Thyroid experts--are these numbers good?

[maize]

Just got lab results back, hoping for some help in interpreting them:

 

T3, Free: 2.9 pg.mL  reference range 2.3-4.2

T4, Total: 5.5 ug/dL rr4.5-10.9

TSH 2.116 uIU/mL rr 0.55-4.78

Thyroid Peroxidase 11IU/mL rr 0-34

Thyroglobulin Antibody <1.0 IU/mL rr0.0-0.9

T3, Total 0.9 ng.mL rr 0.6-1.8

 

Says they're all within the reference range but I think I've seen people on here say that doesn't necessarily mean all is well? My family has a history of Hashimotos.

 

edited to add reference ranges listed on the report

Edited July 16, 2016 by maize

[Ellie]

Just got lab results back, hoping for some help in interpreting them:

 

T3, Free: 2.9 pg.mL 

T4, Total: 5.5 ug/dL

TSH 2.116 uIU/mL

Thyroid Peroxidase 11IU/mL

Thyroglobulin Antibody <1.0 IU/mL

T3, Total 0.9 ng.mL

 

Says they're all within the reference range but I think I've seen people on here say that doesn't necessarily mean all is well? My family has a history of Hashimotos.

 

First, it helps to know what your lab's ranges are, because for some reason they are not all the same. o_0

 

Second, Total T4 and Total T3 are useless numbers, but doctors who don't know how to treat thyroid issues properly tend to do them. You need Free T3, Free T4, and Reverse T3.

 

Third, your TSH is too high, so my guess would be that your Free T3 and Free T4 are too low, meaning that you are hypothyroid.

 

The lack of Thyroglobulin Antibody means that you might or might not have Hashimoto's. Your doctor should order an ultrasound of your thyroid, because Hashi's can be diagnosed that way. I don't have antibodies, either, but an ultrasound showed that my thyroid is definitely a Hashi's thyroid.

 

"Within range" or "normal" does not mean "Everyone whose numbers fall between this point and this point is perfectly healthy and feels like a million dollars." It means "Most people fall between this point and this point." The end. Your numbers--and again, your doctor didn't order the right labs, so we still don't know--need to be optimal: Free T3 in the upper fourth of the reference range, Free T4 in the upper half, TSH in the lower fourth (and you should not, not, not be treated based on TSH but on Free T3 and Free T4).

 

My first piece of advice is to find another doctor right now. Seriously. The less time you spend with someone who doesn't know how to treat you, the more time you'll have to heal. I don't care how kind he is, or that he's been your family doctor for a gazillion years, or anything else; the fact that he (1) ordered the wrong labs and (2) sent you away saying your numbers were "in range" tells me that he does not know how to treat thyroid issues.

 

Actually, that's my major piece of advice. :-)

[maize]

First, it helps to know what your lab's ranges are, because for some reason they are not all the same. o_0

 

Second, Total T4 and Total T3 are useless numbers, but doctors who don't know how to treat thyroid issues properly tend to do them. You need Free T3, Free T4, and Reverse T3.

 

Third, your TSH is too high, so my guess would be that your Free T3 and Free T4 are too low, meaning that you are hypothyroid.

 

The lack of Thyroglobulin Antibody means that you might or might not have Hashimoto's. Your doctor should order an ultrasound of your thyroid, because Hashi's can be diagnosed that way. I don't have antibodies, either, but an ultrasound showed that my thyroid is definitely a Hashi's thyroid.

 

"Within range" or "normal" does not mean "Everyone whose numbers fall between this point and this point is perfectly healthy and feels like a million dollars." It means "Most people fall between this point and this point." The end. Your numbers--and again, your doctor didn't order the right labs, so we still don't know--need to be optimal: Free T3 in the upper fourth of the reference range, Free T4 in the upper half, TSH in the lower fourth (and you should not, not, not be treated based on TSH but on Free T3 and Free T4).

 

My first piece of advice is to find another doctor right now. Seriously. The less time you spend with someone who doesn't know how to treat you, the more time you'll have to heal. I don't care how kind he is, or that he's been your family doctor for a gazillion years, or anything else; the fact that he (1) ordered the wrong labs and (2) sent you away saying your numbers were "in range" tells me that he does not know how to treat thyroid issues.

 

Actually, that's my major piece of advice. :-)

 

Thanks. I added the reference ranges listed on the report.

