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FREE T3/T4 TEST RESULT QUESTIONS

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saint j

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May 26, 2010, 11:47:55 AM5/26/10
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I would like to get an opinion on these test results, if you can.
It's my opinion the Free T3 should have further investigation. My
doctor is one who believes only in test the TSH and if that is in
range, you don't have a problem, no matter what your symptoms. I had
the FreeT4/T3 done at a lab myself. I actually asked for testing for
antibodies, but I doubt she will agree.

TSH is 2.39 range 0.40 - 4.70
Free T3 is 5.18 range 2.5 - 3.9
Free T4 is 1.06 range 0.61 - 1.12

I actually feel hypo - no energy, no focus, etc., but how could that
be with these numbers. I am very tense, my hands are clenched a lot of
the time. I'm irritable and impatient, but my pulse usually is below
55 bpm. My thyroid is also enlarged.

Thanks for the replies


Herman Family

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May 26, 2010, 12:19:48 PM5/26/10
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"saint j" <renn...@toast.net> wrote in message
news:cc602f9a-8e3a-4f22...@i31g2000vbt.googlegroups.com...

Firstly, you need a real endocrinologist.

Your tsh is 2.39, which indicates that your thyroid levels are a little bit
low. Not too much low, but a little low. The range is an older range, it
should only go up to about 3.3, with a recommended level between about 1 and
2.

Your ft3 is too high. Based on this, you should have a hard time calming
down, have too much energy sometimes, and other times be completely worn
out. From this, you are hyperthyroid. Believe it or not, hyper and hypo
share a number of symptoms including fatigue. In one case (hypo) you simply
don't have the energy, and in the other (hyper), you expend it too fast.

Your ft4 is about right, perhaps a wee bit on the high side of normal.

So we have it. TSH says too little, FT3 says too much, and FT4 says high
normal. They don't agree. They are supposed to agree. If they agreed,
your physician would be correct, but you would be slightly hypo. We now
need a reason they don't agree.

One of the possibilities is that the pituitary gland is producing too much
tsh. In this case, the thyroid gland will attempt to produce more thyroxin.
It will even get larger (form a goiter) to do it. There may be other
reasons for this problem, and the reason for the pituitary overactivity
needs to be resolved. Sooner is better than later.

From a problem solving point of view, we've now identified the class of the
problem and a route to the solution. Minor details about exactly what is
wrong will get resolved by the endo.

As I indicated up front, you need an endocrinologist. Your primary
physician is hopelessly outclassed by this particular problem.

Michael


deT notsuH

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May 28, 2010, 11:09:51 AM5/28/10
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Just to add to the comments you've already gotten...
The symptoms you described certainly do fit the hyPERthyroid profile,
and that is consistent with a high T3 result. However, free-T3 is
not a very reliable test. The big question I have is whether these
tests have been repeated? If so, what is your doc doing about them?
If not, then switch to getting free-T4 and total-T3 tests, or get
the THBR test (formerly called the T3-uptake test). The THBR could
help decide the possibility of problems with binding proteins that
might then suggest the true nature of the problem, and that might not
be thyroid at all.

Your TSH is too high for hyPER, unless you are one of an extremely
small number of people with hormone resistance (this is a 1 in 30
million chance). If the free-T3 result is real (which I still doubt),
then you would appear to have T3 toxicosis. This could be from
Hashimoto's thyroiditis, and that your thyroid is indeed heading
toward hyPO. Thyroiditis will flip back and forth between hyPER and
hyPO episodes. But T3 toxicosis also happens with both excess and
deficiency of iodine, so beware of what you are doing if anything
along those lines; if you are supplementing, STOP, if you live in a
goiter belt and eat exclusively local food and don't eat seafood/
iodized salt/milk products/etc sources of iodine etc then consider
a *low* dose around the daily value which is about 150mcg of iodine.
This is definitely not the time to indulge in "thyroid boosting"
supplements. Consider also any other drugs, which includes
supplements of any sort, you may be taking for some other problem.

Also, do you eat a lot of uncooked Brassica or cruciferous veggies,
like broccoli, cauliflower, cabbage or other goitrogen-rich foods
(includes soy, horseradish, turnips etc etc etc) and I do mean A LOT?

Back to the possibility of this not being thyroid, and that the issue
is with, say, binding proteins that could be affected by PCOS, then
you may also be suffering insulin resistance, which might also manifest
with your irritability symptoms. My point, not that I have one or
that insulin resistance is the only other option, is again on the doc
to cast the net a bit wider than just the thyroid. What other testing
has been done so far?

--
deT notsuH bass-ackwards ude.hcimu@pcird
My mind not only wanders; sometimes it leaves completely.

saint j

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Jun 7, 2010, 8:51:23 PM6/7/10
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You guys certainly gave me a lot to think about. I had a much better
responsive reply composed to your replies a week ago, but I lost my
password and tonight I too tired to write much, but it was very
appreciated. My internist is back from vacation and responded with I
need an ultrasound of my thyroid and a radioactive iodine uptake test.
While she was gone, I researched the endos in my area and I'm seeing
one tomorrow.

