What does it mean when most of the results in my thyroid panel have dropped

[Dpaz2271]

What does it mean when most of the results in my thyroid panel have dropped.  I just got tested again and since being tested my levels have dropped.  Here are my results;

TSH .80 (lower)
T3 102 (lowered)
T3 Free 2.9 (lowered)
T4 5.36 (first time being tested)
T4 Free .54 (lowered and first time being below the range)
Thyroglobulin Antibody <.9 (lowered)
Anti Microsomal Anitbody .3 (lowered)

(please excuse any typos in medical terms)

Prior to changing to my wellness doctor I had yearly check ups with my family doctor and despite my constantly complaining of fatigue, constipation, weight gain, etc., I was always told that I was 'as healthy as a horse.  However, I felt something was off, this person who was not as active as before, or fit, or in a good mood less and less was just not me.  So I decided to see a wellness doctor.  My wellness doctor definitely thinks outside the box and even though I had normal ranges last year, he prescribed Armour Thyroid 90 mg which I have been on for almost a year.  (To be fair to him, he did ask me to get tested again before the year mark and it slipped my mind.)  I have noticed that I don't feel the same as when I first stared the meds which included more energy, more active, feeling in a better mood and felt more focused (as not being distracted from being lethargic)  My questions are;

1.  What do the new levels mean?
2.  Could the lowered changes be indicative of more serious issues?
3.  What other ways can I approach this issue in addition to meds?

Thank you for your help on this.

[gimel]

Sorry I am having a tough time trying to line up the test results with the years.  As best I understand it, your TSH has bounced around a bit, but been fairly stable around an average of 173, until the last set of tests.  And your Free T4 and Free T3 levels went down in the last two sets of results,  with you being started on 90 mcg of Armour in between the last two sets of results, correct?

It is not unusual for serum levels to drop slightly when starting on thyroid med, since serum levels are the sum of both natural thyroid hormone and thyroid med.  When starting on thyroid med, the TSH will drop and that reduces output of natural thyroid hormone, so the total serum level can drop slightly or remain about the same as before until the dosage is raised enough to essentially suppress TSH.  At that point further increases in med dosage will cause the Free T4 and Free T3 to rise.  

So the answer to getting your Free T4 to at least  mid-range and your Free T3 into the upper third of its range, or as needed to relieve hypo symptoms, is to raise your dosage of Armour until that happens.  Your tests for antibodies were negative.  Your Reverse T3 was mid-range, so okay.  No problem with the cortisol test, assuming the range is what I see often.  YourVitamin D is lower than optimal, which is at least 50.  You should also test for B12 and ferritin and supplement as needed for those. B12 should be in the upper end of its range, and ferritin should be 100.  

So you should discuss all this with your doctor and get an increase in your Armour dose, along with the additional tests recommended.  I realize none of what I have said totally answers your question as to why your Free T4 and Free T3 levels were dropping even before starting on Armour.  TSH level doesn't explain it.  The only thing I can suggest is to discuss that with the doctor and ask if an ultrasound of the thyroid gland would be advisable.  

[Dpaz2271]

Thank you so much, you have been extremely helpful.

[gimel]

Please check the third line of results.  Not sure what you are showing there.  Also, please check the Reverse T3 result.  Should that be 20.1 instead of 201?  Also what are the reference ranges shown for Free T4 and Free T3?  

[Dpaz2271]

The 3rd line is the Anti Microsomal that was tested in 2011, 2012, 2013 and 2017 with results <10, <10, <10 and .03 respectively.  The Reverse T3 is 201 pg/mL with ranges 90 - 350 pg/mL and the ranges are as follows;  
Free T3: 2.8 - 4.4 pg/mL
Free T4: 0.61 - 1.37 ng/dL

[Dpaz2271]

Test 2011 2012 2012 2013 2015 2017

TSH 1.70 1.42         2.30           1.50        1.74 0.80
Anti Thyroglobulin <20           <20          <.9
AM <10 <10                                  0.03
T4 F 1.19 0.99                  1.09 0.74         0.54
T4 5.36
T3 F           3.4         3.00         2.9
T3                  150                  102
Reverse T3 201
Coritol 18.1
D2 <5.0        <5.0         7.8   <5.0
D3 35.8        18.6        33.4          33.6
D Total 35.8        18.6       41.2          33.6

[gimel]

Please post your thyroid test results from before you started on the Armour.  Also, have you been tested for Reverse T3, cortisol, Vitamin D, B12 and ferritin?  If so, please post those as well.