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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 55784
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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What do my thyroid function tests mean? Serum free T4 level

Customer Question

What do my thyroid function tests mean?

Serum free T4 level (XaERr) ~ Result 13.1 pmo/L (9.0 - 19.1)
Serum TSH level (XaELV) ~ Result 5.1 mu/L (0.35 - 4.95)

Also

Combined total Vitamin D2 and D3 level (XaXhT) ~ Result 55 nmol/L

I sleep 16+ hours a day, struggle to concentrate, have tingles in my arms & hands, sometimes my lower legs too. Headaches, blurred vision (eye sight test was fine) unexplained weight gain of approx 20lbs over 12 months. General feeling of weakness all over, some body / muscle aches (lower back, neck) unable to do simple chores / go out due to weakness & unwell feeling. Cold feet. Low body temperature (done first thing in the mornings) of between 34.4 & 36.3 (but no shivering, like I've became accustomed to the cold) really bad memory, brain fog.... I feel awful & have been this way for maybe 18 months. Last year (12 months ago) I had swine flu, laryngitis & bronchitis all at the same time needing time in hospital & emergency visits from my GP. I've had the flu jab today after my doctor put me in the high priority group. My emotions are everywhere, my GP gave me anti depressants 10 months ago, they've been doubled in dosage 4 months ago & I still don't feel better. I have no anxiety.

I'd just like to feel better now :(

I'm 39, female, on 40mg citalopram, 5ft 7", otherwise healthy.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Since the TSH is slightly elevated, that would be worrisome for hypothyroidism, but there is some controversy in this area. Since TSH (thyroid stimulating hormone) is released by the body in response to brain monoitoring of thyroid levels to stimulate more thyroid hormone production, a high TSH indicates that the brain perceives the thyroid hormone levels to be low. There is evidence and some recommendations that the normal range for TSH should be adjusted, so that the upper limit of normal is 3.0, which would make a level of 5.1 more out of range.

The area of controversy is that it is unclear whether treating someone with a TSH at this level will provide any benefit. However, in someone with symptoms and signs that could be due to hypothyroidism, many doctors would consider prescribing thyroid hormone replacement to see if the symptoms improve.

Customer: replied 2 years ago.
Relist: Incomplete answer.
He never mentioned anything about the T4 levels or the Vitamin D which I'd like to know if they are normal or not..
Expert:  Dr. Thomas, MD replied 2 years ago.
Hello
Your T4 is normal, but you are hypothyroid given the TSH value.
Vitamin D is in the normal range.

There is no doubt that your thyroid should be treated at this point in my view, and according to current recommendations.
good luck

Let me know if you have further questions, details or need clarification, just use reply.......

Customer: replied 2 years ago.
Thank youCustomer

If I'm hypothyroid given the TSH value wouldn't you expect the T4 to be out of normal ranges too?

I'm pleased my vitamin D is ok as my Doctor had told me if it doesn't go higher I 'could' need supplements.

Could you tell me if I should be concerned with my low temperature please? I don't really feel cold at all. In fact I get hot very easily & sweaty but when checking my temperature it tells me I'm cold. I've used various thermometers & they each state the same temperature which confirms to me I'm getting a correct reading.
Expert:  Dr. Thomas, MD replied 2 years ago.
NO
In sub-clinical hypothyroidism the T4 is very often in the normal range....but studies since the 1080s have indicated that it is better to treat...less long term problems.
40 is about where I like to see minimum D levels.
Not the temperature is not a concern, except that it is one further indication of low thyroid.

Good luck


Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 55784
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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