Aa
Low free T3 high free T4
My wife aged 40 years (wt 65kg) developed erratic menstrual bleeding symptoms during last 30days. The Doctor recommended many tests out of which the following results were found abnormal : Free T3 was 1.38 pg/ml and Free T4 > 6 ng/dL. TSH was 2.520 ulU/mL . She has diabetes and takes regular insulin.
The Doctor is yet to diagnose.
May please advise what more tests / diagnostics are required and what do the above indicate ?
Regards , Sugato
The Doctor is yet to diagnose.
May please advise what more tests / diagnostics are required and what do the above indicate ?
Regards , Sugato
Does your wife have any other symptoms of thyroid dysfunction? Fatigue or unusual sleepiness, weight gain (you said no), constipation, brain fog (lack of clear thinking), slowed heart rate or lowered blood pressure, joint pain etc? You can google a more complete list of hypothyroid symptoms.
Both her FT3 and FT4 could be considered low for someone who is on thyroid meds, but considering that she isn't, I think her labs don't look bad. Whether or not to pursue thyroid depends mostly on other symptoms she might have in addition to the irregular bleeding, which as an isolated symptom isn't the usual first symptom of thyroid dysfunction.
You might pursue the change in insulin. I always look for the cause of a new symptom in something that has recently changed. I know that brand changes can sometimes wreak havoc with thyroid conditions, so it might be worthwhile to make sure that the doctor managing her diabetes is aware of this new symptom if he's not the same doctor treating her menstrual problems. Have you researched the side effects of the new insulin?
Both her FT3 and FT4 could be considered low for someone who is on thyroid meds, but considering that she isn't, I think her labs don't look bad. Whether or not to pursue thyroid depends mostly on other symptoms she might have in addition to the irregular bleeding, which as an isolated symptom isn't the usual first symptom of thyroid dysfunction.
You might pursue the change in insulin. I always look for the cause of a new symptom in something that has recently changed. I know that brand changes can sometimes wreak havoc with thyroid conditions, so it might be worthwhile to make sure that the doctor managing her diabetes is aware of this new symptom if he's not the same doctor treating her menstrual problems. Have you researched the side effects of the new insulin?
FT3, FT4 FSH tests were redone and were normal.
The thyroid tests were redone. Now the results were normal:
FT3 2.42 (2-4.4 pg/mL)
FT4 0.99 (0.93-1.7 ng/dL)
TSH 1.62 (0.27-4.2 uIU/mL)
Haematology tests were normal except
Mean corpuscular hemoglobin 31 (31.5-34.5g/dL)
Mean Platelet volume 12.2 (6.8-10.9 fL)
Bleeding stopped after Doctor administered Tranostat MF for 3 days.
USG of Pelvis was normal.
Doc shall conduct Hysteroscopy later ..
Diabetes is type 2. She is on insulin (Human mixtard 30:70) since last 10 years, 2 doses of 24 & 20 units daily along with Vildagliptin & Metformin HCL tablets.
No trauma .. diet change .. weight change .. injury etc
Her insulin brand was changed from Novomix (mix of 30% insulin aspart and 70% protamine crystallised insulin aspart) to Biocon brand (30% as soluble insulin injection and 70% as Isophane insulin injection) recently.
The thyroid tests were redone. Now the results were normal:
FT3 2.42 (2-4.4 pg/mL)
FT4 0.99 (0.93-1.7 ng/dL)
TSH 1.62 (0.27-4.2 uIU/mL)
Haematology tests were normal except
Mean corpuscular hemoglobin 31 (31.5-34.5g/dL)
Mean Platelet volume 12.2 (6.8-10.9 fL)
Bleeding stopped after Doctor administered Tranostat MF for 3 days.
USG of Pelvis was normal.
Doc shall conduct Hysteroscopy later ..
Diabetes is type 2. She is on insulin (Human mixtard 30:70) since last 10 years, 2 doses of 24 & 20 units daily along with Vildagliptin & Metformin HCL tablets.
No trauma .. diet change .. weight change .. injury etc
Her insulin brand was changed from Novomix (mix of 30% insulin aspart and 70% protamine crystallised insulin aspart) to Biocon brand (30% as soluble insulin injection and 70% as Isophane insulin injection) recently.
The thyroid tests were redone. Now the results were normal:
FT3 2.42 (2-4.4 pg/mL)
FT4 0.99 (0.93-1.7 ng/dL)
TSH 1.62 (0.27-4.2 uIU/mL)
Haematology tests were normal except
Mean corpuscular hemoglobin 31 (31.5-34.5g/dL)
Mean Platelet volume 12.2 (6.8-10.9 fL)
Bleeding stopped after Doctor administered Tranostat MF for 3 days.
USG of Pelvis was normal.
Doc shall conduct Hysteroscopy later ..
Please advice .. bleeding is now little/ sporadic 3 days course of Tranostat is over ..
FT3 2.42 (2-4.4 pg/mL)
FT4 0.99 (0.93-1.7 ng/dL)
TSH 1.62 (0.27-4.2 uIU/mL)
Haematology tests were normal except
Mean corpuscular hemoglobin 31 (31.5-34.5g/dL)
Mean Platelet volume 12.2 (6.8-10.9 fL)
Bleeding stopped after Doctor administered Tranostat MF for 3 days.
USG of Pelvis was normal.
Doc shall conduct Hysteroscopy later ..
Please advice .. bleeding is now little/ sporadic 3 days course of Tranostat is over ..
Also please check that Free T4 result. Could it actually be .6 rather than 6?
I think I'd want to repeat those tests just to eliminate the possibility of lab error. That's a huge discrepancy between FT3 and FT4.
At the same time, I think I'd want to pursue an ultrasound. High levels of thyroid hormones, with "normal" TSH levels, can be due to an autonomous nodule (also sometimes called a toxic nodule or toxic adenoma). This would show up on ultrasound.
Is her diabetes type I or type 2? Please describe her menstrual symptoms and elaborate on the other symptoms she's been experiencing.
Does she take meds for diabetes? Is she taking thyroid meds?
Have any other meds or supplements been added recently? Any diet changes? Any recent trauma, injury, surgery, stress (physical or emotional), weight change?
At the same time, I think I'd want to pursue an ultrasound. High levels of thyroid hormones, with "normal" TSH levels, can be due to an autonomous nodule (also sometimes called a toxic nodule or toxic adenoma). This would show up on ultrasound.
Is her diabetes type I or type 2? Please describe her menstrual symptoms and elaborate on the other symptoms she's been experiencing.
Does she take meds for diabetes? Is she taking thyroid meds?
Have any other meds or supplements been added recently? Any diet changes? Any recent trauma, injury, surgery, stress (physical or emotional), weight change?
Range for FT3 2.3-4.2 pg/mL
Range for FT4 0.89-1.76 ng/dL
Antibody testing not done, ultrasound imaging is yet to be done.
Range for FT4 0.89-1.76 ng/dL
Antibody testing not done, ultrasound imaging is yet to be done.
What are the reference ranges on her FT3 and FT4? Ranges vary lab to lab, so you have to report them with results.
Has she had antibody testing to see if her thyroid dysfunction is autoimmune? Has she had an ultrasound or any other imaging?
Has she had antibody testing to see if her thyroid dysfunction is autoimmune? Has she had an ultrasound or any other imaging?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
