can I be hypothyroid with these results ?

[dudley]

Hello,

I'm a newbie here and I will be greatful for any advise you may have. For the last 9 years I suffered the following symptoms - mental fatique, slugish cognitive tempo (it comes and goes), and a mild to mediocre depression. I have also experienced weight gain, muscle cramps and I do have a low heart rate - below 50/min in rest (that is not my complaint, I just know it is a symptom of hypothyroidism). Also, hypothyroidism runs in my family.

I went through a plethora of tests over the last 9 years (including full endo), everything came back negative, I was put on several antidepressants/stimulants but no help. I am revisiting the idea of hypothyroidism since I match quite a few symptoms. I just got new test results (below). Everything seems OK just like the first time I was tested. Am I missing anything ? Can I still be hypothyroid ?

Many thanks.

Thyroxine (T4) Free, Direct, S 1.36 (0.93-1.71 ng/dL)
TSH 1.130 (0.450-4.500 uIU/mL)
Reverse T3 288 (90-350 pg/mL)
Thyroid Peroxidase (TPO) Ab <5 (0-34 IU/mL)
Antithyroglobulin Ab <20 (0-40 IU/mL)
Triiodothyronine,Free 2.9 (2.0-4.4 pg/mL)

[Andros]

Hello,

I'm a newbie here and I will be greatful for any advise you may have. For the last 9 years I suffered the following symptoms - mental fatique, slugish cognitive tempo (it comes and goes), and a mild to mediocre depression. I have also experienced weight gain, muscle cramps and I do have a low heart rate - below 50/min in rest (that is not my complaint, I just know it is a symptom of hypothyroidism). Also, hypothyroidism runs in my family.

I went through a plethora of tests over the last 9 years (including full endo), everything came back negative, I was put on several antidepressants/stimulants but no help. I am revisiting the idea of hypothyroidism since I match quite a few symptoms. I just got new test results (below). Everything seems OK just like the first time I was tested. Am I missing anything ? Can I still be hypothyroid ?

Many thanks.

Thyroxine (T4) Free, Direct, S 1.36 (0.93-1.71 ng/dL)
TSH 1.130 (0.450-4.500 uIU/mL)
Reverse T3 288 (90-350 pg/mL)
Thyroid Peroxidase (TPO) Ab <5 (0-34 IU/mL)
Antithyroglobulin Ab <20 (0-40 IU/mL)
Triiodothyronine,Free 2.9 (2.0-4.4 pg/mL)

Hi and welcome to the board. From what I can ascertain, your rT3 is high which in turn is blocking (or denying a landing zone to the thyroid receptors) of T3. That is why your FT3 is below mid-range. We would normally like to see FT3 @ mid-range or higher because this is your active hormone; the one that supplies your energy.

The major conversion takes place in the liver.

And, while your antibodies are below the recommended range, you do have them which raises an eyebrow as well. Sometimes when you get labs they are not as active so therefore don't show prominently within the range. They do wax and wane.

Here is some info re rT3 and may I suggest you discuss this with your doctor and if you don't get satisfaction, please seek out another who understands this stuff.

http://tinyurl.com/yd42hvc

You have not been feeling well for a long time, I can tell.

Here is a place you can look up all your labs. Learning makes one a good personal advocate.

http://www.labtestsonline.org/

We will be here for you as well

[dudley]

Andros,

First, thank you for your response. So is it plausible that my issues are caused by below mid-range FT3 ? If that is the case, does it make sense for me to talk to my doctor about getting T3+T4 medication ?

Regarding the antibodies, please help me to interpret it: the lab results say "<20" and "<5" so that does not really mean that I have them, right ? All they are telling me that in the range of 0-20 (resp 0-5) so I may not have any antibodies at all.

Again, I appreciate any advice.

[GD Women]

Hello

Sorry you have been suffering with symptoms for so long.

There are a lot of other health issues that share thyroid symptoms, so don't go by symptoms alone.

Everything looks in place as far as your Labs. Believe it or not people have had antibodies as high as in the thousands. And, antibodies are seen in other autoimmune diseases and in a certain percentage of otherwise healthy women, with no thyroid issues at all.

The combo of antibodies and levels, especially levels, are the prevailing diagnose. Antibodies just confirms what the doctor already knows.

FT-3 issues are very, very, very, rare. However it does happen in some cases. Although, T3 and some reverse T3 is normal even in people without thyroid disease, likewise with antibodies.

I hope you find a solution to your issues. Its not fun feeling ill all the time.

Good Luck!

[nasdaqphil]

Your antibodies are essentially negative. They use the greater than / less than to mark very small or insignificant numbers as well as very large.

If this makes you feel any better regarding the antibodies, here's a shot of my lab results below and these results are more indicative of Hashi's. Seldom will you find someone with a really small ab number with really bad Hashi's symptoms unless they are in some sort of temporary remission. My lowest TPO score was like 700+ in the last 7 years. I don't think you have Hashi's but that's not to say something else is going on somewhere in your body.

Thyroid Peroxidase Antibody (TPO Ab) 2,064 (Ref. Range 00 - 39)
Thyroglobulin Antibody (TG Ab) 1244 (Ref. Range 00 - 74)

Have you had a thorough exam? Vitamin D? Magnesium? Glucose? RBC, CBC, etc, etc?

