What Does This Thyroid Test Report Indicate?

Posted on Mon, 5 Dec 2016

Question: Hi, I just had a physical which showed a low TSH <0.005(uIU/mL), T-4 (ug/dL) 9.1 and T-3(Total) (ng/mL) 2.09 My Doc was surprised, was expecting hypothyroid because I've gained a lot of weight. I take up to 400mg of Magnesium Oxide in a Calcium/Magnesium/Zinc supplement daily because it seems to help my achy legs. I'm wondering if the Mag could be skewing the results. Other symptoms I've been having are more along the lines of hyperthyroid but I had attributed them to perimenopause. Feeling hot all the time and being very intolerant of heat, sweating, lighter periods (finally!), not staying asleep, waking up with my mind racing.... So my doc didn't recommend any treatment, he wants to follow up in a few months. I hadn't mentioned the supplement. He only asked about Rx meds not OTC. I was doing some research before I called him. Did a chem 7 so, no serum Mag level. Thanks! XXXXXXX

Answered by Dr. Mirjeta Guni (28 minutes later)

Brief Answer:
Some more exams needed.

Detailed Answer:
Welcome and thank you for asking on HCM!
I read carefully your concerns and understood your query.
From the reported results you have subclininal hyperthyroidism.
If you were a patient in my clinic i would recommend to do some further exams to determine cause of hyperthyroidism ( nodular goitre or Graves' disease).
You would need an ultrasound of the thyroid gland and check the antiTSH receptor antibodies.
If one of the above diagnosis is confirmed and you have symptoms of hyperthyroidism i would suggest to start the treatment with antithyroid drugs.
The supplements you relorted do not cause hyperthyroidism.
Hope i have been helpful.
Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Mirjeta Guni (36 minutes later)

Thank you, doctor Mirjeta. Your information was helpful. Should the ultrasound be done at once or can it wait until the follow up appointment? Can my doc manage this or should I ask for a referral to an endocrinologist right away? Also, why treat with meds if it is subclinical, just for relief of symptoms?

A clarification, I didn't think the supplement would cause hyperthyroidism but since magnesium is required to convert T4 into T3 I thought that adding Mag to my diet gave different lab results than if I hadn't been taking the Mag.

Could there be symptoms before a goiter is apparent? I don't have an apparent goiter. I do remember a great Aunt from when I was a little girl who had a very large goiter but that generation never spoke about medical problems, certainly not to a child.

Thank you again.

Answered by Dr. Mirjeta Guni (2 hours later)

Brief Answer:
See below;

Detailed Answer:
Welcome back!
During my career i have never seen hyperthyroidism caused by magnesium. You should exclude the most common causes of over active thyroid ( mentioned above).
I think you should see an endocrinologist. Subclinical hyperthyroidism left untreated at your age, may be a risk factor ( together with menopause that is about to come) of osteoporosis.
So, having into consideration the presence of clinical symptoms and your age, i would suggest not to let it untreated ( of course if a thyroid pathology is found).
In most cases there is a hereditary factor for thyroid pathologies.
Feel free to ask at any time if you have still queries or further questions in the future.
Regards,
Dr.Mirjeta

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Above answer was peer-reviewed by : Dr. Raju A.T