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Avatar universal

Low Tsh, High T3, High T4 and Hashimotos

Hi,
Please can someone explain these thyroid numbers to me? I had a routine annual physical and these were the lab test results. The doctor said I had Hashimotos and that I should see an endocrinologist. I feel fine and have no symptoms. I am in shock reading about all this. I am 43 yrs, female.
Thyroglobulin Antibodies- 222( <or= 1 IU/ml)
Thyroid peroxidase Antibodies- 115(<9 IU/ml)

T3 uptake- 36 (22-35%)
T4 total- 15.5 (4.5-12.0 mcg/dl)
Free T4 index(T7)-5.6 (1.4-3.8)

T3 total - 175 (76-181 ng/dl)
TSH- 0.03(mIU/L)
4 Responses
Avatar universal
Of the tests done by your doctor, T3 uptake and Free T4 Index are outdated and not very useful.  Even the test for Total T4 and Total T3 would have been much more useful if they had been for the biologically active thyroid hormones instead, which are Free T4 and Free T3.  In the future, always make sure they test you for the Frees, instead of Totals.  So, based on that alone I expect that your doctor is not what you need, which is a good thyroid doctor.  That does not automatically mean an Endo.  

Many Endos specialize in diabetes, not Thyroid.  Also, many of them have the "Immaculate TSH Belief" and only want to use it for diagnosis and treatment.  That does not work.  If they go beyond TSH, and test for Free T4, then they will tell you that any test that falls within the reference range is adequate.  That is also wrong.  Due to the erroneous method used to establish the ranges, they are far too broad to be functional for many patients.  

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

Your TG ab and TPO ab tests do indicate Hashimoto's, which usually results in reduced T4 and T3 levels and an elevated TSH.  Since your results differ from that, it is likely that your Hashi's has also caused nodules on your thyroid gland, which can leak hormone faster than normal and cause elevated thyroid levels.  Hashi's patients often find that they start out with cycles of hyper, then hypo.  You can test to find out if this is the cause, by doing an ultrasound of the thyroid gland.  The reason you feel fine currently is that your thyroid levels are high enough to preclude hypo symptoms, in spite of the Hashi's.  But it is only a matter of time that your thyroid hormone levels will go down and you will start to have hypo symptoms.  

So in preparation for that I suggest that you can get some good insight from this link written by a good thyroid doctor.  

http://hormonerestoration.com/files/ThyroidPMD.pdf

Also, if you will tell us your location, perhaps we can suggest a doctor recommended by other thyroid patients.  
Avatar universal
Both TPOab and TGab are elevated, which indicates Hashi's.  

While Hashi's is ultimately hypothyroid, early stages can be hyper or swing from hypo to hyper.

Right now, all your labs are in the very high end of the ranges or over range, indicating hyperthyroidism.  Levels could continue to rise, or they could swing down again.  

No symptoms?  Weight loss or inability to gain weight, diarrhea, anxiety, insomnia, hand tremors, etc.

  
Avatar universal
Thank you very much for explaining the numbers to me. I am in the Houston area and will start looking for an Endo soon,
Avatar universal
As I mentioned previously you don't necessarily need an Endo, just a good thyroid doctor.  I just sent you a PM with a link to a doctor recommended by several hypo patients.  To access, just click on your name and then from your personal page, click on messages.  
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