Your TSH of 1.46 is well within the reference range, but that doesn't preclude hypothyroidism. TSH is a pituitary hormone that is affected by so many variables 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. If you look at this list of 26 typical hypothyroid symptoms, which ones would you say that you have?
If you have not been tested for Free T3 and Free T4, then you should request those tests and if the doctor resists, then just insist on it and don't take no for an answer.
A good thyroid doctor will treat a patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can gain some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he consults with from a distance. The letter is sent to the PCP of the patient to help guide treatment.
When you go back for the testing I suggested, you should also find out if your doctor is going to be willing to treat you clinically as described in the letter. If he is not then you need to find a good thyroid doctor that will do so.
A single TSH test doesn't give you a full picture of your thyroid health. Other thyroid tests include free T3, free T4, reverse T3, and thyroid antibodies - TPOAb, TgAb. The most common cause of hypothyroidism is due to Hashimoto's Thyroiditis (autoimmune hypothyroidism).
Have your antibodies checked for Hashimoto's Thyroiditis like the previous poster said. To answer your question YES you can have hypothyroid with 1.46. Here is the short reason why, if you have Hashimotos it switches between NORMAL (0.1 to 4.0) lab ranges under THS counts, to HIGH/hypothyroid (4.1 to 12) and LOW/ hyper thyroid (anything under 0.1) THS. So your THS can be in any of those HIGH LOW OR NORMAL ranges and you can still suffer with Hyper or Hypo symptoms. Your body is in limbo it can make you feel crazy!!! So you can test in the normal range and your body will still act Hypothyroid or occasionally Hyperthyroid. More then likely you will feel mostly hypothyriod symptoms at any point. So the short answer is absolutely yes.
Longer answer follows:
Unless your endocrinologist looks past your THS level you will will not know until Hashimotos destroys your thyroid to the point where you are consistently testing in the HYPO range. This is because your thyroid has become so damaged due to your antibodies killing it that it can not produce or convert enough T3 or T4 (or maybe both) to keep you with in the total normal ranges for TSH (THS is the total of all your T numbers. It is only a ball park figure and should be used that way. It is not meant to be the "yes" or "no" of thyroid disease that some medical doctors take it to be) . Without treatment your hypothyroid symptoms will get worse because your thyroid is slowly deteriorating. The damage done to your thyroid is not reversible but it is preventable. You will be put on thyroid medication to stop the antibodies from attacking your thyroid gland. The best to take for Hashimoto's is Armour because of the random damage you can have conversion and production problems and Armour has both of those covered in one pill. I was fine on levothroxine (never synthriod only the generic worked which I was not allowed to take) for 1 and a half years then that stopped working completely. I am back on Armour now but I am going to switch to ERFA. If you have Hashimoto's it's best to have something that cover all the T levels.
It took doctors 10 years to find out I had a thyroid disorder because they only gave me the test you had. My THS was 4.7 when I was 25. That is considered high now but at the time fell under a normal range. I had to get a thyroid panel 2 test by going to an endocrinologist - they usually treat diabetes and thyroid disorders. I knew something was wrong because I worked out 3 to 4 hours a day as a personal trainer. I barely ate 800 calories per day and I weighed 140 pounds when I should have weighed about 100 pounds.....I was tired all day and my hair was brittle and thin, my nails were ridged and the skin around my fingers was so dry it bled at times. I was constipated and depressed for no reason off and on. I had TERRIBLE PMS. My mother and my aunt both have thyroid disorders. Thyroid problems are hereditary.
Four different doctors gave me 4 of the same test you had done. They all showed normal THS levels leaving me walking away wondering what was wrong with me but not helping with any of the symptoms. I eventually convinced myself it was all in my head. Bleeding knuckles were normal - never having a BM for weeks on end normal, being 25 and tired and forgetful like I was in my 70 yes! Normal! How was it possible to have 4 tests, all my levels normal in different years of my life from different doctors and not have a normal thyroid? It didn't make since.
Turns out I had Hashimoto's. My antibody count was over 1 thousand at the time tested. I think its supposed to be under 80. If you think you have thyroid problems please go see an endocrinologist. Very few family doctors will be able to test you properly and help you. They practice on general aspects of the whole body not certain specific systems like the endocrine system. They see people for common ailments and are schooled to treat the general public, very few know anything specialized about certain diseases. That is why they are supposed to refer you to a specialist. Problem is some of them have egos so they do not do that.
Trust me I spent more money and time going to family doctors for years who never got it right then I ever spent on my endocrinologist. Tell them to do a full panel test including antibodies count. The longer you go on with undetected Hashimotos the more damage it does to your thyroid gland. Chances are something is wrong. It is probably your doctor.
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