New thyroid lab questions

[Tam10]

I'm new here--and overwhelmed about what to do.

Haven't had a GP in years but went to one on August because of a really long period (which eventually stopped). She ran a bunch of tests--came back anemic (iron stores of 3 I think) and high TSH.

Waited 3 months and did more thyroid tests. Here are results:

Free T4 is 1.1
TSH is 5.747
Total T3 is 1.14
Anti thyroglobulin is 43
Thyroid peroxidase AB (TPO) is 216.6

So she does not want to start me on meds yet because my T4 and T3 are normal she says, so according to her, my thyroid is still functioning.

I made an appointment with an endo for a second opinion. Should I be on meds? I'm not keen to start that if I can avoid it, but then if they can help me, I'm okay with it.

I also have a strong family history of hypothyroidism on my mom's side.

Thanks in advance.

[LazyMoose]

Tam, in the future when posting labs, it is necessary to also post the ranges used by the lab. This should be included in the lab copy that is provided for you. Not? then ask for it. The ranges actually vary according to the lab equipment used.

The most important thyroid hormone to measure is T3. The most accurate test used to measure the is actually called "Free T3".  What you got 'total T3' is very outdated by a least 15 - 20 years. T3 hormone is the 'consumable' hormone that all cells use every second, after is it converted from the storage hormone T4 in your body.  Not everyone converts well from T4 to T3, why T3 is so important. And Free t3 is most healthy in the middle to upper third of the range. The lower it is the sicker you will be, guaranteed.

Think of it like your car. T4 is the fuel in the tank. T3 is the fuel at the engine. If your fuel line leaks, it doesn't matter that your tank is full, the engine will get less gas (T3).

TSH is not a hormone your cells use. Its really a signal hormone from the pituitary gland telling the thyroid what to do. This is not the best way to measure thyroid health, as it varies per person. But that said , you are a little on what would be called the hypo side of things for MOST people. To really know this get Free t3 tested.

Your TPO, by most ranges that I recall, would suggest you have elevated antibodies indicating Hashimoto  Hypothyroid. Again, pleae refer to the range.

Your Anti thyroglobulin or TgAB at 43 looks to be OK, but not 100 % sure, again please refer to the range. This one really varies.

The big question: what non-gender hypo symptoms do you have if any? Goggle hypothyroid symptoms. By the way, your profile says male. With your second sentence, I guess not.

If you have symptoms, I would suggest finding another, more 'thyroid wise' doctor, if yours will not test what is specifically called Free t3. If you find this to be low, you can benefit from replacement thyroid hormone. Its not really a medicine or drug, its replacement hormone for correcting deficient levels.

[LazyMoose]

T4 is the storage hormone that is converted to T3. T3 is the active hormone your cells use up every second. T3  cannot be zero in any lab range used. You would be very ill, extremely hypO.

TSH on the other hand could be near zero for some people, but most would be hypEr near zero.

[tkd4u2]

Well they are certainly lower than mine. My T3 for example is 2.1. But I like to have it as close to zero as possible. I go up and down and have to adjust medication from time to time.

I can't speak to the TPO number you have but your numbers don't look all that bad but I firmly believe you as the patient should have the ultimate decision. If you think you need to have them lower, be on meds, or need a second opinion you have that right.