 

Just barely starting to look into this so appreciate any input.

[Ellie]

Thanks. I added the reference ranges listed on the report.

 

Just barely starting to look into this so appreciate any input.

 

Ok, your FT4 is definitely hypo, your TSH is definitely too high. Most doctors only treat TSH, and will let it be way too high before doing anything, and even then, they just throw a minuscule amount of a synthetic, T4-only drug at you. Your body needs both T3 and T4, because that's what your thyroid makes (when it's working properly).

 

Free T3 and Free T4 are the amounts of T3 and T4 available for your body to use. If there isn't enough T3 and T4, then the Frees will be low. And then your pituitary gland kicks in with TSH, like  a big red flag warning you that your thyroid is not working properly. See? You treat the thyroid, not the pituitary.

 

Check out Stop the Thyroid Madness. Read every page. You have to be totally prepared when you see the doctor.

 

Also, if you do FB, there are a number of Hashimoto's pages. The many members are very helpful.

[OneStepAtATime]

See if you can get a referral to an endocrinologist to do proper testing and assessment of the results. My normal doctor nearly triggered a thyroid storm because he didn't really understand thyroid issues. My mom had a similar problem with her doctor. She has Hashimotos and I have Graves disease but it took going to endocrinologists to get solid answers and proper initial treatment.

Edited July 16, 2016 by OneStepAtATime

[Tiramisu]

I don't see a free T4. Of all numbers, I'd want to know that one most of all.

 

For some years, the normal TSH range was narrower, maybe .3 to 3.0.

 

TSH annoys me. It's only reliable if your pituitary is normal. My DD has lowish TSH and a known pituitary problem and chronically borderline low FreeT4, but so far the only ending who wanted to medicate her was a resident and the attending doc overruled him.

[Soror]

Personally I'd rather see the T3 since that is what the body really uses. Your numbers could be worse, true, but they are not optimal. "Normal" TSH is around 1. Optimal FT3 is around 3.7+. 

 

Your antibodies don't indicate Hashimotos(at this time) however not all Hashi's have antibodies. 

 

How are you feeling? 

 

You likely need to find a different dr. if you want someone to look into it more. FYI low iron goes along with thyroid issues and low iron exacerbates thyroid issues so that is something you can get checked even w/ a thyroid ignorant dr and can be a big help.

[Ellie]

See if you can get a referral to an endocrinologist to do proper testing and assessment of the results. My normal doctor nearly triggered a thyroid storm because he didn't really understand thyroid issues. My mom had a similar problem with her doctor. She has Hashimotos and I have Graves disease but it took going to endocrinologists to get solid answers and proper initial treatment.

 

On the FB Hashimoto's pages I'm a member of, endos have a really bad rep, because so many have been just as improperly treated by them as by their primary care physicians. Regardless of which medical specialist you see, you have to know what needs to be done (e.g., proper tests, proper medication, optimal lab results, etc.).

[gardenmom5]

Just got lab results back, hoping for some help in interpreting them:

 

T3, Free: 2.9 pg.mL  reference range 2.3-4.2

T4, Total: 5.5 ug/dL rr4.5-10.9

TSH 2.116 uIU/mL rr 0.55-4.78

Thyroid Peroxidase 11IU/mL rr 0-34

Thyroglobulin Antibody <1.0 IU/mL rr0.0-0.9

T3, Total 0.9 ng.mL rr 0.6-1.8

 

Says they're all within the reference range but I think I've seen people on here say that doesn't necessarily mean all is well? My family has a history of Hashimotos.

 

edited to add reference ranges listed on the report

 

free t3 - low.  optimal is above 3.7  (it is very common to be on a t4 synthetic and have low  t3)

totals do NOT tell you how much you are actually using of what is available. they're worthless. 

t4 total - worthless #

t3 total - worthless #

tsh 2.1 - high and worthless #  optimal is below 1.5 

 

the best test is - how do you feel?  are your symptoms resolved?

 

you want FREE t3 & FREE t3, and reverse T3.  those will tell you how much you are actually using, etc.

 

 

it is also common to have cortisol/adrenal dysfunction and low iron comorbid.  those need to also be checked

properly.

