Re: Please comment on these results

[Guest guest]

Cara,

You wrote:

>

> TSH 4.21 REF 0.5 - 5.5 -

> T3 Total 191 (H) REF 60 - 181

> T3 Uptake 24% REF 24 - 37%

> T4 Total 11.6 REF 4.5 - 12.8

> T4 Free 2.8 REF 1.8 - 3.8

> Cortisol AM 34.7 (H) REF 4.0 - 22.0

>

> ... I was wondering if there was any

> perspective available on these numbers now? ...

Two important details: Are you on any kind of thyroid replacement

medication now, and have you been tested for antibodies?

The ratio of Total T4 to FT4 is usually pretty close to the ratio of

Total T3 to FT3. Thus, you can deduce FT3 from these readings. That used

to be the cheapest and most accurate way to do it. I think they have a

better direct method now.

I suspect your endo is going to order more tests for the

pituitary-adrenal axis. You could have Cushing's syndrome rather than

hypoT. Either your pituitary or adrenal glands could be overactive, or

you could be on a medication that causes this as a complication.

Chuck

[Guest guest]

what???? she is seriously hypo. High cortisol is adrenal burnout.

gracia

> Cara,

>

> You wrote:

>>

>> TSH 4.21 REF 0.5 - 5.5 -

>> T3 Total 191 (H) REF 60 - 181

>> T3 Uptake 24% REF 24 - 37%

>> T4 Total 11.6 REF 4.5 - 12.8

>> T4 Free 2.8 REF 1.8 - 3.8

>> Cortisol AM 34.7 (H) REF 4.0 - 22.0

>>

>> ... I was wondering if there was any

>> perspective available on these numbers now? ...

>

> Two important details: Are you on any kind of thyroid replacement

> medication now, and have you been tested for antibodies?

>

> The ratio of Total T4 to FT4 is usually pretty close to the ratio of

> Total T3 to FT3. Thus, you can deduce FT3 from these readings. That used

> to be the cheapest and most accurate way to do it. I think they have a

> better direct method now.

>

> I suspect your endo is going to order more tests for the

> pituitary-adrenal axis. You could have Cushing's syndrome rather than

> hypoT. Either your pituitary or adrenal glands could be overactive, or

> you could be on a medication that causes this as a complication.

>

> Chuck

>

>

>

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[Guest guest]

Gracia,

You wrote:

>

> what???? she is seriously hypo. High cortisol is adrenal burnout.

I would prefer not to jump to those conclusions, although it is a

possibility. That is why I asked the questions I did.

The cortisol reading is unusually high, and there are several

potentially very serious causes that need to be ruled out. That is why I

said that I suspect her endo will check things related to Cushing's

syndrome, such as ACTH responses.

Her FT4 and, by deduction, FT3 are both in the high normal range.

Without antibodies or T3 medication to skew the TSH, her reading is in a

range where 2/3s of people on the street are asymptomatic. Thus, her

symptoms could be purely related to the adrenal problems.

Chuck

> > Cara,

> >

> > You wrote:

> >>

> >> TSH 4.21 REF 0.5 - 5.5 -

> >> T3 Total 191 (H) REF 60 - 181

> >> T3 Uptake 24% REF 24 - 37%

> >> T4 Total 11.6 REF 4.5 - 12.8

> >> T4 Free 2.8 REF 1.8 - 3.8

> >> Cortisol AM 34.7 (H) REF 4.0 - 22.0

> >>

> >> ... I was wondering if there was any

> >> perspective available on these numbers now? ...

> >

> > Two important details: Are you on any kind of thyroid replacement

> > medication now, and have you been tested for antibodies?

> >

> > The ratio of Total T4 to FT4 is usually pretty close to the ratio of

> > Total T3 to FT3. Thus, you can deduce FT3 from these readings. That used

> > to be the cheapest and most accurate way to do it. I think they have a

> > better direct method now.

> >

> > I suspect your endo is going to order more tests for the

> > pituitary-adrenal axis. You could have Cushing's syndrome rather than

> > hypoT. Either your pituitary or adrenal glands could be overactive, or

> > you could be on a medication that causes this as a complication.

> >

> > Chuck

> >

> >

> >

>

>

> --

> No virus found in this outgoing message.

> Checked by AVG Free Edition.

> Version: 7.1.385 / Virus Database: 268.3.0/290 - Release Date: 3/23/2006

>

>

>

>

[Guest guest]

I am not currently on any type of thyroid medication. As well, my

ACTH was tested and it looks normal - 13 with a ref of 5 - 27.

I did anti Tg and Anti- TPO tests a couple of years ago wth

Healthcheck USA and they were both negative. My primary care doctor

did, I think, anti Tg last fall - which was negative, but he did not

do anti TPO.

> >

> > TSH 4.21 REF 0.5 - 5.5 -

> > T3 Total 191 (H) REF 60 - 181

> > T3 Uptake 24% REF 24 - 37%

> > T4 Total 11.6 REF 4.5 - 12.8

> > T4 Free 2.8 REF 1.8 - 3.8

> > Cortisol AM 34.7 (H) REF 4.0 - 22.0

> >

> > ... I was wondering if there was any

> > perspective available on these numbers now? ...

>

> Two important details: Are you on any kind of thyroid replacement

> medication now, and have you been tested for antibodies?

>

> The ratio of Total T4 to FT4 is usually pretty close to the ratio

of

> Total T3 to FT3. Thus, you can deduce FT3 from these readings.

That used

> to be the cheapest and most accurate way to do it. I think they

have a

> better direct method now.

