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My Latest Test Results (Standard Ranges Included)
So my TSH, Free T4 and Free T3 have been consistently close to the bottom of the standard range for years. My problem has been finding a doctor that will do something about it. So I've been going from doctor to doctor to endocrinologist to endocrinologist, trying to find someone to help me.
Here is what happened at my most recent visit to an endocrinologist.
My thyroid test results from 1/15/2016:
TSH 0.65 Standard range 0.3-3
FT4 1.1 Standard range 0.8-1.8
FT3 2.5 Standard range 2.3-4.2
From my research, a low T4 and low/normal T4 score indicates a problem with the pituitary gland. The endocrinologist agreed with me on that. HOWEVER, he said I do not have ALL the symptoms of hypothyroidism.
My symptoms: fatigue, cold intolerance, constipation, muscle pain, etc. But I have problems keeping the weight on. I am 5'4" and go between 110 lbs down to 100 lbs at times. It is hard for me to keep the weight on. I drink weight gain. If I stop drinking it, I start to lose weight so then I start drinking it again and my weight goes back up a few pounds. Then I stop and my weight starts to drop again. I've always been skinny, but I have had problems keeping the weight on since I had my first child at age 22. I am now 39 years old.
He said since I do not have problems losing weight then it can't be hypothyroidism. But I have every other symptom of hypothyroidism. So because I don't check every single last box I'm not hypo?
He was not a total waste of time, though. Since an x-ray of my back had discovered I may have ostepenia, he ordered a bone density scan. A prior scan of my thryoid had found a hyperfunctioning adenoma in the right lower lobe. He said an ultrasound of my thyroid would be more accurate so he ordered that for me as well. He also ordered a pituitary gland panel test to check out my pituitary gland. I've already gotten a few of the pituitary gland test results back.
Cortisol, plasma 7.5 Normal range PM 2.9-17.3
Prolactin 9.2 Standard range 5.2-26.5
FREE T4 0.88 Standard range 0.7-1.48
TSH 0.08 Standard range 0.35-4.94
When I saw my TSH I was like WOW. I know it's not a good indicator, but still, that's pretty low. This doctor said my thyroid results are low, but since they're not below the standard range, it would not require treatment but something they would simply monitor and keep an eye on.
P.S. I had my B12, Vitamin D and iron levels checked as well.
B12 - 538 Standard range 180-914
Vitamin D 71 Standard range 32-100
but here's the kicker - my Ferritin is 6.7 Standard range 23-336 !!!!!!
My iron is 71 Std range 28-170
TIBC is 391 Std range 255-450
The doctor that ran those tests (not the endo I was just talking about) after he did the tests, he called me and told me everything was normal! Grrrrrr! But then of course, when I checked it myself and saw the ferritin, I went to a different doctor. They are going to give me iron infusions to get my iron levels up, thank goodness! And I'm also getting IV infusions that have B12. I just want to twist the neck of some of these doctors!
But anyway, I'm wondering if my low iron is the main reason why I'm tired and cold all the time and it really isn't my thyroid?
Here is what happened at my most recent visit to an endocrinologist.
My thyroid test results from 1/15/2016:
TSH 0.65 Standard range 0.3-3
FT4 1.1 Standard range 0.8-1.8
FT3 2.5 Standard range 2.3-4.2
From my research, a low T4 and low/normal T4 score indicates a problem with the pituitary gland. The endocrinologist agreed with me on that. HOWEVER, he said I do not have ALL the symptoms of hypothyroidism.
My symptoms: fatigue, cold intolerance, constipation, muscle pain, etc. But I have problems keeping the weight on. I am 5'4" and go between 110 lbs down to 100 lbs at times. It is hard for me to keep the weight on. I drink weight gain. If I stop drinking it, I start to lose weight so then I start drinking it again and my weight goes back up a few pounds. Then I stop and my weight starts to drop again. I've always been skinny, but I have had problems keeping the weight on since I had my first child at age 22. I am now 39 years old.
