Unfortunately doctors don't understand that being just anywhere within the so-called "normal' ranges does not mean all is well, because the ranges for Free T4 and Free T3 are far too broad. So when trying to evaluate test results, a good thyroid doctor told me the following.
"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."
A good thyroid doctor will treat a hypothyroid patient by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. So you need to find a good thyroid doctor that will treat you clinically, and adjust your Free T4 and Free T3 levels as needed. Free T4 should be at the middle of its range, at minimum, and Free T3 should be adjusted into the upper part of ts range, as needed to relieve symptoms. Do you think you might be able to get your doctor to treat clinically as described? If not, then if you will tell us your location, perhaps we can suggest a doctor that has been recommended by other thyroid patients.
Also, hypo patient are frequently too low in the ranges for Vitamin D, B12 and ferritin. Low levels can cause symptoms. Low D or low ferritin can also adversely affect the metabolism of thyroid hormone. D should be about 55-60, B12 in the upper end of its range, and ferritin should be about 70 minimum. After testing you can supplement those on your own to optimize.
Sone other possible contributor to your problems is cortisol. Have you tested for that? If not, the best test is a diurnal saliva cortisol test done at 4 times during the day. Doctors don't agree with that and usually only will test a morning serum cortisol test. Cortisol needs to be roughly in balance with thyroid hormone. Low or high cortisol can contribute to hypo problems.
You did not tell us what dosage of NatureThroid you are taking. Also, you mentioned high antibodies. Please post those results.
Thank you gimel. Naturethroid dose is 32.5 & she won't raise it afraid it will race my heart. Still having issues with brain fog, swelling, cold intolerance, tiredness.
Thyroid Peroxidase (Tpo) Ab
Test Low Normal High Reference Range Units
Thyroid Peroxidase (Tpo) Ab 173 0-34 IU/mL
Antithyroglobulin Ab
Test Low Normal High Reference Range Units
Thyroglobulin, Antibody 5.1 0.0-0.9 IU/mL
Test Low Normal High Reference Range Units
Cortisol - Am 12.6 6.2-19.4 ug/dL
Vitamin D3 is 45 a little below the Labcorp range
I'm in central NJ, been to 8 endos in the last 5 years & they all say they are not numbers people then they turn into numbers people when the test results come in within "normal" ranges & I'm still having symptoms which they keep ignoring. My PCP & gyno feel this is all thyroid related & the endo keeps testing various issues like a rheumatology panel but nothing is flagged. Getting very tired of feeling like crap.
Sorry for all the questions, but need more info. How long have you been on the 1/2 grain of NatureThroid? If you have test results from right before starting on that dose, please post them, along with ranges.
Your Vitamin D3 is a bit low. It would be better at 55-60, but that is not a big contributor to your issues. Have you ever been tested for Reverse T3 and also ferritin? If not, do you think you could get your doctor to do so?