Low TSH, Normal FreeT4, Low Free T3?

[mosesgt]

As a general psychiatrist I test a lot of people for thyroid disorders. I usually test TSH & Free T4 (FT4), since I frequently see clinically relevant hypothyroid sx (that also happen to be sx of depression) in people with TSH >3. In those people, I like to see the FT4.
I recently had a 35 yo, white female, not on hormones of any sort, including OCP. She complained of breast milk after taking 25mg of Seroquel, which has almost no proclivity to do that. 2 weeks after stopping the Seroquel, there was no change in the galactorrhea. She also said she was hypoglycemic & had a remote hx of significant head injury. Her labs were as follows:
TSH- 0.336 (0.4- 4)
FT4- 1.15 (0.8-1.9)
FT3- 2.3  (2.4-4.2)
Prolactin 112  (1.9-25)
Fasting Insulin 4 (3-19)
T.Chol 202, LDL 104, VLDL 12 & HDL 86
She was in the leuteal phase of her cycle, according to the LH, FSH & estradiole E2.

I am really curious about what appears to be conflicting thyroid tests, but threw in the others since I know everything affects everything in this wonderful creation of the human body. I am planning on testing the reverse T3 (rT3), but I saw a negative article from one of you on the usefulness of that test. I thought the rT3 could inhibit the conversion of T4- T3 & still provide negative feed back to the pituitary, thereby causing a low TSH. Is that accurate? I will obviously refer to an endocrinologist, but should I do the rT3 or maybe an TRH? I recognize that the anterior pituitary affects both the TSH & the prolactin. Maybe we should scan her brain before sending to endo? Any guidance will be greatly appreciated.
George Moses, D.O.

[kitty9309]

You may get more responses if you post this as a seperate thread.

However, it appears that you have hypothyroidism. The TSH is thyroid stimulating hormone and it increases to try to get your thyroid to produce more thyroid hormone (free t4). It is an inverse relationship between the 2.

Is the doctor going to repeat the blood work in a few weeks to confirm that this is permanent and not transitory thyroiditis? It would be a good idea before taking meds for hypothyroidism.

You can also request to have your blood checked for thyroid antibodies.

[Bev170]

Will someone please define the following?

TSH - Thyroid elevated to 17.81
FreeT4 - .5 low

The nurse offered the above information following blood tests.  What does this indicate?

[GravesLady]

There is no doctor at this particular forum.

However, you can reach the Doctor Thyroid Forum and ask Dr. Lupo at http://www.medhelp.org/forums/show/120      OR
at left of page almost top, under "Thyroid Disorders" in red click on "thyroid" it will take you to the forum.

If you have posted more than one post per the sites rules for doctors forums, you probably won't get answered.  Or if the forum is full and not taking any more questions for the day, you can try another day.