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What Does My Thyroid Test Report Indicate?

Posted on Thu, 25 Aug 2016

Question: I have tch 5

Answered by Dr. Dr.Arnab (26 minutes later)

Brief Answer:
Need some further details regarding..

Detailed Answer:
Hello XXXX, Welcome to HCM,

I've gone through your query but it's too incomprehensible to interpret this..

Can you please specify your concern in details..

Do you mean TCH or TSH ? Also if your referring to any lab investigation value, then please share the complete details so that I can guide you specifically..

Any health concerns which is bothering you recently ?

Please feel free to share your concern in details..

Awaiting for your response..

Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr.Arnab (13 hours later)

Hello Doctor,
The previous message went incomplete from my side (it was only a test msg).

Okay so here is the query in full detail. This is regarding my wife (age 28yrs).
She recently (April-2016) went through a random blood test (Blood Grp A+), and we found a few areas that were not in normal range. We're especially worried about the Thyroid and Haemoglobin levels.

Below is an extract from the test report. Please advise next steps.

1) Thyroid Panel (T3,T4 & TSH) [Test Method - ECLIA]
- Tri-Iodothyronine Total (TT3) 1.33 ng/mL
- Thyroxine - Total (TT4) 5.82 ug/dL
- Thyroid Stimulating Hormone (TSH) 5.18 uIU/ml

2) Lipid Profile
- Cholesterol - HDL 41.0 mg/dl [Test Method - Enzymatic Colorimetric]

3) Complete Blood Count (CBC) with P/S
- Haemoglobin 7.8 g/dL 12.0 - 15.0 Non Cyanide - SLS
- Total Leucocyte Count (TLC) 8.8 10^3/μL 4.0 - 10.0 Flocytometry
- Erythrocyte Count (RBC Count) 4.9 10^6/μL 3.8 - 4.8 Electric Impedence
- Packed Cell Volume (PCV) 29.7 % 36.0 - 46.0 Cumulative Pulse High Detection
- Mean Corpuscular Volume (MCV) 61.2 fL 83.0 - 101.0 Electric Impedence
- Mean Corpuscular Hemoglobin (MCH) 16.1 pg 27.0 - 32.0 Electric Impedence
- Mean Copuscular Hb Conc (MCHC) 26.3 g/dL 31.5 - 34.5 Electric Impedence
- Platelet count 346 10^3/mm 150 - 410 Hydro- Dynamic Focusing
- RDW-SD * 49.0 % 36.4 - 46.3 Electric Impedence
- RDW-CV 23.6 % 11.7 - 14.4 Electric Impedence
- PDW 12.3 % 9.0 - 15.0 Electric Impedence
- Mean Platelet Volume (MPV) * 10.3 % 9.1 - 11.9 Electric Impedence
- P-LCR * 19.6 % 18.5 - 43.5 Electric Impedence
- PCT 0.23 % 0.18 - 0.39 Electric Impedence
- Differential Leucocyte Count
- Neutrophils 57 % 40 - 80 Microscopy/Fluorescence Flocytometry
- Lymphocytes 36 % 20 - 40 Microscopy/Fluorescence Flocytometry
- Monocytes 04 % 02 - 10 Microscopy/Fluorescence Flocytometry
- Eosinophils 03 % 01 - 06 Microscopy/Fluorescence Flocytometry
- Basophils 00 % 00 - 01 Microscopy/Fluorescence Flocytometry
- Absolute Neutrophils 5.03 10^3/μL 2.00 - 7.00 Electric Impedence
- Absolute Lymphocytes 3.09 10^3/μL 1.00 - 3.00 Electric Impedence
- Absolute Monocytes 0.34 10^3/μL 0.20 - 1.00 Electric Impedence
- Absolute Eosinophils 0.28 10^3/μL 0.02 - 0.50 Electric Impedence
- Absolute Basophils 0.03 10^3/μL 0.02 - 0.10 Electric Impedence
- Peripheral Smear Examination Blood film/Light microscopy
Red blood cells are showing aniso-poikilocytosis predominantly microcytic hypochromic with fair numbers of ovalocytes.
Total White blood cells and Differential count with in normal limit.
Platelets are adequate in number.
No immature cells or hemoparasite seen.
COMMENT : Microcytic Hypochromic blood picture.

I can share further report details, if you need insight to other areas as well.
Thyroid/ Lipid/ Liver Function/ kidney Function/ CBC.

Thanks for your prompt response.

Kind Regards,
XXXXXXX

Answered by Dr. Dr.Arnab (2 hours later)

Brief Answer:
Follow the Advises..

Detailed Answer:
Hello XXXX, Welcome back,

Thanks for the detailed follow-up..

I've gone through the reports in details and let me inform you that it's suggestive of Iron deficiency anemia along with possible Vit B12 deficiency with most likely sub clinical hypothyroidism..

You have already shared me the CBC with peripheral blood smear, TFT and HDL from her lipid profile..

It's a condition associated with low concentration of iron in hemoglobin along with an under active thyroid gland and nutritional deficiency, seen quite commonly in day to day practice..

Don't worry, but you need to take her to an Internal Medicine Medicine specialist at the earliest for a detailed clinical check up and some further investigations if necessary(i.e. Reticulocyte count, Anti TPO antibodies etc.)..

I've mentioned 'at the earliest' because the Hemoglobin level is really quite low(7.8) and human body undergoes several compensatory physical changes in those low metabolic parameters for which she is needed to be examined thoroughly without any further delay to decide about initiation of therapy (a combined therapy of Vitamin B12, nutritional, Iron supplementation and/ Thyroxin replacement therapy)..

Some of these therapy can be started in parenteral form (I.V, I.M, S.C etc.) while the others in oral form only (based on the clinical features, drug tolerance and severity of symptoms of her)..

Now, even though you haven't mentioned regarding any immediate family planning, let me still advice you that it's not an ideal time for this, so she needs to be completely treated prior to any family planning in near future..

Let me know if there's any queries/doubts, I'll be glad to clarify..

Take Care of yourself and your wife dear..

Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee