Labs use different ranges depending on how they run their tests, but I'll take a stab at this anyway:
Free T4: 1.2 Typical range is .7-2.0; your result is about at midrange, which is good
T4 Total 9.7 Typical range is 4.5 to 12.5; your result is above the midpoint of the lab range, which is good
T3 Total: 105 Typical range is 80-220; your result is very low in the range, which means your body isn't converting T4 to T3 very well (most of our T3 is made from T4). T3 is the "metabolism" hormone, and when it's low we have trouble losing weight, feel tired, etc. Total T3 measures how much of the hormone is circulating in your blood. A Free T3 would show how much your body is actually USING, so it would have been good to get that run (although many docs are resistant to ordering a FT3).
T3 Uptake: an antiquated test that was used before the free T4 was available. It doesn't really test for Free T3, and it boggles my mind that docs still order this. Your result is 29.6. Normal Adult Range: 27 - 47%
Optimal Adult Reading: 37 %. Since your T3 uptake is lowish in the range, that indicates that your T4 is ok. Here is a blurb about the T3 uptake:
Quote:
This test is mentioned only as a warning not to use it. In fact, it does not measure T3 levels at all -- the name is misleading. It is an old test that was developed before we were able to accurately measure T4 levels. The assumption was that if the patient had a high T4 level, the blood proteins would be saturated with it. Therefore when mixed with T3 (which is easier to measure), the proteins would take up very little T3. Thus a low T3 uptake implies elevated T4 levels and vice versa. Thus the T3 Uptake test is actually an antiquated, inaccurate way to measure T4 levels.
It's not unusual to see low T3 and normal or high T4 in the early stages of Hashi's. Many docs will wait until the TSH level rises above lab range before beginning treatment. Others believe it's best to start treatment early (research has shown that early treatment can actually reverse antibody production and slow the progression of Hashi's). If you want to start treatment, you are going to need to find a doc who is more "thyroid-friendly" than yours seems to be. Since your T3 is low, you will probably do best with Armour or with a combo of Synthroid (T4) and Cytomel (T3).
Good luck,
Linda
__________________ dx pcos 1984, type II diabetes 2001, also hypertension
Met 2000mg since 2001, started Glucophage XR 4/22/04, then switched to Met ER 6/04; also: multi, Vit. C, Vit. E, B12/folic acid combo, fish oil & borage oil combo, garlic capsules, cinnamon, Vitex, calcium with magnesium/zinc, biotin, CoQ10, selenium,iron
Other meds: Verapamil and Altace(for blood pressure)
Started laser hair removal 7/29/03, completed 3/04 (it works!)
UAE for fibroid 3/24/03 and 3/16/04
Thank you sooooooo much!!! I'm going to two more endo's to make sure I get put on something, I'm even thinking of making another appt with my friend endo which is an awesome dr. I can't tell you how much you've helped me out!!! ((((HUGS)))) Now I just have to push the endo's to do something about it
__________________ TWINS!!!! C-section On April 9, 2007 Angelo Joseph, 5lbs 12oz Antonia Angelina, 7lbs 2oz
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You're very welcome. Here's something you might want to take to your new doc for support:
Do You Need Preventive Thyroid Treatment?
From Mary Shomon,Your Guide to Thyroid Disease.
Treating Antibodies When TSH is Normal
"Preventative thyroid treatment" -- It's a controversial subject, and many endocrinologists will simply dismiss you if you ask about it. But new research has been published that supports the understanding that autoimmune Hashimoto's disease may be preventable, slowed, or even stopped entirely before it progresses to destruction of the thyroid gland and hypothyroidism.
In a June 2005 presentation at the Endocrine Society's Endo 2005 conference, Dr. Ting Chang and colleagues reported on giving levothyroxine (i.e., Synthyroid, Levoxyl, etc.) to euthyroid Hashimoto's thyroiditis patients -- patients who had normal range TSH (known as "euthyroid), but elevated antibodies.
