# Lowish Free T4, normal TSH, 4 miscarriages



## chaine1 (Sep 19, 2015)

Hi everyone.

I'm very new to thyroids and this board, and did try to search the forums for something similar, but didnt have much luck.

I'm hoping someone can weigh in on my results. In response to 4 miscarriages, my doctor ordered several thyroid tests. The tests and results are as follows:

*TSH: 0.92 mcIU/ml *Range: 0.35 mcIU/ml - 4.0 mcIU/ml

*Thyroglobulin Antibody A: **< 0.9 IU/ml * Range: 0.0 IU/ml - 4.0 IU/ml

*Anti-TPO Antibody: < 0.3 IU/ml *Range: 0.0 IU/ml - 9.0 IU/ml

*Free T4: 0.7 ng/dL *Range: 0.6 ng/dL - 1.7 ng/dL

The only thing that looks slightly off is the Free T4. I haven't yet spoken to my doctor about this, but I want to make sure I am informed and can advocate for myself when I do speak with her. Would you consider the Free T4 low for the purpose of pregnancy? If so, what would my next steps be? An appointment with an endocrinologitst?

Sorry for the noob questions. Thanks for any help you can offer.


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## Lovlkn (Dec 20, 2009)

Sorry for your losses.

A low FT-4 would indicate a thyroid issue. Your labs for FT-4 are low, closer to 1/2 or 3/4 of range is optimal.

TSH is more diagnostic and since yours is normal, antibodies may be affecting TSH.

You may be in the early stages of thyroid disease. Since you are symptomatic you should ask your doctor for a low dose trial of T4 , also known as Synthroid or levothyroxine.

Next lab, you should ask for both FT-4 and FT-3. Goal is to have both in 1/2 - 3/4 of range.

Do you ever have a sore throat?

I personally would ask fr an ultrasound of my thyroid to rule out any nodules.


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## Andros (Aug 26, 2009)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
(Copy and paste into your browser)

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.

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.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

At this point a FREE T3 test is important as the FT4 could be converting at a very high rate and hyperthyroid could be suspected.

What a shame for your devastating losses. {{{{chaine1}}}}

I am providing some info which may be helpful and I do suggest that you get an ultra-sound of your thyroid as well.

Get that Free T3 test; it is very important to see where it is at.

Welcome to the board!


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## chaine1 (Sep 19, 2015)

Thank you both for your answers and condolences. It's been a rough road, but maybe I finally have some answers. After two losses, one of my doctors ran a TSH test....had I known that a TSH test alone gives an incomplete picture of thyroid function, I would have pushed for more testing. At least I found another doctor who seems more informed.

Lovlkn, you mentioned about the antibiodies affecting the TSH. Since I had two antibodies tested (Anti-TPO Antibody and Thyroglobulin Antibody A), and they both came back very low, are there other antibodies I should be tested for?

I won't say I've had too many unexplained sore throats - mostly just after sleeping in dry air, illness, etc.

Andros - thanks for all the info, I'll be reading it!

So I should expect a free T3 test and possibly an ultrasound of thyroid. Where do most people have that done? And endocrinologist? I'm with a reproductive endocrinologist right now, so not sure if that is the best doctor to deal with thyroid issues??

Thanks again for your input and guidance.


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## Andros (Aug 26, 2009)

Any doctor should not have an issue w/the thyroid tests your request. Of course the insurance companies are another story. You may have to go to battle.

Hugs,


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## Lovlkn (Dec 20, 2009)

> *Thyroglobulin Antibody A: **< 0.9 IU/ml * Range: 0.0 IU/ml - 4.0 IU/ml


https://labtestsonline.org/understanding/analytes/thyroglobulin/tab/test

I'm no expert but a 0 on this test would be optimal. It's a tumor marker test - insist they run a Ultrasound of your gland.

A tumor or nodule can have an impact on thyroid function. So can antibodies. I had bot high TSI and high TPO which only got higher, quadrupling in 4 years.

TPO is thyroid destruction or inflammation meter.

Normal TSH with low range FT-4 points to an issue -

Lets see what the ultrasound shows before additional antibodies testing.

Oh, and relax - you are in a good place. Lots of good information and support here.

Your kids will be with you for the rest of your life - time to focus on YOU for now. {{hugs}}


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## jenny v (May 6, 2012)

Maybe the nurse was confused? I get TSH on the low end, but not FT4.


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