thyroid confusion

[ask123g]

Hii.. im 24 years old my height 5.5" and weight50kg. I tested for Thyroid disorder

THYROID STIMULATING HORMONE (TSH) 0.57
0.5 - 5 uUI/ml
Euthyroid 0.25-5,
Hyperthyroid  7
I can't understand.. plz help me

[gimel]

In order to try and give you the best response we need more info from you.

Were you tested for the biologically active thyroid hormones, Free T4 and Free T3?  What, if any, symptoms do you have?

[ask123g]

TRIODOTHYRONINE, T3, TOTAL 1.50(observed)  0.92 - 2.46 (normal range) nmol/L

THYROXINE, T4, TOTAL 110.14 (observed) 71-161 (normal range) nmol/L

Im always underweight. My skin is extremely dry and wrinkled. Body temperature always higher, hair falling and dandruff

[gimel]

Unfortunately those are for Total T3 and Total T4, not Free T3 and Free T4.  Most of Total T4 and Total T3 is bound to protein, which renders it inactive.  Only a small portion of each is free from protein.  Since several variables can affect the amount of Totals that is not bound to protein, you need to know  what the Free T4 and Free T3 levels are.  So I suggest that you should request to be tested for Free T4 and Free T3.

Symptoms are really the most important for diagnosis; however, your symptoms are somewhat inconsistent.   Dry skin and falling hair are usually due to being hypothyroid.  Weight loss can occur with either but is more often a symptom of hyperthyroidism, along with higher temperatures.  

In view of the above, plus your low TSH I suggest that you should also ask to be tested for Thyroxine Stimulating Immunoglobulin (TSI).  Other tests that are generally helpful in diagnosing thyroid status are the morning serum cortisol test, and an ultrasound of the thyroid gland.  

Thyroid patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  I would ask for those to be tested also.  Ferritin especially since it affect hair growth.  

When you have additional test results please post them here along with reference ranges and we will try to help interpret and advise further.  

[ask123g]

Thank u very much for ur reply. I tested T3 T4 (free)
FreeT3 3.11 range 1.50-3.91cord blood 2.10-4.40 children n adults
T4 free 1.31 range 0.89-4.78
Tsh 0.557 range 0.55-4.78

[ask123g]

My Thyroid Anybody test result will come the day after tomorrow. I asked for TSI test. But they said we are using antibody test.

[gimel]

Please check the reference range you listed for Free T4.  Could it have been .89 - 1.78?  Did they test for TSI also?

[gack12]

I checked  result 1.31
Range 0.89 - 1.76  unit ng/dL

Thyroid profile free (FT3,FT4,TSH- ULTRASENSITIVE)
METHOD: CHEMILUMINESCENCE (CLIA)

they didn't test TSI

[gimel]

/

[ask123g]

I'll post my thyroid antibody test result the day after tomorrow

[ask123g]

Hi i got my result now.
ANTI THYROID ANTIBODIES PANEL
THYROGLOBULIN ANTIBODY (ANTI TG), SERUM result <15.0 range upto 60.0 unit IU/mL

THYROID PEROXIDASE ANTIBODIES (ANTI TPO, SERUM) result <28.0 range upto 60.0 unit U/mL

Lab technician said it's normal. No need other tests

[gimel]

So, your Antibodies tests were not conclusive for Hashi's.  

Looking at your Free T4, it is at 1.31, which is 87% of its range.  Your Free T3 was 3.11, which is only 44% of its range.  That is a bit lower than optimal for many people.  Since your FT4 is much higher in range than your FT3, that is an indication of inadequate conversion of T4 to T3 in your body.  Poor conversion can be the result of many variables, chief among them are selenium, and much more often ferritin.  

Since hypo patients are so frequently low in the ranges for Vitamin D, B12 and ferritin, I suggest testing for all three and then supplementing as needed to optimize.  D should be about 50 min., B12 in the upper end of its range, and ferritin should be about 70 min.  Also be aware that low cellular T3 levels causes hypo symptoms, and also that serum Free T3 does not always correlate well with cellular levels.  So it would also be a good idea to get tested for Reverse T3 and also Free T3 from the same blood draw.  


In addition your low TSH makes me wonder about your pituitary function.  It is also possible that you could be low in cortisol due to a weak pituitary signal.  So I suggest that you test for cortisol also.  

With those tests done, the cause for your symptoms should become clearer.  

[ask123g]

Gimel thank u very much for ur advice.
Vitamin D,
B12 and
ferritin,
Reverse T3 and also Free T3 from the same blood draw
cortisol

These test results will get tomorrow.

What Test for Hashi's ?

[ask123g]

My TSH is low . It means hyperthyroidism. How its hypo? And high TSH causes hashimotos . Right ? Can i get hashi's with low Tsh ?

[gimel]

Your Tests for the antibodies related to Hashi's were both negative, meaning Hashi's was not confirmed.  TSH is affected by so many things that at best it is only an indicator to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, Free T3 and Free T4.  So a low level does not always indicate hyperthyroidism.  

Before discussing further I would like to wait to see the results of your additional tests.  Also, please try to get the TSI test done.  

[ask123g]

Hi .
FREE TRI-IODOTHYRONINE(FT3) SERUM result 3.41 range 2.10 - 4.40 children n adults
*
TRI-IODO THYRONIN(T3) result 93.5 range 60.0 - 181.0 ng/dL
*
25-HYDROXY VITAMIN D result 9.6
Range
Low <20.0 deficiency
20.0 - 30.0 insufficient
30.0 - 100.0 sufficiency
*
Technician said vit D is very low . And reverse T3 and FT3 is normal. I didn't get my ferritin and cortisol result. It will get tomorrow. They said may be they are retesting these tests thats y its late

[gimel]

What was the Reverse T3 result?

[ask123g]

TRI-IODO THYRONIN(T3) result 93.5 range 60.0 - 181.0 ng/dL

I think it is reverse T3 result

[gimel]

No, that is Total T3.  

Your D is terribly low.  You should consider taking about 4000 IU daily of D3 to optimize to 50 min.  

From your thyroid tests, your Free T4 of 1.31 is at 48% of its range, which is not a concern by itself.  Your Free T3 was at 44 % of its range, which is a bit low.  Before going further I want to see the ferritin and cortisol results.

[ask123g]

Hi
FERRITIN result 140.10 range 22.00-322.00

CORTISOL result 12.3
There is no range found

[ask123g]

I forgot to check b12. Now what test required

[gimel]

When I looked for typical ranges for morning serum cortisol, I found this:

5-23 micrograms per deciliter (mcg/dL) or 138-635 nanomoles per liter (nmol/L)

Which measurement units were shown for your cortisol result?

[ask123g]

It's ug/dL

[gimel]

So the range is consistent with 5 -23.  What time of the morning was blood drawn for the test?

[ask123g]

CORTISOL. MORNING .SERUM : COLLECTED ON 23/07/2016 00:00

VITAMIN B12 : 325 range 211 - 911 pg/mL

S. Calcium: 9.9 range 8 to 11 mg/dL

S. Phosphorus: 4.0 range 3 to 5.5 mg/dL

They said everything is Normal except Vitamin D. And no need other testing