I have a 1.38 TSH and a 82 T3. Also noted that Vitamin D is 29. I have had marked fatigue for over three years, feeling of lump in throat (although doctor said thyroid feels normal). Even after sleeping 12 hours, I do not wake up rested, only the same feeling of complete body fatigue. Doctor says thyroid is "normal" but isn't the T3 on the lower side? The range on my sheet says 76-181, although I know all labs are different. The range on my TSH says .40-4.50. Thanks for any help!
First, understand that TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, Free T3 and Free T4. Of the latter, Free T3 is the most important because scientific studies have shown it to correlate best with hypo symptoms, while free T4 and TSH did not correlate at all.
So you should make sure to be tested for Free T3 (not Total T3) along with Free T4 each time you go in for tests. If the doctor resists, just insist on it an don't take no for an answer.
Even though your T3 test was for Total T3, it indicates the likelihood that your Free T3 will also be in the low end of the range, indicative of being hypothyroid. Due to the erroneously manner for establishing the range, it is far too broad to be functional for many patients. Your TSH result is inconsistent with having primary hypothyroidism; however, there is a likelihood of central hypothyroidism, related to hypothalamus/pituitary function
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this link written by a good thyroid doctor. In the link, please note the statement, "In the best tradition of clinical medicine, a physician should prescribe thyroid hormones as needed to eliminate the symptoms and signs of hypothyroidism without producing any symptoms or signs of thyroid hormone excess.
Looking beyond just the thyroid test results, your Vitamin D is too low. Needs to be around the middle of the range. You can take D3 supplements for that. You should also test for B12 and ferritin. Ferritin is especially important to thyroid metabolism.
So, you are going to have to discuss al this with your doctor and persuade to treat clinically, as described, or if not possible, then find a good thyroid doctor that will do so. If you need a recommendation for a good thyroid doctor, just tell us your location and perhaps we can provide a name.
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