Does not make sense to me?

[confusedbydefinition]

I understand that the definition of hypothyroidism is high TSH and low T3 and T4.  My question is this...

If T3 and T4 levels are low T4 = .9 (scale of .8 to 1.8) i.e. in the bottom 11% of normal, and the T3=92 (scale 76 to 181) i.e. in the bottom 18% of normal - why is this not hypothyroidism.  I am tired ALL the time, sleep 12+ hours a day, fatigue easily, have extremely dry skin, am cold all the time, ...  It seems to me that the low T4 and T3 indicate my metabolic rate and energy level are understandably low?

My confusion is that my normal TSH is taken to mean that everything is fine.  I can assure you, it is not fine.

PS All the symptoms started after a total hysterectomy (i.e. included ovaries) - several years ago.

Please explain...  Suggestions???

[specsi]

Is that kind of testing done by an endocrinologist or oby/gyn? I agree that I need to get all of my hormones checked.

[Barb135]

Has either of you had other hormones - estrogen, progesterone, testosterone, etc, tested?  All of these things work "hand in hand" and when some get off, it can throw others off.  AND they can all make you feel horrible.  

[specsi]

I can't answer because I'm still learning about this myself. I just had to comment that my symptoms also started after having a hysterectomy! I didn't have any of the problems I have now.  

[Barb135]

You should ask your doctor to test you for thyroid antibodies to see if you might have Hashimoto's thyroiditis.  Hashimoto's is an autoimmune disease in which your antibodies attack your thyroid and eventually kill it off, so it produces no hormone at all.  You should ask for thyroid peroxidase antibodies (TPOab) and thyroglobulin antibodies (TGab).  You should also ask for a thyroid ultra sound to check for nodules.  

If you have "Hashi", you can have "normal" thyroid levels and still have symptoms.  

Your doctor is not doing you any favors by determining your situation based solely on TSH.  TSH is a pituitary hormone is not actually indicative of what they thyroid is really doing.  Your actual thyroid levels are very low and that could in fact cause the symptoms you are having.  Do you happen to know the actual result of your TSH test?  If it's in the high end of the range, or if your lab is using an "old" range which many do, it would be understandable that you feel "yucky" to put it mildly.  

You are right, most likely all is not fine and if your current doctor won't treat you based on your symptoms as much as your lab results, you might want to think about finding a different doctor.