help understanding lab results

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In May I had the following:

TSH - Normal

T4, Free - normal

T3, Total - 68L (range 76-181)

I have been doing some work on Bilirubin issues and brought my levels down from 2.6 to 1.7 with Broccoli extract. 2 weeks ago I asked my doctor to reorder the T3 test to see if solving the bilirubin effected the T3. He ordered a different test that I am not sure how to interpret, and my follow up is not for 6 months.

Here's my results:

T3 uptake 39H (range 22-35%)

T4 total 6.3 normal

T4 free 2.5 normal

TSH 4.54H (range .4 - 4.5)

You thoughts are appreciated.

2 likes, 11 replies

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11 Replies

  • Posted

    Hi Dave

    I am sorry but I do not understand the issue about Brocolli.  Thanks

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    • Posted

      Brocolli and other cruciferous vegetables are known to help the liver process bilirubin. The liver is also involved in T4 to T3 conversion.
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  • Posted

    Hi Dave, your results differ from what I'm used to, so I can't be much help. My only comments are that the 'H' after a reading seems to indicate 'high' - if this is correct, you are on borderline sub-clinical hypothyroidism. It's worth looking up the symptoms of hypothyroidism and if you have them go back and tell your doctor. Alternatively, monitor the situation over the next 3 months and see if the symptoms get worse, and if so, go back to your doctor then.
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    • Posted

      In UK, NICE guidelines say that someone with subclinical hypothyroidism & experiencing symptoms can be treated with 25mcg Levothyroxine to see if it helps. So it's worth asking your GP if you can try it.
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    • Posted

      Unfortuantely NICE guidlines say nothing of the sort!

      First of all, what they do say, "Confirm by repeat testing of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels, with the addition of measurement of thyroid peroxidase antibodies (TPO-Ab), 3–6 months after the original result."

      So that is the first thing that will have to happen, (and sometimes getting the PH lab to run FT4 and Antibody tests is a problem, but that can be overcome!)

      Then it goes on "Levothyroxine treatment is not routinely recommended."

      Which is a bit of an obstacle.

      Then, "Consider offering levothyroxine treatment if:

      The person has a goitre.

      Their TSH level is rising.

      The woman is pregnant or planning pregnancy"

      There is more, and it can be found at: http://cks.nice.org.uk/hypothyroidism#!scenario:1

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  • Posted

    Hello Dave:

    My name is Shelly and I am a nurse in the USA.  I have Hashimoto's thyroid disease since 1987.

    T3 uptake is high my ref. range in USA says 20 -37%. This test is to measure thyroxine binding problems. A bit high here.

    TSH is 4.5 is at the limit and should be 0.45 to 4.50 but most doctors like it bewteen 1.5 to 3.5 and ideally at 2.0

    Bilirubin has to do with the liver function and are you trying to reduce the amount of Bilirubin via Broccoli extract? Are you jaundiced or yellowish in the whites of your eyes? Avoid any alcohol and some people have fatty deposits on the liver which can cause Bilirubin problems.

    If you are not on any thyroid meds you should be on a low dose to get the TSH down.

    I hope this helps, any questions just ask.

    Shelly

     

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    • Posted

      Shelly,

      Thanks for taking time to respond. I have Gilbert's which leads to high bilirubin levels. I rarely have jaundice, only when fasting or ill. 

      I also have fatigue issues. For a couple decades I have had slightly low T3 total. I took the Broccoli extract to see if it would lower my bilirubin and help my liver to convertT4 to T3. For sure it lowered my Bilirubin. Unfortunately I don't think I can tell from this latest test if it helped my T3 level since T3 total was not ordered. I am feeling a little more energy. Someone on another forum advised that broccoli and other similar vegetables can slow iodine uptake. This may be why my TSH has risen some since being on the Broccoli. I recently started taking a kelp (iodine) supplement perhaps that will help. Another factor could be the change in my BP meds last month. I was on Losartan + Bystolic. Now I am on Losartan / HCTZ + Carvedilol.

      I am not clear on how the T3 uptake in my recent test would relate to T3 total on the earlier test.

      Thanks,

      Dave

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    • Posted

      Most probably dead right, but unfortunately in the UK few Doctors and even fewer Endocrinologists will rush to prescibe L-thyroxine for a TSH as marginal as this, especially as T3 & T4 are within lab range. (Lord protect us from that word "Normal!")

      Further complicated by T3 uptake being high (indicating HIGH thyroid hormone activity and TSH being high indicating LOW thyroid hormones! The probelm with T3Uptake too - it is a test with not much real use, so sometimes only complicates matters.

      Non-thyroid illness can play around with levels so one-off readings are always best to be repeated, so one who really knows his stuff will probably run more tests and consider this, but I have been in a similar situation myself and when repeated marginal tests with (plenty of) related symtoms don't mean automatic treatment here, and it can be like swimming through sand trying to get help, unlike in the US, Belgium and some other countries where Doctors are much more willing to trial replacement therapy, and where even the Lab ranges are often MUCH lower making the diagnsiis so much easier :-(

      If you want more advice, best site with UK info is "ThyroidUK" rather than post a link which takes some time to get posted on here, might be best to search for it. Among other things, it outlines the problems gettinga diagnisis and treatment in the UK can involve.

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    • Posted

      Hello Dave

      Oh I am sorry to hear about Gilbert's Syndrome. Since everything goes through the liver you may have something there with the new BP meds in your system.

      The T3 uptake is not a great test, it would have been better to do a T3  level and a FT3 level. It is kind of an old timey test. Mainly use to check the Thyroid hormone binding capacity.  I will place more weight on the TSH and this test is more of indicator of how your thyroid is doing day to day. I also go by symptoms as they speak louder.

      Since you say you have fatigue and knowing that you are at the limit of the so-called normal level, I have been made aware of Trial periods of Levo for people, and 25mcg is a small dose and would most likely bring your TSH into a better level and the the fatigue would fade away.

      No harm in asking for it. Since I am in the USA, I am only going by what I have been told and learned from others on this forum when it comes to NHS.  I know if you were in the USA they would try you on a low dose.

      I hope this helps,

      Shelly

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    • Posted

      Hello Ian:

      I agree and you are right about the NHS from what I have learned on here from so many.  Many thanks for the information.

      Shelly

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    • Posted

      Sadly its not JUST within the NHS, even privagte Doctors have certain problems, and those that have gone to thinking "outside of the box" and treated "problem" thyroid patients have been hounded into the ground by the GMC.

      That said some are more enlightened than others

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