Don't forget ferritin (and a full iron test panel if you can get it done).
Thank you for your advice
I am seeing next month a np that is pretty good about listening and running any test you would need she also goes about things natural approach , I saw her before how I found my vit d and b was low. I am brining her the lab work reports for opinion and I'll ask her about the ft3 too .
All your symptoms may not be thyroid related; however, with most of those symptoms and your Free T4 and TSH test results, I'd say there is a high probability of you having central hypothyroidism. That type of hypothyroidism is due to a hypothalamus/pituitary problem causing inadequate TSH to be produced by the pituitary gland. In turn, the thyroid hormone levels are also too low and symptoms result. Even though your Free T4 is within the low end of the range, that does not preclude hypothyroidism. The ranges are far too broad to be functional for many people.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
So, you are going to have to get your doctor on board with additional testing and treatment, or find a good thyroid doctor that will treat clinically as described. You need to be tested for both Free T4 and Free T3. Free T3 largely regulates metabolism and many other body functions. I expect you will find your Free T3 to be in the low end of its range as well as your Free T4. Since hypo patients are also frequently low in the range for Vitamin D, B12 and ferritin, you need to have those tested also. Also, you need to get the doctor to consider some pituitary function tests. Do you think there is any possibility of all this happening with your current doctor?
I have pcos the drs have said all my issue are from that weight gain depression anexity thinning hair extreme fatigue, excessive hair growth other places, Which very all might be true I just always wonder about this, every doc I've seen has mentioned my neck is so thick and my symptom sound like it could be a thyroid issue, they always say I come back normal range . My vit levels were little lower over last 6 months have gone up I feel a little better but not totally . No one has ever offered to do an ultrasound or scan, I asked this last time for a scan so could just make sure . She refused said it's not needed, and would humor me and do an ultrasound .
For tsh the labs range is 0.25 to 5.00
Ft4 0.7 to 1.6
Reference range for the Free T4? The reason I ask is that lab results can vary from lab to lab, so the calculated ranges also can vary accordingly. That is why we always want to compare results against ranges from the same lab.
The thyroid volume per Brunn et al is 15 cu cm; while this is about twice of the average, it is below the upper limit (18 cu cm).
If thyroid tissue is not inflamed but overgrown ("soft goiter") it usually asymptomatic; inflammation however can cause tissue to harden and therefore patient feels "a foreign mass". A 7 mm nodule is usually not tested because it is smaller than 1 cm (lesions under 1 cm considered clinically insignificant). In the absence of calcifications and abnormal lymph nodes most doctors will not do biopsy.
What were the "normal" thyroid test results and reference ranges shown on your lab report?