# Help me make sense of these lab results!



## YorkieMama (Jan 21, 2010)

I have previously been diagnosed as hypothyroid. I was first diagnosed because of hair loss, no energy, weight gain, and dry skin. My hair no longer falls out, but the other symptoms still exist.

I took Synthroid 50 mcg for a while until I started having worsened heart palpitations and panic attacks. Now I dont take any meds for my thyroid. I am wondering if I was having those symptoms because of the Synthroid or if something else is going on altogether.

I had my labs done last week and the doctor said they came back "normal". I'm sitting here reviewing them and they don't seem quite normal for me.

Here are my lab results and reference ranges:

TSH- 3.460
Normal range: 0.450-4.500

Triiodothyronine, free, serum- 4.4
Normal range: 2.0-4.4

T4, Free (direct)- 1.07
Normal Range: 0.82-1.77

What confuses me is my T4 being higher than usual and my triiodothyronine being on the higher end as well.

I have always seemed to experience hyperthyroid symptoms along with some hypo symptoms but my triiodothyronine isnt usually in the higher end. Right now I am struggling with dizziness, lethargy, and panic attacks. Could this be related to adrenals rather than thyroid? I've been reading so many different things and I would really appreciate some advice from all of you knowledgeable people on here 

Thanks!


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## Marc Ryan (Mar 22, 2013)

As a functional medicine practitioner and Hashimoto's patient, I may be able to offer some clarity. But, firstly, I'm not clear, were you taking Synthroid at the time of this test?

For my way of thinking, your TSH is a bit high. This is, of course, an inverse number. Meaning that the higher it goes the less optimally your thyroid is functioning. TSH is released by the pituitary to get the thyroid gland to work harder.

Free T4 is within the normal range.

Your Free T3 is high, you have hyperthyroid symptoms and your free T4 is normal.

Since weight gain is an issue, I would look at the possibility of elevated testosterone. Do you have high triglycerides, and/cholesterol, high fasting blood sugar and/or any history of ovarian cysts? This pattern is often found in women with these other symptoms.


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## YorkieMama (Jan 21, 2010)

No I have not taken anything for my thyroid in 6 months. Usually on medication my TSH runs around 1.5. When I was first diagnosed, my TSH was 2.8 and my T4 was really low. That's why I don't understand all of these symptoms if my free T4 is higher than usual. I also dont ever remember my free T3 being so high.

I am on Microgestin 1/20 FE for my birth control. I have been told that hormone tests will not be accurate while on this, so I have never had my testosterone checked. My fasting blood sugar was 89 when they took it last week so that is normal. No history of ovarian cysts. My triglycerides were elevated once when I had bloodwork done- I was not fasting and they said that was the cause. No history of high cholesterol, though that was not checked at my appointment last week.


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## Marc Ryan (Mar 22, 2013)

Ok, you could measure T3 Uptake to find out if your estrogen is being converted to testosterone. T3 Uptake would also be high. This can also cause thyroid receptor site resistance. Usually, this is accompanied by hypo symptoms. However, one thing I have learned about Hashimoto's is that everyone's is different and making generalizations about anything is often wrong! There are so many variables, people are at different stages of progression of the disease and there are many co-existing issues that also through a wrench into the mix.


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## Andros (Aug 26, 2009)

YorkieMama said:


> I have previously been diagnosed as hypothyroid. I was first diagnosed because of hair loss, no energy, weight gain, and dry skin. My hair no longer falls out, but the other symptoms still exist.
> 
> I took Synthroid 50 mcg for a while until I started having worsened heart palpitations and panic attacks. Now I dont take any meds for my thyroid. I am wondering if I was having those symptoms because of the Synthroid or if something else is going on altogether.
> 
> ...


It may be a good idea to have these tests run plus an ultra-sound.

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.

Negative test results means that the autoantibodies are not present in the blood at the time of testing and may indicate that symptoms are due to a cause other than autoimmune. However, a certain percentage of people who have autoimmune thyroid disease do not have autoantibodies. If it is suspected that the autoantibodies may develop over time, as may happen with some autoimmune disorders, then repeat testing may be done at a later date.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

There are binding, blocking and stimulating antibodies and when they are running amok, they can really skew the numbers. Big time.


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## YorkieMama (Jan 21, 2010)

So I'm still confused... could I possibly have Grave's rather than Hashi's with these results? I've been tested for hashi's twice in the past because I do have a lot of problems with my immune system, but the tests have never indicated Hashi's.


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## Lovlkn (Dec 20, 2009)

YorkieMama said:


> I have previously been diagnosed as hypothyroid. I was first diagnosed because of hair loss, no energy, weight gain, and dry skin. My hair no longer falls out, but the other symptoms still exist.
> 
> *I took Synthroid 50 mcg for a while until I started having worsened heart palpitations and panic attacks.* Now I dont take any meds for my thyroid. I am wondering if I was having those symptoms because of the Synthroid or if something else is going on altogether.
> 
> ...


 I am going to bold out items in your post that forms my opinion on what is happening.

First - we need lab history before you began the 50mcg of Synthroid.

When my Free T-3 aka Triiodothyronine, free, serum- is 4.4 or top range I am Hyper as heck.

The overlap of hyper and hypo symptoms is very common.

My hair falls out with any movement in thyroid hormone.

You quit your Synthroid - correct?


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