# Do my labs indicate a thyroid problem?



## Aryka1117 (Mar 14, 2010)

I have been suffering from virtually every symptom of hypothyroidism for the past 5 to 10 years, but never even realized it until I got my latest lab results. I have had thyroid labs drawn in the past, but have never been able to see what my actual levels were and my doctor said they were normal so I never thought to ask. For the past week I have had severe lightheadedness non*stop and, when my labs came back, I thought the thyroid levels, although within a normal range, seemed a little off. My doctor will be calling me tomorrow with her interpretation of my results and I just want to know if I should push for more testing. I'm a little worried that, because it's within that normal range, all of my exact*match symptoms will be ignored.

Here are my levels:

T4 Free: 0.8 (Lab Range: 0.7 to 1.5 ng/dL)
TSH: 2.40 (Lab Range: 0.35 to 4.94 uIU/mL)

What do you think??


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## Andros (Aug 26, 2009)

Aryka1117 said:


> I have been suffering from virtually every symptom of hypothyroidism for the past 5 to 10 years, but never even realized it until I got my latest lab results. I have had thyroid labs drawn in the past, but have never been able to see what my actual levels were and my doctor said they were normal so I never thought to ask. For the past week I have had severe lightheadedness non*stop and, when my labs came back, I thought the thyroid levels, although within a normal range, seemed a little off. My doctor will be calling me tomorrow with her interpretation of my results and I just want to know if I should push for more testing. I'm a little worried that, because it's within that normal range, all of my exact*match symptoms will be ignored.
> 
> Here are my levels:
> 
> ...


Hello and welcome to the Board! Wow!! That is a very low Free T4. When I see that, I always wish the doctor had done a Free T3 test also as T4 is supposed to convert to T3 which is the active hormone and knowing the FT3 would help us know if that is what is going on.

See if I can explain. If FT4 and FT3 both are high and TSH low, then patient is hyper. If TSH is high and FT4 and FT3 are low, then patient is hypo. That part is simple.

But, if FT4 and FT3 are both very low, and TSH is where yours is, we might look to pituitary. If FT4 is high and FT3 is low, we might conclude the patient is not converting or is converting to rT3 (reverse.)  If FT4 is low and FT3 high, we could assume that patient is converting too much and too fast which could indicate hyper.

As I say, it can get complicated so I am going to suggest you get the following labs to help sort things out.

It is imperative to get antibodies tests.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin*binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies),TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/understanding/conditions/thyroid.html

Can't comment much on the 
TSH at this point because when antibodies are at play, there is a lag time between the Frees and the TSH. You are in range but w/that low FT4, something is not right.

Is light*headed your only symptom?


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## Aryka1117 (Mar 14, 2010)

Thanks for the quick reply! Even without a degree, just to hear someone else say that they think my ft4 is low, makes me want to cheer!

Yes, I have tons of symptoms. I have had 3 children and 3 miscarriages. I was diagnosed with PCOS and also have low progesterone. I have an extremely stubborn weight loss problem. I am always exhausted (almost falling asleep at work) while getting 8*9 hours of sleep at night. I spent a year & a half going through every test imagineable (including a spinal tap) trying to diagnose the problem of the fatigue and, at the time, severe headaches. My hair is extremely dry, but I always attributed that to having hard water??? I have been diagnosed with post*partum depression after my last two children because of anxiety, but the meds don't really seem to help. I get extremely irritable and (how embarrassing is this) I have hit rock*bottom in the sex drive department. I am 29 years old and my husband is extremely supportive, thank God, but this is all really wearing on all of us! I don't think I've had the energy I should have for over 5 years and I owe it to my kids to get that back!


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## Aryka1117 (Mar 14, 2010)

I should also add that I am the type of person that always smiles through what I'm going through so I have a tendancy to suck it up more than I should. Sometimes I wonder who this person is that I've become!


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## Andros (Aug 26, 2009)

Aryka1117 said:


> Thanks for the quick reply! Even without a degree, just to hear someone else say that they think my ft4 is low, makes me want to cheer!
> 
> Yes, I have tons of symptoms. I have had 3 children and 3 miscarriages. I was diagnosed with PCOS and also have low progesterone. I have an extremely stubborn weight loss problem. I am always exhausted (almost falling asleep at work) while getting 8*9 hours of sleep at night. I spent a year & a half going through every test imagineable (including a spinal tap) trying to diagnose the problem of the fatigue and, at the time, severe headaches. My hair is extremely dry, but I always attributed that to having hard water??? I have been diagnosed with post*partum depression after my last two children because of anxiety, but the meds don't really seem to help. I get extremely irritable and (how embarrassing is this) I have hit rock*bottom in the sex drive department. I am 29 years old and my husband is extremely supportive, thank God, but this is all really wearing on all of us! I don't think I've had the energy I should have for over 5 years and I owe it to my kids to get that back!


Bettcha' no one did any of those antibody tests, have they?? Aaaaaaaaaaaaaaaaaaaargh. What a shame!

Please try to find a doctor to run these tests for you and if you do, I sure would like to see the results and we must also have the ranges. Different labs use different ranges.

