Dr. Swaraj Waddankeri
Endocrinology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 59 year old male in generally excellent health. I am 5.10 feet tall and weighs 170 pounds. I am very fit for my age. I just had an annual physical and laboratory work, and it was generally excellent. I had a complete thyroidectomy before nine years due to several large but benign cysts in my thyroid gland. I am on 200 mcg of Levothyroxine daily. My blood work showed a TSH of 1.04 and free T4 of 1.93. My laboratory considers normal free T4 to be 0.7 to 1.76. Should I be concerned about this slight high value? I feel great, and all other blood tests were excellent.
Hi,
Welcome to icliniq.com.
I do not think that you should be concerned. For the free T4 to get high and cause worried your TSH (thyroid stimulating hormone) should get suppressed, which is not the case with you. I would suggest you keep the same dose and repeat TSH and free T4 after two months. Still, if it is high, then we can think about dose reduction. Therefore, no need to do anything as of now.
Patient's Query
Thank you doctor,
My primary care physician ran a set of tests for my thyroid. My TSH was again normal at 1.93 mIU/L. My T4 was slightly higher than the last time which was at 2.08 micrograms per deciliter of blood. However, my T3 was normal at .78 ng/dL. I got an appointment with an endocrinologist. But I was unable to see him for a month. I think that I need a slight reduction in my dose of Levothyroxine. But I am confused. Why does my T3 remain in the low normal range? I started a new exercise regimen of very high-intensity cardio about three weeks before my blood tests. I read that intense exercise can temporarily suppress T3. Is this the cause? Should I be concerned about my results? Should I do anything differently before I see the endocrinologist?
Hi,
Welcome back to icliniq.com.
There is nothing to be worried. Your tests were done too early. More importantly, you do not have symptoms of hyperthyroidism. The other option is you can skip the dose of thyroxine on sundays which means stop taking a tablet every sunday and continue with it on all other days. I am guessing here that you are very regular with your medications. Do not skip them now and then.
Patient's Query
Thank you doctor,
I am very regular and inclined to continue until I see my endocrinologist. I am concerned about my low normal T3 levels which seem to be inconsistent with other results. Is this likely a result of the recent acceleration of my cardio exercise routine? Will my T3 levels get normalized when my body adjusts to the new exercise regimen?
Hi,
Welcome back to icliniq.com.
I doubt that your exercise has anything to do with it. Continue taking your medications and do not skip them on any day. Kindly tell me what your endocrinology doctor says after seeing you in person.
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Endocrinology
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