Is this hypothyroid

[Roxanne0312]

I was treated for hyperthyroid, Toxic Diffuse Goiter Without Mention Of Thyrotoxic Crisis Or Storm 3/3/2014

I had RAI in April.  Now my test results are,

TSH (0.27 - 4.20 uIU/mL)standard range  My value 1.98
Free T4 (0.93 - 1.70 ng/dL) standard range  My value 0.70

I feel like crap but also being treated for Diabetes, can't get the control right there.
I think I'm now hypothyroid and I disagree with my doctor.  

Am I hypothyroid.  I know you can't give medical advice.  I just want some confirmation so I can talk with my doctor intelligently.

[gimel]

B12 is best in the upper part of its range.  You really do need to get all those tests done.  Also, agree with goolarra that you should already be on thyroid med.  Most likely you will find need to also supplement with D and iron.

Low thyroid hormone levels can also affect sugar level.  

[Roxanne0312]

i got for thyroid testing again in a week, so I'll see about adding those other tests.  I do have a test for B12 and according to the standard ranges, i'm not low, but was in the 450 range and in some countries I would need B12 supplementation.

[gimel]

Your doctor is apparently one of those with the "Immaculate TSH Belief".   Those doctors will tell you that TSH is all they need to diagnose and medicate a thyroid patient.  That is totally wrong.  Even though they will claim that TSH accurately reflects levels of the biologically active thyroid hormones, TSH cannot be shown to correlate well with either Free T3 or Free T4, much less correlate well with symptoms, which should be the number one concern, not just lab test results.  


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 letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So, how can your doctor, knowing you had RAI, and looking at your Free T4 level, decide you are not hypothyroid?  Beats me.  You need to go back and request to be tested for Free T3, along with the Free T4, each time you are tested.  I'm sure that you will find Free T3 to also be in the low end of its range or below.  Since Free T3 largely regulates metabolism and many other body functions, it is the most important of the thyroid tests.  Scientific studies have shown that Free T3 correlated best with hypo symptoms while Free T4 and TSH did not correlate at all.

In addition, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  It would be a good idea to test those as well.  While getting those tests done, you might want to talk with your doctor about all this and request to be treated clinically, for symptoms, rather than by TSH.  If the doctor resists doing so, then you will need to find a good thyroid doctor that will do so.  

[goolarra]

Yes, I agree with you; you are hypo.  Your FT4 is below range, which indicates hypo.  When you consider that many of us find that FT4 has to be about middle of range to feel well, yours is really very low.  Your doctor is only considering your "normal" TSH.  However, TSH, a pituitary hormone, is influenced by many factors and is an Indirect measure of thyroid status.  FT4 is direct.

In addition, your doctor should be testing FT3.  FT3 is the "active" form of the thyroid hormones and correlates best with symptoms.  

In my opinion, you would benefit a lot by being on meds.