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What Does My Blood Test Report Indicate?

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Posted on Tue, 17 Nov 2015
Question: Hi, I have a question about my thyroid: I felt dizzy two weeks ago, I made blood test and the results are as follows:

T3, Free Result= 2.8 Reference Range= 2.3 - 4.2
T4, Free (Free Thyroxine) Result= 0.8 Reference Range= 0.8 - 1.5
TSH 3rd Generation Result= 3.67 uIU/mL Reference Range= 0.36 - 3.74
Calcium Level Result= 8.4 mg/dL Reference Range= 8.5 - 10.8
Total Testosterone Results= 208 pg/mL Reference Range= 250-1100
Testosterone, Free Result= 54.8 pg/mL Reference Range= 35.0 - 155.0

Now, my question is : The doctor put me on "Levothyroxine" 0.025MG - Is this what I should be taking? All the thyroid related test results are within the normal range (reference range). Now, I have been using these pills for 5 days now. Answer and Advise, please!
doctor
Answered by Dr. Shehzad Topiwala (3 hours later)
Brief Answer:
Thyroid

Detailed Answer:
I have reviewed your attached laboratory tests.

When I see someone like you in my practice, I order the following tests in addition to a thorough physical examination:

Anti TPO (Thyroid Per Oxidase) antibodies
Anti Thyroglobulin antibodies
Ionized Calcium
Phosphorus
25 hydroxy Vitamin D
Intact PTH
Total Testosterone
SHBG (Sex Hormone Binding Globulin)

The reason for repeating Total Testosterone is that a)it is low and b) the time at which the blood sample was drawn is not clear.
This is important because Testosterone must be collected in the morning time before 9 am or so. Otherwise levels drop later and give the false impression of an abnormally low value.
The Free Testosterone appears normal but is on the lower side. Moreover, the best method to measure Free Testosterone is Equilibrium Dialysis. Quest diagnostics where it seems your sample was processed generally uses this technique, to my knowledge but it would be worth confirming.
Regardless, measuring the SHBG and calculating the Free Testosterone indirectly using an online tool is also fairly reliable.

You also have a mildly low blood calcium level. Some of the other tests listed above will give an idea as to the cause. Treatment can then be planned accordingly.

Thyroid autoantibody tests mentioned above will try to ascertain if you truly have a permanently under-active thyroid. If so, lifelong treatment with levo thyroxine is necessary. This determination is best made by an endocrinologist who should also have the opportunity to examine you in-person.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Does My Blood Test Report Indicate?

Brief Answer: Thyroid Detailed Answer: I have reviewed your attached laboratory tests. When I see someone like you in my practice, I order the following tests in addition to a thorough physical examination: Anti TPO (Thyroid Per Oxidase) antibodies Anti Thyroglobulin antibodies Ionized Calcium Phosphorus 25 hydroxy Vitamin D Intact PTH Total Testosterone SHBG (Sex Hormone Binding Globulin) The reason for repeating Total Testosterone is that a)it is low and b) the time at which the blood sample was drawn is not clear. This is important because Testosterone must be collected in the morning time before 9 am or so. Otherwise levels drop later and give the false impression of an abnormally low value. The Free Testosterone appears normal but is on the lower side. Moreover, the best method to measure Free Testosterone is Equilibrium Dialysis. Quest diagnostics where it seems your sample was processed generally uses this technique, to my knowledge but it would be worth confirming. Regardless, measuring the SHBG and calculating the Free Testosterone indirectly using an online tool is also fairly reliable. You also have a mildly low blood calcium level. Some of the other tests listed above will give an idea as to the cause. Treatment can then be planned accordingly. Thyroid autoantibody tests mentioned above will try to ascertain if you truly have a permanently under-active thyroid. If so, lifelong treatment with levo thyroxine is necessary. This determination is best made by an endocrinologist who should also have the opportunity to examine you in-person.