please help me understand my thyroid test results

[Jpifer]

TSH 0.42 range 0-4
T3 TOTAL 86 range 50-170
FREE T4 1.3 range 0-1

I have all the symptoms of hypothyroid and the symptom of hyperthyroid I have is that I am very moody and irritable.

Thank you for your help.

[flyingfool]

First thing that I saw was that the TOTAL T3 test is the WRONG test as others have pointed out.  However because it is low in the range, it is very likily that the Free T3 is also low since there is little Total, and most of the Total is bound to a protein and unusable.

The next glaring thing was that your Ferritin is abysmal.  And you need proper Ferritin levels to metabolize thyroid.

I'm not very knowledgeable on adrenals. But they seem to be out of whack and thus as gimel stated, it is very worthwhile to investigate other hormones and adrenals more deeply to better sort out what is what.  And where to start.  Until that is sorted out.  I'm also in agreement that it may be too early to start on thyroid replacement just yet.

[Jpifer]

Thank you very much for all your help.

[gimel]

From your lab results, your Free T4 is above the listed range, while your Total T3 is only at 29% of its range.  It would be far more revealing if you can get the Free T3 test instead of Total T3.  Total represents all your serum T3.  Only a small portion of that is not bound to protein, thus referred to as "free".  That small portion is the biologically active part that you need to know about.  If your Free T3 is as low in its range as your Total T3, then that would be indicative of being hypothyroid.  In the future you should  always test for both Free T4 and Free T3, not Total T3.

Even with hypothyroid symptoms I would not recommend thyroid med at this time, because your Free T4 and Total T3 appear to show that your body is not adequately converting T4 to T3.  Some of the main factors affecting conversion efficiency are ferritin, selenium, and zinc.  If you look at your ferritin test result you can see that it is terribly low, actually below range.  So the first thing I suggest is to supplement daily with one tablet of Vitron C, which contains about 65 mg of iron and some Vitamin C, which helps avoid stomach distress from the iron.  If you cannot find Vitron C then you could try other forms of iron like ferrous fumarate, ferrous sulfate, or ferrous bisglycinate.  Also take some Vitamin C along with it.  I suggest doing this for about 6 weeks and then re-test to see the effect on your ferritin level and also the T4 to T3 conversion.  It takes a while to build up your ferritin level, so an alternative would be to get the doctor to give you iron infusions.  

Your B12 is good.  You do need to test for Vitamin D and supplement as needed to raise the level to at least 50.

Your cortisol test was  at 7.9, which is below the range.  That is terribly low, so you need to get the doctor to do an ACTH test to see if the problem is with inadequate signal to the adrenals, or if the adrenals are not able to produce enough cortisol.  Due to the low cortisol I think it would also be a good idea to get tested for other major hormones, estradiol, progesterone, DHEA-S and testosterone.  

So at this point, even though you are apparently experiencing some symptoms that can be related to hypothyroidism, I would not suggest thyroid med.  Instead it is most important to get more test info on your adrenal function and see what needs to be done there.  Along with that get your ferritin level optimal and see if that resolves the T4 to T3 conversion issue and raises your Free T3 level adequate to relieve associated symptoms.  

Please let us know how you are doing as you proceed with this.  

[Jpifer]

Here are the symptoms that I am having...

Fatigue
Irritable
Very Moody
Extremely sensitive to cold
Dry hair
Dry skin
Constipated
Weight gain

Thank you.

[Jpifer]

My vitamin B12 test was taken 5 months ago and it was 959, Standard range: >=200.

Thank you.

[Jpifer]

My doctor ordered retest and new blood test yesterday and here are the results...

Prolactin 8, Range 3-10
Costisol AM 7.9, Range 8-25
Ferritin 10, Range 22-291
T3, Total 85, Rang 50-170
Free, T4 1.3, Range 0-1
TSH 0.42, Range 0-4

She also ordered thyroid ultra sound because I am always feeling that there is something stuck in my throat, that will be done this coming Sunday.


Do you think I have hypothyroid and need medication?

Thank again for your help.

[gimel]

That range for Free T4 doesn't look right.  Please double check it.  

You were tested for Total T3.  It should always be Free T3 since only that portion of Total T3 is biologically active.  If your Free T3 falls in the lower part of its range, like your Total T3, along with having hypo symptoms, that would be indicative of hypothyroidism.  

Please list the symptoms you have that you say are hypothyroid.  Also, note that from a very long list of symptoms that can be related to hypothyroidism, the section on Emotional Conditions, shows the following.

    Tension
    Irritability
    Wanting to be solitary
    Mood swings
    Anxiety
    Personality changes
    Feelings of resentment
    Jumpy
    Easily startled
    Lack of confidence
    Nervousness

So your moodiness and irritability may also be hypo symptoms.  

If tested for Vitamin D, B12, ferritin and cortisol,  please list those results as well.