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Should I see an endocrinologist?
Hi, I don't know if I should see an endocrinologist or not. My GP has tested my thyroid a few times - hypothyroidism runs on both sides of my family and I have some symptoms such as fatigue, weight gain, dry skin, and some others but not some common ones like constipation.
She tested my TSH and Free T4. My TSH is always normal and on the lower side. Values of TSH were 0.37, 0.87 and 0.83 over the past 18 months. Free T4 is also "normal" but on the lower side: 0.9, 0.7, and 0.6. My last Free T4 test came back at 0.6 which is the lowest value in the normal range.
Is it normal to have such low T4 when my TSH is also low? My dr just said it was fine and refused to answer my questions any further. I don't want to waste my time or another dr's time by answer shopping but this doesn't seem quite right to me. My symptoms, while not debilitating do have me feeling quite blah a lot of the time but then I doubt myself and think maybe it's just me getting older (41) and needing to be more strict with my diet. Thanks for any advice.
She tested my TSH and Free T4. My TSH is always normal and on the lower side. Values of TSH were 0.37, 0.87 and 0.83 over the past 18 months. Free T4 is also "normal" but on the lower side: 0.9, 0.7, and 0.6. My last Free T4 test came back at 0.6 which is the lowest value in the normal range.
Is it normal to have such low T4 when my TSH is also low? My dr just said it was fine and refused to answer my questions any further. I don't want to waste my time or another dr's time by answer shopping but this doesn't seem quite right to me. My symptoms, while not debilitating do have me feeling quite blah a lot of the time but then I doubt myself and think maybe it's just me getting older (41) and needing to be more strict with my diet. Thanks for any advice.
COMMUNITY LEADER
It's possible your nasal passages could be swollen from allergies... that would not change the fact that you are hypo. Many of us have more than one issue!! Once your thyroid levels are optimized, you might find you need treatment for something else, such as vitamin deficiencies, etc... but you know your body better than anyone else, so don't let a doctor tell you there's nothing wrong with you, when you know there is.
We find that most of us feel best with thyroid hormones, at least, in the middle of the ranges; many need FT3 in the upper half to upper third of its range. Very few people do well with either FT4 or FT3 in the lower parts of their ranges.
We find that most of us feel best with thyroid hormones, at least, in the middle of the ranges; many need FT3 in the upper half to upper third of its range. Very few people do well with either FT4 or FT3 in the lower parts of their ranges.
COMMUNITY LEADER
What is the reference range for the Free T4? Reference ranges vary from lab to lab and have to come from your own report.
Not everyone gets all the same symptoms, so just because you don't have constipation, doesn't mean you can't have hypothyroidism.
Typically, we'd expect your TSH to be higher with an FT4 as low as yours, but it's very possible you have a condition called Secondary or Central hypothyroidism. This means there's really nothing wrong with your thyroid, but there's a problem with the pituitary/hypothalamus axis, so your pituitary gland isn't producing enough TSH to stimulate the thyroid to produce adequate thyroid hormones.
While many of us could be stricter with our diets, that's not a reason for fatigue, dry skin and many other symptoms that go along with hypothyroidism... don't be so hard on yourself.
If your current doctor won't help you, you really should consider a second opinion. Many doctors miss Central hypothyroidism, because all they really look at is TSH and as long as that's low/in range, they think everything is fine, when it isn't...
Next time you get tested, ask for/insist on also getting the Free T3, which is the hormone that's actually used used by every cell in your body... You need that test, along with the Free T4 and TSH.
Not everyone gets all the same symptoms, so just because you don't have constipation, doesn't mean you can't have hypothyroidism.
Typically, we'd expect your TSH to be higher with an FT4 as low as yours, but it's very possible you have a condition called Secondary or Central hypothyroidism. This means there's really nothing wrong with your thyroid, but there's a problem with the pituitary/hypothalamus axis, so your pituitary gland isn't producing enough TSH to stimulate the thyroid to produce adequate thyroid hormones.
While many of us could be stricter with our diets, that's not a reason for fatigue, dry skin and many other symptoms that go along with hypothyroidism... don't be so hard on yourself.
If your current doctor won't help you, you really should consider a second opinion. Many doctors miss Central hypothyroidism, because all they really look at is TSH and as long as that's low/in range, they think everything is fine, when it isn't...
Next time you get tested, ask for/insist on also getting the Free T3, which is the hormone that's actually used used by every cell in your body... You need that test, along with the Free T4 and TSH.
3 Comments
Sorry, I missed the extra post with the reference ranges... thank you. ☺
Your FT4 is way too low...
Your FT4 is way too low...
Thanks for responding. I will definitely get a second opinion and ask for the Free T3. It's just easy to doubt yourself when a dr insists you are fine. She actually suggested that I have allergies that I'm not aware of because the inside of my nasal passages are supposedly swollen and that I might not be getting enough oxygen and that's why I'm tired. Told me to try Allegra. Sooo frustrating.
Thanks for responding. I will definitely get a second opinion and ask for the Free T3. It's just easy to doubt yourself when a dr insists you are fine. She actually suggested that I have allergies that I'm not aware of because the inside of my nasal passages are supposedly swollen and that I might not be getting enough oxygen and that's why I'm tired. Told me to try Allegra. Sooo frustrating.
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