He said since I do not have problems losing weight then it can't be hypothyroidism. But I have every other symptom of hypothyroidism. So because I don't check every single last box I'm not hypo?
He was not a total waste of time, though. Since an x-ray of my back had discovered I may have ostepenia, he ordered a bone density scan. A prior scan of my thryoid had found a hyperfunctioning adenoma in the right lower lobe. He said an ultrasound of my thyroid would be more accurate so he ordered that for me as well. He also ordered a pituitary gland panel test to check out my pituitary gland. I've already gotten a few of the pituitary gland test results back.
Cortisol, plasma 7.5 Normal range PM 2.9-17.3
Prolactin 9.2 Standard range 5.2-26.5
FREE T4 0.88 Standard range 0.7-1.48
TSH 0.08 Standard range 0.35-4.94
When I saw my TSH I was like WOW. I know it's not a good indicator, but still, that's pretty low. This doctor said my thyroid results are low, but since they're not below the standard range, it would not require treatment but something they would simply monitor and keep an eye on.
P.S. I had my B12, Vitamin D and iron levels checked as well.
B12 - 538 Standard range 180-914
Vitamin D 71 Standard range 32-100
but here's the kicker - my Ferritin is 6.7 Standard range 23-336 !!!!!!
My iron is 71 Std range 28-170
TIBC is 391 Std range 255-450
The doctor that ran those tests (not the endo I was just talking about) after he did the tests, he called me and told me everything was normal! Grrrrrr! But then of course, when I checked it myself and saw the ferritin, I went to a different doctor. They are going to give me iron infusions to get my iron levels up, thank goodness! And I'm also getting IV infusions that have B12. I just want to twist the neck of some of these doctors!
But anyway, I'm wondering if my low iron is the main reason why I'm tired and cold all the time and it really isn't my thyroid?
Thanks Gimel, You gave me the name of one doctor that does take insurance, Karen W Thomas, so I am going to see if I can get an appointment with her. Although at this point I'm pretty discouraged and ready to give up.
I don't understand why the doctor is saying all of my tests are "perfect"! It's like no matter what the number is, they don't do anything. I have a feeling even if my score came back a zero they wouldn't do anything! And the Drs. are the same about symptoms. If you are missing ONE symptom from their list, then they say you don't have anything wrong with your thyroid. I feel like I have to be careful what I tell them, so they don't dismiss my complaints.
What incentive is there to not treat me? Do they get a kick back from insurance?
I don't understand why the doctor is saying all of my tests are "perfect"! It's like no matter what the number is, they don't do anything. I have a feeling even if my score came back a zero they wouldn't do anything! And the Drs. are the same about symptoms. If you are missing ONE symptom from their list, then they say you don't have anything wrong with your thyroid. I feel like I have to be careful what I tell them, so they don't dismiss my complaints.
What incentive is there to not treat me? Do they get a kick back from insurance?
1 Comments
I think it is all related to what they were taught in med school: Symptoms have been superseded by thyroid function tests. TSH and Free T4 is all they need to test and if within range, then there is no thyroid problem. Unfortunately that is not correct and hypothyroid patients suffer the results. I am sending you a PM with further info on it. To access, just click on your name and then from your personal page, click on messages.
I agree about the low ferritin, but not Vitamin D. Your last test result you showed for D was 71, which is fine. Your ferritin was extremely low, at 6.7, when it should be about 70.
Along with your symptoms, your limited test results for Free T4, Free T3 and TSH all were relatively low, indicating the possibility of central hypothyroidism, which is a dysfunction in the hypothalamus/pituitary system. That possibility also seems to be supported by some of your adrenal test results. Also, note the following.