Half the patients were given levothyroxine for six months and the other half not treated. Thyroid function tests and autoantibody titers were measured before and after the 6 month period. Those receiving levothyroxine had substantially decreased auto-antibody levels; levels actually increased in some among the untreated group. TSH levels also decreased in the treated group, averaging 0.5 vs 2.5 in the untreated group. The researchers concluded that early prophylactic (preventative) levothyroxine treatment might be useful to help slow down the progression of the autoimmunity of Hashimoto's Thyroiditis.
This is not the first study to show that treatment can help.
In the March 2001 issue of the journal Thyroid, German researchers reported on their study of patients with euthyroid Hashimoto's, half of whom were treated with levothyroxine for a year, the other half untreated. After 1 year, the antibody levels and lymphocytes (evidence of inflammation) decreased significantly only in the group receiving the medication. Among the untreated group, antibody levels rose or remained the same.
The researchers concluded that preventative treatment of euthyroid Hashimoto's patients reduced various markers of autoimmune thyroiditis, and speculated that such treatment might be able to stop the progress of Hashimoto's disease, or perhaps prevent development of hypothyroidism.
Just this year, Japanese researchers found that treatment with levothyroxine can reduce the incidence of Hashimoto's thyroiditis, as well as help alleviate the symptoms of the disease.
In the study of patients with euthyroid Hashimoto's disease, one group of patients received levothyroxine treatment, and the other group did not receive treatment. After 15 months, the treated group had significantly increased Free T4, significantly decreased TSH levels, and a reduction in both anti-thyroglobulin antibody (Tg-Ab) and anti-thyroid peroxidase antibody levels (TPO-Ab). The size of the thyroid also decreased in the treated group, while those not receiving treatment had an increase in thyroid size.
The researchers reported that although levothyroxine treatment is "mandatory in hypothyroid autoimmune thyroiditis patients, LT4 treatment which is shown to inhibit autoimmune process in animal models is still controversial in euthyroid Hashimoto's disease patients where disease has not destroyed the thyroid gland enough to cause hypothyroidism."
They found, however, that levothyroxine treatment at doses keeping TSH at low-normal levels appear sto be effective not only in decreasing the autoantibody levels but also in the goiter size, which could ultimately prevent progression to overt autoimmune hypothyroidism.
What Do You Need to Know?
Some research shows, and practitioners have found that preventative treatment with levothyroxine may be warranted in people with euthyroid Hashimoto's disease (normal TSH levels, but thyroid auto-antibodies that show evidence of autoimmune Hashimoto's disease). Such treatment can in some cases slow down elevation of antibodies, and help prevent autoimmune disease and hypothyroidism.
If you have thyroid symptoms, a "normal" TSH level, but haven't been tested for thyroid auto-antibodies, insist on testing.
If you have thyroid symptoms, a "normal" TSH level, and elevated thyroid auto-antibodies, consider asking for treatment, and if your physician is unwilling, consider finding a more knowledgeable doctor.
Mary Shomon, About.com's Thyroid Guide since 1997, is a nationally-known patient advocate and best-selling author of 10 books on health, including "Living Well With Autoimmune Disease" and "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss." Click here for more information on Mary Shomon.
------------------------------
Sources
En-Ting Chang, Du-An Wu, Dee Pei, Shi-Wen Kuo, Ming-Chen Hsieh. [P2-552] Influence of L-Thyroxine Administration in Patients with Euthyroid Hashimoto's Thyroiditis. Endocrine Society Endo 2005 Abstracts
Thyroid, 2001 Mar;11(3):249-55, "One-year prophylactic treatment of euthyroid Hashimoto's thyroiditis patients with levothyroxine: is there a benefit?"
__________________ dx pcos 1984, type II diabetes 2001, also hypertension
Met 2000mg since 2001, started Glucophage XR 4/22/04, then switched to Met ER 6/04; also: multi, Vit. C, Vit. E, B12/folic acid combo, fish oil & borage oil combo, garlic capsules, cinnamon, Vitex, calcium with magnesium/zinc, biotin, CoQ10, selenium,iron
Other meds: Verapamil and Altace(for blood pressure)
Started laser hair removal 7/29/03, completed 3/04 (it works!)
