Latest Lab Results

[cardfan7920]

I have been experiencing a lot of the symptoms that are similar to those with hypothyroidism.  I have a small nodule on my thyroid that appears to be normal per my endocrinologist.  I just got my latest lab results back and my numbers appear to be all over the board.  The doctor (one I have never seen because mine left the practice overnight) says that everything is normal.  If everything is normal, that's great but I am not sure what else can be wrong.  I am constantly cold and tired, I have put on 30 pounds and my hair is falling out.  My lab history is below:

TSH (range of .47-4.68)
6/25/13- 1.79
4/7/14/ 1.94
7/30/14 .49
9/25/14 3.13

T3 Free (Range of 4.26-8.1)
7/30/14- 4.96

T4 Free ( Range of .78-2.19)
6/25/13- 1.26
7/30/14- 1.12

B12 (Range of 211-946)
6/25/13- 266
7/30/14- 440

Ferritin (Range of 6.24-137)
34

Iron & TIBC
Iron (Range 37-181) - 44
TIBC (Range of 265-497)- 304
Iron-Saturation % (Range of 15-55)- 14

Any thoughts on these numbers would be greatly appreciated.  Thanks!

[Red_Star]

A TSH above 2.5mU/L isn't normal for most people. Please note you can have TSH below that range with hypothyroid symptoms. Your free T4 and free T3 are on the lower end which could indicate you don't have enough thyroid hormone in the blood.  Some people are healthy with low normal free hormone levels. Labs need to be considered along with clinical symptoms.

For most people in developed countries, hypothyroidism is due to an autoimmune disease called Hashimoto's thyroiditis. Labs to request to test for this autoimmune disease are thyroid peroxidase antibodies and thyroglobulin antibodies.

Vitamin B12 levels of 200 - 450 pg/mL are considered borderline deficient. Some studies show that serum B12 levels need to be above 550 pg/ml for brain and nervous system health.  Iron is borderline low.

[gimel]

Oh yeah everything is normal, except that your Free T3 and Free T4 are too low in the ranges, consistent with having hypo symptoms like you mention.  Also your B12 and ferritin (iron) are too low and need to be supplemented.  I'd bet my last dollar that your Vitamin d is also too low unless you are already supplementing D.  Keep your doctor's comment in mind as you read the following.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So you need to supplement with B12 to get your level into the upper end of the range.   You need to supplement with D3 to get your level to around 55-60.  You need to supplement with iron to get your ferritin up to about 70-80 minimum for women.  And you need a good thyroid doctor to treat clinically as described, to get your Free T3 and free T4 high enough to relieve hypo symptoms.  If you will tell us your location, perhaps we can recommend one in your area.