The symptoms of low cortisol, or hypoadrenalism, include:
Mental and psychological ailments such as depression
Faintness and dizziness
Weakness and fatigue
Heart palpitations
Emotional hypersensitivity
Inability to cope with stress
Social anxiety
Muscle weakness
Headache, scalp ache, or general body ache
Severe or dull lower back pain
Extremely sensitive skin
Nausea, diarrhea, and vomiting
Abdominal pain and hunger pain despite an empty stomach
Extreme craving for salty foods
Anxiety and jitters
Clumsiness and confusion
Motion sickness
Insomnia and dark circles under the eyes
Low bladder capacity and symptoms of IBS
Irregular or non-existent menstrual period
Of course, these symptoms won’t all occur simultaneously, or immediately. Some people suffering from low cortisol will experience a couple of these symptoms, perhaps one after another.
If interested in further info on that you can go to the adrenal forum. It seems to me that you really need a doctor who understands that low cortisol does not always show up strongly in lab tests,, and that symptoms need to be taken into account. While you ponder all this I am going to see if I can come up with a good doctor in your area.
Along with your symptoms, your limited test results for Free T4, Free T3 and TSH all were relatively low, indicating the possibility of central hypothyroidism, which is a dysfunction in the hypothalamus/pituitary system. That possibility also seems to be supported by some of your adrenal test results. Also, note the following.
The symptoms of low cortisol, or hypoadrenalism, include:
Mental and psychological ailments such as depression
Faintness and dizziness
Weakness and fatigue
Heart palpitations
Emotional hypersensitivity
Inability to cope with stress
Social anxiety
Muscle weakness
Headache, scalp ache, or general body ache
Severe or dull lower back pain
Extremely sensitive skin
Nausea, diarrhea, and vomiting
Abdominal pain and hunger pain despite an empty stomach
Extreme craving for salty foods
Anxiety and jitters
Clumsiness and confusion
Motion sickness
Insomnia and dark circles under the eyes
Low bladder capacity and symptoms of IBS
Irregular or non-existent menstrual period
Of course, these symptoms won’t all occur simultaneously, or immediately. Some people suffering from low cortisol will experience a couple of these symptoms, perhaps one after another.
If interested in further info on that you can go to the adrenal forum. It seems to me that you really need a doctor who understands that low cortisol does not always show up strongly in lab tests,, and that symptoms need to be taken into account. While you ponder all this I am going to see if I can come up with a good doctor in your area.
So I got the test results for my Pituitary gland.
IGF-1 Somatomedin (GH) 173 Standard Range 106-368
ACTH 7.1 SR <45.9
Prolactin 9.2 SR 5.2 - 26.5
Corisol 7.5 SR 2.9 - 17.3 (taken at 5pm)
Because it takes so long to get appointments with endos in my town, I had made appointments with several different endos. It just so happened that I had an appointment with a different endo than the one that ran these tests. So I showed Endo#2 the results, as well as my other test results to see what he would say.
Endo #2 said that the scan of my thyroid indicated my level was a little on the high side. That my thyroid labs and a good portion of my symptoms mimic hyperthyroidism. (not hypo, as several on here believe).
He said “You have no evidence for pituitary dysfunction. Your TSH has been normal. If it was overtly low and we had a clinical context or other features to suggest pituitary dysfunction, or if we had a reason for pituitary dysfunction, but everything shows your pituitary function is perfect. And pituitary dysfunction doesn’t just sporadically happen to 30 somethings. It would knock out your pituitary function.”
He said “Your symptoms of palpitations. tremors, and low weight suggest Sub clinical hyperthyroidism. I think what is happening is your gland is making a little bit more than your pituitary wants you to have. Your T4 is slighter higher than your body wants.
And we don’t have to treat this. You have as many symptoms of hypothyroidism as of hyperthyroidism. You have symptoms of irritable bowel, growth hormone deficiency, rheumatoid arthritis, and fibromyalgia.
Your thyroid is a little bit high but considering the bad reaction you had to Methomozile I would not offer any treatment. All of your tests are right on the nose, every single one is perfect.”
I then asked him to look at my T3 score, which was 2.5 with Standard Range 2.3 - 4.2. He said “T3 is a very bad test. T3 is a very difficult test that must be done by a specialized machine. If I did it 5 different times on the same specimen of blood I would get 5 different results. So T4 is a more reliable test.” He then pointed to my T4 score of 1.1, with a standard range of 0.8-1.8. He said “This is a pretty acceptable number.”
