need help with test results

[Rdumona]

I recently rec'd the following test results and would appreciate help in knowing what they mean before sitting down with the doctor.
test      range             my score
T3        71-180           105
T4         4.5-12            6.2
T4free  .76-1.46           .81
TSH w reflex to Free T4
             .358-3.74       10.349 (after this test the T4free test was ordered a 2nd time w/the same result)
I'm a 60+yr old white male with generally good health, 5'10" wgt stable at 180lbs no current medications but have been treated throughout my adult life for depression which is still an issue. Gall bladder removed 2 mos ago. Low energy/fatigue, memory problems are other issues. My mother and a niece are currently taking thyroid supplements.
I'd be hesitant about embarking on a lifelong regime of thyroid supplement w/o very clear indicators.  Should I see an endocrinologist?  

[Rdumona]

Thanks Barb!
Do you think Hashimoto's could be responsible for my life-long trials with depression? Wouldn't that have caused more definitive damage to the thyroid long ago or does it have a slower acting scenario as well? I think it's possible that my more pronounced recent fatigue may be due to my gall bladder removal a few months ago. So, while I want to thoroughly look into the possibility of Hashimoto's I want to be as aware as I can of other possibilities. I remember reading that the pituitary can be a key in some cases which is why I considered that an endrinologist might be helpful
Also, I've read that when one is on a thyroid supplement, the thyroid stops making its own supply. True? If so, does it recover if/when the supplement is stopped? I'd also be interested in your views about synthetic vs natural supplement.
Thanks again for your info and support!
Roger

[Barb135]

"I'd also recommend a thyroid ultrasound, which can help diagnose Hashimoto's depending on the depending on characteristics of your thyroid."

Sorry about the "depending on depending on"... I don't stutter; my computer was acting up when I typed that and we don't have an edit feature, as yet. lol

[Barb135]

The most common cause of hypothyroidism is Hashimoto's Thyroiditis, which is an auto-immune disease that eventually destroys the thyroid so it no longer produce any hormones at all.  If that's the cause of your hypothyroidism, you will be on medication for life, since you can't live without thyroid hormones, which control metabolism, heart rate, body temperature and other body functions.

While there "are" other causes of hypothyroidism, most people who start on thyroid hormones, end up staying on them for life. Once started on thyroid meds, your levels may come back to normal, but if you go off them, levels will again go back out range...

Your symptoms of low energy/fatigue and memory problem are consistent with those of hypothyroidism, as is depression, which is very common with hypothyroidism.

Unfortunately, your doctor tested Total T3 and Total T4 which are considered obsolete and not very useful.  TSH w/reflex to T4 is also "antiquated" and as you can see, often leads to further testing and wasted time.  

S/he should have ordered Free T3 and Free T4, which are the active thyroid hormones, since most of the Total T3 and Total T4 is bound by protein and can't be used.  We need to know the amount of the Frees, because those are what the body actually uses with Free T3 correlating best with symptoms.

The next testing you have should include Free T3, Free T4, TSH and the thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  You need both of the antibody tests because some of us have one or the other and some have both; both are markers for Hashimoto's.  I'd also recommend a thyroid ultrasound, which can help diagnose Hashimoto's depending on the depending on characteristics of your thyroid. An ultrasound will also determine if there are nodules on your thyroid.  While nodules are very common with Hashimoto's and usually nothing to worry about, it's good to know if they're there and keep an eye on them.

Whether or not you go to an endocrinologist is up to you.  You should be aware that not all endos are good thyroid doctors, since many specialize in diabetes and are not well versed in thyroid testing/treatment.

If you can get the necessary tests from your current doctor, you may be just fine; if not, I recommend someone else.

[ScalpMassager]

Starting on something like synthroid need not be a lifelong course, I'd of thought.  Has someone told you otherwise?

Sometimes, a med's started to help pin down whether or not it's the solution.