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What Does This Thyroid Test Report Indicate?
Question: Dear Sir,
Please see my reports for the thyroid functon:
TOTAL TRIIODOTHYRONINE (T3) C.L.I.A 89 ng/dl 60-200
TOTAL THYROXINE (T4) C.L.I.A 4.1 μg/dl 4.5-12
THYROID STIMULATING HORMONE (TSH) C.L.I.A 2.78 μIU/ml 0.3-5.5
Looks like T4 is under the below range. Please advise.
Please see my reports for the thyroid functon:
TOTAL TRIIODOTHYRONINE (T3) C.L.I.A 89 ng/dl 60-200
TOTAL THYROXINE (T4) C.L.I.A 4.1 μg/dl 4.5-12
THYROID STIMULATING HORMONE (TSH) C.L.I.A 2.78 μIU/ml 0.3-5.5
Looks like T4 is under the below range. Please advise.
Brief Answer:
Thyroid
Detailed Answer:
Yes the Total T4 is below the lower limit of normal for this laboratory. This merits further investigation. There are a few different possibilities.
1 It could be that your 'thyroid carrier proteins' in the blood are abnormally low, such as TBG (thyroid binding globulin). This however does not cause any medical problem
This leads to a low-appearing Total T4. This situation does not require any intervention as long as the TSH is normal.
To ascertain this, there are 2 ways :
a) Check blood levels of TBG
or
b) Check blood levels of Free T4
Free T4 is a better marker although it has some limitations occasionally too.
2) The next potential diagnosis is Secondary Hypothyroidism
This means that there is a pituitary problem. This typically requires an MRI of the Pituitary in addition to other tests like checking blood levels of Prolactin.
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 last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day.
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Thyroid
Detailed Answer:
Yes the Total T4 is below the lower limit of normal for this laboratory. This merits further investigation. There are a few different possibilities.
1 It could be that your 'thyroid carrier proteins' in the blood are abnormally low, such as TBG (thyroid binding globulin). This however does not cause any medical problem
This leads to a low-appearing Total T4. This situation does not require any intervention as long as the TSH is normal.
To ascertain this, there are 2 ways :
a) Check blood levels of TBG
or
b) Check blood levels of Free T4
Free T4 is a better marker although it has some limitations occasionally too.
2) The next potential diagnosis is Secondary Hypothyroidism
This means that there is a pituitary problem. This typically requires an MRI of the Pituitary in addition to other tests like checking blood levels of Prolactin.
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 last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day.
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
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
Answered by
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