, which is not the case for your husband.       Those FT3 and TT3 levels seem to indicate that his body is trying to convert extra T4 to T3 in an effort to maintain thyroid function as well as possible.  

Most doctors, including Endocrinologists, will look only at your husband's test results and tell him that they are within the "normal" range and that he doesn't have a thyroid problem.    That is incorrect, there is sufficient evidence for hypothyroidism and that he needs to be on thyroid medication adequate to get his FT4 to about mid-range, and his Free T3 into the upper part of its range, and adjusted from there as needed to relieve hypo symptoms.   What he needs  is a good thyroid doctor that will diagnose and treat clinically, based on symptoms, not just test results and especially not TSH results.  

Your results are kind of what I would expect with you being on 100 mcg of T4 med.  Both FT4 and FT3 are about 28% of their reference ranges, which is lower than most people seem to need.  I expect that those levels are the reason why you still experience some symptoms, and I expect that you probably tend to overlook some of those.    AS I mentioned, most of us have found that for symptom relief  we needed for FT4 to be about mid-range, and FT3 to be in the upper half of its range, adjusted as needed to relieve symptoms.    I expect that your doctor is adjusting your med dosage based on keeping your TSH in range, which is wrong.    Taking a large dose of thyroid med once daily is totally different from the continuous low flow of thyroid hormone in the untreated state.  A single large dose tends to suppress  TSH for the day.  That does not mean hyperthyroidism, unless there are accompanying hypo symptoms due to excessive levels of FT4 and FT3.  

So both of you need to either get your doctor to diagnose and treat clinically, based on symptoms, supported by FT4 and FT3 test results, rather than based on TSH, or other test results alone.  I also suggest that you ask the doctor if he is willing to prescribe T3 meds like NatureThroid, Armour Thyroid, and Cytomel when needed to raise FT3 levels.  If either answer is no, then you are going to have to find a good thyroid doctor that will do so.  If you get to that point, and will give us your location, perhaps we can give you names of doctors  recommended by other thyroid patients.

Before I forget, at first opportunity you should also ask to be tested for Vitamin D, B12 and ferritin.  All three have an effect on the response to thyroid hormone.   D should be at least 50 ng/mL, B12 in the upper  part of its range, and ferritin should be at least 100.

If you want to confirm what I have said, click on my name and then scroll down to my Journal and read at least the one page Overview of a full paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.  
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