Should I get a more complete thyroid panel?

Thread starter #1
Should I get a more complete thyroid panel?

There doesn’t seem to be anything wrong with my thyroid. I do feel I get more tired than I used to, but I assumed that was low T. It's easy to get to sleep, but I often wake up at 2-3 AM. After an hour, I get back to sleep.

My TSH reading has been between 1.6-1.8 for the last 20 years. These readings are from a few weeks ago. I could post the entire lab, but it's pretty normal outside of total T of 348 mg/dl, not even out of range.


TSH 1.60 uIU/mL {0 0.450-4.500 uIU/mL}
Ferritin, Serum 224ng/mL {30-400 ng/mL}
Thyroxine (T4) Free, Direct, S 1.00ng/dL {0.82-1.77 ng/dL}

Iron and TIBC
Iron Bind.Cap.(TIBC) 357ug/dl {250-450 ug/dL}
UIBC 249ug/dL {111-343 ug/dL}
Iron 108 ug/dL {38-169 ug/dL}
Iron Saturation 30% {15-55 %}

I am not sure if I there is any reason to do a more complete thyroid panel.

What do you all think?
 
Thread starter #3
Have you previously ruled out the autoimmune potential that is revealed with the antibody panels??
No, what you see is the more comprehensive test I have ever done. 23 years ago I did get T3 uptake, which at the time was slightly below range at 24.4% (25-35%) But 23 years ago doesn't count for spit.
 

Vince

Moderator
#4
I'm not the thyroid expert but looking at your free T4, in the low range. I would definitely get a complete thyroid panel along with reverse T3 and check your antibodies again.
 
#5
No, what you see is the more comprehensive test I have ever done. 23 years ago I did get T3 uptake, which at the time was slightly below range at 24.4% (25-35%) But 23 years ago doesn't count for spit.
I'd dig a little deeper. Run both antibody panels, rt3, t3...and avoid any of those tests that have "uptake" associated with them. No value to you.
 
Thread starter #6
I would get the following if I decide to get a full thyroid panel, I would get the following.

BTW< I have seen some websites recommend also testing Sex hormone binding globulin, I don't know why. I didn't think SHBG was involved with thyroid hormones.

Thyroid-Stimulating Hormone (TSH) - Evaluates overall thyroid function
Total Thyroxine (T4) - Measures the total amount of T4 produced by the thyroid gland
Free Thyroxine (T4) - Measures the amount of T4 available to the cells and tissues
Free Tri-iodothyronine (T3) - Measures the amount of T3 (the active form of the hormone) available to the cells and tissues
Reverse T3 - Measures the non-functioning form of the active hormone T3
Thyroglobulin antibody (ATA) - Often measured along with TPO, these antibodies can attack proteins involved in the production of thyroid hormones rendering them dysfunctional
Thyroid Peroxidase antibody (TPO) - Often measured along with ATA, these antibodies can attack proteins involved in the production of thyroid hormones rendering them dysfunctional

Any thoughts on why SHBG was sometimes included?

Another question, has anyone moved their FT4 from the lower part of the range to the upper, if so, what effect has that had on energy and metabolism? Any side effects?
 
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Thread starter #8
Once you get the results back you can compare them to this excellent website:
https://www.restartmed.com/normal-thyroid-levels
Pay special attention to your RT3. Needs be less than 15. Also your FT3/RT3 ratio needs be more than 20.
I don't know of anyone including SHBG when testing thyroids

This was my mistake. When I read a description of what affects thyroid hormones, there was something about thyroxine being bound to a protein, I thought it was SHBG, but with Thyroxin there is also TBG which is Thyroxin-binding globulin and behaves like SHBG. TBG binds thyroxin.

TBG usually isn't important to measure, but you can get a blood test to measure your level of TBG.

I did get a blood test, I just haven't yet gotten the results back. For sure by the end of the week.
 
Thread starter #10
So just now I got in my thyroid panel results. What do you all think?

