# Trying to understand my results



## Becky (Apr 9, 2014)

Hi. I I am new to this board and need some help! I got my lab results back yesterday and the Endo I am seeing very vaguely went over them with me. As in, "your TSH is normal but your antibodies were abnormal so you have Hashimoto." I left feeling like I should have asked a lot more questions but of course didn't. I want to be better prepared when I go back and I think the first step would be by understanding my labs better!

My Results:
Thyroid Peroxidase Antibody 241 (<35)
T3, FREE 3.0 (2.3-4.2)
T4, FREE 1.3 (0.8-1.8)
TSH 2.79 (0.40-4.50)

FNA Results:
Consistent with lymphocytic thyroiditis (Bethesda Category II : Benign)

He wanted to take a wait and see approach. I did bring up all the symptoms I am having (hair loss, weight gain, memory fog, tired all the time, feeling of something stuck in my throat, just to name a few) and what I am supposed to do about them. He said that my thyroid wasn't causing them since my TSH was within normal range BUT if I wanted we could try synthoid 50 MCG. So, I agreed and go back in 2 months where he will again check my TSH and FT4 again.

Thanks!


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## joplin1975 (Jul 21, 2011)

Your TSH might be within normal range, but many, many people would not feel well with it that high. A lot of people (but certainly not everyone) feel better with a TSH around 1.0.

Your free numbers (which is what you want to concentrate on from here on out are ok, but a little on the low side. You want each free value to be at midpoint of the range (minimally) and, especially for your free t3, you want that to be around 75%. Your free t4 is just at midpoint and your free t3 is slightly on the low side, so adding in some synthroid could very well help.


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## Becky (Apr 9, 2014)

Thanks for the reply Joplin!

I definitely am glad I pushed a little then on his whole "wait and see" approach and got him to give me the Synthoid.

Should he be checking more than just my TSH and FT4 when I go back?


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## joplin1975 (Jul 21, 2011)

It would be really great if they checked free t3 as well. That the optimal approach. That said, because the test is expensive and because my insurance company was being a jerk, what I did was relied on TSH and free t4 at the beginning and then once free t4 got high enough, if I continued to feel sluggish, we agree to test free t3, regardless of how much the insurance company may have made me pay. It's admittedly not ideal, but it's one way to go about it.


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## jenny v (May 6, 2012)

> I definitely am glad I pushed a little then on his whole "wait and see" approach and got him to give me the Synthoid.


It's easy for doctors to say "wait and see" when they aren't the ones living with the day to day symptoms! I'm glad you pushed for the meds.


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## KLB (Apr 4, 2014)

I totally get it must be hard to feel good once thyroid is removed. I had thyroid cancer and it was .removed last year and haven't seen a dr since last April. I did just get blood work T-4 free. 1.5. T-3 total 64.7 (71.0 -180. ) TSH .59. The only thing off is t3 is that's what's making my vision blurry hair shedding and weight gain? I thought that TSH is what caused that. I didn't see the thyroglobulin on this report

Any suggestions I should ask the dr next month when I see him?


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## joplin1975 (Jul 21, 2011)

Oh, goodness, KLB...if your TOTAL t3 is low, then is stands to reason that your free t3 (which is the unbound hormone available for your body to use) is probably nearly non-existent. Its only of those things where you don't want to say "the only thing off is t3"...t3 is the active hormone that enables your body to function. So, in sense, it's the most critical piece. TSH is produced by the pituitary gland. Those of us with cancer pay attention to it because suppressing TSH usually means we lessen the chances of recurrence, but it has absolutely nothing to do with hwo you feel and quality of life after a TT. And, assuming you are in the States, most people start feeling crummy once their t4 gets above 1.4....you are getting close. You need to add in some t3, either by switching to dessicated meds entirely or adding in cytomel.


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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)

If they did FNA and identified the Hurthle Cells indigenous to Hashimoto's (thyroiditis), then you do have Hashimoto's and being on thyroxine replacement in some cases not only makes you feel better re your symptoms but in fact should shrink the nodules.

I do believe that you should have labs every 8 weeks for further titration of your thyroxine replacement. Most of us feel best w/TSH @ 1.0 or less and the FREE T4 and FREE T3 at about 75% of the range supplied for those tests.

And follow-up ultra-sounds on a yearly basis at the very least. In the meantime, should you continue to have trouble swallowing, it might be a very very good idea to see an ENT.


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## KLB (Apr 4, 2014)

Hi Joplin 
Thanks for your input. I had the papilary with hurthle cell cancer but didn't go into lymph. I didn't have radiation after because on was 
"Right on the border" as to have that. Did you have the radiation? I don't see the Dr till mid May and I still don't know what the result was for the thymoglobin. Does the T3 have any influence on that? I was thinking about doing a big detox to see if it would boost my energy and maybe loose a few lbs .... now I'm not sure if that is a good idea from what little I've read on low T3 it says almost impossible to loose weight. Any thoughts on that?


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