Aa
Think I might be hypothyroid
I feel like I have a lot of symptoms but my labs appear normal. My feet and hands are always freezing, I am always cold all of the time, constipation, bloating, fatigue, frequent sinus infections, irregular cycles, and infertility. My TSH 3.52 and my total T3 is 88. what do you think?
Well, you're not quite over the hill reproductively...you have some time left! LOL However, you do want your thyroid hormone levels stabilized before conceiving. Low maternal thyroid hormone levels can contribute to miscarriage and slowed fetal development.
T4 is the "storage" form of the thyroid hormones. It's all made in the thyroid. T4 basically floats around in your bloodstream until cells need it. However, cells can't use T4; first it has to be converted to T3, the "active" form of the hormones. While a tiny bit of T3 is made in the thyroid, most of conversion happens at the site of demand.
So, since your FT4 is just over midrange, it looks like your thyroid is in good shape. Assuming your FT3 is as low as your TT3 is...and it may not be...it would seem like you might convert slowly. This is a bit unusual for someone who isn't on thyroid meds, but a number of things can impact conversion, including, but not limited to, other health issues, surgery, trauma, other meds (e.g. amiodarone), stress (physical and psychological), selenium deficiency, and the list goes on.
If I were you, I think the first thing I'd do is ask my doctor to repeat thyroid tests, replacing TT3 with FT3 (or at least adding FT3 if she insists on TT3). Also, I'd ask for RT3 (reverse T3) to be tested. When T4 is converted, some is converted to FT3 and some to RT3. RT3 is inert, so if the balance of FT3 to RT3 gets tipped, you end up with hypo symptoms. It's important to remember that RT3 raw numbers are not important. It's the ratio of FT3 to RT3 that you have to look at, so you want FT3 and RT3 on the same blood draw. I'd ask your integrative medicine doctor for this one. Many "mainstream" doctors don't think RT3 is important and won't order it.
You might also request a selenium test. The enzyme that catalyzes the conversion of T4 to T3 is a selenium based enzyme.
I'd also recommend testing vitamins D and B-12, both of which can cause hypo-like symptoms. A complete iron panel, including ferritin, would also be worth doing. As with thyroid tests, levels of all of these should be well up in the ranges, not just low in the ranges.
If you have those tests now, you will have them in hand when you get your appointment with the specialist and have a much better idea of what to discuss with him.
T4 is the "storage" form of the thyroid hormones. It's all made in the thyroid. T4 basically floats around in your bloodstream until cells need it. However, cells can't use T4; first it has to be converted to T3, the "active" form of the hormones. While a tiny bit of T3 is made in the thyroid, most of conversion happens at the site of demand.
So, since your FT4 is just over midrange, it looks like your thyroid is in good shape. Assuming your FT3 is as low as your TT3 is...and it may not be...it would seem like you might convert slowly. This is a bit unusual for someone who isn't on thyroid meds, but a number of things can impact conversion, including, but not limited to, other health issues, surgery, trauma, other meds (e.g. amiodarone), stress (physical and psychological), selenium deficiency, and the list goes on.
If I were you, I think the first thing I'd do is ask my doctor to repeat thyroid tests, replacing TT3 with FT3 (or at least adding FT3 if she insists on TT3). Also, I'd ask for RT3 (reverse T3) to be tested. When T4 is converted, some is converted to FT3 and some to RT3. RT3 is inert, so if the balance of FT3 to RT3 gets tipped, you end up with hypo symptoms. It's important to remember that RT3 raw numbers are not important. It's the ratio of FT3 to RT3 that you have to look at, so you want FT3 and RT3 on the same blood draw. I'd ask your integrative medicine doctor for this one. Many "mainstream" doctors don't think RT3 is important and won't order it.
You might also request a selenium test. The enzyme that catalyzes the conversion of T4 to T3 is a selenium based enzyme.
I'd also recommend testing vitamins D and B-12, both of which can cause hypo-like symptoms. A complete iron panel, including ferritin, would also be worth doing. As with thyroid tests, levels of all of these should be well up in the ranges, not just low in the ranges.
If you have those tests now, you will have them in hand when you get your appointment with the specialist and have a much better idea of what to discuss with him.
Thanks for the reply. No I am not taking any thyroid meds. I am just comming to the idea of being hypothyroid on my own. I spent a lot of time on Dr's for certain symptoms. (Such as sinus infections every 3 months- No allergies, CT clear, MRI clear) It's just the past few months where I've connected my symptoms thinking its all related. I've had hormone levels tested in the past (from family Dr. and a OBGYN clinic) and everyone says normal (Never asked for my labs then to know what the numbers were).My labs now are from an intrgrative medicine dr. Her only tx for me was to refer me to yet another dr. I am now waiting to hear when my apt is with an endocrine reproductive specialist. I really want to get pregnant, and feel like I'm running out of time at almost 32 ,so I think thats why she made this referal. I hope he knows something about the thyroid...I need to start feeling better soon.
Your FT4 is at 56% of range, which is right where it should be. However, your total T3 is dismal at 7% of range. Upper half to upper third is the guideline for T3.
Unfortunately, your doctor has ordered total T3 rather than FREE T3. Next time, you should request FT3. Total T3 tells the total amount of T3 in your blood, but much of that is chemically bound by protein and unavailable to cells. FT3 tells what's available. Various conditions can cause more or less T3 to end up bound, so your FT3 could be higher or lower than your TT3.
I have some more information for you, but I have a couple more questions first. Are you taking thyroid meds? If so, how long have you been taking them, which do you take and what's your dose?
Unfortunately, your doctor has ordered total T3 rather than FREE T3. Next time, you should request FT3. Total T3 tells the total amount of T3 in your blood, but much of that is chemically bound by protein and unavailable to cells. FT3 tells what's available. Various conditions can cause more or less T3 to end up bound, so your FT3 could be higher or lower than your TT3.
I have some more information for you, but I have a couple more questions first. Are you taking thyroid meds? If so, how long have you been taking them, which do you take and what's your dose?
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