# Finally a Doctor that didn't doubt me and ran labs!



## Dahlena (Jun 28, 2017)

Hi Everyone!

I am new to this board and so glad that I found it! I have been experiencing serious fatigue, dry skin when I used to be oily, heavy weight gain in a short amount of time and a myriad of other issues.

After finally getting insurance again I made an appointment with an Internal Medicine Doctor. I explained to her my symptoms and went over family history of Thyroid Disease. She asked questions to get deeper answers (which I was grateful for) and said that she has other Hashi's patients and that she was ordering a number of tests for me. I am still waiting to hear from her but the results have been posted to "MyChart" online and I wanted to get some opinions from patients and you guys are all so amazing and helpful.

So here goes:

*Tsh* 1.17 mIU/L 0.40-4.50 mIU/L
*Free T4* 1.0 ng/dL 0.8 - 1.8 ng/dL
*Thyroglobulin Ab * <1 IU/mL < or = 1 IU/mL
*T3,Total* 121 ng/dL 76 - 181 ng/dL
*T3 Free* 2.8 pg/mL 2.3 - 4.2 pg/mL

These two were also listed but I don't see results or know what they mean for sure:
THYROID CASCADING REFLEX
THYROTROPIN-BINDING INHIBITORY IMMUNOGLOBULIN (TBII)

Thank you all for any tips or thoughts!

~Dahlena


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## Lovlkn (Dec 20, 2009)

Welcome to the board!



> *Free T4* 1.0 ng/dL 0.8 - 1.8 ng/dL * ((1.3-1.55))** is 1/2 to 3/4 range*
> 
> *T3 Free* 2.8 pg/mL 2.3 - 4.2 pg/mL*((3.25-3.725))is 1/2 to 3/4 range*


We like to see labs closer to 3/4 range for both FT-4 and FT-3.

Your labs are clearly in hypo range. Your doctor may brush you off and say all is good, simply because you are "in range". That's when you need to stand up for yourself and stress how poorly you feel.

A trial of levothyroxine is in order. Ask for 50mcg to start and retest FT-4 and FT-3 in 8 weeks.


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## Dahlena (Jun 28, 2017)

Thank you so much for the information! I don't think the doc will give me a hard time just based on her understanding in our initial appointment but I will definitely fight for myself. I can barely make it out of bed each morning and I'm exhausted by the end of the day.


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## Dahlena (Jun 28, 2017)

This lab result just came back but I still have no idea what it means... anyone here know?

TBII (Thyrotropin Binding Inhibit Immunoglobulin)

<6.0 %

<=16.0 %


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## Lovlkn (Dec 20, 2009)

http://www.questdiagnostics.com/hcp/intguide/EndoMetab/EndoManual_AtoZ_PDFs/TBII.pdf

In simple terms - it's a test to see what's inhibiting TSH. In your case, your low range FT-4 and FT-3 should be producing a higher TSH result. You don't appear to have any so there has to be another reason. Your doctor is looking for the cause of your low thyroid function. What sort of doctor are you seeing? A regular GP or Functional MD?

How often have you had TSH tested? Is it always in the 1 ish range?


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## Dahlena (Jun 28, 2017)

I'm seeing an Internist. This is my first time having labs in several years and I was never given the results before, just told they "looked fine". This was with a different Doctor. I am still awaiting the call from her to go over the results, I am guessing she was waiting on this last result to come back before calling me.


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## Lovlkn (Dec 20, 2009)

The good news is as an "internist" she is running the correct tests. That's a rare find - I'm curious to hear what her plan is for you.


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## Dahlena (Jun 28, 2017)

Yes, I did a lot of research before choosing a new Doctor due to the fact that my previous PCP was at a new practice and not accepting new patients until FEBRUARY!!! And it was lucky that she is a little younger and has patients with Hashi's and other Thyroid disorders so she was well versed in probing questions to really get to the bottom of what was going on.

I will definitely be posting as soon as I have heard from her as to her plan of care for me.


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## Dahlena (Jun 28, 2017)

Just heard back from the Doctor's Assistant. While the DR is out sick the nurse called to let me know that she thinks my tests are "unremarkable" and she doesn't know how to explain my symptoms. I guess I was a little too hopeful that she would want to treat me. I told the nurse that I was not better and to the point of breaking from exhaustion and depression. I also told her that while I was in fact in the normal range everything was on the extremely low end and I was concerned with that. She said she would send the Doctor a message letting her know but it may be middle of next week before I hear from her.


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## Lovlkn (Dec 20, 2009)

> nurse called to let me know that she thinks my tests are "unremarkable"


She's a nurse - if you have to, go back into he office and demand s trial of levothyroxine.

Your labs are "in range" Yes, your TSH is quite "normal" Goal for FT-4 and FT-3 is somewhere between 1/2-3/4 of range. Be strong - ask for what you need from the doctor directly.



> *Free T4* 1.0 ng/dL 0.8 - 1.8 ng/dL * ((1.3-1.55))** is 1/2 to 3/4 range*
> 
> *T3 Free* 2.8 pg/mL 2.3 - 4.2 pg/mL*((3.25-3.725))is 1/2 to 3/4 range*


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