# Lab results...a question please



## Meria (Jan 22, 2013)

These are the results of my initial test after a routine exam revealed that my thyroid is enlarged. Ultrasound showed nodules, which will be biopsied in a couple weeks. Meanwhile, I've been doing some research and while these numbers are normal (except the FT3, which is close enough not to matter, according to my PCP), they're all on the low side of the range.

3rd Gen TSH -- 0.587 (0.358-3.74 mclU/ml)
FT3 -- 2.3 (2.4-4.2 pGm/ml)
T4 Free -- 0.92 (0.66-1.38 nGm/dL)

I'm just wondering if anyone who knows more about this than I do thinks there's anything here to look into.

Thank you!


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## Lovlkn (Dec 20, 2009)

> 3rd Gen TSH -- 0.587 (0.358-3.74 mclU/ml)
> FT3 -- 2.3 (2.4-4.2 pGm/ml)
> T4 Free -- 0.92 (0.66-1.38 nGm/dL)


FT3 is below range which is a hypo reading.

FT4 is below mid range which isn't good either, especially having such a low FT3.

Your TSH is tracking toward hyper which leads me to think you might also have some antibody action happening as your FT3 and FT4 track hypo. Suppressing antibodies could be causing that.

Have they referred you to an endo? In my opinion you need additional testing , antibodies to be specific. TPO and TSI antibodies tests.

How do you feel? Hypo would be my guess.


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## Meria (Jan 22, 2013)

I have an appointment with an endo on Feb. 7th for what will probably be an FNA. I also have an appointment on the 11th with an ENT for the same thing (I was shopping around, looking for the earliest available appt). Now I have to decide which appt. to keep. Work schedule-wise, the 7th is best for me. The ENT doc, however, is listed on the "top thyroid doctors" website.

How am I feeling? Besides wishy-washy, you mean?  Confused and a little anxious top the list right now, with all this going on. I just took some time at lunch to compile a list of what I've been feeling. Some things I have been attributing to other reasonable explanations but I guess they could be thyroid-related too:

- almost never wake up feeling refreshed
- tired during day
- brain fog
- trouble concentrating
- ringing in ears
- dry hair (feels like straw sometimes when I rinse out shampoo)
- enlarged thyroid with nodules
- feeling like there's a lump in my throat at the base of my neck, slightly above where collar bones meet
- sort of tickly or scratchy feeling in throat sometimes, need to clear throat more than usual
- feel the cold a lot more than I used to, but I've also lost a lot of weight in the last year (planned, not unexpected) and can't say this is my new normal, not having all that fat as insulation; a more recent development is frequently cold hands and feet
- at the same time, my weight loss has slowed to less than a crawl even though I'm still under-eating my daily calories and still exercising well
- when I get hungry, if I don't eat something I end up feeling nauseated for a while
- mild depression

Thank you!


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## jenny v (May 6, 2012)

Although symptoms do and can cross over, all of your symptoms sound exactly like mine when I'm hypo. I've been slightly hyper for a few weeks thanks to a medication change, but it's the first time I've felt warm in months! The cold, dry hair and skin, fatigue and weight gain are the symptoms I get the most when hypo.


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## Meria (Jan 22, 2013)

Wow. Y'know, I've been tested on and off over the years for hypo, but my blood values were always within the normal range (I never thought to ask what exactly they were) so we just figured my depression was what it was. The rest of the symptoms can be explained by or blamed on other things. I think I'll keep the appointment with the endocrinology/thyroid clinic and see what they have to say about the bloodwork and symptoms etc. Must remember to take the list of symptoms with me, as well as the names of those other tests mentioned earlier.

This is all kinda scary, you know? With not knowing, the mind tends to wander, and sometimes it stays where it belongs, sometimes it goes to darker places.


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## Andros (Aug 26, 2009)

Meria said:


> These are the results of my initial test after a routine exam revealed that my thyroid is enlarged. Ultrasound showed nodules, which will be biopsied in a couple weeks. Meanwhile, I've been doing some research and while these numbers are normal (except the FT3, which is close enough not to matter, according to my PCP), they're all on the low side of the range.
> 
> 3rd Gen TSH -- 0.587 (0.358-3.74 mclU/ml)
> FT3 -- 2.3 (2.4-4.2 pGm/ml)
> ...


It is worth noting that all 3 lab results are very very low. Not what one expects to see.

Maybe pituitary in nature? Adrenal? Estrogen dominance? Or a non-functioning thyroid for a variety of possible reasons.

Will you please let us know what the endo has to say?


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## Meria (Jan 22, 2013)

My original post is here: http://www.thyroidboards.com/showthread.php?t=7565

Got the results back from my nodule biopsy and they are "reassuring...findings consistent with a benign thyroid nodule...therefore no active treatment is needed at this time...we should plan a follow-up in 12 months with a repeat ultrasound...there is a less than 2% chance of the results being falsely benign..."

So he is unconcerned about my blood levels. The PCP is unconcerned. Should I just let it go at this point? I have one more appt with a different endo at a different hospital on the 28th and COULD use that as a 2nd opinion. But if that doctor is another TSH'er then it'll just be a waste of my time.

I'm not sure if I should pursue a holistic/functional medicine doctor (who would most likely find a hormonal imbalance since I'm also in surgical menopause and not on any HRT), but I'm a little wary of that approach. I'm not looking to force a diagnosis if there is none to be had. But I don't like being left with questions, you know? What if there really IS a need for some kind of thyroid medication that would help?

Ugh. Maybe I will just bide my time, track symptoms, and see what happens.


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## Meria (Jan 22, 2013)

Bump...trying to decide whether or not to cancel appt with a different endo next week. Suggestions? Thank you!


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## Andros (Aug 26, 2009)

Meria said:


> Bump...trying to decide whether or not to cancel appt with a different endo next week. Suggestions? Thank you!


It may be wise to pursue this as many have noted and myself included have noted that your lab results are odd in that "everything" is low. 
And while rare; that TSH test may have been skewed or even lagging behind the FT3 and FT4 which I have seen many many times.

You don't feel good and there is a reason. I would want to know.


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## Meria (Jan 22, 2013)

Thank you Andros. That's what I'm thinking--about going anyway to see what they say. I also found a local holistic/functional medicine doctor who specializes in metabolic and hormonal imbalances and am considering making an appointment there. They do a full range of testing and take what sounds like a much more rounded, open-minded approach. However, it would be all self-pay and I'm not sure I'm comfortable with that route right now.

I'm tired of all these doc appts--broke my toe last week and have seen an ortho for that, seeing another ortho for my collar bone pain, and probably another endo visit. Work is going to think I'm a complete hypochondriac, lol.


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## Meria (Jan 22, 2013)

So frustrated. Just got a call from B&W saying they noted that I'd recently had a biopsy at MGH and wanted to know if I wanted to keep my appt. tomorrow as a 2nd opinion or cancel. The appt. at B&W was apparently just for an ultrasound and then biopsy if needed. Nothing to discuss my issues in general--THAT would be a "new patient appointment." Apparently they wrote me in for a "nodule" appointment. Doc at B&W doesn't have any "new pt appts" until May or June. That's what I thought I was getting, both at MGH (which explains why he didn't want to hear about any of my other issues) and at B&W. I told her to cancel tomorrow.

Maybe I'll wait and revisit with my PCP in April. Or go to the endos he wanted me to go to in the first place (I chose Boston because it's convenient to work...but NONE of this has turned out convenient at all so what's one more hassle at this point). Bleah.


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