Am I hyper or hypo thyroid????

Hello. I just had lab work done & my thyroid levels are off, could someone please tell me if I am hyper or hypo? I'm guessing slightly hyper?

[greygoose]

Your TSH is low and your FT4 high, but more information is needed.

Firstly, have you been diagnosed with anything? If you have been diagnosed as hypo, and are on thyroid hormone medication, then you are over-medicated, not hyper.

If you have high Hashi's antibodies, then you are on a Hashi's, 'hyper' swing, not hyper in the true sense of the word.

If this is your first test, and that's all they tested, then no true diagnosis is possible.

[Hidden in reply to greygoose]

The doctor told me hypothyroidism. But I always thought the lab work would be the exact opposite, if I was hypo. So I guess I was just a little confused.

[greygoose in reply to Hidden]

But, are you taking levo, or something? Have you had your antibodies tested?

[Hidden in reply to greygoose]

No, I haven't. I'm not on any type of medication at the moment either. I haven't been to the endocrinologist yet, I'm still waiting on a phone call from them.

[SlowDragon Administrator]

For full evaluation you need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

All thyroid tests should be done as early as possible in morning and fasting. This gives highest TSH and most consistent results

[Hidden in reply to SlowDragon]

Ok. I haven't been to the endocrinologist yet, so I'm not taking any meds. My doctor was supposed to refer me to one, but I have yet to receive a phone call. They did test my vitamin D and it was low, but other then that I'm not sure on the other things you mentioned sense I haven't gone to the endo. The first time they checked my thyroid, my T4 was 2.3 and my TSH was 0.01. I didn't fast when I had the blood work done, because the doctor told me is wasn't necessary.

[SlowDragon Administrator in reply to Hidden]

Fasting is patient to patient tip. It helps keep TSH higher

Your bloods are odd, as you have low TSH and low FT4

Usually low TSH has high FT4

High TSH has low FT4

So you have been referred to endo, possibly considering central hypothyroidism

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

How low was vitamin D and has GP started you on vitamin D supplements

Ask that thyroid antibodies are tested, plus ferritin, B12 and folate too

[Hidden in reply to SlowDragon]

Okay I will ask them to be tested for the other things. My vitamin D was 21. She just told me to take over the counter vitamin D supplements. I'm taking 2000iu a day.

[greygoose in reply to SlowDragon]

SlowDragon , what did you see as range for the FT4? I see 0.8 - 1.8. So, the OP's FT4 is high.

[Hidden in reply to greygoose]

Yes that's what I see also. Which I understand is only slightly elevated. I have spoken with a few hyperthyroid sufferers and they're ft4 is a lot higher than that.

[Fruitandnutcase in reply to Hidden]

If it’s any help, when I was first diagnosed with Graves my TSH was <0.03 but was probably lower and my T4 was almost 30, plus really high antibodies of course.

[Hidden in reply to Fruitandnutcase]

Yes Thank you. I'm thinking I might have Central hypothyroidism. Which someone else had suggested. Since my T4 is only slightly elevated at 2.7.

[SlowDragon Administrator in reply to Hidden]

Because the range is small numbers

0.8 -1.8

2.7 doesn't sound much higher

But if you looked at it as 80-180 then 270 seems much higher

[SlowDragon Administrator in reply to greygoose]

Yes sorry my mistake

Will amend reply

Always good idea to say if not based in UK, as this is UK support group

[Hidden in reply to SlowDragon]

I'm sorry. I didn't realize anything would be different lab wise. I can't find a group in the U.S to answer any of my questions.

[Valarian in reply to greygoose]

I think UK measure for FT4 is usually pmol/L ? The unit used here is ng/dL, so 2.7ng/dL appears to equate to 34.7 pmol/L - see unitslab.com/node/121. I think the upper end of the range used for my tests is 25 - haven’t got them with me at the moment., but that would make this above range, so combined with the low TSH, a “hyper” result, although you’d obviously need confirmation of the range to be sure. The H after the FT4 range, and L after the TSH also look like a clue to High and Low.

If you were in the UK Dimples924, the endo would almost certainly order FT3 and antibody tests. FT3 is also likely to be elevated and if so, will need to be brought under control. The antibody tests will help identify what the cause is for being hyper.

I don’t know much about central hyperthyroidism (I have Graves, the most common cause), but believe TSH remains unsuppressed, whereas unless they are using an odd range, yours is low.

Do you have any symptoms ? Untreated hyperthyroidism often leaves people feeling pretty awful.

[greygoose in reply to Valarian]

I think Dimples924 has left the group. I think she got confused because she realised it's a UK based group, and didn't realise that she could still belong.

[Valarian in reply to greygoose]

That’s a shame. Apart from the fact that she hasn’t found a US equivalent, it’s interesting to compare treatment plans from one country to another.

[greygoose in reply to Valarian]

Absolutely. Still, nothing we can do about it.

[Hidden]

I'm in Texas, but this was the only site I could find to help answer some of my questions. Lol I will call my doctor back & ask them how much I need to take of Vitamin D. Thank you for all your help.

[SlowDragon Administrator in reply to Hidden]

Well ignore that advice then - completely different range in USA

endmemo.com/medical/unitcon...

21ng/ml = 50nmol

So 21 ng/ml is too low

But not as low as 21nmol

Looking for it to be around 40ng/ml