# Need some help understanding my labs...



## bip1112 (Oct 28, 2013)

Hi there--

I was diagnosed with hypothyroidism in 2013. Since then I've been on .75mg of synthroid. Recently I started feeling very out of whack (hair falling out, tired, anxious, dry skin...the usual. I'm an ultramarathon runner and running has felt very hard lately, but because of my running my weight stays very low). So I got a full panel done with a new dr. I talked to a PA last night about my results and was told 'high normal'...but no specifics. This morning I got a copy of my labs and discovered that it would appear I've got some issues going on, and am hoping people can help me out.

Reverse T3 is 25.7 (H)

Thyroglobulin Antibody is 0.0

TPOAb is 33 (High in range)

T4, Free (Direct) is 1.86 (H)

Thyroid Stim Immunoglobulin is 55

TSH is 1.16

...I also have low ferritin, which is an issue as I'm a runner, and my iron saturation is low normal. My TSH is usually around 2.5, so I'm surprised to see it as low as it is, although I know it's technically in range.

Anyway--can anyone help me with what I'm looking at? And potentially recommend next steps? I know I don't feel normal, and unfortunately that's not getting me too far.


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## joplin1975 (Jul 21, 2011)

Well first off your have TSI which, even when it's "in range," is a really crummy antibody that can make you feel just atrocious.

More importantly, your free t4 is high and your revese t3 is high, which usually indicates that you are not properly converting t4 (synthroid) into t3, which is the form of a thyroid hormone needed for metabolism. Its what you body uses when, for example, you are running.

You next step should be to ask for a free t3 test.


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## Lovlkn (Dec 20, 2009)

Welcome to the board!

How often do you have labs run?

I agree with everything Joplin said.

Have you ever had an ultrasound of your thyroid?


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## bip1112 (Oct 28, 2013)

Thanks so much for the responses! I will request free T3. I'm sad to say this is the first time I've ever had full labs done--I had TSH, T3 & T4 originally and it seemed textbook hypothyroid, so I went on Synthroid. That seemed to work fine until now...so this is the first time I've ever had this much work done. I've never had an ultrasound--should I request one?


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## Pamzilla13 (Sep 9, 2013)

Do you have any lab results for B12 and Vitamin D?

It is clear that you have an issue with those thyroid lab results.

Vitamin deficiency can contribute to symptoms and since you are an athlete, those vitamins are crucial and are most often over looked.

Just something to think about and help complete the picture.


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## jenny v (May 6, 2012)

I would definitely request an ultrasound, if you've never had one. You've got TSI and TPOAb floating around, which can sometimes make things a rollercoaster and can make it hard to regulate doses (I had both, too).

Have you done a complete iron panel (including TIBC, % saturation, etc.)? Low ferritin can mess with the body using T3 properly and it can build up into Reverse T3 instead of being utilized by the cells, which it looks like is happening with you. Definitely get that Free T3 test.

And when you get any more labs, please post the ranges for each. That helps us tell things more accurately.


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## bip1112 (Oct 28, 2013)

You are all so helpful, thank you so much. I am going back to the Dr at 8 AM tomorrow.

I will request (demand, really):
-Free T3

-b-12 & D

-Ultrasound

I do have a full iron panel. The ferritin was the most concerning to me given my symptoms and my running:

Ferritin, Serum 21 
Iron Bind.Cap.(TIBC) 365 
UIBC 271 
Iron, Serum 94 
Iron Saturation 26

I just want to say thank you--this has been a very frustrating and lonely experience so far, and it is so helpful to not feel so alone. I'm typically a more mild personality when it comes to going to the dr, so it's been helpful to be armed with information to go and be a bit more demanding.

Thank you!!!


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## Lovlkn (Dec 20, 2009)

If you still have a monthly cycle - your ferritin levels will change depending on where you are in your cycle at time of lab draw.


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## bip1112 (Oct 28, 2013)

Okay just got back...Dr is convinced my synthroid is too high and wants to lower the dosage. I asked for additional testing first. We did:

--Free T3

--Vitamin D (Probably not covered by insurance...lovely)

--Vitamin B-12

--Vitamin B-1

--Cortisol

--Epstein Barr

--Thiamin

...I'll report back when I get results.


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## bip1112 (Oct 28, 2013)

I just got my results back..everything is looking pretty normal. My Free T3 is 112. I'm not really sure what that means? I know there is some trick with Free T3 and Reverse T3, but I'm not sure if I'm doing it right...Dr wants to lower my synthroid as she thinks the dosage is too high.

