In the words of a good thyroid doctor, ""The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms." Of course these ranges are different than yours, but if you convert them to percentages of their ranges, then the doctor is saying that if the FT4 is below 50% of the range, and the FT3 is below about 60% of its range, then hypothyroidism is likely the cause of a persons symptoms.
Looking at it that way, your Free T4 is only at about 39% of its range, and your Free T3 is only at 33% of its range. So they are in the so-called "normal' range but not optimal, because the ranges are flawed.
I'm sure you have heard of postpartum thyroiditis, which occurs with about 5% of women and usually within the first 12 months after birth, and it causes inflammation of the thyroid gland. Symptoms can actually be either hypo or hyper. If it were that I don't think you would see the relatively low TSH along with relatively low FT4 and FT3.
What, if any, symptoms did you have before pregnancy? Do you have any other symptoms now?
Have you been tested for Vitamin D and ferritin (an iron related test)?
Let's start with your ferritin level. Note the following quote from a reliable source.
"Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone. Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present".
Also some info on symptoms that can be caused by low ferritin.
Loss of energy
Loss of libido
Shortness of breath
So low ferritin symptoms can mimic hypothyroidism. Shortness of breath is also a symptom of low ferritin levels. 93% of patients with ferritin under 50 ng/ml were iron deficient. Excessively low ferritin as well as low iron can result in hyper symptoms when raising desiccated thyroid (armour). Severely low ferritin or iron can be improved quickly with iron injections or IV iron infusion - a few weeks as compared to a few months from iron supplementation.
Also from another source, "If iron is lacking, metabolism simply cannot run at an optimal pace, resulting in all the symptoms of hypothyroid—even in the presence of normal T4 and normal T3."
So with your ferritin being so low, you might want to talk with the doctor about iron injections to get your level optimized. Your Vitamin D is only a bit low of optimal of 55-60, so a daily supplement of D3 should also be discussed. Also, in view of your symptoms and your relatively low Free T4 and free T3, I would ask the doctor about the possibility of central hypothyroidism and a therapeutic trial of thyroid medication adequate to raise your Free T4 above the middle of its range, and Free T3 into the upper 1/3 of its range, or as needed to relieve symptoms.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve hypo symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH. If your doctor is unwilling to treat clinically then you are going to have to find a good thyroid doctor that will do so.
I did not notice that hair loss was not in that list. Note the following.
"Research has shown that a large proportion of women reporting hair loss had low ferritin levels, compared with the levels generally found in women without hair loss, and interestingly in men. The main reason for this difference is due to the loss of blood during menstruation, which is just enough to cause a gradual depletion of iron stores, particularly in women who eat little or no red meat.
Low iron intake has been known for some time to be a potential problem for millions of women, but it is only now that it is recognised that this factor can contribute to increased hair shedding, and that this condition is really quite common.
In fact, in a recent survey of 500 women, it was found that a staggering 33% reported hair loss. This was observed as an increase in the amount of hair shed or a reduction in the length grown, both of which contribute to a reduction in hair volume if the problem persists for any length of time.
So if you believe your hair has less volume than it did a few years ago you can at least console yourself with the fact that 1 in 3 women also consider themselves to be in the same position. If your diet has little or no red meat and/or you suffer heavy menstrual bleeding then this increases the likelihood that a dietary imbalance is causing the problem.
Correcting the imbalance can increase the length of hair growth
Research has shown that if the iron deficiency is corrected and the serum ferritin level is raised to a certain 'trigger point' then hair growth will start. In fact, what actually happens is that the growing stage of the follicles is lengthened so there are, at any one time, more hairs in the growing stage.
This means that hair volume will start to increase and any excessive shedding will reduce. But this takes several months because ferritin levels can only be raised gradually and once the 'trigger point' is reached and hair growth starts, it takes 2-3 months for the shedding to reduce and another 3-6 months for the new hair to reach a length that contributes to hair volume."
I was also going to mention that hypo patients are often too low in the ranges for Vitamin D, B12 and ferritin. Low levels can cause symptoms. Low levels of D and ferritin can adversely affect metabolism of thyroid hormone. When I did some looking about possible causes for high folate, I found this to be a possible clue.
"Pernicious anemia may cause high serum folate levels, due to impaired utilization of folate. According to a 2006 article by Florence Aslinia, M.D., and colleagues, published in the journal "Clinical Medicine & Research," if you are a person with a vitamin B12 deficiency caused by pernicious anemia, your serum folate levels will tend to be increased, ...."
Still reviewing my blood test, and came up with another question... Any reason why my folate level would be high? It's just out of range and seems kinda odd.
Increased folic acid serum may be due to:
* Supplementing with folate/high dietary intake of folate
* Vitamin B12 deficiency
* MTHFR genetic defect
* Blind loop syndrome
Just to add though, my sister and I have autoimmune pernicious anaemia and we did not have high folate with vitamin B12 deficiency. I had low normal folate and my sister had folate deficiency. I do eat way more vegemite than my sister does though (vegemite is high in folate). :)
Just realized my prenatal vitamin had a high amount of folate! Kinda a no brainier haha. Thanks for the reply!