And he said I also tested negative for both thyroglobulin and thyroid peroxidase antibodies, so he said I don’t have a thyroid dysfunction, if anything it’s a little on the high side, but should not be treated.
So now I don’t know what to think!!
My HYPER symptoms- weight loss, heart palpitations, anxiety, tremors, muscle weakness
My HYPO symptoms – cold intolerance, low blood pressure, fatigue, constipation, poor memory, inability to concentrate, loss of bottom third of eyebrows, heavy periods, muscle stiffness, muscle aches and pains.
But some of these symptoms could be related to low vitamin D and low iron. I'm about ready to just concentrate on my D and iron levels and forget about trying to get treatment for my thyroid.
IGF-1 Somatomedin (GH) 173 Standard Range 106-368
ACTH 7.1 SR <45.9
Prolactin 9.2 SR 5.2 - 26.5
Corisol 7.5 SR 2.9 - 17.3 (taken at 5pm)
Because it takes so long to get appointments with endos in my town, I had made appointments with several different endos. It just so happened that I had an appointment with a different endo than the one that ran these tests. So I showed Endo#2 the results, as well as my other test results to see what he would say.
Endo #2 said that the scan of my thyroid indicated my level was a little on the high side. That my thyroid labs and a good portion of my symptoms mimic hyperthyroidism. (not hypo, as several on here believe).
He said “You have no evidence for pituitary dysfunction. Your TSH has been normal. If it was overtly low and we had a clinical context or other features to suggest pituitary dysfunction, or if we had a reason for pituitary dysfunction, but everything shows your pituitary function is perfect. And pituitary dysfunction doesn’t just sporadically happen to 30 somethings. It would knock out your pituitary function.”
He said “Your symptoms of palpitations. tremors, and low weight suggest Sub clinical hyperthyroidism. I think what is happening is your gland is making a little bit more than your pituitary wants you to have. Your T4 is slighter higher than your body wants.
And we don’t have to treat this. You have as many symptoms of hypothyroidism as of hyperthyroidism. You have symptoms of irritable bowel, growth hormone deficiency, rheumatoid arthritis, and fibromyalgia.
Your thyroid is a little bit high but considering the bad reaction you had to Methomozile I would not offer any treatment. All of your tests are right on the nose, every single one is perfect.”
I then asked him to look at my T3 score, which was 2.5 with Standard Range 2.3 - 4.2. He said “T3 is a very bad test. T3 is a very difficult test that must be done by a specialized machine. If I did it 5 different times on the same specimen of blood I would get 5 different results. So T4 is a more reliable test.” He then pointed to my T4 score of 1.1, with a standard range of 0.8-1.8. He said “This is a pretty acceptable number.”
And he said I also tested negative for both thyroglobulin and thyroid peroxidase antibodies, so he said I don’t have a thyroid dysfunction, if anything it’s a little on the high side, but should not be treated.
So now I don’t know what to think!!
My HYPER symptoms- weight loss, heart palpitations, anxiety, tremors, muscle weakness
My HYPO symptoms – cold intolerance, low blood pressure, fatigue, constipation, poor memory, inability to concentrate, loss of bottom third of eyebrows, heavy periods, muscle stiffness, muscle aches and pains.
But some of these symptoms could be related to low vitamin D and low iron. I'm about ready to just concentrate on my D and iron levels and forget about trying to get treatment for my thyroid.
@Gimel - About the ferritin, sorry I goofed, that 391 score was for TIBC, not ferritin.
Next time I see the endo I will have to see if he's willing to prescribe me anything for the T3, T4 levels. Thanks for the link, I will check that out.
Next time I see the endo I will have to see if he's willing to prescribe me anything for the T3, T4 levels. Thanks for the link, I will check that out.
1 Comments
Gimel I just read through the link you posted. Interestingly, I do believe I have some malabsorption issues. In the other tests the previous dr ran showed several tests showed that low scores indicate malnutrition.
