Thyroid levels and second opinion

Greetings:

I live in Hong Kong as a Canadian ex-pat. I recently had my thyroid tested as I had several indications that it was not functioning well. I've tried to research the results on the web BUT HK levels are not standard when I try to look them up. My medical plan will not pay for retesting and it is very expensive here. The doctor said it all checks out along with other tests but I just don't feel well.

Free T3 Result 4.10 Reference 2.63 - 5.70,

Free T4 14.00 9.01 - 19.04

TSH 1.190 0.350 - 4.940

Anti-TG .94 <4.11

Anti-TPO 5.54 <5.61

Thank you. I am also gluten and casein (all dairy protein - tested) intolerant.

[greygoose]

Hi marlenejanice, welcome to the forum.

What do you mean by 'HK levels are not standard'? Are you talking about ranges? It doesn't matter, ranges change from lab to lab anywhere in the world. You just have to interpret your results according to the range used by your lab.

So, you have Hashi's - I guess you know that - which means that you need your TSH suppressed.

Your FT3 is just a gnat's whisker under mid-range, so too low for you to feel well.

Your FT4 is almost exactly mid-range.

So, you're under-medicated. You don't say what you're taking, nor how much, nor how long you've been on that dose. But, going by these labs, you need an increase in dose.

[Hidden in reply to greygoose]

Greetings greygoose:

Thank you for your VERY timely response. Actually, I am not on any meds at all for thyroid, but before having the blood test, and taking the many quizzes, I thought it had to be my thyroid. This doctor (who I felt very uncomfortable with from the moment I sat in front of him), said I am all within range. I don't believe it either and it's in the family. I guess I need to be retested or at least go see another doctor and just pay out of pocket. Something's wrong. But, when you start in Hong Kong, the tests, the doctors, it never ends especially with the specialists. Just goes on and on especially if you are an ex pat with insurance. Have a good day and thanks again greygoose. Any other advise would be appreciated. P.S. I love the handle.

[shaws in reply to Hidden]

This is a list of clinical symptoms. Hashi's is the commonest form of hypothyroidism and both are treated identically.

thyroiduk.org.uk/tuk/about_...

All tests for thyroid hormones have to be at the earliest possible, fasting (you can drink water) and allow 24 hour gap between last dose and test and take afterwards.

[Hidden in reply to shaws]

Greeting: Just going over posts and thank you. Not quite sure exactly what you mean by ....allow 24 hour gap between last dose and test and take afterwards? Thank you...

[shaws in reply to Hidden]

If you take a tablet(s) at 8 a.m. you don't take on the morning of the test but afterwards.

If you take a tablet (s) at bedtime, miss this dose and take after test and again at bedtime.

[greygoose in reply to Hidden]

Ah, I see! Yes, I know what you mean about it going on and on, it's the same here in France! lol

But, of course, you're right, it is in your family. It's Hashi's. Your TPO ab is so close to the top of the range, that I'm 99.9 % certain it's Hashi's. That often runs in families. Antibodies fluctuate all the time, so it's more than likely that if you did another test, they would be well over-range.

However, any doctor looking at your hormone levels would not say you are hypo at the moment. I had assumed that you were taking thyroid hormone replacement, and answered accordingly. Interpretations are different for medicated and un-medicated. And, for someone not on thyroid hormone replacement, you are euthyroid at the moment. But, you need to keep a careful eye on it.

Doctors do not understand ranges. They think that anything in-range is perfect. But, it's not good enough to just say to a patient 'you're in-range' - they can see that for themselves! They don't need to pay a doctor to be told that. What is important is where in the range the result falls. And, as yours are mid-range at the moment, you are in fact euthyroid. But, if your FT3 level decreases, you will become hypo.

[Hidden in reply to greygoose]

Thanks again..... very much appreciated!

[greygoose in reply to Hidden]

You're welcome.

[Puska]

Until you reach over the TSH range and over the antibody range I’m pretty sure in Australia then you would just be monitored and not be diagnosed just yet. Once you’ve been diagnosed and on treatment then the ranges are treated somewhat differently.