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Forum Name: Endocrinology Topics

Question: Hypothyroidism Symptoms But T3,T4,TSH are Normal


 butterfly1985 - Fri Jul 23, 2010 1:25 am

I have hypothyroid symptoms like fatigue,dry itchy skin, weight gain,Slowed speech,hair loss, decreased sweating.But when i tested T3,T4,TSH it was 1.1 ng/ml,8.9 ug/dl,3.1 ulU/ml respectively.
Please give me some advise.
 Dr.M.Aroon kamath - Fri Jul 23, 2010 12:29 pm

User avatar Hi,
"Reverse T3 (rT3) Dominance" is a condition which needs to be excluded first in your case. The thyroid gland produces two main hormones: thyroxine (T4) and triiodothyronine (T3).T3 is only produced in small amounts by the throid, but it is the active form of the T4.The conversion from T4 to T3 occurs peripheral tissues. In some conditions, a molecule called Reverse T3 (rT3) is produced out of T4 rather than T3. rT3 is biologically inactive. If this is produced in excess, the condition of "Reverse T3 (rT3) Dominance" results and many of these patients exhibit clinical features of hypothyroidism in the presence of apparently normal thyroid function test results.

Kindly visit the following link for further information on this. Please do consult your regular doctor and have this possibility excluded.

viewtopic.php?f=83&t=47131&hilit=+hypothyroid
Good luck!
 butterfly1985 - Fri Jul 23, 2010 10:37 pm

Respected sir,
Thank you for your kind reply.

as per your suggestion total T3 = T3 + rT3.So if rT3 is higher than total T3 will be normal.But as per my laboratory report they have written "Decreased value of T3 (T4 and TSH Normal) have minimal clinical significance and not recommended for diagnosis of hypothyroidism"
 Dr.M.Aroon kamath - Mon Jul 26, 2010 11:54 am

User avatar Hi,
I always insist that readers must provide the laboratory reference ranges alongside the lab results so that meaningful inferences may be drawn.Laboratory reference ranges vary from laboratory to laboratory.You have said that your laboratory told you that the T3 is 'decreased'. Here is one reference range for T3 according to 'my'(!) laboratory - 110-230 ng/dl (in adults). Of course your lab has reported in ng/ml. As per 'my' lab, your T3 value is at the lower end of the 'normal' range(low, yes- but still normal).This demonstrates the importance of the lab reference ranges.
Best wishes!

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