Aa
T3 = 0.81, T4=8.1 and TSH=8.66 of my daughter, aged 32 yrs. Is medication required?
Rest of her blood tests are all normal like HbA1C, Lipid, KFT, LFT. Only her Vit B12 is less at 188.
The thyroid tests for Totals are a measure of the total amount in the blood. Most all of that is bound to protein and thus biologically inactive. Only the small portions that are not bound, and thus called Free , are biologically active. So you should try to make sure they always test for Free T4 and Free T3 in the future.
Your daughter's Total T4 is about 41% of its range. Her Total T3 is very low at only 17% of its range. If a potential hypothyroid patient has symptoms typical of hypothyroidism, and Free T4 and Free T3 are below below the middle of their ranges, that is usually a good indication of hypothyroidism. The ranges are far too broad due to the erroneous assumptions used to establish ranges. Her TSH is high enough to need further evaluation for the possibility of Hashimoto's Thyroiditis. With Hashi's the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland. As this proceeds, less thyroid hormone is produced, resulting in increasing levels of TSH in a vain attempt to stimulate the gland to increase output of thyroid hormone. Your daughter may be in the early stages of Hashi's, so it would be a good idea to also test for Thyroid Peroxidase antibodies (TPO ab and Thyroglobulin antibodies (TG ab).
In addition hypothyroid patients are frequently deficient in Vitamin D, B12 and ferritin. So those should also be tested and supplemented as needed to optimize. D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100. If your daughter's Free T4 and Free T3 levels reflect the same position in range as the Totals, then that might also indicated poor conversion of T4 to T3. Ferritin has a very important effect on conversion.
Every potential diagnosis of hypothyroidism is a probability theory. There are no biochemical tests that can be used as a pass/fail decision about it. When there is the possibility of hypothyroidism, the patient should be given a therapeutic trial of thyroid med adequate to raise Free T4 and Free T3 into the upper half of their ranges and if symptoms ease then the theory is supported and dosages can be adjusted until optimal.
At this point though I think it is most important to first get the above mentioned tests for Free T4, Free T3, Vitamin D, B12 and ferritin done, along with the TPO ab and TG ab tests. I also suggest testing for cortisol to get a baseline for that, since it affects thyroid hormone. Do you think you can get these tests done for her?
Your daughter's Total T4 is about 41% of its range. Her Total T3 is very low at only 17% of its range. If a potential hypothyroid patient has symptoms typical of hypothyroidism, and Free T4 and Free T3 are below below the middle of their ranges, that is usually a good indication of hypothyroidism. The ranges are far too broad due to the erroneous assumptions used to establish ranges. Her TSH is high enough to need further evaluation for the possibility of Hashimoto's Thyroiditis. With Hashi's the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland. As this proceeds, less thyroid hormone is produced, resulting in increasing levels of TSH in a vain attempt to stimulate the gland to increase output of thyroid hormone. Your daughter may be in the early stages of Hashi's, so it would be a good idea to also test for Thyroid Peroxidase antibodies (TPO ab and Thyroglobulin antibodies (TG ab).
In addition hypothyroid patients are frequently deficient in Vitamin D, B12 and ferritin. So those should also be tested and supplemented as needed to optimize. D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100. If your daughter's Free T4 and Free T3 levels reflect the same position in range as the Totals, then that might also indicated poor conversion of T4 to T3. Ferritin has a very important effect on conversion.
Every potential diagnosis of hypothyroidism is a probability theory. There are no biochemical tests that can be used as a pass/fail decision about it. When there is the possibility of hypothyroidism, the patient should be given a therapeutic trial of thyroid med adequate to raise Free T4 and Free T3 into the upper half of their ranges and if symptoms ease then the theory is supported and dosages can be adjusted until optimal.
At this point though I think it is most important to first get the above mentioned tests for Free T4, Free T3, Vitamin D, B12 and ferritin done, along with the TPO ab and TG ab tests. I also suggest testing for cortisol to get a baseline for that, since it affects thyroid hormone. Do you think you can get these tests done for her?
In trying to assess a person's thyroid status, the most important consideration is symptoms. So please tell us about any symptoms she has. Also please clarify if the T3 and T4 results are Total T3 and Total t4, or Free T3 and Free T4. Also please list the reference ranges shown on the lab report for those.
1 Comments
The values are of Total. Normal ranges in Report are given as T3=0.60-1.81; T4=5.01-12.45 and TSH=0.35-5.50. There are no symptoms like dry skin, sleepines, tiredness, but she has gained slight in weight from 69 Kg to 73 Kg which is not getting reduced even with lots of walking exercises.
Have an Answer?
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.
