Thyroid labs without treatment - odd results - ... - Thyroid UK

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Thyroid labs without treatment - odd results - can someone give an opinion if I'm low

Gates profile image
14 Replies

T4, Total 6.1 Range: 4.5-12.0

T4, Free 1.0 Range .8 - 1.8

T3, Free 2.9 Range 2.3 - 4.2

T3, Total 62 Range 76-181

T7 2.0 Range 1.4-3.8

TSH 2.21 Range .40 - 4.50

The only one out of range is Total T3, and I'm wondering what the cause is. I'd be curious if my Free T3 and Free T4 look on the low side to anyone knowledgeable about blood work. This is on no thyroid hormones; before I started taking them. I also have Hashimoto's antibodies of 67.

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Gates
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SilverAvocado profile image
SilverAvocado

Both your freeT4 and freeT3 are pretty low. Being inside the range is not enough, it matters where they are. For in medicated results you'd expect the frees to be mid-range or higher. Once medicated you probably want them a bit higher, in the top quarter.

The only thing I think is a little strange is the TSH is lower than I'd expect. 2.2 is a tiny bit raised - healthy people's TSH will be close to 1, maybe as high as 1.5. But with they very low freeT4 and freeT3 you might expect higher.

TSH stands for thyroid stimulating hormone. This is the messenger produced by your pituitary to tell your thyroid to make more hormone. It reacts to low levels of hormone by getting higher.

You were very lucky to get diagnosed with results like this, as doctors will often look at TSH only, and will wait till it gets to the top of the range, or even much higher.

Gates profile image
Gates in reply to SilverAvocado

I agree, I was lucky to get diagnosed. If I had not had total T3 tested every year, I might not have picked up on it, as this was my only thyroid hormone which was decreasing every year, with my decreasing energy mirroring that. I'm presently on .50 mg. levo and .30 mg. Armour, both taken in the a.m, and feel good. Levothyroxine by itself (112 mcg) got my labs up much higher, but I still felt like a sleepwalker. So I feel lab results are of limited use as far as fine tuning our dosages.

I also have throid peroxidase antibodies of 67, which should be less than 9 IU/ml according to lab results. Would LDN be something I should look into, or is that only for more serious cases? I also have always had animal allergies and hay fever, although I guess these aren't classified as "autoimmune" disorders.

ShootingStars profile image
ShootingStars in reply to Gates

Hi Gates. Labs coupled with symptoms is the basis for fine tuning dosages. The reason that 112 mcg levo made you feel like a sleep walker is because it contains only straight T4. What was your FT3 level after taking the levo? In your bloods above, your FT3 is low, as well as your FT4. Getting your thyroid hormones as close to optimal range is what will help you the most.

Your antibodies aren't very high. Are you following the AIP diet? You could try LDN if you want. If it works, it is a lifetime medication. Once you stop it, antibodies would no longer be suppressed and will increase. Allergies are also an immune response. While they are not autoimmune, your body is still reacting negatively to a foreign invader (dander and pollen). This is not much different than the bacterias, fungus, and illnesses that can increase thyroid antibodies. Keeping your allergic reactions under control might help reduce potential for increased autoimmune response during exposure to animals and pollen. Some people prophylactically take allergy medication during times for increased potential for exposure to what triggers their allergies.

SilverAvocado profile image
SilverAvocado in reply to Gates

Hi Gates, really sorry, I thought I'd answered this a few days ago.

If you're feeling completely fine on your current dose, you don't need to worry about additional treatments for antibodies. If you still have symptoms, it's worth looking into all avenues.

Your current antibodies of 67 are fairly low. The reference range of <9 is telling you what a healthy person who doesn't have Hashimotos would have. Once you have Hashimotos, antibodies may reduce a bit, but they will always be there. There isn't a cure for Hashimotos as such, all we can do is replace the thyroid hormone, and hopefully feel well.