>

> I suspect your endo is going to order more tests for the

> pituitary-adrenal axis. You could have Cushing's syndrome rather

than

> hypoT. Either your pituitary or adrenal glands could be

overactive, or

> you could be on a medication that causes this as a complication.

>

> Chuck

>

[Guest guest]

the current range for TSH is .3-3 so you are over the range, if you believe

in that stuff. (I don't)

Gracia

>I am not currently on any type of thyroid medication. As well, my

> ACTH was tested and it looks normal - 13 with a ref of 5 - 27.

>

> I did anti Tg and Anti- TPO tests a couple of years ago wth

> Healthcheck USA and they were both negative. My primary care doctor

> did, I think, anti Tg last fall - which was negative, but he did not

> do anti TPO.

>

>

>

>> >

>> > TSH 4.21 REF 0.5 - 5.5 -

>> > T3 Total 191 (H) REF 60 - 181

>> > T3 Uptake 24% REF 24 - 37%

>> > T4 Total 11.6 REF 4.5 - 12.8

>> > T4 Free 2.8 REF 1.8 - 3.8

>> > Cortisol AM 34.7 (H) REF 4.0 - 22.0

>> >

--

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[Guest guest]

Cara,

You wrote:

> I am not currently on any type of thyroid medication. As well, my

> ACTH was tested and it looks normal - 13 with a ref of 5 - 27.

>

> I did anti Tg and Anti- TPO tests a couple of years ago wth

> Healthcheck USA and they were both negative. My primary care doctor

> did, I think, anti Tg last fall - which was negative, but he did not

> do anti TPO.

Thank you for sharing these results. Make sure your endo knows about all

these tests.

There is also a dynamic ACTH test to measure how the pituitary reacts to

changes in adrenal secretions, but your results suggest a problem with

the adrenal glands themselves rather than the pituitary. As Gracia said,

this could very well be due to adrenal fatigue, which should be

addressed before trying to fix the thyroid.

Chuck

[Guest guest]

Gracia,

You wrote:

>

> the current range for TSH is .3-3 so you are over the range, if you believe

> in that stuff. (I don't)

If you read the fine print, this is the range recommended by the

American Society of Endocrinologists for clinical care, which means for

purposes of adjusting dosages of thyroid replacement hormones. For

initial screening, which this case is, values outside the new

recommendation but still within the lab's reference range (i.e. 3-5) are

considered " suspect " but not definitive for diagnosis. That means you

need to look at other tests, which were taken.

In this case, the strongest evidence that this is not thyroid

insufficiency is that the FT4/FT3 is in the high normal range.

Chuck

[Guest guest]

Thanks Chuck and Gracia,

I believe that technically I am hypothyroid - deficient in my

thyroid hormones - as indicated by symptoms and elevating TSH. The

OK FT4 and high TT4 and TT3 say to me that I am probably producing

and converting the hormones OK, but somehow not using the T3

properly, so it would be important to get to the bottom of this,

which is most likely the adrenals.

I feel good about this endo so far - he is on the top docs list - so

I'm interested to hear his comments and grateful that I now have a

little bit of corroboration to back up what I am thinking. I'll

update you if I find more out.

Cara

-- In hypothyroidism , Chuck B <gumboyaya@...> wrote:

>

> Gracia,

>

> You wrote:

> >

> > the current range for TSH is .3-3 so you are over the range, if

you believe

> > in that stuff. (I don't)

>

> If you read the fine print, this is the range recommended by the

> American Society of Endocrinologists for clinical care, which

means for

> purposes of adjusting dosages of thyroid replacement hormones. For

> initial screening, which this case is, values outside the new

> recommendation but still within the lab's reference range (i.e. 3-

5) are

> considered " suspect " but not definitive for diagnosis. That means

you

> need to look at other tests, which were taken.

>

> In this case, the strongest evidence that this is not thyroid

> insufficiency is that the FT4/FT3 is in the high normal range.

>

> Chuck

>

[Guest guest]

Actually the test was not for FreeT3 but for total t3 which is not very

useful. She could have high free T4 and low Free t3.

Kerry

> TSH 4.21 REF 0.5 - 5.5 -

> > T3 Total 191 (H) REF 60 - 181

> > T3 Uptake 24% REF 24 - 37%

> > T4 Total 11.6 REF 4.5 - 12.8

> > T4 Free 2.8 REF 1.8 - 3.8

> > Cortisol AM 34.7 (H) REF 4.0 - 22.0

> >

Re: Re: Please comment on these results

Gracia,

You wrote:

>

> the current range for TSH is .3-3 so you are over the range, if you

believe

> in that stuff. (I don't)

If you read the fine print, this is the range recommended by the

American Society of Endocrinologists for clinical care, which means for

purposes of adjusting dosages of thyroid replacement hormones. For

initial screening, which this case is, values outside the new

recommendation but still within the lab's reference range (i.e. 3-5) are

considered " suspect " but not definitive for diagnosis. That means you

need to look at other tests, which were taken.

In this case, the strongest evidence that this is not thyroid

insufficiency is that the FT4/FT3 is in the high normal range.

Chuck

[Guest guest]

Kerry,

You wrote:

> Actually the test was not for FreeT3 but for total t3 which is not very

> useful. She could have high free T4 and low Free t3.

Not really possible. As I had previously explained, FT3 = FT4/T4 x T3.

If you measure all three on the right hand side, you can calculate FT3.

That used to be the preferred way to get FT3. The fraction of Total that

is bound is the same for both T4 and T3. That is because they are bound

by the same mechanism for albumin and globulin independent of which

thyrodine is involved. Thus, the ratios of bound to unbound and

equivalently unbound to total are the same for T4 and T3.

Chuck