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What does my lab test report indicate?

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Posted on Wed, 18 May 2016
Question: Hi I need help with my thyroid results.
3 months ago I woke up with chills, neck pain, lymph nodes ,dizziness, palpatations ect. Was misdiagnosed for 10 weeks. What do my thyroid results mean. They were dropping then when I had my periods they were high again. My uptake scan and antibodies was normal.
Im now waking up with headrushs
Is it viral

22/1/16
TSH 1.56 (.40 - 4.2)
FT4 26.6 (11-22)

29./1/16
TSH 1.06
FT4 22.8
FT3 4


4/2/16
TSH 1.82
FT4 20
FT 3 4.6


16/2/16
TSH 1.14
FT4 19.2


1/3/16
TSH 2.47 (.4 - 4.2)
FT4 23.6 (11 - 22)
FT3 4
doctor
Answered by Dr. Shehzad Topiwala (3 hours later)
Brief Answer:
Thyroid

Detailed Answer:
Your thyroid results look normal. It is extremely unlikely that your thyroid is not functioning normally.

It is possible you had a thyroid problem 3 months ago but as you pointed out, your uptake scan and antibodies were normal. So unless the TSH and Free T4 were abnormal at that time, it is hard to say for sure what may have happened.

Regardless, your thyroid seems to be working fine now based on the laboratory results you have shared here.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
25 hydroxy Vitamin D
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (12 minutes later)
can I please ask though was is my T4 high and sometimes out of range? I have had terrible shaking, palpatations, raised heart rate when at rest. I am still waking with head rushes and vomiting every morning and feel extremley nervous.
doctor
Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer:
Follow up

Detailed Answer:
Yes there is a good plausible explanation for this.

Free T4, also often abbreviated as FT4, is not a perfect test. So sometimes it can give a misleading report. For instance, two of your FT4 results are above normal while couple others are within normal limits. This likely represents a shortcoming of the method used to test FT4 in the blood.
To get around this, I typically order

Total T4
Total T3
T3 resin uptake

These are all blood tests which can be done at any time of the day and do not require fasting.
Please note the T3 resin uptake is a completely different test versus the Thyroid Uptake and Scan.

If these three are normal we are virtually certain that FT4 has been fallacious.

Overall FT4 is a good test and is commonly used worldwide. However as you can see it can have limitations in select circumstances.

Lastly, as I mentioned in my first response, there are rare conditions like Thyroid Hormone Resistance (THR) where blood tests can resemble yours and symptoms such as the ones you are experiencing can occur.
The results of these three tests I have just recommended may help to shed light on this possibility.
Seeing an endocrinologist in-person will be important to interpret these tests if THR is suspected.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (17 hours later)
could it possibly be a type of viral thyroiditis?
I dont see an Endo for another 4 weeks.
Is there anything I could be doing as in diet or supplements to try and lower my T4?
doctor
Answered by Dr. Shehzad Topiwala (4 hours later)
Brief Answer:
Second follow up

Detailed Answer:
Although possible it is unlikely to be viral thyroiditis.

Most likely it is a laboratory test abnormality.

Since it is not a real problem as such, nothing needs to be done about it in terms of diet change

Next time you may wish to check TSH along with
Total T4
Total T3
T3 resin uptake

and if these are normal, it is extremely likely your thyroid is functioning normally.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (51 minutes later)
Thankyou. I will get these test done as I still have alot of symptoms. The only other test that came back abnormal was High Cortisol and Low Lymphicytes
doctor
Answered by Dr. Shehzad Topiwala (11 hours later)
Brief Answer:
Best wishes

Detailed Answer:
for good health
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What does my lab test report indicate?

Brief Answer: Thyroid Detailed Answer: Your thyroid results look normal. It is extremely unlikely that your thyroid is not functioning normally. It is possible you had a thyroid problem 3 months ago but as you pointed out, your uptake scan and antibodies were normal. So unless the TSH and Free T4 were abnormal at that time, it is hard to say for sure what may have happened. Regardless, your thyroid seems to be working fine now based on the laboratory results you have shared here. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) HbA1c (Glycosylated Hemoglobin = your 3 month glucose average) Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) 25 hydroxy Vitamin D