ShootingStars profile image
ShootingStars in reply to SilverAvocado

The TSH is that high probably because of the medication being too low. For Hashimoto's, while on medication the TSH should be suppressed. In order to get the FT3 and FT4 up in to optimal range, it's common that someone with Hashi's will have TSH closer to or under 0.50.

SilverAvocado profile image
SilverAvocado in reply to ShootingStars

Shootingstars,

I believe this is unmedicated TSH. So before starting any medication, Gates had a TSH of 2.2

2.2 is not a particularly high TSH. Indeed it is well inside the normal range (not that that means much). Overall I'd say this is borderline at the high end of normal, in that a TSH well over 2 is unusual in the healthy population.

ShootingStars profile image
ShootingStars in reply to SilverAvocado

Hi. Thanks for the clarification. TSH is not what medication is prescribed off of, if the doctor knows what they are doing. The FT3 and FT4 above, plus symptoms are enough to prescribe meds. That, coupled with the TSH of 2.2. And particularly all of those levels and the fact that she has Hashimoto's, medication is warranted.

nettecologne profile image
nettecologne in reply to ShootingStars

I do not disagree, but could you tell me exactly why you think or know that TSH should be suppressed in Hashimoto patients?

ShootingStars profile image
ShootingStars in reply to nettecologne

The idea is to take the strain off the already over strained thyroid. Thyroid antibodies attacking the thyroid is just another intense blow to the thyroid, as well as the entire body, on top of just being hypothyroid. In addition, once autoimmunity is active, a person is more susceptible to an immune response from illness, bacteria, fungi, trauma, stress, etc., which in turn can make antibodies increase. When that happens, that is additional stress and attack on the thyroid on top of the current attack levels and current hypothyroid status. Getting the thyroid hormones up into optimal range is where most people feel their best and is where the thyroid is operating neither too slow, nor too fast. Along with this can come suppressed TSH. As long as TSH is not too suppressed and/or a person does not become hyperthyroid or experience hyper symptoms, then symptoms should be neither hyper nor hypo and should be nonexistent or minimal. Equilibrium in terms of thyroid hormones, TSH and a reduction of thyroid antibodies is the goal.

Gates profile image
Gates

My free T3 while on levo 112 mcg only went up from 2.9 (no meds) to 3.1. But I felt worse! So that is why I am tinkering with combos of Armour and levo.

ShootingStars profile image
ShootingStars in reply to Gates

Can you line out all of your levels and ranges before medication, then following start of medication (including the type and dosage), then key subsequent lab results, including the most recent ones? Including thyroid antibodies, too. It's hard to follow what your labs were when and medications. :-)

Gates profile image
Gates

The TSH above in my first post, was on NO thyroid hormones. At my present dose, last measurement of TSH showed .22, and that was after not taking any pill for over 24 hours.

ShootingStars profile image
ShootingStars in reply to Gates

TSH is not what will give you symptoms. It's current levels of FT3 and FT4 that will.

Gates profile image
Gates

I understand that. I don't have a doctor who will routinely test free T3, so have no frequent scale of results.

Also, when I am on NO medication, shown above, you'll note that morning free T3 was 2.9, which may not be bad for someone on no thyroid meds. That was really the basis of my question; did I need thyroid hormone in the first place?

The last test I had while on current dose (50 mcg levo, 30 mcg Armour) showed free T3 LOWER than on no meds at all. In the a.m., 24 hours after my last dose, my free T3 was 2.1. I attribute this to the peaks and valleys that taking Armour with T3 causes. It shuts down your own production to some extent when you replace it with pills.

This is why I go by how i feel. My free T3 was highest of all on 112 levo, and so was my free T4. But I felt the worst; worse than on nothing at all. So labs are helpful but I also need to go by other symptoms.

Does anyone know why docs don't want TSH suppressed too much? I can understand wanting to avoid heart palpitations, but I wonder if there are other medical reasons.

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