Help! Hypo?! Total T3 low and Free T4 low?!

[andeflora1]

I just got test results back and I have many symptoms of hypo. I have horrible dry itchy skin, im always exhausted, hair is falling out, scalp is flaking and itchy all of the time, constipation and in the last 2 years I have gained 40lbs. Until I was 23 I was 106lbs and wore a size zero. No matter how many miles I run a day or how many salads I eat I keep gaining weight. Both sets of test were taken at the same time of day, if that matters. The endo I am seeing does not want to treat since the TSH is normal and the others are low but normal.

May 2014
TSH 0.93 range .5-4.5
Free T4 0.9 range .82-1.77
Total 82 range 71-180

August 2013
TSH 1.46 range .5-4.5
Free T4 1.0 range .82-1.77
T3 110 range 71-180
Also in August an ultrasound showed the left side of my thyroid was enlarged and very lumpy but the right side was normal.

Any help would be much appreciated!!!!!!!!!!!!
Thanks, 
Andrea

[andeflora1]

Thanks Barb I will have him look at my pituitary!

[Barb135]

Not everyone has "typical" hypothyroidism.  It's possible that your TSH is low because your actual hormone levels haven't gotten low enough to get your pituitary gland going.  

It's also possible that there's really nothing wrong with your thyroid, but your pituitary gland isn't producing TSH to stimulate it into producing hormones.  You might need some pituitary tests done.

You should be aware that Total T3 is considered obsolete and of little value.  When you have testing again, ask for Free T3, along with the Free T4 and TSH.

Since your thyroid was enlarged, with nodules, you should also ask for thyroid antibody tests to confirm/rule out Hashimoto's Thyroiditis.  The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  Both are markers for Hashimoto's, so you need them both.  Some of us have only one of them, while others have them both.  

[andeflora1]

Scheduled an appt with Endo in 2 weeks. I really hope he will treat me based on my sypmtoms and not just my labs. The TSH isn't too bad, but the Free T4 and Total T3 are just barely above the low end of the range.    

PLEASE I need some ideas of what is going on?!?! Typical hypo is high tsh and low free T4 and low total t3. So why are all 3 low???