You should probably go get yourself a really good diagnostic blood draw so your doctors can start ruling things out.

[nasdaqphil]

At second glance, Im wondering if a little shot of Cytomel which is pure T3 would work well for you. It may be just what you need.

[Andros]

Andros,

First, thank you for your response. So is it plausible that my issues are caused by below mid-range FT3 ? If that is the case, does it make sense for me to talk to my doctor about getting T3+T4 medication ?

Regarding the antibodies, please help me to interpret it: the lab results say "<20" and "<5" so that does not really mean that I have them, right ? All they are telling me that in the range of 0-20 (resp 0-5) so I may not have any antibodies at all.

Again, I appreciate any advice.

Hi and you are welcome. I do think it would be logical to find out why you are not converting; at the very least, get your liver checked.

That said, yes............I would definitely talk to your doctor about this and as others have stated, you could respond very well indeed to a bit of Cytomel (T3) and or a T4/T3 combo med such as Thyrolar (synthetic), Armour, Westhroid or a pharmaceutical compound.

You have a "trace" of antibodies which is below the recommended range. That is how I read it. Ranges are only guidelines established by cohorts and mean averages.

I am a non-converter and have done well on Armour for years; many years in fact.

[dudley]

Thank you to all of you for your response.

I realize that there are other health conditions that would result to my symptoms; as I said before I went through all test I and other doctors could think of (CAT scan, MRI, EEG, ENG, allergy test, apnea test to name a few). I had a thorough blood test on multiple occasions. Whatever it is, it is somehow atypical or rare.

I have a very good primary physican, he listens to me and he is willing to experiment. What is your opinion, should I ask him to try just T3 (Cytomel) or T4/T3 combo ?

[Andros]

Thank you to all of you for your response.

I realize that there are other health conditions that would result to my symptoms; as I said before I went through all test I and other doctors could think of (CAT scan, MRI, EEG, ENG, allergy test, apnea test to name a few). I had a thorough blood test on multiple occasions. Whatever it is, it is somehow atypical or rare.

I have a very good primary physican, he listens to me and he is willing to experiment. What is your opinion, should I ask him to try just T3 (Cytomel) or T4/T3 combo ?

By all means! Either it will work for you or not. I suspect the former. You need FT3, you cannot function w/o sufficient amount. Nor can you heal.

So, please go ahead and make an appt. to talk to your doc and let us know.

The "usual" starting dose for Cytomel is 5 mcg. (please note mcg. not mg.) It is powerful and some even split that tiny pill in half and take some in the morning and the other 1/2 in the afternoon.

Or if you prefer Armour, if you do not have myxedema, the usual starting dose is 30 mg. (1/2 grain). If you do have mxedema, 15 mg. (1/4 grain.)

[dudley]

I just saw my doctor and he expressed doubts that my symptoms could be related to hypothyroidism. He said that not only my tests results look pretty normal but what he finds pretty unusual is that my symptoms are recurrent - I have them for a few days and then I feel pretty normal for a week or so. He said this almost never happens with hypothyroidism (at the end he gave me a prescription for Cytomel anyway).

Is he right ?

[Andros]

I just saw my doctor and he expressed doubts that my symptoms could be related to hypothyroidism. He said that not only my tests results look pretty normal but what he finds pretty unusual is that my symptoms are recurrent - I have them for a few days and then I feel pretty normal for a week or so. He said this almost never happens with hypothyroidism (at the end he gave me a prescription for Cytomel anyway).

Is he right ?

That all depends on what your test results were. If you could please post them with the ranges (different labs use different ranges), we can have a look. Did he not do any antibodies tests? The waxing and waning is most common w/ antibodies on the loose.

And, why did he Rx Cytomel if he is convinced it is not your thyroid? That bothers me, a lot.

How much did he Rx? You have to be very very careful with that stuff.

[dudley]

Andros,

Thanks for the reply. My results are in the very first message of this thread. The reason why he prescribed Cytomel is because I convinced him to do that - I told him I wanted to eliminate this possibility. I forgot how much he prescribed (I have not picked up the meds yet) but I know it is a very low dosage.

[nasdaqphil]

Be VERY careful with Cytomel. That stuff is pure T3 and is very potent. Even a low dose can turn you very hyper very quickly if you don't require it. Please make sure this doctor thinks you should have it versus you thinking you should have it - unless of course you are a doctor.

There are very few people in the world who need pure T3 and personally I don't think it will help. If anything it might make things worse but regardless, just be careful and listen to your doctor so you don't get hurt.

[Andros]

Andros,

Thanks for the reply. My results are in the very first message of this thread. The reason why he prescribed Cytomel is because I convinced him to do that - I told him I wanted to eliminate this possibility. I forgot how much he prescribed (I have not picked up the meds yet) but I know it is a very low dosage.

Thank you for refreshing my memory!! Now that we have refreshed my memory; yes...........................a tiny dose of Cytomel is worth a try. I do believe you would feel better w/ TSH down around 1 or less.

We did discuss that rT3 as well so, I concur........you are a candidate to try the Cytomel. I am glad you were able to convince the doc of that and clearly he has an open mind.

So, when you fill the Rx, will you please let us know the dosage amount? Probably 5 mcg..

Also, I personally sure would like to track your journey on the Cytomel. So, I do hope you keep us posted on that as well.