Based on the thyroid readings, can you please tell the cause of extreme fatigue?

Question

Hi doctor,

Can you please give a second opinion of what you see with these thyroid test readings in a patient with extreme fatigue for 30 years? TSH - 0.170 mIU/mL, T3 - 48.9 ng/dL, reverse T3 - 29.5 ng/dL, T4 - 1.49 mcg/dL, TPO - 68 IU/mL.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through the values you have provided. And I have some queries.

1. Values you have provided are incomplete. I would like to see an entire report with reference ranges to give an accurate opinion.

2. Is the value of TSH (thyroid-stimulating hormone) 0.170 or just 170?

3. Is the patient taking any medications related to the thyroid?

4. Are they free T3 (triiodothyronine), T4 (tetraiodothyronine), or total T3, T4?

5. Are there any other symptoms other than fatigue like sensitivity to heat, sweating, weight loss, appetite changes?

6. Are there any other blood tests other than thyroid which could contribute to fatigue?

TPO (thyroid peroxidase) levels are elevated, which points towards an autoimmune cause. TSH of 0.170 mIU/L is low with elevated T3. It could be related to Hashimoto’s thyroiditis with features of hyperthyroidism. I will need to see the entire report with reference ranges and medication or concomitant medical condition history to say accurately. I would be happy to help you if you have any more questions. Thank you.