 

eta: I second finding a new dr. I'd  switched several times due to insurance - then I learned what tests I really needed. the last dr wanted to test me every three months before writing rx. (cash cow) she kept me on a minimal dose of synthetic t4 - and didn't care about all of my hypo symptoms. she dosed to the tsh of about 4.  after learning about what tests are useful, I would ask her to run the free t3 & free t4.  I finally got very assertive and she said she would.  I was reading the test results after they came back -  she did NOT - she did the totals.  completely worthless numbers.  when I confronted her, she used the excuse of "your insurance wont' pay for them".  (as colonel potter would say - horse hockey).  it was my motivator to go to the nd I'd wanted to try for awhile for a different health problem. 

 

the ND ran them, the insurance paid.   we've started me on NDT and adrenal support.  we do blood tests again in two weeks to see where we are and where we need to go (I'm definitely still hypo.)

Edited July 16, 2016 by gardenmom5

[Ellie]

 

the ND ran them, the insurance paid.   we've started me on NDT and adrenal support.  we do blood tests again in two weeks to see where we are and where we need to go (I'm definitely still hypo.)

 

It's good to hear that you're finally making progress. :party:

 

I will trade you a chart for a chart. :-) This is how the dosing for NDT should go:

 

 

 

IOW, I hope your NP started you at one grain and will increase it appropriately, based on how you feel and not on lab results. There's a danger in staying too long on too low a dose. You don't stay at the same level of not-well; you actually lose ground (#2 and #8 especially).

[OneStepAtATime]

On the FB Hashimoto's pages I'm a member of, endos have a really bad rep, because so many have been just as improperly treated by them as by their primary care physicians. Regardless of which medical specialist you see, you have to know what needs to be done (e.g., proper tests, proper medication, optimal lab results, etc.).

Wow, that's just sad.  And pathetic.  Why go through all that specialized training and spending a fortune on your education when you aren't actually learning how to be an effective specialist in your area of expertise?  

Edited July 16, 2016 by OneStepAtATime

[Ellie]

Wow, that's just sad.  And pathetic.  Why go through all that specialized training and spending a fortune on your education when you aren't actually learning how to be an effective specialist in your area of expertise?  

 

Indeed.

[gardenmom5]

It's good to hear that you're finally making progress. :party:

 

I will trade you a chart for a chart. :-) This is how the dosing for NDT should go:

 

 

 

IOW, I hope your NP started you at one grain and will increase it appropriately, based on how you feel and not on lab results. There's a danger in staying too long on too low a dose. You don't stay at the same level of not-well; you actually lose ground (#2 and #8 especially).

 

yeah - she started me at one, and allowed me to increase 1/2 grain.  (I actually tried doing 2 grains - but realized I need adrenals first)  - so we're currently in the holding before labs.  she really wants labs before increasing past 1 1/2. 

 

I started adrenal support because I was still way too tired.  we've been e-mailing back and forth.  she's happy with the gaia herbs with 90mg of holy basil leaf I chose.  (I did ask her about her preferred brand) she'd expected to add adrenal support, she'd just planned on getting thyroid up and running numbers first.

 

a couple years ago - I injured my leg, it's been reinjured, it has never properly healed. it has caused me much difficulty. (I saw the sports med guy at the practice I was before, for what was a 2nd/3rd degree MCL - and he basically did nothing.) I started the adrenal support when I did after reading about five separate leg muscles affected by low adrenal function that can destabilize the pelvis.  NDT (and I'm still hypo) made a HUGE difference in how my leg felt.   it was .. weird.  two days after I started 1 1/2 grains, I felt this wave of cold sweep down my leg - and nerves and muscles started settling down.  I'd started with a new chiro and PT just before this to see if we could finally resolve the leg.  the chiro (whom I've seen the most as he referred me to the PT) has repeatedly commented on how fast my leg is improving and that my pelvis is stabilizing just since improving my chemistry.

 

Edited July 16, 2016 by gardenmom5

[Ellie]

yeah - she started me at one, and allowed me to increase 1/2 grain.  (I actually tried doing 2 grains - but realized I need adrenals first)  - so we're currently in the holding before labs.  she really wants labs before increasing past 1 1/2. 

 

Again, don't stay too long on too low a dose. There's no reason to wait for labs to increase if you are still symptomatic, adrenals notwithstanding (although it is good that you are addressing those; did you do the 24-hour saliva test?). You will *know* when you reach the right dosage; you won't need labs to tell you that. Two grains of NDT is not that much, BTW. I take almost five, and that's not uncommon.