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What Does This Lab Report Indicate?

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Posted on Sat, 7 Oct 2017
Question: My annual health checkup showed Thyroid abnormality.
On consultation with a general physician, he advised to repeat Thyroid test and undergo vitamin tests. When Vitamin B and D were found to be low, he suggested that Thyroid levels might be abnormal due to Vitamin deficiency and advised Vitamin supplements.

Then, i had general weakness, and feeling tired, more so during mornings.
Now, i also have the feeling of choking and jaw muscle pain/stiffness.
Feeling of choking aggravates in air conditioned environment.

Please advise what to do.

As this question box doesn't have an option to attach test reports, i am summarizing the results below.

13 August 2017
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Vitamin B12: 238 pg/mL
25-OH VITAMIN D (TOTAL): 8.88 ng/ml

Thyroid
TOTAL TRIIODOTHYRONINE (T3) C.L.I.A 91 ng/dl 60-200
TOTAL THYROXINE (T4) C.L.I.A 9.7 μg/dl 4.5-12
THYROID STIMULATING HORMONE (TSH) C.L.I.A 5.91 μIU/ml 0.3-5.5
FREE TRIIODOTHYRONINE (FT3) C.L.I.A 2.81 pg/ml 1.7-4.2
FREE THYROXINE (FT4) C.L.I.A 1.23 ng/dl 0.7-1.8

29 XXXXXXX 2017
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Total Cholestrol: 216 mg/dL (METHOD : CHOD-POD, SAMPLE TYPE : SERUM)
HDL Cholestrol: 54 mg/dL (METHOD : ENZYMATIC COLORIMETRIC, SAMPLE TYPE : SERUM)
TRIGLYCERIDES: 124mg/dL (METHOD : GPO-POD, SAMPLE TYPE : SERUM)
Direct LDL Cholesterol: 137 mg/dL (METHOD : ENZYMATIC COLORIMETRIC, SAMPLE TYPE : SERUM)

TSH 9.49uIU/mL
T4 9.2 mcg/dL
T3 107 ng/dL

Rest everything was in normal range.
doctor
Answered by Dr. Minal Mohit (15 hours later)
Brief Answer:
subclinical hypothyroidism!

Detailed Answer:
Dear XXXXXXX hi!
As i can see, you have subclinical hypothyroidism, i.e. on reports things seem normal with only TSH being in high range. you are clinically symptomatic as well. so what is required is -
1. your family history of thyroid dysfunction
2. anti TPO and anti TGA reports.
3. Free T3 T4 levels (You have got total T3 T4 levels tested)
these will help us in deciding whether to treat you or not.
regards!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Minal Mohit (33 minutes later)
Hello Dr. XXXXXXX

Please find my response to your questions below.

1. My parents never had unusual thyroid levels. However, one of my father's sister has hypothyroidism for about 20 years.

2. Should i get these tests (anti TPO and anti TGA) done?

3. I had got free T3 and free T4 tests done. Result of the test done on 13 August 2017 below.
FREE TRIIODOTHYRONINE (FT3) C.L.I.A 2.81 pg/ml 1.7-4.2
FREE THYROXINE (FT4) C.L.I.A 1.23 ng/dl 0.7-1.8

More generally, could you help me understand the root cause of this?
If it is something which can be fixed by regular exercise and/or relaxation techniques, i would like to do that before taking any medication.

Please advise.

Thanks, and regards,


Hello Dr. XXXXXXX

Please find my response to your questions below.

1. My parents never had unusual thyroid levels. However, one of my father's sister has hypothyroidism for about 20 years.

2. Should i get these tests (anti TPO and anti TGA) done?

3. I had got free T3 and free T4 tests done. Result of the test done on 13 August 2017 below.
FREE TRIIODOTHYRONINE (FT3) C.L.I.A 2.81 pg/ml 1.7-4.2
FREE THYROXINE (FT4) C.L.I.A 1.23 ng/dl 0.7-1.8

More generally, could you help me understand the root cause of this?
If it is something which can be fixed by regular exercise and/or relaxation techniques, i would like to do that before taking any medication.

Please advise.

Thanks, and regards,
doctor
Answered by Dr. Minal Mohit (4 minutes later)
Brief Answer:
family history is positive.

Detailed Answer:
Dear mr. XXXXXXX your paternal aunt had hypothyroidism that makes you susceptible.
tests you must get done to tell you about your autoimmunity.
treatment we will consider after the test reports.
natural remedies like yoga and meditation do work, but i am not an expert at alternative medicine. so will not be able to guide you much on that. but as a doctor will advise you the right treatment.
regards!
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Minal Mohit (2 days later)
Hello team,

I have a follow up question for Dr. XXXXXXX XXXXXXX which I am unable to post on the portal. It throws some error.

Could you forward my query to her?

Hello Doctor,

Regarding the choking feeling that i have in air conditioned environment, which aggravates in closed air conditioned environment like car, whom should i consult?

An Endocrinologist face to face or an ENT specialist?

Also, could you suggest a doctor in XXXXXXX for the same.

Thanks,
doctor
Answered by Dr. Minal Mohit (18 minutes later)
Brief Answer:
seems to be phobic disorder.

Detailed Answer:
dear XXXXXXX endo or ENT might not be able to help you. seems like a phobia , you might need a psycho counseling. doctor in XXXXXXX ? i m sorry but google or HCM platform might help you.
regards!
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Minal Mohit

Endocrinologist

Practicing since :1998

Answered : 836 Questions

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What Does This Lab Report Indicate?

Brief Answer: subclinical hypothyroidism! Detailed Answer: Dear XXXXXXX hi! As i can see, you have subclinical hypothyroidism, i.e. on reports things seem normal with only TSH being in high range. you are clinically symptomatic as well. so what is required is - 1. your family history of thyroid dysfunction 2. anti TPO and anti TGA reports. 3. Free T3 T4 levels (You have got total T3 T4 levels tested) these will help us in deciding whether to treat you or not. regards!