Lab Work Questions

[Sunnyday01]

I have some lab work that falls in "normal" ranges but all symptoms point to hypothyroid! need help!
Symptoms are:
fatigue
low sex drive
hair loss
weight gain/cant get it off despite exercise and diet
night sweats  hot/cold symptoms during the day
memory loss/lack of concentration
kidney stones (parathyroid)
mood swings
I just dont feel right and feel like something is wrong and getting worse

Blood work done 6/18 and 6/22
TSH 0.86 uIU/mL 0.30 - 5.00 uIU/mL
Free T4 (FT4) 0.97 ng/dL 0.80 - 1.80 ng/dL
Free T3 (FT3) 3.3 pg/mL 2.3 - 4.2 pg/mL
Calcium 9.8 mg/dL 8.2 - 10.2 mg/dL
Vit.D 21 ng/mL >20 ng/mL

[Sunnyday01]

lol ok just making sure i was understanding.
After my initial TSH came back my PCP sent me to my GYN to have a few hormones tested along with the FT3-FT4, he was reluctant to test but tested a few anyways, Without knowing when my last true menstrual cycle was the only thing that came back low was progesterone which was low at 0.7. After talking with the PCP this morning she insists its all normal bloodwork levels so I did discuss the possibility of Secondary Hypothyroidism, she doesn't think so but gave me a referral to an Endocrinologist so we'll see how that apt goes.
Thanks For all your advice its much appreciated and has given me some insight on a direction to go in

[Barb135]

Duhhhh... my mistake!!! I missed the dates above the tests and didn't realize the results above are the new tests you've just had done; I thought you were "getting" tests done!!! Sorry for that.  

I stand by what I said, originally; your Free T4 is much too low in the range, indicating that your thyroid is not producing and adequate amount of thyroid hormone.  

Your thyroid produces, both, T4 and T3, but mostly T4.  Of the total T4 produced, most (about 95%) is bound by proteins and can't be used, which is why we test the Free T4.  Free T4 isn't used, directly; it must be converted to T3, which is where most of the T3 in our bodies comes from.  

Like T4, most of the T3 is bound by protein and can't be used, which is why we test Free T3.  Free T3 is the hormone that's used by nearly every cell in your body  and should be higher in its range than Free T4.

Central hypothyroidism is still hypothyroidism and needs to be treated with replacement thyroid hormones, just like hypothyroidism caused by an autoimmune condition or any other cause.

Since the pituitary is called the "master gland", some people with Central hypothyroidism also have other conditions caused by low pituitary hormones.  You should ask your doctor to test other endocrine hormones, including reproductive, adrenal and pancreatic hormones, as well.

[Sunnyday01]

The results I posted were copy and pasted right from my record online, it said free in the title of the lab test, is that what I'm looking at?

[Barb135]

I hope the T3 and T4 tests were v Free T3 and Free T4... If not specified Free, you will get the totals, which are obsolete and not very useful... Be c sure to pay results when you get them.

[Sunnyday01]

Thanks for responding. I went in for a hormone panel yesterday and had to convince the dr to add the t3-t4 test to it since I was getting my blood drawn again anyways and he was very reluctant to do it as the tsh levels were normal but, I'm glad it was done! I'll have to make an apt with an endocrinologist to get things going with a diagnosis. Thanks for all the helpful info to get me going in the right direction

[Barb135]

While your labs all fall within the "normal" lab ranges, they certainly wouldn't be "normal" for most of us and it's understandable why you don't feel well.  

Most of us find that we feel best with Free T4 about the mid range point; yours is only at 17% of its range, which means that your thyroid is not producing at an optimal rate.  

Likewise, most of us find that we feel best with Free T3 in the upper half to upper third of its range; yours is at 47%, which isn't "horrible", but considering that your FT4 is as low as it is, we'd expect your FT3 to begin dropping soon, since the majority of FT3 is converted from FT4.  That means that almost all of the FT4 your thyroid is producing is currently be converted in order to keep you going...

With thyroid levels like yours, we'd expect to see TSH higher than yours, and since your TSH isn't elevated as it, typically, is with hypothyroidism, we'd have to suspect Central or Secondary hypothyroidism, which is a problem with, either, the pituitary or hypothalamus gland, not the thyroid gland, itself.  Many doctors miss Central hypothyroidism, because they only look at TSH and since it's in range, they think all is well.  You'll need to discuss this possibility with your doctor or find another doctor that's willing to explore that possibility for you...

In addition to low thyroid hormone levels, your vitamin D level is way too low.  Optimal vitamin D is, at least, 60.  Like most other labs, many doctors think that as long as it's "in range", anything is okay... Vitamin D deficiency can cause many hypo-like symptoms.