Labs analysis

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I think I've a problem with my thyroid. I have many symptoms of hypothyroidism. I did labs that are recommanded to determined if there's a problem. There's the results : TSH 1.5 mUI/L, FT4 15,6 pmol/L, FT3 5,4 pmol/L, TBG 14.1 µg/mL, RT3 0,038 nmol/L, DHEA 250,55 ug/dl, anti-TPO 26 IU/mL, TgAb 25 IU/mL, Cortisol AM 268 nmol/L.

I know that my adrenals glands are low, but I don't know if I have a thyroid issue. I've read about T3/TBG ratio and the FT3/RT3 ratio, but I don't know how to calculate.

Can somebody help me please?

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5 Replies

  • Posted

    Hello PKCam:

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

    Your TSH is 1.5  and the range is 0.45 to 4.50 and that is normal at 1.5.

    FreeT4 is (FT4)  15.6?   Should be 0.82  to 1.77   (too high at 15.6)

    Free T3 is 5.4 ?  Should be 2.50 to 3.90  (this seems too high at 5.4)

    TPO 26 should be  0 to 34 so you are normal there.

    TgAb  should be 0.0 to 0.9  and you are at 25

    Cortisol should be 2.3 to 19.4  and you are at 268? 

    DHEA should be 2.94 to 220.5 and yours is 250.55  HIGH/abnormal.

    can you recehck your lab values and give us the ref. range since you are way high on Cortisol and FT4 and FT3.  It could be Hypothyroid but your TSH is normal. I am leaning towards Adrenal gland problems.

    Your  adrenal gland is producing too much cortisol and you should have imaging to see if there is a tumor on it.  A lot of people get this.  Also be checked for CUSHING's Disease. This disease can make you gain weight and be tired also.

    Symptoms of Hypothyroid are: feeling cold, low temp, bruising, weight gain, nails are brittle hair loss and dry scalp, muscle aches, no periods or irregular ones, feeling depressed, sleepy/tired all the time.  There are more these are common.

    Please recheck the lab work values and see if I am correct from what values you gave us.



  • Posted

    Hi shellyC19,

    Thank you for you reply. I understand that the lab work value help. So here it is : 

    TSH 1.5 mUI/L (range lab is 0.340 to 5.600)

    FT4 15,6 pmol/L (range lab is 12-22)

    FT3 5,4 pmol/L (range lab is 3.1 to 6.8)

    TBG 14.1 µg/mL (range lab is 12.7 to 25.1)

    RT3 0,038 nmol/L (range lab is 0.012 to 0.038)

    DHEA 6.80 (range lab is Men : 20-44 years old <18.7 umol/L)

    anti-TPO 26 IU/mL (range lab is 5 to 34)

    TgAb 25 IU/mL (range lab is 0 to 115)

    Cortisol AM 268 nmol/L (range lab is 166 to 828).

    I have this symptoms : feeling cold, low temp, bruising, nails are brittle, hair turn gray rapidly, dry scalp, muscle aches, feeling depressed, sleepy/tired all the time, yellow face in the area of the nose.

    Thank you again! 

    • Posted

      Hello Pkcam:

      Thanks for giving me your ref. range.  It helps. Your labs for the thyroid are good except RT3 which is at the boderline. All seems  to be in good order.  Yellowing of face is not a normal thyroid symptom and fits with Liver (Hepatitis) or Adrenal problems more.

      CUSHINGS's can cause sleepy/tired and a moon face and also muscle aches and it can mimic most of the thyroid symptoms.  They should image both your Liver and Adrenal Gland for any growths or abnormal results.


      Your reverse T3 is on the borderline so maybe you are at the start of thyroid disease. Maybe your body is not being able to use T3 well enough. Are you on any replacement hormone?  Please follow up with your Endocrinologist about the Adrenal glands and RT3.



    • Posted

      Hi shellyC19,

      Thank you again for your reply. My family doctor think my labs are normal, but she don't know that much about thyroid issues. I had to go see another md and ask her about the labs to do. So I did the labs, but she also don't know much about thyroid issues, but she said to me that my cortisol and DHEA results were too low, so she prescribed me DHEA. I didn't receive the replacement hormone yet.

      I have to mention an important thing that I forgot to mention before. I was on Paxil for 5 years before I decide to stop it earlier this years because I feel that I was more stable and I was OK to deal with daily stress. I taked it because of my anxiety was too high. But after a couple of months without Paxil, my anxiety was just growing up and I had a lot of troubles with sleep. So 3 weeks ago, I decided to go back to Paxil because I can't go lower that I was. It helps me to sleep and I'm less anxious. 

      But I don't know if the cause of my abnormal results are my anxiety or my anxiety cause my abnormal results? 



    • Posted

      Hello Phil (PKCAM):

      I never heard of Paxil causing people problems.  It is an antidepressent and has been around for many of years.  However, if your cortisol levels are off, I would look into that either high or low needs to be investigated by  imaging like a CAT scan or MRI and blood work.  Addison's is a condition that can result from low levels of cortisol and the adrenal gland and thyroid tend to interact together. 

      Sometimes certain high doses of Levo can cause problems with the adrenal  gland.  All meds do go through the liver and I would have them scan the liver or do liver enzyme blood work to make sure it is working correctly.  As we age we can develop problems with a "fatty liver" and that can make the liver not work correctly.

      Anxiety/Stress and worry can make your adrenals feel fatigue so you should resume the Paxil and do what your doctor prescribed the medication for.  Avoid alcohol while on this medication.

      Stay well, keep us updated.



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