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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 47605
Experience:  Board Certified Oncologist
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Is there a possibility that the normal level of T3 and T4 and

Customer Question

Is there a possibility that the normal level of T3 and T4 and consequently TSH production differs in person to person and race to race? My Chinese wife always a 'hyperthyroid ' individual has now become 'Hypo'. Doctors find an astronomically high level of TSH [ 3 times the given average level] but because T3 and T4 are in 'european white patient norms' they say everything is good!!!! Is there the possibility that her T3 and T4 levels were always far above the recognised european levels for these hormones, and she is being classified as "normal" despite years of fatigue related symptoms?
Submitted: 3 years ago.
Category: Oncology
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

I am of Chinese descent and have a history of graves disease.

Dr. David :

T3 and T4 have long 1/2 lives, but the best guage of your body's thyroid levels is your TSH level.

Dr. David :

after a long period of being hyperthyroid, the thyroid gland can sometimes burn itself out and become hypothyroid.

Dr. David :

also autoimmune thyroiditis needs to be checked and can cause thyroid levels to go up and down.

Dr. David :

anti thyroid peroxidase antibody and anti thyroid globulin antibody have to be checked.

Dr. David :

if these are elevated, this could mean hashimotos thyroiditis.

Customer:

A cyst in the thyroid was removed 3 years ago but the history of 'burn out' has been going on for 15 years. Heriditary problems include high blood pressure and high cholesterol. Funnily enough after a visit to an endocrinologist he suggested auto immune could play a part- My wife having also a lack of saliva though Schogrens [ please excuse the spelling] has been ruled out. We do have a thyroid scan and further blood test planned for over 2 weeks but it feels like I am fighting the medical profession every step of the way.

Customer:

Back to my original question- Could the one patient have a normal level of T3 and T$ that lies far above the accepted norms????

Dr. David :

I would disagree with the doctors if the TSH levels are super high that normal T3 and T4 means she is euthyroid or normal thyroid.

Dr. David :

that is not correct.

Dr. David :

what is her TSH level?

Customer:

Sorry , just grabbing the blood analyse.

Customer:

TSH 10.13 mU/l 0.36----4

Dr. David :

yes, that is a very high TSH level.

Dr. David :

she is hypothyroid, I don't care what the T3 and T4 say.

Customer:

T3 0.83 norm 0.70 - 1.91?

Dr. David :

T3 has a shorter 1/2 life

Dr. David :

it is not not reliable in this situation.

Dr. David :

I bet she is hypothyroid.

Dr. David :

TSH levels need to be between 0.3 and 3.0

Customer:

T4 7-50

Dr. David :

when I had my thyroid gland destroyed with radioactive iodine, my TSH levels got all the way up to 38.

Dr. David :

it was horrible.

Dr. David :

she must be feeling cold and gaining weight

Customer:

Exactly - my suggestion too but hard fighting the system

Customer:

She is skinny- idle, pretty and petite 155 cms- 45 kilos

Dr. David :

she needs to consult with an endocrinologist

Customer:

Feels cold though all the time. Summers with an electric blanket and foot warmer

Dr. David :

and get the anti thyroid antibody testing I mentioned above.

Dr. David :

she is hypothyroid.

Dr. David :

do you have any other questions?

Customer:

No . Nice to get a professional opinion other than that from the consultants. Unfortunately more than half the family [8 doctors] are in the profession but we are now living in another country where their expertise is situated in other fields- general cancer and brain surgery but not available for consultation. Thank you for the advice- online consult. Do hope this page can be saved so I can show the endocrinologist at the end of the month.

Dr. David :

you are welcome

Dr. David :

if done for now, please leave +++ positive feedback below the chat box so I can get credit for you today

Dr. David :

best of luck to you and your wife.

Dr. David :

you can reach me as Dr. David if you have other questions

Dr. David :

http://www.justanswer.com/medical/expert-dr-david/

Dr. David :

is my webpage if you have any other questions.

Dr. David :

you might have to scroll down to see the ratings area

Dr. David :

thanks for using JustAnswer.com

Dr. David and other Oncology Specialists are ready to help you
Customer: replied 3 years ago.

Dear Dr David,


No further questions from us. Endocrinologist at the Hospital Particular near Alvor in the Algarve reluctantly suggested an increase from 50 micrograms [?] per day to 50 /75, every other day. TSH levels now normal. My wife now takes 75 micrograms per day everyday but her zip for life [improvement] remains absent. [Thyroid scan revealed that half of the thyroid was removed, not just the cyst.]


We have a follow up consult due mid September to hear following a further blood exam whether further medicinal increase might be necessary.


Thank you for your further interest in Mey Ping's health. By further queries concerning the specialist's treatment here I will contact you again.


Regards. Chris Kimmings

Expert:  Dr. David replied 3 years ago.
you are welcome
thanks for your prior positive feedback

thanks for using JustAnswer.com