Doc says tsh normal, but I am exhibiting hypothyroidism

[Tomiro1]

Hello, I live in the Uk, and I was wondering if anyone could help interpret my blood work results. I seem to be exhibiting hypothyroid symptoms, but my docs says I have normal thyroid function, but my hair is falling out I have gained 30lbs and can't seem to shift it with diet and moderate exercise, I am losing some hair eyebrow eyelash foggy memory really bad. Please help if you can. Need to know if iam rt3 dominant and leptin resistant. Also I have some nodules in both sides of my thyroid.
Bld work
Hematology
Active b12.                               124 pmol/L
Folate(serum).                          10.8 ug/L

Biochemistry
Magnesium.                              .87mmol/L
Ferritin.                                       101ug/L
Serum zinc.                                14.6umol/L
Selenium.                                    123ug/l

Endocrinology
T4.                                               114nmol/L
TSH.                                             1.22mIU/L
Free thyroxine.                             14.7pmol/L
FreeT3.                                         5.0pmol/L

IMMUNOLOGY
Thyroid antibodies.                      
Thyroglobulin antibody.                  26.6IU/mL
Method used for anti_tg: Roche modular
Thyroid peroxidase antibodies.      22.5 IU/mL
Method used for anti-TPO: Roche modular

Endocrinology
Triiodothyronine (T3).                      2.1nmol/L

Special pathology
Reverse T3.                                     22.8ng/dL

Endocrinology
25 OH vitamin D.                              85 nmol/L

Special pathology
TSH receptor antibodies.                .43. IU/L

Please help. Tired of my doc looking at me like I am imagining things.

[Barb135]

Will look forward seeing further results.  You'll get it sorted out, eventually; just be persistent and don't stop until you've found the answers.

[Tomiro1]

Thanks Barb, I will talk to my doc and have him prescribe the test you mentioned and discuss further with him and get back to the forum. Hope I can sort this out.

[Barb135]

Going down your list of  blood work,  I have to say that your B-12 levels are good, at 71% of the reference range.  Your folate is also good.

Your magnesium is rather low in the range, which could cause some of your symptoms.  Low magnesium can cause multiple symptoms, including muscle weakness, irritability, nausea, etc.

Both your ferritin and zinc are good.  Your selenium is actually over range, and selenium can be toxic if levels are too high.  Symptoms of too high selenium can include:  a garlic odor on the breath, gastrointestinal disorders, hair loss, sloughing of nails, fatigue, irritability, and neurological damage.

Both your TSH and FT3 are good.  Your FT3 is actually at 78% of its range; many of us on replacement hormones would love to have FT3 levels up there.  Your FT4, however, is quite low in the range, at only 27%, and could indicate that your thyroid production is beginning to decline.

The thyroid produces mainly T4, which is converted to T3 prior to use.  It often takes a while for T3 to track T4, either up  or down.

I'm not an expert on the rT3 issue and I don't really put a lot of stock in it, most of the time, because it's normal for the body to convert some T4 to rT3, as well as to FT3.  If I did the calculation correctly, I came up with a ratio of 1.7, which, while not "perfect", in my opinion, does not indicate rT3 dominance, either.  It's the same as mine, which was determined to be just fine.

Your vitamin D level is good.  

Your antibody levels are negative for autoimmune thyroid disease. Nodules on the thyroid are very common; I've read that they can be the basis for Hashimoto's diagnosis even if antibodies are negative, but that seems to be controversial.  Possibly, your antibody levels haven't ramped up and they'll be higher, at some point in the future.

There aren't any tests listed that would indicate leptin resistance.

I would have to ask if you've had blood sugar levels tested - not just fasting blood sugar levels, but the hemoglobin A1c test, as well as glucose tolerance testing, insulin levels, etc.  The goal with these tests would be to determine if you might be insulin resistant.  Insulin resistance can also cause weight gain/inability to lose.

Do you know what your cholesterol and triglyceride levels are?  High cholesterol is a symptom of hypothyroidism and it's also a factor in a  condition called metabolic syndrome, which consists of the following: increased blood pressure, a high blood sugar level, excess body fat around the waist and high triglyceride, low HDL cholesterol.  Any one of these conditions, alone is not metabolic syndrome, but 3 of them, together is.

While I can't specifically say that your symptoms are thyroid related, neither can I specifically say they aren't, because the possibility exists.  The possibility also exists for other things to be the cause of your symptoms, since multiple conditions can present the same symptoms.  You should ask your doctor for further testing of the things I mentioned, if they haven't already been done.

[Tomiro1]

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Tomiro1
Hi guys thus is an updated version with my ranges included.
Hello, I live in the Uk, and I was wondering if anyone could help interpret my blood work results. I seem to be exhibiting hypothyroid symptoms, but my docs says I have normal thyroid function, but my hair is falling out I have gained 30lbs and can't seem to shift it with diet and moderate exercise, I am losing some hair eyebrow eyelash foggy memory really bad. Please help if you can. Need to know if iam rt3 dominant and leptin resistant. Also I have some nodules in both sides of my thyroid.
Bld work
Hematology
Active b12.                               124 pmol/L.     25.1-165
Folate(serum).                          10.8 ug/L.       4.6-18.7

Biochemistry
Magnesium.                              .87mmol/L.     .60-1.00
Ferritin.                                       101ug/L.        13-150
Serum zinc.                                14.6umol/L.     11-18
Selenium.                                    123ug/l.         53-105        

Endocrinology
T4.                                               114nmol/L.       59-154
TSH.                                             1.22mIU/L.       .27-4.2
Free thyroxine.                             14.7pmol/.L      12-22
FreeT3.                                         5.0pmol/L.        3.1-6.8

IMMUNOLOGY
Thyroid antibodies.                      
Thyroglobulin antibody.                  26.6IU/mL.      0-115(negative)
Method used for anti_tg: Roche modular
Thyroid peroxidase antibodies.      22.5 IU/mL.      0- 34
Method used for anti-TPO: Roche modular

Endocrinology
Triiodothyronine (T3).                      2.1nmol/L.    1.3-3.1

Special pathology
Reverse T3.                                     22.8ng/dL.      9- 35

Endocrinology
25 OH vitamin D.                              85 nmol/L.        50-200

Special pathology
TSH receptor antibodies.                .43. IU/L.            1.5 - 1.75   Borderline      
                                                                                                     Negative
SPECIAL pathology:
Reverse T3.                                       22.8ng/dL.        9 - 35

Please help. Tired of my doc looking at me like I am imagining things.

[Red_Star]

Okay well sorry I just read that is active B12. Could be normal then. :)

[Red_Star]

You have vitamin B12 deficiency. Treatment is needed ASAP.  And to add optimal vitamin D is 100 - 150 nmol/L.

Info from Vitamin B12 awareness...

"What are the Causes of B12 Deficiency?

Decreased stomach acid
Atrophic gastritis
Autoimmune pernicious anemia
Helicobacter pylori
Gastrectomy, intestinal resection
Gastric bypass surgery
Malabsorption syndromes
Crohn’s disease
Celiac disease (gluten enteropathy)
Chronic pancreatitis
Bacterial overgrowth (small bowel)
Fish tapeworm
Alcoholism
Malnutrition—Eating disorders
Vegetarianism
Advanced liver disease
Transcobalamin II deficiency
Inborn errors of B12 metabolism
Certain drugs
Nitrous oxide"