UAE for fibroid 3/24/03 and 3/16/04
Thank you soooo much! I just printed it out and have three endo appt's I'm going to push to get put on something here. Thank you again for your awesome knowledge!!!!
__________________ TWINS!!!! C-section On April 9, 2007 Angelo Joseph, 5lbs 12oz Antonia Angelina, 7lbs 2oz
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Really interesting. I'll have to understand my results better and see if I should take preventative treatment
Quote:
Originally Posted by nobimbo
You're very welcome. Here's something you might want to take to your new doc for support:
Do You Need Preventive Thyroid Treatment?
From Mary Shomon,Your Guide to Thyroid Disease.
Treating Antibodies When TSH is Normal
"Preventative thyroid treatment" -- It's a controversial subject, and many endocrinologists will simply dismiss you if you ask about it. But new research has been published that supports the understanding that autoimmune Hashimoto's disease may be preventable, slowed, or even stopped entirely before it progresses to destruction of the thyroid gland and hypothyroidism.
In a June 2005 presentation at the Endocrine Society's Endo 2005 conference, Dr. Ting Chang and colleagues reported on giving levothyroxine (i.e., Synthyroid, Levoxyl, etc.) to euthyroid Hashimoto's thyroiditis patients -- patients who had normal range TSH (known as "euthyroid), but elevated antibodies.
Half the patients were given levothyroxine for six months and the other half not treated. Thyroid function tests and autoantibody titers were measured before and after the 6 month period. Those receiving levothyroxine had substantially decreased auto-antibody levels; levels actually increased in some among the untreated group. TSH levels also decreased in the treated group, averaging 0.5 vs 2.5 in the untreated group. The researchers concluded that early prophylactic (preventative) levothyroxine treatment might be useful to help slow down the progression of the autoimmunity of Hashimoto's Thyroiditis.
This is not the first study to show that treatment can help.
In the March 2001 issue of the journal Thyroid, German researchers reported on their study of patients with euthyroid Hashimoto's, half of whom were treated with levothyroxine for a year, the other half untreated. After 1 year, the antibody levels and lymphocytes (evidence of inflammation) decreased significantly only in the group receiving the medication. Among the untreated group, antibody levels rose or remained the same.
The researchers concluded that preventative treatment of euthyroid Hashimoto's patients reduced various markers of autoimmune thyroiditis, and speculated that such treatment might be able to stop the progress of Hashimoto's disease, or perhaps prevent development of hypothyroidism.
Just this year, Japanese researchers found that treatment with levothyroxine can reduce the incidence of Hashimoto's thyroiditis, as well as help alleviate the symptoms of the disease.
In the study of patients with euthyroid Hashimoto's disease, one group of patients received levothyroxine treatment, and the other group did not receive treatment. After 15 months, the treated group had significantly increased Free T4, significantly decreased TSH levels, and a reduction in both anti-thyroglobulin antibody (Tg-Ab) and anti-thyroid peroxidase antibody levels (TPO-Ab). The size of the thyroid also decreased in the treated group, while those not receiving treatment had an increase in thyroid size.
The researchers reported that although levothyroxine treatment is "mandatory in hypothyroid autoimmune thyroiditis patients, LT4 treatment which is shown to inhibit autoimmune process in animal models is still controversial in euthyroid Hashimoto's disease patients where disease has not destroyed the thyroid gland enough to cause hypothyroidism."
They found, however, that levothyroxine treatment at doses keeping TSH at low-normal levels appear sto be effective not only in decreasing the autoantibody levels but also in the goiter size, which could ultimately prevent progression to overt autoimmune hypothyroidism.
What Do You Need to Know?
