# Lab Results Help- Does TSH Even Matter?



## slore (Jun 11, 2016)

Hello! I'm brand new to the board and any thing thyroid related.

In March my doctor ran some generic blood work on a regular work-up. My TSH came back with a reading of <0.03. She sent me back for repeat blood work in case of lab error as well as to check my T3 and T4. In the mean time she referred me to an endo. Those results came back a week later:

TSH 0.04 (0.30- 4.00)
Free T4 13 (9-23)
Free T3 4.7 (3.5-6.5)

The endo thought it could be subclinical hyperthyroidism, because my T4 and T3 were normal. She opted to leave everything along for now but wanted to monitor my levels. So she sent me away with a requisition to redo my blood work in 3 months. I went this week and my results came back:
TSH 4.98 (0.30- 4.00)
Free T4 12 (9-23)
Free T3 5.4 (3.5-6.5)

Why? How did my TSH to go from being SO low to being high in less than a 3 month span? My T4 and T3 seem so consistent with the previous blood work and still within the labs normal range. I've read there's some feeling that TSH general doesn't matter at all, does that mean this is pretty much a non-issue? Has anyone else experienced this?

Thanks!


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## Pamzilla13 (Sep 9, 2013)

Are you on any thyroid medications? If not, then those labs in March may be a lab error.

For any doctor to get a better idea of what is really going on more tests need to be ran.

For instance you want to test FREE T3 and FREE T4 instead of what you have listed there (T3 and T4)

The FREE tests show what is actually available to the body on a cellular level (unbound hormone what is available to the body). The tests that you had done show bound *and* unbound hormone.

I also suggest testing for antibodies.

Your most recent blood test shows an elevated TSH which points to hypo, but the other T3 and T4 tests no one can really know what is going on with out the FREE tests. They don't look "bad" but you never know.

TSH is a diagnostic test for hypothyroidism. If you are on replacement therapy such as Armour, TSH is irrelevant because it will be supressed. Dosing of thyroid hormone is generally done by the FREE values. But if you are not on any meds, then it points to hypo. Because of such a fluctuation from low to high TSH in your case, further testing needs to be done.

I am sure others will chime in and give some answers...


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## slore (Jun 11, 2016)

Thank you for replying. I wasn't clear in my initial post but the T4 and T3 tested were FREE. When I can figure out how to edit the post I will. I'm fairly sure the March results were not a lab error because my Dr retested to be sure if that- and my TSH was always between 0.03 and 0.04 in March/ beg. of April.

I do not not take any medications.


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## Lovlkn (Dec 20, 2009)

Welcome to the board!

As far as your TSH movement, that is a FLAG. Especially since your FT-4 did not change significantly but your FT-3 did.

There is likely some sort of antibody invlvement.

Have you had antibodies testing to include thyroglobulin, and TPO and TSI? An ultrasound of your thyroid?

What did your doctor have to say about the changes in your TSH?

I've edited in the range inside the range that most here would agree we feel our best. 1/2 - 3/4 of range.

Your issue is to determine why your TSH is going from hyper to hypo with generally hypo FT labs ( except for 1 completely normal FT-3 lab)



> T4 12 (9-23)* 1/2 range is 16 and 3/4 is 19.5*
> 
> T3 5.4 (3.5-6.5) *1/2 range is 5 and 3/4 is 5.75*


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## slore (Jun 11, 2016)

Thanks.

I haven't had any antibody tests or ultrasounds. The idea was just to keep an eye on things flipping into hyper so I was pretty surprised by this newest lab result!


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## Lovlkn (Dec 20, 2009)

I'd like to add that an ultrasound would reveal any nodules you may have which can also have an impact on thyroid function.


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## WhatHappened (Nov 12, 2015)

What next steps has your endo put in place after the latest results? Meds, more testing? (ask for the U/S and antibody testing).

Do you feel the "same" or did you get symptomatic during the wait?


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