Cortisol is 14.5

EBV Ab IgG and IgM are both negative

T3 112B

B12 849

D 42.1 (on the low end)

Anyone who wants to interpret/offer advice, be my guest!


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## bip1112 (Oct 28, 2013)

Just talked to a friend, looks like dr ordered wrong test. Lovely.


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## jenny v (May 6, 2012)

Please post ranges for each of those labs, it helps us tell a lot more. Also, what T3 test is that? Free, total?


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## bip1112 (Oct 28, 2013)

Sorry! These are the full results of the T3. My understanding is this T3 is useless. I don't know if it was a clerical error that I didn't get FT3?

Triiodothyronine (T3) 71-180 112

Vitamin D, 25-Hydroxy 30.0-100.0 42.1

Vit. B1, Whole Blood 66.5-200.0 155.9

EBV Ab VCA, IgG 0.0-17.9 <18.0 Negative <18.0 Equivocal 18.0 - 21.9 Positive >21.9 EBV Ab VCA, IgM 0.0-35.9 <36.0 Negative <36.0 Equivocal 36.0 - 43.9 Positive >43.9 Cortisol - AM 6.2-19.4 14.5


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## jenny v (May 6, 2012)

Hmmm, it looks like that's not Free T3, which is disappointing. I'm guessing it's total T3 which doesn't tell us much unfortunately since it doesn't usually track with FT3. However, it is on the lower side. Can you ask your doctor to do a FT3 lab since they did it wrong the first time?


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## bip1112 (Oct 28, 2013)

I did! I'm going in tomorrow morning for the draw. I think she's getting a bit testy as I said 'I requested FT3, not Total T3--I'd really like to get that number." She said I was free to come in for FT3, she didn't think it would change our treatment plan, and if I'm unsatisfied she's happy to refer me to an endochrinologist.

I said not yet--I'd just like to get that lab back, and depending on what it says I'll decide if I think the endo referral is necessary or not.

What a flipping process.


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## BurntMarshmallow (Feb 26, 2016)

Are you taking iron for your low ferritin? Look into zinc, copper, vitamin A, b2, b3 and B6. All
Of them are needed for making blood cells and using iron.

I got my ferritin up from 30 to 45 after taking 25,000 IU retinyl palmitate form of vit A for two months. I'd been taking iron for six months before that with no change.

Similarly, zinc in needed for iron use, and absorption is lower when you take iron supplements. You might want to ask for blood tests for these nutrients too.


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## bip1112 (Oct 28, 2013)

I have really upped my supplements! I'm at work so I can't tell you the dosage but I'm currently taking:

-B-12

-E

-D

-Iron

-Selenium

-Evening Primrose Oil

I'm still waiting on the FT3 result, but I did start the lower dosage of Synthroid yesterday, so we will see. Just to make sure I'm right when I get the FT3 #, if it's in the hundreds, I just divide it by my RT3 (25.7) BUT if it's a decimal, I multiply by 100 THEN divide by RT3 to get my ratio? And I'm looking for a ratio over 20, correct?


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## bip1112 (Oct 28, 2013)

Finally got my FT3, it is 2.9. The nurse who called couldn't even tell me the ranges and said it's 'normal'. But everything I'm looking at says it isn't, especially when you consider my RT3 was 25.7.

Help??


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## bip1112 (Oct 28, 2013)

Just to put everything in one place for everyone to better help me...

Reverse T3 is 25.7 (H) (9.2-24.1)

Thyroglobulin Antibody is 0.0 (0.0-0.9)

TPOAb is 33 (High in range) (0-34)

T4, Free (Direct) is 1.86 (H) (0.82-1.77)

Thyroid Stim Immunoglobulin is 55

TSH is 1.16 (0.450-4.5) (Low for me)

Triiodothyronine (T3) 112 (71-180)

Vitamin D, 25-Hydroxy 42.1 (30.0-100.0)

Vit. B1, Whole Blood 155.9 (66.5-200.0)

FT3 2.9 (Range unknown b/c honestly, what I am paying these people for)


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## bip1112 (Oct 28, 2013)

It does not say anywhere on them. I did get the new that the range for FT3 used is 2.0-4.4.


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## bip1112 (Oct 28, 2013)

I made a new post to put this all in one place...

http://thyroidboards.com/forums/topic/21578-need-some-help-with-thyroid-issuesbeen-working-with-dr-for-over-a-month/


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