Those symptoms should be cause for the doctor to test further. Assuming the T4 test you mention is for Free T4, I expect that your 10.9 result is at the bottom of the range. You also need to know your Free T3 level and should make sure they are both tested every time you go in for tests.
Just because your thyroid test results fall within the so-called "normal' ranges does not mean they are adequate for you. The ranges are far too broad to be functional across their entire breadth for everyone. Note the following quote from a good thyroid doctor. The numbers and ranges are different from yours, but you can get the picture.
"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."
Based on your relatively low TSH, and with your symptoms and test results, it is an indication that there is a dysfunction in the hypothalamus/pituitary system. So you are going to need thyroid med to raise your Free T4 and Free T3 levels adequate to relieve symptoms. Many members say that symptom relief required Free T4 at the middle of its range, and Free T3 in the upper third of its range, or as necessary to relieve symptoms.
Since hypo patients are so frequently low in the ranges for Vitamin D, B12 and ferritin, I also suggest testing those as well. D needs to be about 55-60, B12 in the very upper end of its range, and ferritin should be 70 minimum.
Thank you so much for your reply. I was beginning to think I was going mad!
My Vit D levels are really good when I had them tested as I was taking supplements. However, I think an apt wihpth an endocrologist is in order now.
What's your background? Are you a specialist in thyroid disorders?
Oh and yes I did mean Free T4!
Long suffering hypothyroid patient until I found this Forum 7 years ago and learned about the importance of Free T3. Got mine tested and confirmed as low in the range, even though my Free T4 was at the top of the range, while taking 200 mcg of T4 med. Convinced doctor to prescribe med with T3 and after some tweaking I felt the best I could even remember in the last 30 years or so. I am retired, so since that time I have spent a huge amount of time researching testing and treatment of hypothyroidism so that I can pass that info to other members.
By the ay, you don't necessarily need an Endo, just a good thyroid doctor that will treat clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms. Symptom relief should be all important, not just test results and especially not TSH results. We find that Endos are often very rigid in their "Immaculate TSH Belief' and use of "Reference Range Endocrinology" and pay little attention to symptoms.. Also, being in the UK will give you additional difficulty in getting the testing and treatment needed. One of our UK members who had great difficulty in getting needed testing and treatment was finally successful and told us this.
"What I have learned from my experience is that you have to go to the Dr's office and TELL THEM WHAT YOU WANT and to go backed up with knowledge. You have to tell them that you have done your reading and looked into your condition and care about the long-term treatment of your health and thyroid. If you fight for what you want, you will eventually find someone that is happy to go along with your wishes. But we all have to take charge of our own health, right?"
So here is a link with some good info for you to use to persuade your doctor. If unsuccessful you may have to go private, if that is a possibility.
One other thing to keep in mind is that hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. Low levels can cause symptoms. Low D or ferritin can adversely affect metabolism of thyroid hormone. D needs to be about 55-60, B12 in the very upper end of its range, and ferritin should be about 70 minimum. You should get those tested and supplement as needed to optimize.
Wow - you are very knowledgable - thank you so much for all the information you have provided. I will certaintly be reading all this in more depth in the morning and getting to grips with my next action plan with the doctors!
Thank you again and I'll update again
Well I got my results back!
TSH now 2.07 ( range is .27-4.20) ( previously 1.1 , then 1.7 )
Ferritin 37.7 ( range 20-150)
T4 17.03 ( range 12-22). Previously 10.9 but the range was different - started at 10-30)
T3 4.88 ( range 3.1-6.8).
I have an apt Monday with a thyroid specialist so hopefully he can tell me if I have a slight thyroid issue or not. I just want to feel better ( and warm!)
Based on all of our experiences, the chances of a doctor looking at your lab results and diagnosing hypothyroidism is about 10% at best. Since you are in the UK where they are directed to pay most attention to TSH, chances may even be a bit less than that.
Your Free T4 is right at mid range, which is a good minimum level. Unfortunately your Free T3 is less than 50%, and it needs to be higher, enough to relieve hypo symptoms. In addition your B12 is way too low. Needs to be in the very upper end of the range, so you can supplement on your own to raise that level Also, your ferritin is much too low. Low ferritin can adversely affect conversion of T4 to T3 and may be a cause for your Free T3 being lower in its range than your Free T4 in its range. Also low ferritin can cause the following. Also don't forget to find out your Vitamin D level and supplement as needed to optimize.
• Faster heart rate
• Hair loss
• Foggy thinking
• Memory problems
• Loss of sex drive
• Increased irritability
• Abdominal pain
• Pica, or the compulsive eating of non-food items
• Pagophagia, or the compulsive eating of ice
• Numbness or tingling of extremities
Common Visual Signs
In addition to the list of possible symptoms, those with low levels of ferritin may also have visible signs of deficiencies that can be seen physically. These symptoms may include:
• Easy or excessive bruising
• Paleness of skin
• Brittle nails
• Sores at the corner of the mouth
When my ferritin was about 40 I had to take about 50 mg of a good iron supplement to raise it to 80.
So my best suggestion for your Monday appointment is to take a copy of this list of the 26 typical hypothyroid symptoms, marked up with those you have and give it to the doctor and emphasize those symptoms and the need to raise your thyroid hormone levels adequately to relieve symptoms.
Yay! I've been to see a specialist who is recommended by the Thyroid UK website and I have been diagnosed with adrenal fatigue which is stopping me using my Thyroid. I've started medication which after a few weeks will bring noticeable improvements and then we have to check my symptoms and my thyroid again as once my adrenals are up and running my thyroid will probably struggle and need support.
Finally I feel I have found someone who has listened and I know I'm not mad!
He was shocked at my basal temps and said within 3/4 months I will feel ' normal' again like the person I used to be.
Thanks for your help on here too. My mood has lifted just knowing there's a light at the end of the tunnel.
Thanks for sharing the good news with us.
Hello. I just wanted to update you as I'm feeling so much better!
Thanks to your advice I am on the road to recovery.
My ferritin levels have gone from 37.7 to 79.9 in 5 weeks after taking the adrenal support supplement. I no longer need to nap for 3 hours every day which is amazing.
My tsh levels are still rising and my doctor had said that I might need to take Nutri-thyroid once my adrenals are back up and running.
I just wanted to share the good news that although I'm not yet fully better, I've definitely noticed the difference. Thank you again
Great to hear that you are doing so much better.