You sound like you do have autoimmune thyroid disease. Miscarriages are common with thyroid disease and I am so so sorry for your losses.


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## Aryka1117 (Mar 14, 2010)

Well, doctor says there's nothing abnormal about my results.

I asked about the baseline free t4 and she said it's normal and wouldn't cause any symptoms at that level. I asked if she could do further testing and she said (through her nurse, by the way) that she did not feel any further testing was necessary.

I found out this AM that my brother has an underactive thyroid and takes meds to control it. I have an appt with his doctor on Monday.


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## Andros (Aug 26, 2009)

Aryka1117 said:


> Well, doctor says there's nothing abnormal about my results.
> 
> I asked about the baseline free t4 and she said it's normal and wouldn't cause any symptoms at that level. I asked if she could do further testing and she said (through her nurse, by the way) that she did not feel any further testing was necessary.
> 
> I found out this AM that my brother has an underactive thyroid and takes meds to control it. I have an appt with his doctor on Monday.


This is good news. This other doc does not understand that you need sufficient T4 to convert to T3 which is your active hormone. Not to mention the other possibilities I mentioned.

That was quick too. I am so glad you could get in. Oh, you must let us know as soon as you can.


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## Lovlkn (Dec 20, 2009)

Aryka1117 said:


> Well, doctor says there's nothing abnormal about my results.
> 
> I asked about the baseline free t4 and she said it's normal and wouldn't cause any symptoms at that level. I asked if she could do further testing and she said (through her nurse, by the way) that she did not feel any further testing was necessary.
> 
> I found out this AM that my brother has an underactive thyroid and takes meds to control it. I have an appt with his doctor on Monday.


You might ask the doctor to check you iron and ferritin levels and Vit D levels as if those are low in addition to the thyroid it makes the fatigue even worse. I agree that your FT-4 is very low which can and will cause alot of the symptoms you have.


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## Aryka1117 (Mar 14, 2010)

I also made an appt with a doctor who does saliva hormone testing. Unfortunately, most of the doctors around here don't really consider anything except what is in black & white. I know that this new doctor will at least listen to me and do what it takes, but I'm not sure how much she actually knows about treating thyroid disorders. I guess the most important thing at this point is just to find someone who will listen and refer me to the appropriate doctors that will cooperate with me.


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## Andros (Aug 26, 2009)

Aryka1117 said:


> I also made an appt with a doctor who does saliva hormone testing. Unfortunately, most of the doctors around here don't really consider anything except what is in black & white. I know that this new doctor will at least listen to me and do what it takes, but I'm not sure how much she actually knows about treating thyroid disorders. I guess the most important thing at this point is just to find someone who will listen and refer me to the appropriate doctors that will cooperate with me.


I sure hope so; I am anxious about the lab tests and somebody definitely has to do at least some of those labs for antibodies.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies),TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/understanding/conditions/thyroid.html


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## Aryka1117 (Mar 14, 2010)

Whew! Ok, it's been quite awhile, but I was finally able to get some labs to further evaluate my thyroid. My levels seemed to have improved on their own, but let me provide a little background.

After my doctor refused to do more testing, I sought a second opinion from another doctor who thought that, perhaps instead of thyroid, we should be looking at vitamin levels and such so he ran some different tests. My vitamin D levels were looking low, but everything else was said to be normal. In October, I went back to my regular doctor for my yearly checkup and, when she asked how I had been feeling, I told her about the same. She then suggested I see an endo which brings me to where I am now. I had an appt today and they did an ultrasound of my thyroid (normal) and drew more labs (normal). They also ordered a saliva steroid test, but I can't take it for a few weeks due to just finishing a 7 day prescription for Prednisone (steroid).

I am also currently taking the following medications for the explained reasons:

PREDNISONE 
MOXIFLOXACIN 400 MG TABLET 
FLUTICASONE 50 MCG/ACT NASAL 
(For a sinus infection/walking pneumonia that I've had since October and won't go away)

YASMIN Birth Control DROSPIRENONE-ETHINYL ESTRADIOL 3-0.03 MG 
(to regulate menstrual cycle/control PCOS symptoms)

PHENTERMINE 30 MG CAPSULE
(Taking in 3 months on/3 months off increments to help maintain weight)

I'm curious to know your opinion now with the new results?

