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TSH normal, T3 & T4 relatively low, antiboy high, constipation, weight gain, thin hair

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Practicing since : 2001
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what's the diagnosis and treatment
Hello Doctor,

my 27 years old daughter recently had a blood test which showed

TPOab > 1000 ( >35)
THyroglobulin AB < 20 (< 20)

TSH 1.58 (0.4-4.5)
T4 Free 0.9 (0.8-1.8)
T3 Total 71 (76-181)
T3 Uptake 33 (22-35%)

Her PCP recommended her to see an Endocrinlogist. I just don't understand why her TSH is normal but T3 & T4 all relatively low. And her antiboy is extremely high.
Does she has underactive Thyroid (Hashimotos) ? Any treatment needed ?

ALso my 19 years old daughter has a blood test which showed

TPO AB < 10
THyroglobulin AB < 20

TSH = 0.68 (0.5-4.3)
T4 total 5.3 (5.6 - 14.9)
T3 Update 33 (22-35)
T4 Free 1.7 (1.4-3.8)

What's her problem, why everthing is relatively low ? What if the number is getting lower and lower (compared her TSH with previous years, it is getting lower)? What treatment is needed in the future ?

They both have some hypothyrodism symptoms (constipation, weight gain,thin hair).

Please advise, I really appriciate it. Thanks !!
Posted Sun, 15 Apr 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. V. Kumaravel 12 hours later

I do understand that your daughter has features of constipation, weight gain and has some abnormality in blood results.

Your first daughter's TPOab (Thyroid Peroxidase Antibody) of > 1000, TSH (Thyroid Stimulating Hormone) and FT4 (tetra-iodothyronine) is normal with a low T3 (tri-iodothyronine). Your daughter is probably suffering from autoimmune thyroid disease due to Hashimotos disease. Her thyroid functions are normal as her TSH and FT4 is normal. She may not require any thyroid replacement as of now, but in view of high TPOab, she may require regular thyroid blood test and treatment if required.

Your second daughter's report is relatively normal, except for T4 total. Free hormones are more reliable than total hormones. As her Free T4 is normal we can ignore the value of T4 total. TSH is a range and as long as it is within normal ranges nothing to be concerned.

Hope I have answered your query. Please accept my answer in case you do not have further queries.

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