Some research shows, and practitioners have found that preventative treatment with levothyroxine may be warranted in people with euthyroid Hashimoto's disease (normal TSH levels, but thyroid auto-antibodies that show evidence of autoimmune Hashimoto's disease). Such treatment can in some cases slow down elevation of antibodies, and help prevent autoimmune disease and hypothyroidism.
If you have thyroid symptoms, a "normal" TSH level, but haven't been tested for thyroid auto-antibodies, insist on testing.
If you have thyroid symptoms, a "normal" TSH level, and elevated thyroid auto-antibodies, consider asking for treatment, and if your physician is unwilling, consider finding a more knowledgeable doctor.
Mary Shomon, About.com's Thyroid Guide since 1997, is a nationally-known patient advocate and best-selling author of 10 books on health, including "Living Well With Autoimmune Disease" and "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss." Click here for more information on Mary Shomon.
------------------------------
Sources
En-Ting Chang, Du-An Wu, Dee Pei, Shi-Wen Kuo, Ming-Chen Hsieh. [P2-552] Influence of L-Thyroxine Administration in Patients with Euthyroid Hashimoto's Thyroiditis. Endocrine Society Endo 2005 Abstracts
Thyroid, 2001 Mar;11(3):249-55, "One-year prophylactic treatment of euthyroid Hashimoto's thyroiditis patients with levothyroxine: is there a benefit?"
I don't know the ranges, but my RE gave them to me over the phone. Can anyone tell me what they think?
Free T4: 1.2
T3 Total: 105
T4 Total 9.7
T3 Uptake 29.6
Free T4 Calculated 2.87
TSH 1.78
Free T4 1.2
According to Drs. Broda Barnes and Barry Durrant-Peatfield (respectively), free T4 and free T3 should be in top third of range, so your free T4 is actually slightly low. It's certainly not optimal. This is of course dependant upon the ranges for those results. Do you know which lab was used? Your doc is required by law to give you a copy of all labs if you ask for them.
Total T3 and uptake are outdated and are virtually useless to determine hypothyroid. They measure (like the name says) only the totals overall. You need free T3 along with that free T4 to see what's available in your body. You should also ask for reverse T3 and look at the ratio of free T3 to RT3 (divide FT3 by your RT3 to get the ratio).
What are your symptoms? How are your temps? Have you had cortisol tested via saliva?
My TSH is 4.2mU/L (0.4-4.00) that's above the normal range, but how does it compare to the numbers that you guys have? I'm wondering if I'm in the preventative treatment range and dont have hypothyroidism yet...
Thanks for that info. I looked at my values for fT4 (14pmol/L range 10-20) and fT3 (5.0pmol/L range 2.8-6.8) and they are not in the top third of the range. They are in the second third of the range, just barely for fT4 and mid way for fT3.
Thanks again, I really needed this to understand where I'm at, so I have it a little into perspective now, not just numbers on a page that are above the range (as it was for my TSH which is 4.2mU/L range 0.40-4.00)
My endocrinologist suggested not giving me medication as it's something you take for life....and she said that the aim is to see if the 'process "burns itself out" '
I was going to research more into Diane-35, as that is meant to help with the slight increased hair growth above where an adams apple would be, AND weird solitary black hairs that popped up at my collar bone and a couple smaller ones
But I will ask for reverse T3 and then check the ratio.
Why do you ask for cortisol testing?
... I'm two weeks into Diane-35 and nothing different yet, but wanted to start and see how it goes incase its a matter of the sooner the better for preventing more hair growth. If it doesent stop it after a designated period of time, whatever that is, I'll be going off them.