Component	Your Value	Standard Range Units

*March 2010* 
WBC	8.8	3.3 - 10.9 K/uL 
RBC	4.77	3.80 - 5.20 M/uL 
Hemoglobin	14.0	12.0 - 16.0 gm/dL 
Hematocrit	41.4	35.0 - 45.0 % 
MCV	86.9	80.0 - 98.0 fl 
MCH	29.3	27.3 - 34.0 pg 
MCHC	33.8	32.0 - 37.0 g/dL 
RDW	12.0	11.5 - 15.1 % 
Platelet Count	322	140 - 420 K/uL 
Seg Neut Absolute	4.7	1.9 - 7.0 K/uL 
Lymphocytes Absolute	3.3	1.0 - 4.0 K/uL 
Monocytes Absolute	0.4	0 - 1.0 K/uL 
Eosinophils Absolute	0.2	0 - 0.7 K/uL 
Basophil Absolute	0.1	0 - 0.2 K/uL 
Neutrophils Percent	54	45 - 77 % 
Lymphocytes Percent	38	16 - 43 % 
Monocytes Percent	5	2 - 10 % 
Eosinophils Percent	2	0 - 5 % 
Basophil Percent	1	0 - 2 % 
Bilirubin Total	0.2	0.2 - 1.3 mg/dL 
BUN	14	5 - 20 mg/dL 
Calcium	9.7	8.4 - 10.7 mg/dL 
Chloride	101	95 - 110 mEq/L 
CO2	26	22 - 34 mEq/L 
Creatinine	0.60	0.50 - 1.30 mg/dL 
Potassium	4.2	3.5 - 5.4 mEq/L 
Sodium	137	137 - 150 mEq/L 
Glucose	77	70 - 100 mg/dL 
Albumin	3.9	3.4 - 4.8 gm/dL 
Alkaline Phosphatase	106	38 - 126 U/L 
AST - SGOT	12.0	0 - 37.0 U/L 
ALT - SGPT	12	0 - 55 U/L 
Protein Total	7.9	
T4 Free	0.8	0.7 - 1.5 ng/dL 
TSH	2.40	0.35 - 4.94 uIU/mL 
ESR	12	0 - 20 mm/Hr

*May 2010* 
Rheum Fact Quant	<9	0 - 11 IU/mL 
Folate Serum	10.9	>=5.4 - ng/mL 
Vitamin D 25 Hydroxy	32	30 - 100 ng/mL 
Vitamin B12	566	211 - 911 pg/mL 
T3 Free	3.4	1.7 - 3.7 pg/mL

*January 2011* 
Thyroid Peroxidase Antibody	<3.0 - <=5.5 IU/mL 
Thyroglobulin Antibody	<3.0 - <=4.0 IU/mL 
T4 Free	1.1	0.7 - 1.5 ng/dL 
TSH	2.01	0.35 - 4.94 uIU/mL


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## Andros (Aug 26, 2009)

Aryka1117 said:


> I have been suffering from virtually every symptom of hypothyroidism for the past 5 to 10 years, but never even realized it until I got my latest lab results. I have had thyroid labs drawn in the past, but have never been able to see what my actual levels were and my doctor said they were normal so I never thought to ask. For the past week I have had severe lightheadedness non*stop and, when my labs came back, I thought the thyroid levels, although within a normal range, seemed a little off. My doctor will be calling me tomorrow with her interpretation of my results and I just want to know if I should push for more testing. I'm a little worried that, because it's within that normal range, all of my exact*match symptoms will be ignored.
> 
> Here are my levels:
> 
> ...


Hi there and welcome. Gosh, your FT4 is in the basement and TSH looks like it might be on the rise. And by the way, thanks for the reference ranges.

My suggestion is to also get FREE T3 which is your active hormone and antibodies' tests listed.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), 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/unders...s/thyroid.html

A lot of times, the normal thyroid panel (FT4, FT3, TSH) will come in in normal range but meanwhile the antibodies are wreaking havoc and making the patient quite ill.

There reason you need the FREE T3 is so we can find out why the FT4 is so low. Either it is converting very quickly to FT3 (active hormone) or the pituitary is not notifying the thyroid to produce T4 or it is notifying but the gland is so ill, it cannot put forth the necessary T4 to convert to T3?

Hope I made that simple? Yikes!! Complicated stuff here.

Sum it up; I'm with you. I think something is running amok w/ the thyroid!


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## Andros (Aug 26, 2009)

Aryka1117 said:


> Whew! Ok, it's been quite awhile, but I was finally able to get some labs to further evaluate my thyroid. My levels seemed to have improved on their own, but let me provide a little background.
> 
> After my doctor refused to do more testing, I sought a second opinion from another doctor who thought that, perhaps instead of thyroid, we should be looking at vitamin levels and such so he ran some different tests. My vitamin D levels were looking low, but everything else was said to be normal. In October, I went back to my regular doctor for my yearly checkup and, when she asked how I had been feeling, I told her about the same. She then suggested I see an endo which brings me to where I am now. I had an appt today and they did an ultrasound of my thyroid (normal) and drew more labs (normal). They also ordered a saliva steroid test, but I can't take it for a few weeks due to just finishing a 7 day prescription for Prednisone (steroid).
> 
> ...


I am presuming you have had lung x-rays?


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## lainey (Aug 26, 2010)

>>May 2010	
T3 Free	3.4	1.7 - 3.7 pg/mL

January 2011	
Thyroid Peroxidase Antibody	<3.0 - <=5.5 IU/mL 
Thyroglobulin Antibody	<3.0 - <=4.0 IU/mL 
T4 Free	1.1	0.7 - 1.5 ng/dL 
TSH	2.01	0.35 - 4.94 uIU/mL<<

Your numbers are really very much in the normal range. You will be hard pressed to get a doctor to treat you for a thyroid problem, especially if the sonogram is also normal.

Explore the cortisol issue with the endo, perhaps there is something there regarding adrenal fatigue. Chronic fatigue syndrome is also possible, and it is a diagnosis of exclusion.


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