abnormal labs

[SarahSmith]

Please advise:

TSH: 2.090
Thyroxine (T4): 4.0
T3 Uptake: 27
Free Thyroxine Index 1.1

Thank you!!

[Barb135]

Are you vegetarian or vegan?  I kind of get mixed up on the 2 (lol), but if you do any animal products at all, eggs are an excellent source of protein, as is dairy - yogurt, cottage cheese, etc. (whey protein is very good).  If you don't do any animal products look into pea protein.  It's not as good as whey protein, but is better than soy.

I will look forward to hearing from you in the near future.  

[SarahSmith]

Thank you so much Barb.  I will follow up with you once I get further lab values.  I really appreciate such a thorough response.

[Barb135]

I'm concluding that you're hypo on the basis of your Total T4, which even though, being an outdated test is below the reference range. Since Free T4 is only a fraction of the Total T4, it stands to reason that Free T4 will be low, as well.   As I noted above, Free Thyroxine Index is an outdated way to calculate Free T4, and it, too is below the reference range... even though the tested are outdated, there's no conclusion to make, other than that you are hypo.

IMO, the symptoms you have (constipation and cold intolerance) would be due to hypothyroidism).

TSH is basically a messenger hormone, which is meant to stimulate the thyroid to produce more thyroid hormones.  Since your thyroid hormones are so low, technically, your TSH should be much higher than it is.  You could have a pituitary issue or possibly there's enough hormones for your pituitary, but not for the rest of your body.  To answer your question - no, the normal TSH does not mean that your thyroid is generally normal.  Your thyroid is not producing adequate hormones.

Yes, the tofu and soy products are problematic, since soy is a goitrogen.  Goitrogens are substances that suppress the function of the thyroid gland by interfering with iodine uptake.  Iodine is necessary for the production of thyroid hormones.

Other goitrogenic foods include cruciferous veggies like cabbage, broccoli, cauliflower, kale, nuts, etc.  You can google "goitrogens" for a complete list.  It's important to know that cooking goitrogenic foods removes the goitrogenic properties, but this does not apply to soy, which should be avoided, completely.

Have you been tested for thyroid antibodies to determine if you have Hashimoto's Thyroiditis?  Hashimoto's is an autoimmune thyroid disease in which the body sees the thyroid as foreign and produces antibodies to destroy it. The disease is progressive, in that the antibodies continue to attack until they've "killed" the thyroid so it no longer produces any hormones at all, leaving the patient dependent on replacement hormones for life.  Hashimoto's is the number 1 cause of hypothyroidism in the developed world.  Many of us on the forum have Hashmoto's.  

There are 2 antibody tests you need to diagnose Hashimoto's.  They are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  You need them both, because either one can determine the diagnosis and some people have one or the other, some have them both. Talk to your doctor about them.

[SarahSmith]

Thanks so much for responding Barb!!

I will have the doctor order Free T4 and Free T3.  If the other tests are outdated, how are you coming to the conclusion that I am hypo?  I have some other symptoms like constipation and cold intolerance but they may be related to other health causes I just changed to a much higher protein diet.  I"m not on any thyroid meds.  I am a vegetarian; are the tofu and other soy products problematic?

Does the normal TSH mean that my thyroid is generally normal in spite of the other values?

Thanks again.

[Barb135]

Unfortunately, thyroxine is an outdated test, as well - it's the same as Total T4, which isn't very useful.  Free thyroxine index is also rather outdated; its a round about way of measuring Free T4.  There's an actual direct Free T4 test, that you should ask your doctor for, as well as a Free T3 test. Judging from the testing ordered, your doctor may not be well versed about thyroid issues.

At any rate, your tests indicate that you have hypothyroidism or underactive thyroid.  Weight gain is a symptom of hypothyroidism, but could also be attributed to other medications, as well.

Do you  have other symptoms, such as constipation, cold intolerance, hair loss, muscle/joint aches/pains, fatigue, etc?

Are you currently on a thyroid replacement hormone?  If so, which one, what dosage and for how long have you been on it?

[SarahSmith]

TSH 2.09  (0.450-4.50)
Thyroxine (T4) 4.0  (4.5-12.0)
T3 Uptake 27 % (24-39)
Free Thyroxine Index 1.1 (1.2-4.9)

The TSH is normal but the T4 and Free Thyroxine Index are a bit low.  Not sure what this means.  I have experienced weight gain but perhaps this can be attributed to medications (lithium, etc.) or getting older.  

Thank you!!

[flyingfool]

Please post the reference ranges of the tests as well.. They are ususally shown in parenthesis adjacent to your results.

T3 uptake unfortunately is an outdated test of little value.

Also please list any symptoms you are having.  How you feel really matters more than what the technical numbers indicate as everyone feels well at different levels.