... The only reason I found out about pcos is after missing a period, weight gain and hair growth...and tests show that I have 'multiple greater than 12 less than 10mm diameter follicles arising from both ovaries'
edit ... I have raised antibodies ++ Anti-Thyroglobulin Ab 150U/mL (<60), + Anti-Thyroid Peroxidase Ab 110U/mL (<60), + Testosterone 3.1 nmol/L (0.3-2.8), +++ Androstenedione 5.2ug/L (0.3-3.3) or in SI units 18nmol/L (1.0-11.5) Plus signs are to draw attention I guess. TSH has one + and is described as being upper-normal. Suggesting adequate compensation at present, for reduced Thyroid reserve. This antibody pattern suggests an underlying autoimmune inflammatory process eg Graves' and Hashimoto's. Elevated Androgen level, may point to: an Androgen - excess syndrome, Stein-Leventhal/Polycystic ovaries, Cushing's syndrome, Androgen-producing neoplasm of Ovary or Adrenal, Adult-onset Partial CAH (-congenital enzyme anomaly), Hypothyroidism, opiate use, hormone implant
lol
Quote:
Originally Posted by verbal0rchid
According to Drs. Broda Barnes and Barry Durrant-Peatfield (respectively), free T4 and free T3 should be in top third of range, so your free T4 is actually slightly low. It's certainly not optimal. This is of course dependant upon the ranges for those results. Do you know which lab was used? Your doc is required by law to give you a copy of all labs if you ask for them.
Total T3 and uptake are outdated and are virtually useless to determine hypothyroid. They measure (like the name says) only the totals overall. You need free T3 along with that free T4 to see what's available in your body. You should also ask for reverse T3 and look at the ratio of free T3 to RT3 (divide FT3 by your RT3 to get the ratio).
What are your symptoms? How are your temps? Have you had cortisol tested via saliva?
Last edited by williewagtail; 10-13-2009 at 04:30 AM.
Hi, I was hoping maybe someone could take a look at some of my lab results? No doctor has ever commented on it but ever since I did a bit of reading on the subject I'm a bit concerned about my TSH. I don't feel hypo at all (quite some cysters tend to feel hypo rather than hyper, but I think for me - if anything - I'd be more hyper than hypo) I'm afraid it could be Hashi's?
I got my results from different days of testing, and I know hormones fluctuate and even your intake of vitamins could affect your values, but not this much right?
October last year only my TSH was tested: 0.67 mIU/l
March this year my TSH was 1.7
Free T4 was 16.0
Two weeks later my TSH was tested again at 0.64 mE/l
Free T4 13 pmol/l
Free T3 4.5 pmol/l
I'm a bit concerned about my TSH doubling (almost tripling) and halving whenever it feels like it. I think my Free T4 and T3 are like Williewagtail's and she doesn't seem to happy about it, or does that have to do with the fact that her TSH is higher than mine?
I know that wacky thyroid could have something to do with irregular cycles (that's what I have), and since the doctors can't agree on whether I have PCOS or not I thought maybe thyroid could be a factor here. I noticed last year my thyroid has 'hardened'. One doctor felt it too, but said she didn't think it was a problem.
Could someone with knowledge about thyroids and lab results please share her thoughts on my situation? TIA (it's very much appreciated)!
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How hard is your thyroid? It's not rock hard is it? I've never checked mine before, but will try to keep an eye on it whilst having tests etc
The doctor said I probably have Hashimoto's but thats because of the elevated antibodies, so you will have to see what yours are.
I dont think I've had irregular cycles. What got me onto pcos amoungst the other things was having a period and then having a light period a week after, which may have been a failed pregnancy.
'Cause if it's rock hard it's my Adam's apple? I can push it from the sides but from the front it does feel a bit hard. It's right in the middle of my neck. I thought an Adam's apple was higer..?
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With those antibodies, you have Hashi's, which means swinging from hypo to hyper periodically. RTH has a huge amount of info as well as STTM on Hashimoto's.
The reason I asked about cortisol is because generally you want to at least get your adrenals checked to rule out adrenal fatigue or insufficiency before beginning any thyroid treatment. Proper adrenal function and support is crucial to tolerate and use thyroid hormone. The body can't use thyroid without it.
