Please verify the reference range for the FT4 result. That's a very narrow range you have listed and your result is actually quite high in the range, at 75% and is more indicative of hyperthyroidism. I've never really seen a range like that, though
Your FT3, on the other hand, is quite low in the range (38%), which is more indicative of hypothyroidism, since FT3 is the hormone used by individual cells in the body.
Your TSH is just about perfect and most doctors would tell you, based on that, that there's nothing wrong with you.
Thyroid Peroxidase Antibodies (TPOab) are high in the range, but not over, so would be considered negative; Thyroglobulin Antibodies (TgAb) would also be considered negative, therefore, you would be considered not to have Hashimoto's. I would, most likely, tend to disagree with that, though, since your TPOab is so close to the upper range and because Hashimoto's is the number one cause of hypothyroidism in the developed world. It should be noted, however, that TPOab can be present with other autoimmune diseases, which can share symptoms with hypothyroidism.
Questions I'd have to ask are: Are you currently taking a thyroid hormone replacement medication?
What actual symptoms of hypothyroidism do you have? Many symptoms can apply to either/both hyper/hypothyroidism as well as other conditions, including some vitamin deficiencies.
Thank you for the reply. I did recheck the free T4 range, it is correct, however the units are ng/dl rather than pg/ml as I had mentioned incorrectly earlier.
I am currently not on any thyroid meds, never have been.
1) cold intolerance
3) Very low testosterone levels
4) weight gain, mainly the visceral fat
5) Bad memory
6) Mild depression
I understand that most of these symptoms are similar to low testosterone as well, but my low testosterone could also be due to hypothyroidism?
Is that the range actually used by your lab? I've never seen a lab use different units in the result than they do in the reference range, so they make the patient have to do the conversion.
Your symptoms are consistent with hypothyroidism, even if your labs don't necessarily bear that out. There are some other things that share symptoms, though that should also be looked at.
Have you actually had testosterone levels tested? While low testosterone often goes with hypothyroidism, being hypo doesn't cause it. There are quite a few other things that do, though and can also mimic symptoms of hypothyroidism... Both testosterone and thyroid hormones are endocrine hormones, which must all work together in order for one to be healthy.
Being overweight is one cause of lowering testosterone and as you know is also a symptom of hypothyroidism. Weight gain is also a symptom of insulin resistance/metabolic syndrome.
Stress (high cortisol levels) decreases testosterone production...
Over consumption of alcohol reduces hormone production.
Vitamin/mineral deficiencies reduce testosterone levels. Some of these vitamins/minerals are necessary for the metabolism of thyroid hormones. Common deficiencies that affect testosterone levels are Vitamin D, zinc, magnesium, selenium and Vitamin A. Vitamin D is necessary for the metabolism of thyroid hormones and deficiency is also known for causing low testosterone levels. Same goes for selenium, which has also been shown to help in the conversion of the thyroid hormone Free T4 to the usable Free T3. Vitamin D deficiency mimics hypothyroidism.
Depression causes low testosterone, endocrine disruptors such as environmental chemicals (chlorine, fluoride, phthalates, parabens, and other chemicals the mimic estrogen), along with poor diet, lack of sleep, over training, some medications, hot baths and tight pants can all cause low testosterone levels.
You should try to rule out as many of the above causes for low testosterone as possible and I would, definitely recommend that you try to get the Vitamin D checked as that test is readily available. The tests for zinc, selenium and magnesium aren't quite so common and that may be more difficult.
All of that said, when I go back to your list of symptoms, I still lean toward hypothyroidism as a cause for your major symptoms, except for the low testosterone. Your big problem will be to find a doctor who will treat you with a TSH of 1.75.
Thanks again for your detailed reply, very helpful. Yes I have got my testosterone checked and its in hypogonadal range. My endo does not think I am hypothyroid but he is willing to put me on TRT for low testosterone. However, I am working towards finding the root cause of my low T and will look into all the causes which you have listed.
Hi Barb I got my thyroid tested again. T3 and T4 are very low but free t3 and free t4 are normal. Does this mean anything?
TOTAL TRIIODOTHYRONINE (T3) 60 ng/dl (60 - 200)
TOTAL THYROXINE (T4) 5.1 µg/dl 4.5 - 12.0)
THYROID STIMULATING HORMONE (TSH) 2.20 µIU/ml (0.30 - 5.5)
FREE TRIIODOTHYRONINE (FT3) 3.2 pg/ml (1.7 - 4.2)
FREE THYROXINE (FT4) 1.44 ng/dl (0.70 - 1.80)
ANTI MICROSOMAL ANTIBODY (AMA) C.L.I.A 7 IU/mL Negative : <34
Total T3 and Total T4 are actually obsolete tests. They show the total amount of hormones produced by the thyroid, much of which is bound by protein and is unusable. The free amounts are what isn't bound by protein and is available for use and those levels are what we go by.
Based on your latest FT levels, it would appear that your thyroid is functioning adequately. Your FT3 is at 60% of its range - rule of thumb is that FT3 should be in the upper half to upper third of the range. Your FT4 is at 67% of its range - rule of thumb is that FT4 should be around mid range, therefore your FT4 is actually higher than it should be.
Have you ruled out the other possibilities I listed above, that could cause your symptoms?
Vitamin B12 deficiency should also be looked at, since it can cause fatigue and brain fog/memory issues.
Are you supplementing the testosterone?
No i am not supplementing testosterone yet as TRT has its own complications, trying to avoid it if possible. Working on bumping it naturally. Started supplementing vitamin D. Will also look into B12. Thanks again, your help is immensely appreciated.
Yes, I know TRT has its own complications, but low can T, by itself can also cause your symptoms.
Have you looked into insulin resistance/metabolic syndrome?
Those symptoms are listed under low testosterone levels. One way to increase testosterone naturally is with saturated fat. Yum. :)
Excerpt from Comprehensive Fitness Solutions - Epic Saturated Fat Experiment - "The Effects of 15 days of 100 Grams of Saturated Fat Per Day on Cholesterol Levels in a healthy adult male"...
"Most significantly, Testosterone increased ~70%, from 586-841 and triglycerides decreased 34%, dropping from 100 to 66. HDL also increased ~27%, from 60 to 76."
Excerpt from Switzer Daily - Saturated fat does not cause heart disease...
"In the March 18, 2014 Edition of the Annals of Internal Medicine, a very large meta-analysis involving 72 studies of around 600,000 people looked at the relationship between saturated fat intake and heart disease, something many august heart associations around the world have been telling us for years was a done deal.
This comprehensive analysis from one of the most respected institutions in the world, Cambridge University, clearly showed that there is no link between saturated fat and heart disease risk."