Thyroxine (T4) Free, Direct, S 131-305-5863-0
T4,Free(Direct) 1.06 ng/dL 0.82-1.77 CB

TSH 131-305-5863-0
TSH 2.000 uIU/mL 0.450-4.500 CB

Reverse T3, Serum 131-305-5863-0
Reverse T3, Serum 16.4 ng/dL 9.2-24.1 BN

Thyroxine (T4) 131-305-5863-0
Thyroxine (T4) 6.4 ug/dL 4.5-12.0 CB

Thyroglobulin Antibody 131-305-5863-0
Thyroglobulin Antibody <1.0 IU/mL 0.0-0.9 CB

Thyroglobulin Antibody measured by Beckman Coulter Methodology
Thyroid Peroxidase (TPO) Ab 131-305-5863-0
Thyroid Peroxidase (TPO) Ab 12 IU/mL 0-34 CB

Triiodothyronine,Free,Serum 131-305-5863-0
Triiodothyronine,Free,Serum 2.7 pg/mL (FT3) 2.0-4.4


Normally for the last 20 years my TSH has been 1.6 - 1.8, last taken 4/21/2918. Maybe it's 2.0 because this is a different lab, or maybe TSH went up because I see the blood test I did 4/21 had TSH at 1.6 and Free T4 at 1.0 ng/dl, now Free T4 is at 1.06 ng/dl, a small increase and consistent with a higher TSH.

Curious to see the next time I pull results.

So I am guessing not optimal, but should I do anything about it? What do you all think?
 
#11
This is the one that really impact you, Free T3:

Triiodothyronine,Free,Serum 2.7 pg/mL (FT3) 2.0-4.4

You're rather low there and I know most of the discussion is going to want to treat that and may be concurrently with some T4, too, which is quite low as well, possibly contributing to the hypo symptoms you have.
 
#12
Looks like your thyroid is in a steady decline, it's not just a lack of FT3 but also lower FT4 and T4. Nowhere near optimal and far from average in my opinion.
 
Thread starter #13
This is the one that really impact you, Free T3:

Triiodothyronine,Free,Serum 2.7 pg/mL (FT3) 2.0-4.4

You're rather low there and I know most of the discussion is going to want to treat that and may be concurrently with some T4, too, which is quite low as well, possibly contributing to the hypo symptoms you have.
How does one usually treat this?
 
#14
armour thyroid, cytomel, NDT, I'm not sure exactly what might be better for you in this case, I would think that a mono T3 replacement would alleviate any symptoms but I'm a little novice on Thyroid treatments. I *think* it would be better what ever option treats T4 and T3 together.
 
#15
My two cents is, Synthroid and liothyronine are so inexpensive why not just use them two. You can also target the FT4 and FT3 separately. I believe you can buy both from overseas pharmacies, but they're even more inexpensive with a script.

The hard part is finding a good thyroid doctor.
 
Thread starter #16
My two cents is, Synthroid and liothyronine are so inexpensive why not just use them two. You can also target the FT4 and FT3 separately. I believe you can buy both from overseas pharmacies, but they're even more inexpensive with a script.

The hard part is finding a good thyroid doctor.

How expensive is something like Synthroid with Defy, and does Defy supply a script or fax this into a local pharmacy outside of Florida?

As far as a "good thyroid doctor" I am guessing it will be the same problem as with TRT. If you aren't outside of the ranges, they are going to consider it more like enhancing the quality of life (anti-aging) vs disease.

I think a lot of doctors do understand that you might feel better with a higher level of testosterone or higher thyroid levels, but they are constrained by the medical industrial complex. Mostly insurance companies who don't want to pay for anything that improves your life Vs an actual disease. And most doctors do see a lot of patients who are really sick Vs people like us who want to improve what we have.
 
#17
Your labs aren't great, but before you start taking thyroid meds you may want to try supplementing iodine and selenium for a while. Look up Dr. David Brownstein's bookIodine: Why You Need It, Why You Can't Live Without It
 
Thread starter #18
Your labs aren't great, but before you start taking thyroid meds you may want to try supplementing iodine and selenium for a while. Look up Dr. David Brownstein's bookIodine: Why You Need It, Why You Can’t Live Without It

I can give Selenium a try, I don't get a lot or any from supplements, but should't I get plenty of iodine from ionized salt? I don't make any effort to avoid salt in my diet and most of it is ionized.
 
#20
How expensive is something like Synthroidwith Defy, and does Defy supply a script or fax this into a local pharmacy outside of Florida?

As far as a "good thyroid doctor" I am guessing it will be the same problem as with TRT. If you aren't outside of the ranges, they are going to consider it more like enhancing the quality of life (anti-aging) vs disease.

I think a lot of doctors do understand that you might feel better with a higher level of testosterone or higher thyroid levels, but they are constrained by the medical industrial complex. Mostly insurance companies who don't want to pay for anything that improves your life Vs an actual disease. And most doctors do see a lot of patients who are really sick Vs people like us who want to improve what we have.
I use Advanced Lipidology in Wisconsin for my thyroid doctor and get prescription from CVS. I don't remember the exact price, my guess is about $20 dollars for each 90 day supply.
 
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