do I have hypothyroidism

[claud23]

Good evening everyone,

I received my results Endocrine Review:

tsh 3.21 mUI/L (0.27-4.20)

Ft3 5.63 pmol/L (3.90-6.80)
3.70 pg/ml (2.57-4.47)

T4l 17.40 pmol/L (11.00-22.00)
1.36 ng/dl (0.86-1.72)
Tell me please if I have to make thyroid ultrasound (prescribed by my endo) or not
for info i have all the symptoms of hypo which includes a tiredness immense feeling of exhaustion, diffuse hair loss to see my hair all over my body, chills to the point of taking a shower is vertigo, skin problem, to less effort my heartbeat panic or sometimes slowed down, mood jump, irritability ... etc the list and long.

[gimel]

We have found that the more you know about hypothyroidism, the more effective you can be at getting the testing and treatment needed from your doctor.  If you want to do a bit of reading about hypothyroidism, read at least the first two pages of the following, and more if you want to get into the discussion and scientific evidence for all that is recommended.  

http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf

[gimel]

There is nothing in those test results that clearly show hypothyroidism.  Your Free T4 is at about 58 % of its range, which is adequate.  Your Free T3 is at about 59% of its range, which is usually adequate for many people.  Your body's conversion of T4 to T3 appears to be good.  TSH is not a good indicator of thyroid status unless it is at high levels, which yours is not.  You have a number of symptoms that may relate to hypothyroidism due to causes other than just thyroid hormone levels, or  other possible causes.

First thing to note is that contrary to what many doctors believe, hypothyroidism  is not just caused by insufficient thyroid hormone, correctly sensed by the hypothalamus/pituitary which then secretes TSH.  Hypothyroidism is best defined as insufficient T3 effect in tissues throughout the body due to inadequate supply of, or response to, thyroid hormone.  This Tissue T3 Effect is what determines your status as hypothyroid, euthyroid or hyperthyroid.  The big difference in definition is that there are numerous processes and variables that affect Tissue T3 Effect.  Some of the more important variables are cortisol, Vitamin D and ferritin.  In view of your tiredness I would also include B12.  

From your test results and symptoms I don't see the need for an ultrasound test, at least at this point anyway.   I suggest that instead you get tested for cortisol, Vitamin D, B12 and ferritin and then supplement as needed to optimize.  D should be at least 50 ng/mL. B12 in the upper end fo its range, and ferritin should be at least 100.   It might also be a good idea to request a test for Reverse T3, along with a Free T3 from the same blood draw, to assure the ratio of FT3 to RT3 is adequate.  Do you think you can get these tests done?

[claud23]

thank you for your reply, Really I appreciate your help