Help interpreting my thyroid results?

[vamah]

Some background, I have long had symptoms of hypothyroidism but my tests have always come back in the normal range. The most glaring symptom is low body temp and feeling cold all the time. I also get reynaud in my fingers and toes. I asked my doc to do a more in depth thyroid screen and these are the results:

Tsh 1.456. Range .350-4.5
T3 total 92.4. Range 80-204
T4 free .99. Range .80-1.80
T3 free 2.7. Range 2.3-4.2

I thought he was going to test reverse t3, but as I understand that is a ratio of t3 to t4. Does anyone know if my ratio is ok? Any other thoughts? It looks to me like everything is on the low side of normal. One website I looked at seemed to indicate that these are results typical of adrenal fatigue, but I'm not sure if I'm reading it correctly. Thanks.

 

[Ema]

Hi @vamah -

RT3 is a ratio of FT3 to RT3. You can also do it with total T3 if that is all you have available. But unfortunately you need the RT3 result as well to say anything much about conversion.

I agree that your FT4 and FT3 are both low. Typically, FT4 is more like 1.2 and FT3 is above 3 in people who have optimal thyroid function.

The TSH is fine but that is generally not the issue in cases where the thyroid has been turned down to reduce the metabolism in cases of chronic illness. It could also be as a result of HPA axis dysfunction as well.

You could certainly give thyroid replacement a try in my opinion to see if you feel better. It's just not as straightforward as it might be if you "only" had hypothyroidism.

 

[vamah]

Hi @vamah -

RT3 is a ratio of FT3 to RT3. You can also do it with total T3 if that is all you have available. But unfortunately you need the RT3 result as well to say anything much about conversion.

I agree that your FT4 and FT3 are both low. Typically, FT4 is more like 1.2 and FT3 is above 3 in people who have optimal thyroid function.

The TSH is fine but that is generally not the issue in cases where the thyroid has been turned down to reduce the metabolism in cases of chronic illness. It could also be as a result of HPA axis dysfunction as well.

You could certainly give thyroid replacement a try in my opinion to see if you feel better. It's just not as straightforward as it might be if you "only" had hypothyroidism.

Thanks. I've been doing research this afternoon and it seems to me that whatever thyroid problems are an effect of being sick rather than a cause. I may ask my doc about thyroid meds or hydrocortizone to see if it makes me feel better in cold weather. I am having a lot more pain since the weather turned cold and feel like I can never get warm no matter how much I turn up the heat. Right now I'm kind of pissed at my doctor though because I specifically asked him to test reverse T3. I could tell he wasn't listening to me that day. He's usually good about running tests I ask for.

 

[August59]

Have you tried any Lugol's iodine? It could certainly perk up your thyroid enough to get your freeT's closer to the mid range anyway.

Maybe others that have used it with good results or have good knowledge of it will join in and lend some knowledge of your situation.

 

[Ema]

I would not use iodine unless I had tested for Hashimoto's and knew that I did not have autoantibodies.

Iodine can sometime worsen a Hashi's attack so it needs to be used with caution since the vast majority of hypothyroidism is autoimmune in nature.

 

[barbc56]

The symptoms of hypothyroid can also be symptoms of many other conditions so it's important to see an endocrinologist and make sure you have a good workup, ruling out other causes. The later could be done by your PCP but it's important to make sure they consult one another.

The endocrine sysrem is a delicate balance, so if one aspect is off, it can also mean others are as well.

It's a myth that low body temperature in the morning means you have hypothyroidism as that's the time of day our body temperature is lowest. As far as low body temperature at other times in the day, I'm not sure if it's significant or not.

Good luck whatever route you take. Keep us posted and hopefully you can get this resolved.

Edit. If you are on the low side of normal, it's best to have more frequent tesrs for monitoring. Sometimes it can be the relative decrease over time that's important. I had this when not only my thyroid was low normal bot also sodium as a couple of timess I ended up in the hospital. After that I was monitored more closely.It turned out this was a reaction to a medication and when switched to another that acted the same, my sodium has been normal since then.