Making sense of Thyroid lab results

[Snowdrop11]

My doctor has been tracking my Thyroid for a few years as my TPO antibodies were discovered to be elevated and my mom and grandma have hashimoto's. The trend has been puzzling. I have a lot of hypothyroid symptoms. The latest results are as follows:

TPO antibodies 54 (range <50)
TSH 0.85 (range 0.2 to 5.0)
Free T4 11.5 (range 9.0 to 23)
Free T3 3.6 (range 3.5 to 6.5)

I get my blood tested every 3 months or so and everything is trending downward. Nothing is in the treatable range yet according to my doctor. However, I have been feeling terrible. From what I've read it seems like secondary hypo due to pituitary may be the cause. Has anyone experienced something similar?

[Barb135]

Who says nothing is in the "treatable" range?  Your Free T4 and Free T3 are both at the bottom of their ranges and though you aren't specific about what "hypo" symptoms you have, those levels could easily explain many symptoms.

You're correct that your levels could indicate Secondary or Central hypothyroidism. Have you discussed this with your doctor?  

I'm guessing s/he might be waiting for your TSH to be elevated out of range, which won't happen if you have Secondary hypothyroidism.  Too many doctors rely only on TSH as an indicator of hypothyroidism and they do a great disservice to their patients.  My strong recommendation would be to get a second opinion if this doctor won't listen or start you on replacement thyroid hormones.    

[Snowdrop11]

Thank you barb135. I think I've had hypothyroid symptoms for the past 5 years: brain fog, fatigue, cold intolerance, dry eyes, puffiness. Almost a year ago I also started having muscle fatigue, twitching, numbness and tingling. My hair also started falling out. The only thing that has turned up in any testing is the down trending thyroid values and thyroid antibodies. Needless to say I am currently on a journey to figure all this out and it has been frustrating to say the least. I think I will push for a referral to an endocrinologist, which can have a long wait list here in Canada. My GP holds fast to the belief that TSH is the only value of relevance...which we know is not true!.

[Barb135]

You don't necessarily need an endocrinologist... many of those specialize in diabetes and are not good thyroid doctors.  Any doctor will do as long as it's one that doesn't worship TSH.  

What if you mentioned Secondary/Central hypothyroidism to your doctor or even take him some articles to read? Some are open to change if they have the proper information.