thyroid symptoms but normal lab result

[kt878]

I have many symptoms of hypothyroidism:extreme fatigue, weight gain, dry skin, foggy brain, acne, mild depression, but lab results are in the normal range. I had a baby 20 months ago and just want to get back to feeling normal. I have not changed my diet, I exercise frequently and I have always been a healthy weight. Family history of Hashimoto's. No goiter. Lab results are:
TSH 2.170 ( range .450-4.500)
T4 Free 1.32( range .82-1.77)
T3 Free 3.1 (range 2.0-4.4)

Anyone had similar experiences?

[Quedie]

Hi! do you take Armour Thyoid, or Synthroid. I was told a week ago that my thyroid functions where fine, but I feel sluggished, tired, expriencing hair thinning. brain fog,.weight gain. I was told my antibodies where elevated.

[Klaraj7]

I have a family history of Hashimoto's. But every one is different. Some people take iodine,synthetic thyroid, or cortisol. Just because the test came back normal does not mean you do not have it. What has helped me is a gluten-free diet and taking cortisol in the morning so I don't feel fatigued in the morning.

[gimel]

The most important diagnostic for hypothyroidism is symptoms, followed by the biologically active thyroid hormones, Free T4 and Free T3.  Your Free T4 is at 53%, which is slightly above our usual recommendation of mid-range as a minimum.  Your Free T3 is at 46%, which is not bad but everyone has different levels at which they feel their best.  We typically recommend having Free T3 in the upper part of its range, as needed to relieve hypo symptoms.  

Free T4 and Free T3 levels are not the whole story however.  In order to have adequate thyroid effects at the cellular (tissue) level, there are other variables also involved such that serum levels do not always reflect tissue thyroid levels.  That is why it is important to always consider symptoms first, rather than just test results compared to reference ranges that are too broad to be functional for many people.  

So, before deciding you do not have a thyroid problem, the doctor should also test you for Reverse T3 which is a mirror image molecule of T3, but RT3 is biologically inactive.  T4 is converted by the body to both T3 and Reverse T3.  Under some conditions excess RT3 is produced and there is evidence of RT3 binding to cell membrane receptors and producing hypo-metabolic effects.   RT3 is an excellent marker for reduced cellular T4 and T3 level not detected by TSH or serum T4 and T3 levels.  At the same time you get tested for Reverse T3 you should get a Free T3 test from the same blood draw.  The ratio of Free T3 to Reverse T3 is a good indicator also.

Hypothyroid patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin.   Deficiencies in these can also cause symptoms that mimic hypothyroidism.   I suggest that you also test for those and supplement as needed to optimize.  D should be about 50, B12 in the upper end of its range, and ferritin should be about 70 minimum.

If you can get those tests done, then post results and reference ranges and we will be happy to interpret and advise further.