Can you help with thyroid results? I have been having symptoms of hypo.

[annmariei]

Here are the lab results:  
T3 uptake was 38 ( 22 - 35 normal range)
T4 6.1 (4.5-12.0 range)
Free T4 2.3 (1.4-3.8 range)
TSH .99 (.4 - 4.5)
T4 free 1.2 (.8-1.8)
T3 free 2.8 (2.3-4.2)
T3 total 74 (76-181)
T3 reverse 14 (8-25)
TBG 13.5 (13.5-30.9)

[gimel]

In assessing a patient for possibility of hypothyroidism the most important consideration is whether the patient has symptoms that occur more frequently with hypothyroidism than normal.  You have a  number of symptoms like that.  In addition, thyroid status is the direct effect of what is called Tissue T3 Effect.   Tissue T3 Effect results from the supply of, and response to, thyroid hormone at the tissue level.  There are a number of processes and variables that create Tissue T3 Effect, so there is no biochemical test that is adequate to be a pass/fail diagnostic for thyroid status.  Having thyroid test results like yours  does not preclude hypothyroidism.

A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH levels.  

You can read about all this in the following link.  I highly recommend reading at least the first two pages, 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

[Barb135]

Hi there...

Can you tell us what symptoms of hypo you do have?

Were all the test results obtained in the same blood draw?  If so, can you explain why there are 2 Free T4 tests and why they have different reference ranges?

The Free T4 of 2.3 (1.4-3.8) puts your Free T4 at 38% of its range, when it's recommended that Free T4 be about mid range.  Your Free T3 is only at 26% of its range and it's recommended that Free T3 be maintained in the upper half to upper third of its range.  That means your levels do indicate hypothyroidism.

Some of the other tests, such as T3 uptake, Total T4 and Total T3 are obsolete and don't tell us much of anything.  

It is surprising, however, that your TSH is as low as it is, with your actual thyroid hormone levels as low as they are.  This would make us suspect Central, or Secondary, hypothyroidism, in which the thyroid might work fine, but there's a problem in which the pituitary gland doesn't produce enough TSH to stimulate the thyroid adequately to produce enough thyroid hormones.

I'm not sure why the TBG was ordered.  That's a protein that carries thyroid hormones through the blood and is not, typically, used in the diagnosis of a thyroid condition.

You might ask your doctor to order thyroid antibody testing to rule out or confirm Hashimoto's Thyroiditis, though.  The tests you need for that are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  You need them both, as some of us have one or the other and some of us have them both...

[annmariei]

thanks for the reply.  There were Three things with T4:

T4 (Throxine), Total 6.1
Free T4 Index (T7) 2.3
T4, Free 1.2

Thyroglobulin antibodies <1
Thyroid Peroxidase Antibodies 1
TBG 13.5

Symptoms:
fatigue, weight gain, constipation, dry skin, intolerance to cold, eyebrows are almost gone,depression, high cholesterol

[annmariei]

Yes, all the blood work was done at the same time.  I had the blood work done myself at a lab.