thyroid issues even after levels within limit

[rush76]

my TSh is 1.96, free t3 is 2.60 and free t4 is 0.93 , yet i am gaining weight rapidly. what could be the reason. i get inflamation right below my ear... am constantly fatigued, and have cold sensitivity and also have difficulty breathing on days when i am feeling dead tired. Doc says all parameters within limits... so cant do anything, Am going crazy with weight gain even after a controlled diet which is what was before the weight gain too,

[gimel]

Perhaps the first thing to be pointed out is that hypothyroidism is not just "inadequate thyroid hormone" as typically understood.  Serum thyroid levels do not always accurately reflect thyroid levels in tissues of the body.  In addition there are a number of variables that affect metabolism of thyroid hormone in tissue.  So, the best definition of hypothyroidism is, "Inadequate T-3 effect in tissues throughout the body, due to insufficient levels of, or response to, thyroid hormones."  

So the number one indicator of thyroid status is symptoms that occur more frequently with hypothyroidism than normally occurring.  You have several of those.  In addition, your FT4 is only at 13% of its range and FT3 is only 40% of its range.  Your FT3 is higher in range than FT4 because your body is apparently trying to maintain thyroid function by increasing conversion of T4 to T3.

Levels of FT4 and FT3 in the lower half of their ranges are also indicative of hypothyroidism, because the ranges are far too broad due to erroneous assumptions used to establish ranges.  You can read about this in Recommendation 2 on page 9 of the following link.  For info about the flawed ranges, have a look at Item 2 on page 4.

http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf

I highly recommend reading at least the first two pages, and more if you want to get into the discussion and scientific evidence for all that is recommended.  

A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  If your doctor is unwilling to treat you clinically, as described, then you might give him a copy of the link and ask him to review and reconsider.  If that fails, then you will need to find a good thyroid doctor that will do so.  

Hypothyroidism frequently causes low stomach acid, which results in poor absorption of vitamins and minerals.  Vitamin D should be at least 50 ng/mL, B12 in the upper end of its range and ferritin should be at least 100.  Ferritin is one of the important variables affect conversion of T4 to T3.  Levels of cortisol and Vitamin D affect metabolism of thyroid hormone.  D should be at least 50 ng/mL. B12 in the upper end of its range and ferritin should be at least 100.  So you need ot test and assure optimal levels.

If I understand correctly you take 60 k of Vitamin D once a month for 3 months.  I expect that you need to take that average amount of 2000 daily for the whole year.  

[gimel]

I don't know where your doctor gets that he "can't do anything"  because your test results are within limits.  Wrong.  There is much to discuss but first please post the reference ranges shown on the lab report for those tests.  Also, if tested for Vitamin D, B12 and ferritin please post those as well.

[rush76]

I have historically been low on Vitamin D, so once a year I take Uprise 60k (1 tablet for 3 months, 1 every month)

Reference range as below

FT3 : reading 2.60 pg/ml (range 1.4-4.4)
Ft4 : reading 0.93 ng/dl(range 0.8-1.8)
TSH : reading 1.96 (range 0.4 - 4.5)
I haven't tested for B12 and ferritin . B12 was tested about 10 months back , again I remember it was within range. Ferritin never tested