These health forums can be very informative and helpful. I learned
more from 3 forums than any doctor would be able or willing to tell
me. After awhile you can separate the people who actually are
knowledgeable about the subject.

Thanks again.

Renne

PS to deT notsuH - I'm not self treating with anything (meds or foods)
I take lots of supplements, but I have for years. Mainly vitamins and
minerals.

Herman Family

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Jun 9, 2010, 9:30:22 PM6/9/10
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"saint j" <renn...@toast.net> wrote in message
news:e130c0a9-2d34-4d67...@d37g2000yqm.googlegroups.com...

Taking supplements, whether vitamins, minerals, or herbs is treating
yourself, and the effects of each alone and in combination need to be
considered at some point.

Michael


Megan

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Jul 6, 2010, 1:02:29 PM7/6/10
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Just so you know, you're not the only person with a free T3 that just
does not agree with anything. My fT3 was through the roof, while my
fT4 was normal and my TSH was 2.33. I have chronic and annoying
symptoms of HYPOthyroidism. I am tired all the time, joint aches, gray
hair, etc. T3 Toxicosis is apparently rare, as we (My doctor's and I)
cannot find a reasonable cause.

golgolg...@gmail.com

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Apr 22, 2015, 10:36:04 AM4/22/15
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Sir pleaseeee explain it-
FT3-4.70
FT4-8.90
TSH-3.18
Sir is this ok?
i am 22year old girl and very confused ..so please help me..

polygonum

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Apr 22, 2015, 1:35:28 PM4/22/15
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You need the reference ranges from the lab that performed the tests.
Anything else is at best a guess.

--
Rod

deT notsuH

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Apr 22, 2015, 4:45:14 PM4/22/15
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In addition to the reference ranges for the tests, what time of day was
the test? If you don't have the reference ranges, then how about the
units for the fT3 and fT4 tests? Are you taking any thyroid medication?
If so, what are you taking, what dose, and when was the last dose
taken before you had the blood test? Are you taking any other
medications? Do you eat a lot of soy? Did they do any other blood
tests? Amemia, for example. What prompted the testing? How are you
feeling? I can keep going with even more questions that would be useful
for us amateur sleuths.

Too bad they didn't run a total-T4 in addition to the free-T4. Would
have told us more about some non-thyroid issues related to estrogen
levels, for example, or whether you take aspirin etc etc. It might
explain why your TSH isn't screaming high in my speculations below, and
would confound the testing you've had done so far.

Another missing test might be for anti-TPO. These are thyroid
antibodies and might help predict the course of your thyroid saga.

I am going to speculate that the fT4 and fT3 tests are in pM (picomolar,
picomoles/liter, pmol/L, etc, are ways of saying the same thing), in
which case your fT3 is probably in the normal range while the fT4 is
low. In that case, it is likely that you are hyPOthyroid. Sometimes
this corrects itself on its own. Most of the time, not so much, and
you'll need a prescription for thyroid medication or an increase to the
dose if you are already taking some.
--
deT notsuH bass-ackwards ude.hcimu@pcird
In the time it takes to read this sentence, some 50,000 cells
in your body will die and be replaced.

deT notsuH

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Apr 27, 2015, 9:54:25 AM4/27/15
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Just to let others play along at home.... The feedback that I got
offline was that indeed the fT4 was below range, and fT3 was midrange.
Ordinarily, with a very low fT4, TSH *should* be screaming high, yet was
still in range, albeit at 3-something. I'm still leaning toward hyPO as
the root cause here, but the TSH is telling us that there is some
central, pituitary or hypothalamus fault also at play. The reason T3 is
still ok is that the body will do its darnedest to keep that active
hormone as close to normal as possible to the bitter end. Something
else to consider here would be the possibility of iodine deficiency.
Rather than taking high doses, however, I recommend keeping the dose
nearer to daily value, which is 150mcg. If you take more than about
1000mcg, that actually does a disservice and actually blocks the thyroid
from producing hormones.

As for the central role of the pituitary, which regulates the thyroid by
producing TSH, the hypothalamus regulates that process with a hormone
called TRH. Low thyroid hormone stimulates the production of more TRH,
which leads to higher levels of TSH, which should stimulate the thyroid
to work harder. As fT3 is mostly "normal" this cycle is stuck at the
moment despite the very low fT4. Sometimes this is due to other
medications, and also due to non-thyroidal illness. In this case, the
person is experiencing high fever. That could turn down the TSH spigot.
Another possibility might be adrenal insufficiency. The major concern
here is that simply treating the thyroid now could lead to an adrenal
crisis. That needs to be ruled out first, or take the thyroid
vvvveeerrrrrryyyyy slooooooooowly. This is one case where you don't
just jump to taking full replacement right away. Start much lower until
you know you can handle it. Of course, the high fever really has to be
addressed, too. Maybe if that is fixed, the thyroid will follow, or the
thyroid situation will be at least clearer if that is the cause of the
central fault in the first place.
--
deT notsuH bass-ackwards ude.hcimu@pcird
In the time it takes to read this sentence, some 50,000 cells
in your body will die and be replaced.

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