The Wellness Q&A with Elaine Moore

Welcome to the Wellness Q&A where members can ask Elaine Moore any health-related question. Moore is a medical writer and retired clinical laboratory scientist with over 30 years experience in immunology. Get started by selecting Member Questions. This is a question-and-answer forum, and each thread represents a member question or set of questions. The question will only appear once it's answered. Thank you for joining.


No doctor, need help understanding readings?
Last Post 16 Feb 2022 04:10 PM by Elaine Moore. 1 Replies.
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DMMUser is Offline New Member New Member Posts:
03 Feb 2022 09:23 AM
    Greetings Elaine,

    I hope this finds you well and smiling. Last we spoke I have had subclinical Hyperthyroidism due to Graves Disease. I was diagnosed with Graves in 2005. I've been off methimizole for seven years after being on for 10 years with doctors only using TSH readings I was over medicated.

    I get my labs done myself and I watch for Free T3 and T4 and I know you say I want them in the upper range.

    Do I still have subclinical Hyperthhroidism? What do you see happening here over time? Any advice? What to look for in future? Further testing?

    As always thank you, thank you, thank you!

    TSH (0.450-4.500) over the last year:
    Aug. 2020: 0.494
    June 2021: 0.542
    Sep. 2021: 0.346
    Jan. 2022: 0.176
    Feb. 2022: 0.277

    Thyroxine (T4) (4.5-12.0):

    T3 Uptake (24-39):
    23 %

    Free Thyroxine Index (1.2-4.9):

    Above is TSH Panel. Below are other readings with dates:

    Thyroxine (T4) Free, Direct (0.82-1.77):
    Aug. 2020: 1.34
    June 2021: 1.36
    Feb. 2022: 1.47

    Triiodothyronine (T3), Free (2.0-4.4):
    June 2021: 2.7
    Feb. 2022: 2.7

    Triiodothyronine (T3) (71-180):
    Aug. 2020: 121

    Thyroid Stim Immunoglobulin (TSI) (0.00-0.55):
    Aug. 2020: 0.29

    Thyroglobulin Antibody (0.0-0.9):
    Aug. 2020: 95.3
    June 2021: 241.3

    Thyroid Peroxidase (TPO) Ab (0-34):
    Aug. 2020: 323
    June 2021: 206


    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:3836
    16 Feb 2022 04:10 PM
    Hi Donna,
    You don't have subclinical hyperthyroidism because TSH is falsely decreased in Graves' disease patients even by traces of TSH receptor antibodies, By now you likely mostly have blocking TSH receptor antibodies, which neutralize any stimulating ones.
    Your labs look good and all you need is a TSH, FT4 and FT3. The index that you had is a calculation and not as accurate as the direct measure of FT4.
    Most of us have these antibodies for may years so our TSH result is usually misleading although if you were to suddenly move into hypothyroidism it can rise. Best to you, Elaine
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