Subject: Thyroid Lab Results and Instructions

From: Nancy Jones, Registered Nurse

Hello Jane. Your thyroid stimulating hormone (TSH) level is high. Dr. Harris believes this is causing your fatigue and weight gain.

Dr. Harris ordered a prescription for Levothyroxine. You should start feeling better in a week or so, but we want to recheck your TSH in two weeks. I set a reminder for the follow up. I also selected three patient education links for you.

If you have any questions, please send me a message or call (215-555-5555, Ext. 5)


Levothyroxine Sodium (Synthroid), 175 mcg. 1 pill per day. Ready for pickup at pharmacy. Cost $4.23


Follow Up:

Visit office for blood draw to recheck TSH in 2 weeks. No appointment needed. Email reminder set for 6/11/13.

Test: Thyroid Panel [info] Assessment Normal Range Your Result
Thyroid Stimulating Hormone (TSH) High 0.45 to 4.50 27.03
Thyroxine (T-4), Serum Normal 4.2 to 13.0 8.4
Free T-3 Normal 2.0 to 4.4 2.7
Triiodothyronine (T-3), Serum Normal 55 to 170 79
Free Thyroxine Normal 2.0 to 4.4 1.32
Subject From Date Time
Thyroid Lab Results and Instructions Nancy Jones, RN
Re: Refill Request Fran Smith, RN
Dermatology Referral Processed John Hanson, Office
Power Chair Dr. Smith
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