My BUN was 13 Std Range 7-20
My Creatine was 0.447 Std Range 0.8-1.4
calcium was 8.9 Std Range 8.5-10.9
protein was 6.4 Std Range 6.3-7.9
I suspect I may have a human growth hormone deficiency - symptoms are low bone density - (x-ray has already found ostepenia) muscle weakness (I have a hard time pushing open store doors and carrying pots of food) and elevated cholesterol levels.
My CHOL was 176 Std Range 0-200
My HDL-C was 69 Std Range 45-65
LDL was 97 Std Range 0-100
Human growth hormone deficiency is one of the symptoms of pituitary failure, so it seems like it is tied together. I'm waiting to get the test results back from the growth hormone test results, very interested to see what that looks like.
My BUN was 13 Std Range 7-20
My Creatine was 0.447 Std Range 0.8-1.4
calcium was 8.9 Std Range 8.5-10.9
protein was 6.4 Std Range 6.3-7.9
I suspect I may have a human growth hormone deficiency - symptoms are low bone density - (x-ray has already found ostepenia) muscle weakness (I have a hard time pushing open store doors and carrying pots of food) and elevated cholesterol levels.
My CHOL was 176 Std Range 0-200
My HDL-C was 69 Std Range 45-65
LDL was 97 Std Range 0-100
Human growth hormone deficiency is one of the symptoms of pituitary failure, so it seems like it is tied together. I'm waiting to get the test results back from the growth hormone test results, very interested to see what that looks like.
Found some interesting info on the weight issue. Here is the link.
http://drhoffman.com/article/underweight-and-malabsorption-2/
http://drhoffman.com/article/underweight-and-malabsorption-2/
Following are symptoms that can be related to low ferritin.
Minor aches
Fatigue
Weakness
Heart palpitations
Increased pulse
Loss of energy
Loss of libido
Confusion
Irritability
Shortness of breath
So I do not think your long list of symptoms that can be related to hypothyroidism is due to the very low ferritin. Also, I am a bit confused about your ferritin level. In one of your prior posts you showed a ferritin level of 391 Standard Range - 255-450 Any idea why?
Your Free T4 has been lower than optimal in both of the last two tests. Optimal is mid-range, at minimum. Your Free T3 was very low. It should be in the upper third of the range, or as needed to relieve symptoms. Your Vitamin D is good. B12 would be better in the upper end of the range.
Having such a low TSH along with those relatively low Free T4 and Free T3 seems to indicate a dysfunction in the hypothalmus/pituitary system. That might tie in with the doctor checking your pituitary function and the somewhat low-in-the- range cortisol result, at only 32% of the range.
Even though weight loss is not normally associated with hypothyroidism, it is not unheard of. I am going to do some more searching on the subject. In the interim I would push to get some thyroid med to raise your Free T4 and free T3 levels. Is there a doctor of yours that will agree to do that?.
Minor aches
Fatigue
Weakness
Heart palpitations
Increased pulse
Loss of energy
Loss of libido
Confusion
Irritability
Shortness of breath
So I do not think your long list of symptoms that can be related to hypothyroidism is due to the very low ferritin. Also, I am a bit confused about your ferritin level. In one of your prior posts you showed a ferritin level of 391 Standard Range - 255-450 Any idea why?
Your Free T4 has been lower than optimal in both of the last two tests. Optimal is mid-range, at minimum. Your Free T3 was very low. It should be in the upper third of the range, or as needed to relieve symptoms. Your Vitamin D is good. B12 would be better in the upper end of the range.
Having such a low TSH along with those relatively low Free T4 and Free T3 seems to indicate a dysfunction in the hypothalmus/pituitary system. That might tie in with the doctor checking your pituitary function and the somewhat low-in-the- range cortisol result, at only 32% of the range.
Even though weight loss is not normally associated with hypothyroidism, it is not unheard of. I am going to do some more searching on the subject. In the interim I would push to get some thyroid med to raise your Free T4 and free T3 levels. Is there a doctor of yours that will agree to do that?.
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