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Concerned about the thyroid hormone levels

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Practicing since : 2002
Answered : 52 Questions
Tsh level - out of range -5.67
T3 -4.0
T4- 1.0
Posted Wed, 11 Jul 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Anantharaman 17 hours later
Thanks for the query.
I'm worried about your test results, mainly because your T4 levels that you have given are very low (if the units are microgram/dl). Please revert back with some details of your illness and please specify the units of measurement and the normal range specified in your laboratory report. This is because the normal range varies from lab to lab.

A low T4 with a normal TSH or only a slightly increased TSH could mean that you have central hypothyroidism - a problem with the pituitary gland or hypothalamus.

If infact the T4 is low, get a freeT4 level done. If that is again low, we need to measure other hormones as well to get a better picture of what is happening
Awaiting your reply

Above answer was peer-reviewed by
Follow-up: Concerned about the thyroid hormone levels 4 hours later
Hi Doctor

Thanks for your revert, Well i have attached a copy of thyriod test report, please let me know if i have got to take any other test for the same.

Answered by Dr. Anantharaman 12 hours later

Thanks for uploading the report. I have read them in detail. There are some abnormalities in your tests.

let’s start with the ones which are straight forward.

25(OH)VitaminD - 6ng/ml is very low. Usually it should be above 30 at the very least above 20 ng/ml. This can be treated by taking either ergocalciferol(50,000IU) or cholecalciferol (60,000IU) weekly for 6 weeks followed by monthly once. Please approach the local endocrinologist for a prescription.

The other abnormality is TSH slightly high. This is called mild hypothyroidism.

You will probably benefit from a small dose of thyroid hormone if you have any or a few of the following

1) A family history of hypothyroidism.
2) Positive anti Thyroid peroxidase antibodies.
3) If you are trying to conceive/ to get pregnant.
4) If you have symptoms of hypothyroidism- tiredness, puffiness of the body, menstrual irregularity.

I see that you are 26 years old, in case you have not completed your family and thinking of conception you should probably initiate thyroid hormone supplementation and continue it until you have finished nursing-, which will be for a few years.

After which you can stop it and see what happens to the TSH. If you have completed your family, not having any of the concerns that I have mentioned above, you can leave it alone and retest after 6months to a year.

The third problem is that your ALT levels or slightly on the higher side. For women it is supposed to be below 15 IU/l though it is in the normal limits for your lab (there is lot of debate in the medical community regarding what should be the normal ALT).

On your next test if you again get a value, which is high, you may see a Gastroenterologist.

The things that you can do to reduce your liver enzyme levels include

1) Losing weight if you are overweight.
2) Regular physical activity- you should do a physical activity of sufficient intensity to get your heart rate to 120-130 /min (eg. walking at 5-6.5 kmph on a treadmill). This you should do for at least 150 minutes a week (20-30 min a day).

3) Have a balanced diet XXXXXXX in fibers and antioxidants.

Wishing you good health.
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