Low free t3 & feeling cruddy

[mtmomster]

generally feeling cruddy, low energy, cold, constipated, can't stop gaining weight etc.. all the classic signs.  test results from ZRT labs blook spot test:

free t4 1.3 ng/dl (0.7-2.5)
free t3 2.2 pg/ml (2.5-6.5
TSH 0.8 uU/ml (0.5-3.0)
TPO 20 IU/ml (0-150 70-150 borderline)

Seems strange from what I have learned; the t3 being out of range (low), with t4 "normal" and TSH being in the low end of normal.  

local doc ordered their own lab work, but didn't seem too concerned (no results yet).  Tired of feeling junky.  I work out 4 days  week, cardio/weights, eat 1200-1500 calories (very healthy stuff too)  On a good vitamin//mineral supplement.  

Any suggestions?  One thing I read pointed to pituitary issues?  

[Barb135]

Are you currently taking a replacement thyroid hormone?  If so, what med, dosage and for how long have you been taking it?  

What symptoms are you having?

[gimel]

Just because lab results fall within the so-called 'normal'  range does not mean that they are adequate for you.  I say that because the ranges are far too broad due to the erroneous method by which they were established.  the result is that Free T3 and Free T4 results in the lower half of the range are frequently indicative of being hypo. In addition, every person may have different optimal levels at which they feel best.  Your TSH level likely indicates that you have central hypothyroidism, which is related due to  hypothalamus/pituitary issues.

In the words of a good thyroid doctor, ""The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

A good thyroid doctor will also treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by TSH levels.  Symptom relief should be the main consideration, not just test results.  I suggest that you should discuss all this with your doctor, especially about your symptoms, and request to be started on thyroid meds.  You should also find out if the doctor  is willing to treat clinically as described.  If not, then you will need a good thyroid doctor that will do so.  

I think you can gain some good info from this link written by a good thyroid doctor.

http://www.hormonerestoration.com/Thyroid.html

[CuriousPinky]

I was recently tested for Thyroid Antibodies and followed up with a T4 and T3 Free lab. Results were stated to be WNL. Labs as follows:

TSH 1.49 (0.4 - 5.0)
T4 Free 1.0  (0.6-1.5)
T3 Free 2.5 (2.5-3.9)

Are these labs in therapeutic range? Still have mega symptoms.

[gimel]

Looks like your TSH level is inconsistent with the results on the actual, biologically active thyroid hormones FT3 and FT4.  TSH is a pituitary hormone that is affected by so many variables that it is inadequate as a diagnostic for thyroid problems.  Even so, your low TSH may well point to pituitary issues, so testing would be advisable.  

As far as your symptoms, they are very understandable, considering your very low FT3 result.  FT3 is the most important thyroid hormone because it is four times as active as FT4.  Studies have also shown that FT3 correlates best with hypo symptoms. Symptom relief should be all important to you, so you need to get the doctor to prescribe meds to increase your FT3 level to the upper part of its range, and your FT4 level to at least midpoint of its range., or as necessary to relieve symptoms.

You probably should find out if the doctor is willing to treat your symptoms by testing and adjusting FT3 and FT4 levels as necessary to relieve symptoms, without being constrained by TSH levels.  If not, then you will need to start looking for a good thyroid doctor that will do so.