Hi there...I hope I've seen your post in time...
In one word: No... normal on a lab report isn't always normal for you... We're all different and need different levels of hormones to feel well.
We really need the reference ranges for the Free T4, since ranges vary from lab to lab, but comparing your Free T4 to ranges we, typically, see, we can figure that it's pretty low in the range. Your TSH is also low in the range.
TSH is meant to stimulate the thyroid to produce thyroid hormones and with your low Free T4 as low as it looks to be, we'd expect your TSH to be much higher than it is.
Since, both, TSH and Free T4 are low, it would appear that your problem is Central or Secondary hypothyroidism, rather than Primary hypothyroidism, which is what your doctor would have been looking for. She probably looked at the TSH, saw that it was low and didn't go any further, which is what happens all too often.
With primary hypothyroidism, the problem is that the thyroid stops working, which is why TSH keeps rising in an effort to stimulate the thyroid. With secondary hypothyroidism, the thyroid actually works just fine, but there's a problem with the pituitary/hypothalamus, so there isn't enough TSH to stimulate the thyroid, which is why, both TSH and FT4 are low. Either way, it's hypothyroidism and needs to be treated.
When you see your new doctor, be sure to point this out and ask her/him to add Free T3 to the Free T4 and TSH tests that s/he will undoubtedly order. Just to be on the safe side, s/he should also order thyroid antibody tests to rule out/confirm Hashimoto's, which is an auto-immune thyroid condition. The tests you need for that are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb). You need them both, as some of us have one or the other and some have them both. If both are not done, you risk misdiagnosis.
Well that was a huge waste of time. My doctor refused to test my T3 because its "too controversial" and not many people believe in it to determine an issue. He did claim my T4 is low but that my TSH looks good cause low is high and high is low. My head is spinning!!
He is very old. Lol Makes me think maybe he is a little closed minded to things like this. He said if I wanted to further test, to see an endo, cause my t4 is low. He said that can be indicative of an issue. No kidding! That's what I'm saying! I'm making an appointment for tomorrow with a female endo. Fingers crossed.
The only test which is very reliable to test thyroid problems is Free T4 so even if your TSH is normal or low and if your Free T4 is close to low reference range (provided you not took levothyroxine or other thyroid medication for at least 24 hrs before blood draw) then you need thyroid hormone pill.
The treatment approach is to make Free T4 come close to middle of reference range by taking levothyrxine or NDT or a combination. For this also need to make sure not take levothyrxoine or other thyroid horomone pills for at least 24 hrs before blood draw otherwise it might show false high.
T3 also have major role in subsiding symptoms as its the active hormone but T4 is the basic which need to be addressed and in no point Free T4 should go close to low reference range as T3 half life is very small but T4 very high (acts a s a buffer or storage hormone) and thus very crucial to maintain optimal levels.
2 pm today I'm going to a female endo. I really hope she listens. There are a dozen doctors in the group so hopefully someone can help me. You ever feel like you KNOW what's wrong but no one will help you?! I could just cry....
I want to say thank you for all of your responses. I went today and had an appt with an endo. She was nice and asked a lot of questions about my symptoms. She mentioned that I definitely needed to retest my TSH as well as all the antibody testing because autoimmune disorders run in my family. She also mentioned that since my weight gain was sudden (30 lbs in 3 months) she wants to test me for Cushings Disease, a cortisol disorder. My lifestyle is super high stress, so that kinda makes sense...
It doesn't look like she ordered the Free tests. She did order 2 cortisol and creatinine tests.
:-) Good luck!
Anyway if doing the Free T4 and Free T3 test along with TSH and if on that result too see a low Free T4 level as before,
FREE T4 range: 0.8 - 1.8 NG/DL result: 0.9 NG/DL
then no matter what your TSH or Free T3 value is you need to take either levothyroxine or NDT or a combination of both as hypothyroidism is there and no need to do any further test to confirm it as maintaining an optimal Free T4 is very crucial.
Generally if Free T4 level is low like .9 then TSH value will be raised much high but if have central hypothyrodism then TSH will not increase. Your case is similar like this so don't let your doctor dtermine whether you need replacement pill based on TSH value, tell to he or she, about central hypothyrodism.
More about central hypo here
Just got my antibodies test back and the Peroxidase was at a value of 40 with a standard range of <9
So the doctor emailed me and said that I need to be periodically monitored because of my elevated antibody levels, but don't need treatment :( I'm so devastated
Obviously it is time for you to see a good thyroid doctor. I have sent you a PM with a few candidates in your general area. To access the PM, just click on your name and then from your personal page click on messages.
Thank you very much! Sadly, that was a thyroid doctor. I appreciate your help!
An Endocrinologist is not necessarily a good thyroid doctor. A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resulting TSH levels. Symptom relief should be all important, not just test results. Clearly that was not the case with your recent doctor experience.
Ohhh. I see. I emailed her back asking to retest the Free t4 and t3. We'll see what she says