Avatar universal

Would you see treatment?

So, lately I have been feeling tired, fatigued, moody, my periods have been irregular, my hair has been falling out, i have nooo energy, dry skin and acne. I went to my doctor and she ran some labs

TSH was 1.3
Ft4 1.1
Ft3 2.9
Total T3 75 (76-181 ng/dl)
Ferritin. 16

I know my tsh is good but dont you think my thyroid hormones are on the low side and thats what is causing my symptoms? Would you seek treatment? I was thinking of trying a natural thyroid replacement to see if it would help
6 Responses
Avatar universal
The only value for TSH is to identify overt hypothyroidism (TSH >10) and to identify primary hypothyroidism from central hypothyroidism.   The most important indicators are symptoms, which you have, and Free T4 and Free T3 levels compared to their reference ranges.  So before going further please post the reference ranges shown on the lab report for those results.  
Avatar universal
The reference ranges are as follows
TSH 1.3 (0.4-4.50 mIU/L)
Ft4 1.1 ( 0.8-1.8 ng/ml)
Ft3 2.9 ( 2.3- 4.2 pg/ml)
Total t3 75 ( 86--181 ng/dl)
Ferritin 16 ( 10-154 ng/ml)
Avatar universal
In the words of a good thyroid doctor, "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."  

So with your symptoms and those lab results clearly you are hypothyroid.  Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  Your ferritin is terribly low.  You need to supplement with a good iron supplement like ferrous bisglycinate, ferrous fumarate, or ferrous sulfate.  Along with that I recommend taking some Vitamin C or magnesium to prevent possible stomach distress from the iron.  Ferritin should be about 70 minimum. You also need to test for D and B12 and supplement as needed to reach about 55 min. for D and and the very upper end of its range for B12.

A good thyroid doctor will treat a hypo patient clinically 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 lab results..  Many members have found that symptom relief required Free T4 at the middle of its range, at minimum, and Free T3 n the upper third of its range, or as needed to relieve symptoms.  

If your doctor is unwilling to treat clinically as described then you need to find a good thyroid doctor that will do so.
Avatar universal
Rule of thumb to feel well is to have BOTH of the following.

1) FT4 to be 50% of the range or a little higher. You are testing only at 30%.

AND - means in addition to #1 above

2) FT3 to be 50% to 67% of the range, leaning more towards the 67%.  You are testing at only 32%.

So both of these are well below the rule of thumb.

Also your Freeitin should be ideally about 70 and you are WELL below that with a measly 16 as well.
Avatar universal
You're TSH readings are different than other blood tests. If you add a hormone to this your TSH will go down such as from a 1.3 to a 1. You do not want to do this or you will make yourself hyperthyroid! You are in a good range. Your TSH is not a current reading of what is going on in your body. Your current TSH tells the doctor what has been going on weeks prior to now. Try biotin and moisturizing shampoo for your hair. Are you eating correctly and getting exercise, sleep? Are you stressed? Sounds like you might be slightly anemic from your ferritin level which can cause all the problems you are describing. Ask your doctor about an iron supplement. This should help. Vit B is good for energy and feeling well
Avatar universal
Patients go to doctors typically because of having unwanted symptoms, as did Kosmos 2301, who had symptoms of being tired, fatigued, moody, irregular periods, hair loss, and dry skin,   Yes, low ferritin can cause a person to be tired/gatigued and hair loss.  But so can being hypothyroid, plus the other symptoms mentioned were irregular periods and dry skin, which are typical of being hypo.  In addition, her Free T4 and Free T3 levels are less than optimal, consistent with being hypothyroid.  

So ignoring her hypo symptoms, and her low FT4 and FT3 and just supplementing with ferritin and trying to de-stress is less than optimal treatment.  She needs an increase in meds as needed to relieve symptoms, which typically requires FT4 at least at mid-range, and FT3 high enough in the upper half of its range to relieve symptoms.   Along with that she needs to find out her Vitamin D and B12 levels.  Of course the extremely low ferritin is a big issue also.  All three of these need to be optimized as mentioned above.  

As for TSH I will be glad to provide information that due to a number of reasons proves that TSH is inadequate as the main diagnostic for potential hypothyroid patients,  When a patient is already taking thyroid med TSH is basically a wasted test because so frequently it becomes suppressed when taking adequate thyroid meds.  That does not mean the patient is hyperthyroid unless there are hyperthyroid symptoms due to excessive levels of Free T4 and Free T3.  So increasing meds and reducing the TSH adequate to relieve symptoms will make Kosmos euthyroid, not hyperthyroid.  
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