# Thyroid lab help



## applellama (Aug 13, 2015)

I'm a 30 year-old female in pretty good shape, no kids, and I eat well and exercise regularly. The last 3-4 years, I've been exhausted no matter how much sleep I get (even after 9-10 hours) and struggle with mild depression no matter what lifestyle changes I've made. I recently got tested by an endocrinologist and the results all came back in the normal range which was a little disappointing, though I realize the ranges are not always the best indicator of normal functioning.

Could you guys take a look at my test results and let me know if there's anything that might be worth following up on or that the doctor might have missed?

Thyroxine (T4) 9.7 ug/dL (4.5 - 12.0)
Triiodothyronine (T3) 154 ng/dL (71 - 180)
Thyroxine (T4) Free, Direct, S 1.26 ng/dL (0.82 - 1.77)

Vitamin B12 363 pg/mL (211 - 946)
Thyroid Peroxidase (TPO) Ab <6 IU/mL (0 - 34)
TSH 1.440 uIU/mL (0.450 - 4.500)
ACTH, Plasma 14.1 pg/mL (7.2 - 63.3)

Vitamin D, 25-Hydroxy 40.3 ng/mL (30.0 - 100.0)

Cortisol, Serum LCMS 27 ug/dL (8:00 AM 8.0 - 19; 4:00 PM 4.0 - 11)

I also had a basic metabolic panel done. If any of those results might be helpful, I can add them. Thank you!


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## Lovlkn (Dec 20, 2009)

Vitamin D is very low - do you supplement yet?

You might want to ask for a Ferritin test which will give you an accurate idea of iron levels. If you have a monthly cycle - make note when the lab is drawn as it tends to bottom out after a cycle.


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## Andros (Aug 26, 2009)

SUGGESTED TESTS
TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/
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TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
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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.
Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/
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Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

Ferritin (should be 50 to 100; the closer to 100,the better) 
http://www.thewayup.com/newsletters/081504.htm
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Substances not found in normal serum
http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm
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Welcome to the board.

It does sound like your ferritin level is low as per Lovlkn. And this is not uncommon w/thyroid disease.

So, check the ferritin and request an ultra-sound of your thyroid and I am providing important info above. Your doc did not run the FREE T3 which is essential and you do have a smattering of TPO Ab where you should have none.

Lots of reading but it should serve you well.


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## applellama (Aug 13, 2015)

Hi Lovlkn, thank for your suggestion for Vitamin D. I don't regularly take supplements but I'll definitely look into adding them into my daily routine.

Andros, thank you for pointing out the TPO Ab and the suggestion for an ultrasound

In your experience, what is the best way to go about requesting these additional tests from your doctor if they haven't ordered them? In my follow-up report, the doc just said "everything looks normal, follow up with your normal gp."


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