Wife's Thyroid Blood work With Antibodies

Smokin Joe · Sep 9, 2016

We had this done recently after posting the initial a couple of months back.
It was suggested to add antibodies.
She is post menopausal several years now.
Goes through periods of low low energy and some heart palpitations which we have had checked out.
Benign according to the Cardiologist.
Looking to thyroid just in case.
Chris would you please give us your thoughts on the following...
Thanks.

T-4 Free Direct, 1.14 ng/dl, range .82-1.77
TSH, 2.56 Uiu/ml, range .450-4.5
Reverse T-3 Serum, 13.9, range 9.2-24.1 ng/dl
Thyroxin T-4, 6.8 ug/dl, range 4.5-12.0
Thyroglobulin Antibody, <1.0 Iu/ml, range 0.0-0.9
Thyroid Peroxidase (TPO)AB, 15 IU/ml, range 00-34
Triodothyronine Free Serum, 3.4 pg/ml range 2.0-4.4

Vettester Chris · Sep 9, 2016

Smokin Joe said:
We had this done recently after posting the initial a couple of months back.
It was suggested to add antibodies.
She is post menopausal several years now.
Goes through periods of low low energy and some heart palpitations which we have had checked out.
Benign according to the Cardiologist.
Looking to thyroid just in case.
Chris would you please give us your thoughts on the following...
Thanks.

T-4 Free Direct, 1.14 ng/dl, range .82-1.77
TSH, 2.56 Uiu/ml, range .450-4.5
Reverse T-3 Serum, 13.9, range 9.2-24.1 ng/dl
Thyroxin T-4, 6.8 ug/dl, range 4.5-12.0
Thyroglobulin Antibody, <1.0 Iu/ml, range 0.0-0.9
Thyroid Peroxidase (TPO)AB, 15 IU/ml, range 00-34
Triodothyronine Free Serum, 3.4 pg/ml range 2.0-4.4

Joe, her RT3/FT3 ratio is > 40 points, that's great!! FT4 is sitting about 34% of reference range, FT3 is at 58%. Possibly getting the reserves up (FT4) closer to the 60% will provide more T3 conversion. I would have suspected pooling, but her RT3 ratio looks great!!

Is she taking any BHRT (progesterone, estrogen, test, DHEA, etc)? How does her iron panel look, and has she taken a 4x cortisol lab?

Smokin Joe · Sep 9, 2016

Thanks Chris.
She uses a low dose otc estriol and progesterone.
Unfortunately she's not totally consistent.
No dhea as hers stays on the mid to high side of normal.
We have never tested her cortisol though I have often wondered about it as we have had several stressful life events over the last several years.
Iron has always been border line low normal and it's been a while since we have looked at it.

Vettester Chris · Sep 10, 2016

Good that she is on BHRT!! I can almost assure you her thyroid numbers wouldn't be that good without the progesterone therapy, thus keeping estrogen dominance in check. Iron serum is usually a factor that tends to be on the low end during peri/post menopausal stages. If the DHEA is naturally staying high, YES, check the adrenals, see if there's anything out of range on cortisol, and the demand it places upstream on pregnenolone, which higher DHEA levels can "sometimes" be a marker for an imbalance.