Additionally, if you get a reverse T3 and find the ratio is suboptimal it can be an indication of adrenal fatigue. It means there is something causing the body to not convert T4 to T3 adequately like it should. This typically means adrenal fatigue but it can also be due to the sex hormone imbalance. The best way to check adrenals is a 24 hour saliva cortisol test. You can get a kit from your doc or order on your own from a place like CanaryClub.org. It's like $99 for the 4x. You spit into a cup 4x for a day, ship it off to the lab and in a couple weeks should have your results.
Pardon me, but your endo is an idiot. Upper-normal, my a$$. (scuse my mouth LOL) If you have hypothyroid or Hashi's (which you have) the process never just "burns itself out". You need to be treated for it. Jeesh! Even the range used for TSH (which I have found never to be a true indication of hypothyroid or not, personally) is outdated. The new range is .3 - 3.0 so you see how high you really are? The best docs consider anything above 2.5 to be hypo.
Quote:
Originally Posted by williewagtail
(as it was for my TSH which is 4.2mU/L range 0.40-4.00)
My endocrinologist suggested not giving me medication as it's something you take for life....and she said that the aim is to see if the 'process "burns itself out" '
edit ... I have raised antibodies ++ Anti-Thyroglobulin Ab 150U/mL (<60), + Anti-Thyroid Peroxidase Ab 110U/mL (<60), This antibody pattern suggests an underlying autoimmune inflammatory process eg Graves' and Hashimoto's.
Hi, I was hoping maybe someone could take a look at some of my lab results? No doctor has ever commented on it but ever since I did a bit of reading on the subject I'm a bit concerned about my TSH. I don't feel hypo at all (quite some cysters tend to feel hypo rather than hyper, but I think for me - if anything - I'd be more hyper than hypo) I'm afraid it could be Hashi's?
I got my results from different days of testing, and I know hormones fluctuate and even your intake of vitamins could affect your values, but not this much right?
October last year only my TSH was tested: 0.67 mIU/l
March this year my TSH was 1.7
Free T4 was 16.0
Two weeks later my TSH was tested again at 0.64 mE/l
Free T4 13 pmol/l
Free T3 4.5 pmol/l
I'm a bit concerned about my TSH doubling (almost tripling) and halving whenever it feels like it. I think my Free T4 and T3 are like Williewagtail's and she doesn't seem to happy about it, or does that have to do with the fact that her TSH is higher than mine?
I know that wacky thyroid could have something to do with irregular cycles (that's what I have), and since the doctors can't agree on whether I have PCOS or not I thought maybe thyroid could be a factor here. I noticed last year my thyroid has 'hardened'. One doctor felt it too, but said she didn't think it was a problem.
Could someone with knowledge about thyroids and lab results please share her thoughts on my situation? TIA (it's very much appreciated)!
Everyone is different. If you feel your throat is hardened you could have a goiter, which is common with hyper thyroid. Have you had antibodies tested? TPO and TG? If you have them could you post the ranges for those frees? That will more than anything give an indication of what you're dealing with. Also consider, those measuring units are different. Nigel on RTH has some skill in converting them to show what they mean to each other. Did your doc use a different lab by chance on the second tsh test?
What I can tell you from now is just my own experience. My initial TSH was .74, which is considered well in the "normal" range, and even leaning toward hyper. However I had all the symptoms of hypothyroid and my frees were, quite frankly, the pits. I had an extremely high RT3 because of all the adrenal issues I had prior that had gone undiagnosed and untreated for 25 years. This is what Dr. Mark Starr considers Hypothyroidism Type II. (or subclinical hypothyroid)
The reason we found my tsh was so low is because i had pituitary damage. My thyroid wasn't getting the signal to produce its hormone at all, thereby making me hypo. Ultimately, symptoms matter more than labs anyway so I'd chart your temps and check the STTM site's list of hypo symptoms and see if you really feel hyper or otherwise. Mary Shomon has a list of hyper symptoms I believe on about.thyroid.com (or however it's written)
So roundabout way of saying, yes you can be hypo and still have a low tsh. As for the fluctuating, you could ask on RTH because I'm not all too sure about it, honestly.
Got my lab results...need advice? 
