High FT4/FT3 ratio

[KarenLynx]

My free T4 is high (1.8 - just outside of upper range .8-1.7) and my free T3 is low (2.5 - but in range: 2.2-4.4). Is the appropriate treatment Cytomel only?

BTW, I have a goiter but only mid range for TPO antibodies (14; range 0-34). And a multitude of hypo symptoms: hair loss, dry mouth, dry eye, trouble swallowing, weight gain, very low resting pulse-(~45); low basal temp (97.2F), swollen eye tissue, mild constipation, elevated cholesterol, and several more.

I know this high FT4/FT3 ratio can be seen in early Hashimoto’s Thyroiditis where the T4 is high (because of spillage from a damaged thyroid into the blood stream) and/or peripheral cellular resistance as these levels indicate a decreased conversion of T4 to T3.

[KarenLynx]

TSH is1.19. However, I have empty sella syndrome and pituitary is not functioning at an optimal level. Also, free T4 is on the high side and I have many hypo symptoms.

[Mark Lupo, M.D.]

The TSH (which you did not list) is the most valuable lab for diagnosing thyroid problems.  The TPO antibody is normal (so does not look like hashimoto's).  The Free T3 is likely the least accurate thyroid lab test.