# Help with LAB results please



## beth4455 (Jun 25, 2021)

I am 47 and have had joint and muscle pain, weakness, brain fog, fatigue, insomnia and weight gain. Trying to find root cause and not accept fibromyalgia diagnosis. Only medication is celexa at this time. I have stopped all supplements as I have no idea what is helping and what is unnecessary. My diet is well rounded. I tried to add BHRT last year but it made symptoms worse which from my reading leads to adrenals or thyroid. Does anything in labs look suspicious? Doc ordered total t3 instead of free.Free t3...in Janurary was low=now Total t3 is high?
*6/25/2021 LABS 
TSH 1.260* uIU/mL range _0.465 - 4.680 uIU/mL_* 
T3 total 189.0* ng/dL range _97.0 - 169.0 ng/dL _
*Free T4* *0.83* ng/dL range _0.78 - 2.19 ng/dL _
*B12 385* pg/mL range _239 - 931 pg/mL _
*Vit D 46.5* ng/mL 
Reference Range:
Deficiency: <20 ng/mL
Insufficiency: 21-29 ng/mL
Optimal Level: >=30 ng/mL
Possible Toxicity: >80 ng/mL 
*Folate * *17.7* ng/mL Range: >2.8 ng/mL 
*TIBC* *254* ug/dL range _265 - 497 ug/dL _
*Iron* *86* ug/dL range _37 - 170 ug/dL _
*Ferritin* *24.9* ng/mL range _6.2 - 137.0 ng/mL _
*January 2021 
T3, Free 2.5* pg/mL range _2.8 - 5.3 pg/mL_* 
THYROID PEROXIDASE 0.7* IU/mL range_0.0 - 9.0 IU/mL _
*ANTI-THYROGLOBULIN *hyroglobulin Antibody <0.9 0.0-4.0 IU/mL=*negative *


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## GOLGO13 (Jun 13, 2018)

beth4455 said:


> I am 47 and have had joint and muscle pain, weakness, brain fog, fatigue, insomnia and weight gain. Trying to find root cause and not accept fibromyalgia diagnosis. Only medication is celexa at this time. I have stopped all supplements as I have no idea what is helping and what is unnecessary. My diet is well rounded. I tried to add BHRT last year but it made symptoms worse which from my reading leads to adrenals or thyroid. Does anything in labs look suspicious? Doc ordered total t3 instead of free.Free t3...in Janurary was low=now Total t3 is high?
> *6/25/2021 LABS
> TSH 1.260* uIU/mL range _0.465 - 4.680 uIU/mL_*
> T3 total 189.0* ng/dL range _97.0 - 169.0 ng/dL _
> ...


Thyroid labs are interesting. Good news is you don't likely have Hashimotos. Those antibody tests certainly don't show it. TSH is fine, but your free tests show a bit low for some reason. I would consider that TSH to be optimal. FT3 was way too low (even below the range). FT4 is on the low side. In general, somewhere in the middle would be expected. But everyone is different. And not being on medication for it, it's hard to say where your optimal FT4 and FT3 would be. I'd say it's unlikely it would be below the range though.

I agree with stopping supplements as it can be hard to say if they are helping or hurting. Best to add when you find something you are deficient in. I wouldn't pay much attention to total T3. The FT3 is the more important test.

Although rare, you could have them check to see if you have pituitary disease: Hypopituitarism - Symptoms and causes ... That can explain a normal TSH but low levels of FT4 and FT3. Usually endocrinologists should be good at diagnosing something like this. However, you may get them saying everything is normal despite you having an out of range FT3 in Jan. Now, there may be some folks that naturally have that low a FT3, but I don't think it would be normal and you are having unhealthy symptoms.

However, it depends a bit on when you have your labs taken, where in the daily cycle your labs were (they can go up and down throughout the day). 

You could try a different anti-depressant to see if that's causing you some issues. But if you were doing well on that maybe not. Then again, if your T3 got better you may be doing better with anxiety and depression. 

Honestly endocrinologists can be a bit of a pain sometimes in my experience. Try to find a really good one in a large city and high quality hospital. Look for one with good reviews that deal with thyroid and such. They can be good at figuring out weird cases like you may have. But they are not always good at managing thyroid like you would think they would be. But they should be who you would go to in order to rule out something like pituitary problems.


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## GOLGO13 (Jun 13, 2018)

You should get more Iron levels checked. How to fix Iron levels ask your doctor. I don't think it's always just taking Iron. But pay attention to Iron sources in your diet. Iron is important for thyroid function. The below maybe somewhat extreme, but should be a bit of a guide. Your ferritin seems a bit low. 

Here is another link talking about central hypothyroidism: Normal Thyroid Hormone Levels: What are Normal Thyroid Hormone Levels? Normal Thyroid Hormone Level Symptoms, Treatment, Diagnosis - UCLA .... Again, this is something an endocrinologist should be able to figure out. But find a good quality one that doesn't just check your TSH. I would specifically say you want to be checked for central hypothyroidism or something like that. To ensure they look further than just TSH for your thyroid.


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## GOLGO13 (Jun 13, 2018)

It maybe helpful to understand your diet a bit. Your B12 looks a bit on the low side. If you were vegan, that could explain some of this. But I would assume if you were you'd be taking B12 as it cannot be gotten otherwise. B12 issues can cause a lot of problems also. But, if they were to figure out why your FT4 and FT3 are on the low side, you maybe able to fix some of those other issues. The body needs balance to work optimally. 

Here are some things to consider for optimal thyroid hormone conversion (converting T4 to T3). T3 is the more active hormone. Still, it looks like you don't have either one in a high amount at this point. But you want to ensure you are converting as much as possible. Even if you end up not having a specific issue with the thyroid, this could help.


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## GOLGO13 (Jun 13, 2018)

One more point. They could scan your pituitary to see if anything is up with it. It's probably an ultrasound or something like that. They could check your thyroid with that also. Worth a check I would think.


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## GOLGO13 (Jun 13, 2018)

I really like this website and they have a good topic on central hypothyroidism: Why is central hypothyroidism so difficult to diagnose?


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## Lovlkn (Dec 20, 2009)

Welcome to the forum Beth,

At first glance I see need to increase D, B-12 and Ferritin levels. Goal for all 3 should be at least 3/4 of range. Note where in monthly cycle the ferritin levels were drawn and it naturally will be low after your cycle.


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