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What Does This Thyroid Test Result Indicate?

Posted on Fri, 17 Oct 2014

Question: My latest result shows IgM 0.35g/L, IgA 3.78g/L,, IgG 11.15 g/L.
Thyroid results TSH 0.39mIU/L,, Free T4 14.8 pmol/L,, Total T3 2.0nmol/L
Taking 0.75 mg Levothyroxine Sodium daily one in morning empty stomach, feeling all day tired, should I continue wiith this dose, diabetic,

Answered by Dr. Shehzad Topiwala (19 minutes later)

Brief Answer:
Diabetes & thyroid

Detailed Answer:
Sorry to note you feel tired all day.

The thyroid dose of 75 mcg seems reasonably good. Each laboratory has their specific ranges for normal depending on the test method they use. So it is best to go by the lab reference ranges too, in order to ensure the Free T4 is on the higher side of the normal range. TSH is perhaps a more universal target of 0.4 to 2.5, at least as far as I am concerned. Few exceptions are when a person has severe untreated osteoporosis or an irregular heart rhythm problem or chest pains from heart disease, then in these situations I aim for a a more lenient TSH of 1 to 3.
On the contrary when I see someone who has had thyroid surgery for thyroid cancer, then I give higher doses for the first 5 years till it is presumed cured.
Is this the case with you?
Furthermore, knowing your thyroid antibody status will help you determine if you truly have an underactive thyroid, unless of course you have had your thyroid removed surgically or been given radiation treatment for the thyroid in the last.
Regarding Diabetes, you can feel tired if the glucoses are running high. Would you know your most recent A1c value?
And with regards to Ig M etc, there have no direct impact with your current diabetes and thyroid treatment. There is no standard practice to order these in the management of a person's diabetes or thyroid condition.
The most qualified person to interpret the Ig M/A/G would be an Immunologist.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (10 minutes later)

Thanks, Thyroid Peroxidase antibody is 10 kIU/L Tissue Transglutaminase IgA 1.7 KU/L , AIC is 0.063 done Sept 10.2014,taking total 3 tablets metformin 500 mg daily
for hypertension taking Ramipril 2.5 mg daily one
what do you suggest should I continue with 0.075 MG thyroid, confused ,
are u suggesting thyroid surgery?
please clarify so that I can request this this to doctor

Answered by Dr. Shehzad Topiwala (4 hours later)

Brief Answer:
Follow up

Detailed Answer:
1 It appears your thyroid peroxidase antibodies are negative. You should check your anti thyroglobulin antibody levels.
If they are positive then it is quite likely you need levothyroxine for life.
If it is negative then there is still a small chance you need it forever but only an endocrinologist can make this decision by examining and following you in person. it will not be possible on this online forum to make a complex decision like this one as it needs long term follow up

2 Tissue transglutaminase and other antibodies fall in the domain of gastroenterology and immunology. Please consult respective specialists

3 I have noted your BP medication. BP management is another matter all together

4 Regarding the comment on thyroid surgery, let me clarify. I was trying to say that TSH targets are different for those who have thyroid surgery for thyroid cancer.

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