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High thyroid antibodies, normal thyroid results, no estrogen or testosterone

My wife Beth, is 48 years old and exercises religeously and has been fit and healthy her whole life. Beth has been feeling absolutely horrible for the past 6 months, showing many symptoms, fatigue, no sleep, hair loss, irritability, constipation, hoarseness, intolerance to cold, weight gain, muscle weakness, loss of balance. Beth went to an endocrinologist and had full blood work done. Beth received the following results. High level Anti-Microsomal Ab (Thy. PEROX) 83 High <35
Estradiol, Serum 7.07. Testosterone Free + Total w/ SHBG, Albium. Albium 5.0 within range. Testosterone,  TOT.,S <2.5 Very Low. Sex Horm Bind Glob 118 Normal. Free Testosterone Can't Calc.
T3, free (FT3) 3.1 normal. Thyroxine, Free (FT4) 1.27 normal. Thyroid Stimulating Hormone (TSH) 1.93 normal. Lastly Vitamin B-12, 1326 High.
High antibodies,  normal thyroid, no hormones, high B-12, and all these symtoms. Where do we start? What is recommended?
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Please post the reference ranges for the Free T3 and Free T4 tests, as shown on the lab report.  Test results should always be compared to their reference ranges.  Also, what did the Endo say about all those results?
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649848 tn?1534633700
COMMUNITY LEADER
We need to know the reference ranges for the Free T3 and Free T4, as ranges vary lab to lab and have to come from her own report.

Just because your wife's thyroid hormones are in the "normal" range doesn't mean they are normal for her.  They can be in range and still be inadequate.

The low testosterone in men can have an effect, as well, as it can change how thyroid hormone is used in the peripheral tissues. From what I've read it should work the same in women, but I'm still researching that.

The high antibodies would indicate that she has Hashimoto's Thyroiditis, though they can be present in small numbers with other autoimmune diseases, as well.  There's another antibody test that's typically done to diagnose Hashimoto's, called Thyroglobulin Antibodies (TgAb)... both should be done, since many of us often have one or the other, some have both.  Sometimes a person will have a small amount of one antibody and a large number of the other... Just for clarification, you can ask for the TgAb, but it's probably not necessary.  A thyroid ultrasound can also confirm Hashimoto's.

Vitamin B-12 is water soluble and isn't toxic so the high level isn't really a concern.  My question on that would be whether she supplements B-12 or not.  If so, she could probably back off on the supplement.

Did she have vitamin D or ferritin tested?  Vitamin D deficiency can cause some thyroid like symptoms and vitamin D is necessary for proper thyroid hormone metabolism.  Ferritin is the iron storage hormone and iron is used in the conversion of the Free T4 storage hormone to the active, usable Free T3.
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