Avatar universal

Is my thyroid functioning optimally?

I got my lab results back from my blood work, with my thyroid being the main concern. My TSH is a 1.98 in a .30 to a 3.00 range, my free t3 is a 3 in a 2.5-4.00 range, my free t4 is a .95 in a .60-1.5 range. I know these numbers are considered "normal" but are they "optimal"? I had a baby six months ago and my eyebrows and lashes have been shedding like crazy, that is why I intially got the test done.
6 Responses
Avatar universal
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)?

Thank you for the reply. The lash and brow loss started in the last three months of pregnancy and has been happening continually, although the hairs are growing back, just falling out at a faster pace. That has been the biggest symptom if I can call it that. More recently within the past couple weeks I have been having waves of sickness were I feel generally weak, sick to my stomach, have bad acid reflux, nausea, and sometimes a racing heartbeat. I have no clue if this is all connected or not. Most people tell me to chalk it up to changing hormones, I just want to feel 100% again. My Vitamin D, 25 Hydroxy is 49.9 in a 30.00-100 range, my Ferretin level is a 14.4 in a 11.0-307.0 I have no clue if these are optimal ranges or not. Any info on this would help a ton! Before pregnancy I had no symptoms and have always had great health. I am only 20 years old, and don't want to have to worry about thyroid problems...
Avatar universal
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.

  Minor aches
    Heart palpitations
    Increased pulse
    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.  
Thanks so much that information it is great to know! I have an appointment with my doctor but it's not for another two weeks, and I wanted to know as much as possible before the appointment. The low Ferretin symptoms feel exactly like what I'm going through, plus the hair loss. I will definitely supplement D3 and ask about the iron injections. Thank you so much for your help, another thing that came up as odd on my blood test was high folate levels...42.4 in a 6.5-40.00 range. Any clue why that is?
Avatar universal
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, ...."
Great info, this makes me feel like it all can be fixed. Thanks so much! I will do more research but I feel like I know a lot more now about what is causing my symptoms.
Thanks so much for the info. I feel like I know a lot more about why I'm having these symptoms now! I'm going to try and improve all my levels with diet and supplement. Curious to see what my doctor will recommend, but regardless I feel like I can now take my healthcare into my own hands. Thanks so much.
Avatar universal
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.
1756321 tn?1547095325
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). :)

Avatar universal
Just realized my prenatal vitamin had a high amount of folate! Kinda a no brainier haha. Thanks for the reply!
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
Avatar universal
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
The first signs of HIV may feel like the flu, with aches and a fever.
Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
Millions of people are diagnosed with STDs in the U.S. each year.