hypothyroid and free t3 levels

[Jsabba]

almost 25 years ago i developed Graves after the birth of my second child after being gestional with the birth. Auto immune runs in my family. I drank the RI, and since have been on Synthroid, currently at .125 mcgs. I am confused about the free t3 levels, i have always had a weight problem. over the last 2 years i went on Weight Watchers and lost 50 Ilbs. And i still have about 30 more to go. Lately i have been gaining weight back despite the fact that i work out 6 days a week. and watch what i eat. I am 58 and have gone threw menopause. I have extremly dry skin and my joints ache all the time.  At times my hands and feet are freezing, other im hot!
My recent lab results are as follows
TSH  0.471  ref range .0350-5.000
free t3   2.5         "      2.2-4.0
t4,free    1.2         "     0.8-1.5
vit d, 25 hydroxy  32.2      ref  30.0-100.0
After doing readying here is my t3 low
I lost a lot of weight when the graves was active, also since i am now hypo do i forget about having graves?
thank you for your help

[Jsabba]

thank you

[gimel]

You lost a lot of weight with the Graves' because you were hyperthyroid at that time.  Since the RAI treatment your thyroid gland is producing little or no thyroid hormone.  So you have to replace that with thyroid medication.  

The main problem I see is that your Free T4 is adequate, at the middle of its range, but your Free T3 is much too low in the range, being only 16% of the range.  Typically Free T3 needs to be in the upper third of the range, or as needed to relieve symptoms.  Your Free T3 being so much lower in its range than your Free T4 is an indication that your body is not adequately converting the T4 med to T3, so you need to add a source of T3 to your med, and gradually increase the dosage until those hypo symptoms are relieved.  As you do this, your TSH will most likely become suppressed below its range.  This happens frequently when taking adequate doses of thyroid med.  Do not let the doctor misinterpret this suppressed TSH as being hyper.  You are hyper only when having hyper symptoms due to excessive levels of Free T4 and Free T3.  

In addition to the low Free T3, your Vitamin D is too low.  D should be about 55, so you need to supplement to optimize your level.  Also, you need to test for B12 and ferritin.  Hypo patients are frequently too low in the ranges for those as well.  B12 should be in the upper end of its range, and ferritin should be about 70.