# Need help with Labs



## Girlwonder72 (Oct 11, 2015)

Good afternoon-

I have been struggling since last October with my weight. I am an avid gym rat (6 days a week) and perform cardio 6 days a week. I have gain and lost the same 5 pounds for months. During this time, I have experienced neuropathy, hair loss, the sweats, inability to lose weight, headaches, and other symptoms with the major one---Chronic Fatigue. I have been to the Rheumy (as I was ANA positive round and speckled), a Neurologist, finally to the Endocrinologist. Previous Doctor's have just tested TSH or TSH reflex T4 which was in the normal range. The Endocrinologist performed a TSH, free T4 and free T3. Both Thyroid Peroxidase and immunoglobin came back negative

Results:

TSH 1.29 REF: .27-4.20 (This is declining from previous tests. Beginning Sept. it was 1.42)
Free T4 1.13 REF: .78-2.19
Free T3 1.86 L Ref: 2.0- 4.4
A.M. Cortisol 26 H Ref: 6.20-19.4

The nurse practitioner told me my thyroid levels were in normal range and that Free T3 levels fluculate throughout the day. She is sending me for a 24 hour urine test (she said there were three hormone tests).

Is this hypothyroidism? I did little research on the internet they only thing I am coming across is low t3 syndrome. I guess I am thrown off as the interpretation charts don't show a normal TSH, Free T4 and Low Free T3. Also, it appears the high cortisol causes T3 suppression? A

Thanks for your thoughts, input.


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## jenny v (May 6, 2012)

Are you on any kind of thyroid medication now? While it's true FT3 can fluctuate throughout the day, you don't really want it to go below the range. A lot of the symptoms you describe can be attributed to low FT3. Your FT4 is also a bit low, too. The midpoint of the range is 1.4 and you are below that. It would probably help to get a thyroid antibody panel done, too.


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## Girlwonder72 (Oct 11, 2015)

Thanks, I had both the immunoglobin and Thyroid Peroxidase antibody tests. They were negative. I am not on any thyroid meds at this time.


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

Substances not found in normal serum
http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm
(Copy and paste into your browser)

Your FT3 is clearly in the basement and this is a case where the only good thing about a range is that it detects movement either up or down.

If this doctor won't treat you, please find one that will.

Also, do you have a copy of the TPO and Thyroglobulin test results and ranges? They often just say they are negative when they are within the range. In actuality, the healthy body has none of the above.

Info furnished and Welcome to the board!


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## Seeking (Sep 19, 2013)

Girlwonder72 said:


> Thank you Andros!
> 
> Thank you for the information. I had a gut feeling the Free T3 was a concern. I am dealing with a NP because the Endo I was referred to is out on maternity leave. I cut and pasted my TPO and TPI. I guess I will be looking for another Endo tomorrow. lol My TPO was <10 (Ref 0-35) and Thyroid stim immune was 91 (Ref: <=122%). I am going to look at the links your provided. Thank you so much for your help
> 
> ...


I don't know what to make of your second antibody test, maybe someone else here can. Mine looked very different from yours. Mine was like this:

*Thyroglobulin Antibody: 177 IU/mL*
Reference: 0.0-0.9

The fact is, however, that a healthy body would produce zero antibodies (the antibodies are actually auto-antibodies--an autoimmune reaction in which the body's own immune system attacks the internal organs, in this case, your thyroid). Any autoimmune activity inside the body can and will cause some form of trouble. Your TPO, T3 and symptoms are enough to continue investigating things with another doctor. Look for a "functional medicine," "naturopathic" or "holistic" doctor.


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## Andros (Aug 26, 2009)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

You have TSI; that means hyperthyroid. Trab keeps that in bounds.

More info floating your way.

You definitely need an ultra-sound of the thyroid if you have not had one; the better choice in your circumstances may be RAIU (radioactive uptake.)


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## Lovlkn (Dec 20, 2009)

> Free T4 1.13 REF: .78-2.19
> Free T3 1.86 L Ref: 2.0- 4.4


Hypo



> THY STIM IMMUNO | 91 | | <=122 % | SB


Shows hyper thyroid

quote from Andros



> You have TSI; that means hyperthyroid. Trab keeps that in bounds.


That is exactly what is happening with you.

Only mystery to me is how you do not have any TPO antibodies

High thyroglobulin antibodies

REQUEST an ULTRASOUND of your THYROID.

Do not worry about Cortisol levels now - not your biggest issue. Also, saliva cortisol is the best test to determine accurate levels.


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## Girlwonder72 (Oct 11, 2015)

Thank you for the post. Well this is interesting. I wish I had symptoms of hyper as I am having trouble losing weight not matter what I do. I am and have been fatigued for almost a year. I will see what I can do to get a ultrasound. The NP at the Endo keeps telling me my thyroid levels are normal and the Free T3 fluctuate throughout the day. She decided to pursue the cortisol since a.m. cortisol levels were high. I am in the process of trying to find another endo.


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## Girlwonder72 (Oct 11, 2015)

Just thinking....may be totally unrelated......I tested ANA positive round and speckled in October 2014. I was tested due to what they call nerve hypersensitivity (had severe abdominal distention and pain---I looked 9 months prego).


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## Andros (Aug 26, 2009)

How is your liver? Do you have diabetes? Both can cause ascites.

More test need to be done if you have ANA. ANA is only "suggestive" of a myriad of things.

Get tested for RA, Lupus etc. to rule out or rule in. Lupus is Anti-dsDNA.

Hugs,


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## Girlwonder72 (Oct 11, 2015)

My liver is fine. No diabetes. I have been tested for everything under the sun as it relates to ANA testing and nothing.

The endo emailed me on Friday and told me all the tests (Creatinine Clearance, 24 hour Cortisol, etc) were all normal and that there's nothing going on Endo related. I am concerned with the Thyroid results. I am looking for a functional doctor or a more holistic Endo.


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