results are within normal range - hypothyroidism possible?

[dhbike]

My energy level crashed about a month ago and I've been battling with fatigue.  It's so bad to the point that I rather stay home and sleep instead of going to beaches on weekends to hang out with my friends.  I also noticed that I gained 10 pounds in just 2 months without changing my diet (I'm 5'2" and now 125 pounds).  It just feels like something is wrong with me.  I thought I might have hypothyroidism but my doctor told me I'm within normal range so I'm healthy.  I'm just getting old and lazy for not exercising.  
My lab results were:
TSH 1.42 ulU/mL
T4, free 1.2 ng/dL
T3, total 93 ng/dL
Is it still possible that I have hypothyroidism?

I have an appointment with an endocrinologist in a couple of weeks and want to be prepared.  I'd appreciate any guidance/insight you may have.
Also, if anyone knows a good doctor in Honolulu... please let me know.
Thank you.

[Barb135]

Your FT4 is quite low, at only 25% of its range. Your Total T3 is only at 10% of its range.  However, as I noted above, Total T3 is obsolete and doesn't tell very much.  Of the Total T3, approximately 90-95% of that would be bound by protein and unavailable for use by individual cells.

Both the low FT4 and TT3 indicate that your thyroid is not producing enough hormones.

Definitely recommend seeing a different doctor.  You already have an appointment with an endo.  Since you have that, I'd probably go ahead and see what s/he says.  I note that gimel has already sent you the name of another doctor, so that would be your next option if the endo doesn't work out.

[gimel]

Be aware that being an Endo does not guarantee a good thyroid doctor.  Many Endos specialize in diabetes,  Many have the "Immaculate TSH Belief' and only want to use TSH to diagnose and medicate a hypo patient.  That simply does not work.  If they test beyond TSH, then it usually is Free T4 and then they will use "Reference Range Endocrinology", by which they will tell you that a test result that falls anywhere within the range is adequate.  Wrong.  The range is far too broad to be functional across the entire range.  Plus, each patient may have different optimal levels.  

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

I have the name of a Honolulu doctor recommended by hypothyroid patients.  Sending PM with info.  Just click on your name and go to personal page.  Then click on messages.  

[dhbike]

Thank you very much for your comment.
The reference ranges are:
TSH: 0.27 - 4.20 ulU/mL
T4, Free: 0.9 - 2.1 ng/dL
T3, Total: 80 - 200 ng/dL

No, I haven't been tested for antibodies yet.  I'll definitely get it tested.
I just started doing the research on thyroid.  I realized that I just can't rely on doctors for the information.  I need to take matter into my own hands!

[Barb135]

What's the reference range for the Free T4 and the Total T3?  Reference ranges vary lab to lab and have to come from your own report.  Unfortunately Total T3 is obsolete and not very useful.  It would have been much better if your doctor had ordered Free T3, instead, but we'll work with what we have.

I'd bet my right arm that your doctor took one look at your TSH and decided your fate... lol   The reason I say that is because TSH is what most of them do and your TSH is "perfect"...

Ranges for the FT levels will tell the rest of the story.

Have you been tested for thyroid antibodies to determine if you have Hashimoto's Thyroiditis?  Hashimoto's is an autoimmune thyroid disease that destroys the thyroid over time and eventually, the thyroid doesn't produce enough (or any) thyroid hormones.  If one has Hashimoto's, it's not at all unusual for symptoms to appear long before thyroid labs indicate an issue.  

If you haven't had the antibody tests, ask the endo to test Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  You need them both, because elevated levels of either would be the basis for a diagnosis of Hashimoto's.  Some of us have one or the other, some have both.