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Feedback on 'you don't have hypothyroidism'?

Can I get some feedback on my tests?  I'm almost laughing at the medical community anymore.  Firstly, here are the most uncomfortable of my many 'symptoms':

Low AM body temps, 95.4 through 96.5...and not much higher during the day, even after exercising
Slow heart rate at rest, mid to upper 40s, palpitations especially late in the day and evening
Intolerance to cold where it never bothered me 'before'
Cold hands and feet, always had great circulation
Hair non stop falling out, thinning and dry, skin dry
Weight gain despite good diet and daily exercise of at least 30 minutes vigorous, no sweating
Digestion issues, bloating
Tinnitus, reduced hearing
Achey joints, tired muscles
Lethargy, sluggish and hard to get motivated

I'm a retired 65 year male who has always been athletic, eats well, meditates.  It's just been the past couple of years that things have gradually progressed to where I know there are no more coincidences or attributing things to getting old/older.  I almost laugh at the doctors now when they tell me my blood tests are within the ranges and they can't justify prescribing me any thyroid medicines.  Are there none with clinical common sense anymore?  I even give them printouts of some of the latest clinical findings and scholarly articles on hypo but that doesn't seem to change their treatment protocol.  They seem to fear getting into trouble by going 'outside the box' of their medical school training.

Here is my latest blood work: (I've also been taking supplements for thyroid health the past several weeks out of frustration and an 'abundance of caution).

TSH    2.36 uIU/ml          range: 0.34 - 4.82
FT4       .99 ng/dl                        0.45 - 1.63  
FT3     2.80 pg/ml                       2.00 - 3.50
T3        111 ng/dl                         71 - 180
Throid Perox AB  .9
Thyroglobulin       3.5
Testosterone 454 ng/dl             199 - 1586

Finally, thankyou to any/all of you who will provide feedback/input and if possible I would certainly appreciate a recommendation for a 'good thyroid doctor' in my area of Farmville, Virginia, 23901.

Tom.

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Avatar universal
Just sent you a PM with doctor info.  To access, just click on your name and then click on messages.  
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Avatar universal
From what I have read the hemoglobin test is not an adequate indicator of ferritin levels.  Doctors tend to overlook the possibility of low ferritin in men, but being hypothyroid seems to cause low stomach acid and cause poor absorption of vitanutrients.  The first time tested my ferritin was 40.  I had to take about 75 mg of iron daily to raise it to 80.
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Avatar universal
Gimel, thanks so much for the input and time you've given my situation.  Midlothian is an hour from here but a small drive to take for a quality doctor.  No price or challenge is too great for good health.  So yes, I would be interested in both of those doctors.

As an aside, I also had a CBC done at the same time and my hemoglobin was 17.8 G/DL, scale is 14.0 - 18.0.  Would this be an indication that my ferritin levels are good?  Thanks again!

Respectfully, Tom.
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Avatar universal
You certainly have a lot of classic symptoms of being hypothyroid.  Hard to understand how a doctor could listen to all those and ignore the possibility of you being hypo, just because of your lab results.  They should read the very introduction to the Practice Guidelines for Hypothyroidism, from the ATA and the AACE.  It reads as follows, "The guidelines are not inclusive of all proper approaches or methods, or exclusive of others.  The guidelines do not establish a standard of care, and specific outcomes are not guaranteed.  Treatment decisions must be made based on the independent judgment of health care providers and each patient's individual  circumstances.  A guideline is not intended to take the place of physician judgment in diagnosing and treatment of particular patients."  

So there is nothing that blocks the doctor from diagnosing by signs and symptoms, along with blood test results, as long as the doctor understands that the reference ranges are really guidelines within which to adjust the patient's serum levels as necessary to relieve symptoms.  The ranges are not pass/fail decisions.    The ranges for Free T4 and Free T3 are far too broad to be functional for every patient, due to the erroneous assumptions used in establishing the ranges.  Free T4 and free T4 ranges based on data from healthy adults with no known thyroid pathology would look more like the upper half of the current ranges.  Hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  Your D should be more like 55-60.  B12 is fine.  You need to get ferritin tested at first opportunity.  Vitamin D and ferritin are important to properly metabolize thyroid hormone.

More importantly for you I think is that your Reverse T3 is at the high end of its range, while Free T3 is only at 53% of its range.  Thus your Free T3 to Reverse T3 ratio is lower than recommended.  There are various recommendations on the ratio, but I'd say the ratio is best when at least 1.8.  Your ratio calculates at about 1.2.  Your ratio is low mainly because of high Reverse T3.  

There is a lot of good info in this link about RT3 dominance, as it is called, and the many potential causes.  In fact, there are so many potential causes to be considered, that the most expedient approach to reducing the RT3 level seems to be taking T3 med (and if taking T4 med, to reduce the dosage so there is less T4 to convert to RT3) .  Again you can read about that in the link.
  
http://www.custommedicine.com.au/health-articles/reverse-t3-dominance/

Next thing is to find a doctor that knows enough about RT3 dominance and is willing to work with you to fix the problem.  I have two prospects for you.  Both happen to be in Midlothian.  Is that close enough to be of interest?

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Avatar universal
The following test results failed to appear with my original post:

RT3 23.5  range: 9.2 - 24.1
Magnesium 2.2 mg/dl  range:1.6 -2.6
Vit D 25-OH  36.8  range: 30 - 96
Vit B12  840 pg/ml  range: 213 - 816
Folate  33.2 ng/ml  range:>3.5
Testosterone 454 ng/dl  range:199 - 1586

Tom.
Helpful - 0
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