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Just got results of my blood work today from Quest Labs…
Tsh- 2.51 (0.40-4.50)mIU/L
t4 free- 1.1 (0.8-1.8)ng/dl
t4 free- 365 (230-420)pg/dl
RT3- 23 (11-32)ng/dlferritin- 112 (20-345)ng/ml
Dhea-sulfate- 76 (110-370)mcg/dl
pregenenlone- 96 (13-208)ng/dl
*prior to the above blood test I was on HC @ 15-20mg/day and t3 @ 50-75mcg/day for the past 4 months….
**I am fatigued and sleepy all the time, depression, metabolism is definately slow, diffuse rapid hair loss over the past 5 months (went from full head of hair to severe diffuse thining in just 5 months..)…. i used to think i had adrenal probs but i really think i am just hypothyroid… the tsh of 2.51 is the highest I have ever had, I have always been between 2.0 – 2.3 in previous tsh tests… my free t4 has dropped from previous tests which was usually 1.2 -1.3, my free t3 has roughly stayed the same…
TSH is the brains signal that it needs more thyroid hormone.
The actual thyroid hormones include T4 (inactive) and T3 (active).
The free levels are determined by the amount of thyroid binding proteins in the blood. These are, in turn, affected by multiple signals such as estrogen signaling.Ron Rothenberg MD, remarked to me years ago, that there was a study done which showed that when most people with Hashimoto’s Thyroidism were eliminated from a population, the average TSH drops down to 1.0. He noted this begs the question of what is an optimal TSH and perhaps a TSH closer to 1.0 is more optimal.
Note that a TSH of 1.0 in this population still includes a substantial number of people who are symptomatic for hypothyroidism or exhibit signs of hypothyrodism – those who I would consider as having suboptimal thyroid signaling. They just don’t have the autoimmune thyroid disease called Hashimoto’s.
In some illnesses, such as mental illnesses and metabolic illnsnesses, the brain, itself, is not functioning well. This can lead to a reduced production of TSH and lower thyroid hormone signaling. Yet, if one was using TSH solely to determine the presence of hypothyroidism, in these cases, one can be greatly mislead.
As a rule of thumb, when TSH is over 2.0, using TSH as a single test, then I generally find signs of hypothyroidism in the patient, and symptoms also.
Whether or not to treat with thyroid hormone depends on what is causing the signaling deficit. For example, some people have adequate thyroid hormone in the body, yet elevated TSH if thyroid hormone can’t pass the blood brain barrier for various reasons. Adding thyroid hormone is not the solution. Addressing the blood brain barrier problem would be the solution. If reverse T3 is elevated, causing the deficit in thyroid hormone, then addressing the cause for the elevated reverse T3 would be a better and more definitive solution than adding more thyroid hormone. Thus, it is important to look at thyroid metabolism and related systems to determine the course of treatment.
@billy3z 3254 wrote:
Just got results of my blood work today from Quest Labs…
Tsh- 2.51 (0.40-4.50)mIU/L
t4 free- 1.1 (0.8-1.8)ng/dl
t3 free- 365 (230-420)pg/dl
RT3- 23 (11-32)ng/dlferritin- 112 (20-345)ng/ml
Dhea-sulfate- 76 (110-370)mcg/dl
pregenenlone- 96 (13-208)ng/dl
*prior to the above blood test I was on HC @ 15-20mg/day and t3 @ 50-75mcg/day for the past 4 months….
**I am fatigued and sleepy all the time, depression, metabolism is definately slow, diffuse rapid hair loss over the past 5 months (went from full head of hair to severe diffuse thining in just 5 months..)…. i used to think i had adrenal probs but i really think i am just hypothyroid… the tsh of 2.51 is the highest I have ever had, I have always been between 2.0 – 2.3 in previous tsh tests… my free t4 has dropped from previous tests which was usually 1.2 -1.3, my free t3 has roughly stayed the same…
With my t4 being on the low end and my high rt3 to free t3 ratio being = 16 which is not good…. would it be of benefit to supplement with T4 as well as T3 to help clear my symptoms of hypothryoid….?
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