Is it possible to have a thyroid disease with normal TSH, T3 & T4?

[ayoya9331]

hi am 19 years old. and i have most of the hypothyroidism symptoms
but my result came normal
TSH 1.89 (0.3-5) uiU/Ml
free T3 2.9 (2-4.7) pg/ml
free T4 1.1 (0.8-1.8) ng/dl

im just wondering why my TSH is low and i don't feel hyper at all??
i'm always tired with low energy
could it be a secondary hypothyroidism?

[SarahB79]

It's likely caused by something unrelated to thyroid. Diet, sleep apnea, heart rate, vitamin d deficiency, depression, etc.  good luck. But your thyroid is just fine.

[Barb135]

Your TSH is not all that low and with your levels of FT3 and FT4, it's very possible that you could have hypo symptoms.  You should ask to get tested for thyroid antibodies - Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) to see if you have Hashimoto's Thyroiditis.  

With Hashimoto's, it's not at all unusual for symptoms to appear before blood tests show a real problem.  

If being tired, with low energy is your main symptom, you should also ask to get vitamin B12 levels tested.  B12 that's too low in the range can cause extreme fatigue and low energy.  

[Red_Star]

The simple answer is yes.  This is the very reason why Dr Kharrazian wrote the book "Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal?".

Your free T3 and free T4 are at the bottom end of the normal reference range. Many feel better at the upper end of the range.  Your current TSH is in optimal range but don't rely on that as a diagnosis.  TSH fluctuates for various reasons including Hashimoto's thyroiditis (the most common cause of hypothyroidism).

[ayoya9331]

thanks barb for ur reply :)
but i took Vitamin B12 and i didn't help me

[ayoya9331]

thanks alot for ur reply
T3 and free T4 are at the bottom end of the normal reference range so that means that I'm hypothyroid??
i took alot of vitamins but it didn't work with me

[Red_Star]

Your lower than optimal free T3 and free T4 may explain your hypothyroid symptoms but you would not officially be diagnosed as having hypothyroidism based on your current lab work.  According to the American Association of Clinical Endocrinologists (AACE), a TSH of above 3mU/L is classed as hypothyroidism.

[flyingfool]

You are Hypo in the sense that YOU are having symptoms of having too little Thyroid.  The "numbers" hardly matter, what REALLY matters is how you FEEL.  Adjusting medicine dosage until you feel well and then the numbers will indicate the target YOU need to hit in order to feel well.

Many people find that they need to get their Free T4 in the MIDDLE of the range if not slightly higher AND (that means in addition to) their FT3 levels in the UPPER 1/3 of the range.

For you:  

Your FT4 tested @ 1.1 and the middle of the range would be 1.3
Your FT3 tested @ 2.9 and upper 1/3 would start at 3.8

So your numbers are by no means horrible. But if you are having symptoms in all likelihood they might go away with a starter dose of thyroid meds.

Based upon your numbers it does not appear that you have a conversion problem so a straight T4 medication would probably work for you.

The reference ranges are simply taking 100% of the population and throwing out the 2.5% at both the top and bottom and thus the range represents where the other 95% of the population would fit in.  The HORRIBLE problem with this is that FAR more than 2.5% of the population are actually Hypo.  But because they were included in the "normal" or reference range then they are not classified as Hypo or maybe we should say less than optimum Thyroid.  As a result Dr's reliance upon TSH and even the reference ranges means that MANY, MANY people are left untreated and feeling like crap.  many of these people are taking other medications to cover up symptoms that the Thyroid is causing.

The Dr's don't even know this is going on so if they can medicate you into the bottom of the range they are happy and stop and call you "normal" and there must be something else wrong or say that it's all in your head. Combined with the Pharmaceutical company's don't care because they can sell you 6 different expensive prescriptions to cover 6 symptoms that could otherwise be solved by one simple low cost Thyroid medicine.  

You have no idea how incredibly lucky you are to have a Dr who even tests for both Free T4 and Free T3.  My wife and I so far have been unable to have this.  But my wife sees a new Dr on March 9th. so we have our fingers crossed.  She wrote and sent the new Dr a 3 page letter stating her issues/history and what expectations she has etc.  I hope it helps.

[ayoya9331]

thanks alot for your help :)
and i would see what my Dr say about that