On first glance, everything looks peachy, but taking a closer look, your Free T4 is extremely low in it's range (8% of range when it should be about mid range), which indicates that your thyroid is barely producing any T4 at all. T4 is the main hormone produced by the thyroid, which is then converted to T3 for use by individual cells in the body. Your Free T3 is even less than is typically needed at only 42% of range, when it should be in the upper half to upper third of its range.
Typically, with lower thyroid hormones, we'd expect to see higher TSH which would indicate hypothyroidism caused by thyroid malfunction. However, there is another type of hypothyroidism called Central or Secondary hypothyroidism. With Central hypothyroidism, the thyroid works fine, but there's inadequate TSH to stimulate the thyroid to produce hormones. This is caused by malfunction in the pituitary or hypothalamus glands.
Many doctors miss Central hypothyroidism because they depend on TSH to determine if one is hypothyroid and since TSH is "normal" or low with Central hypothyroidism, they assume that all is fine, when in fact, actual thyroid hormones are typically way too low.
This is still hypothyroidism and needs to be treated with replacement thyroid medication just as any other type of hypothyroidism.
If you haven't been tested for Vitamin B-12, Vitamin D and Ferritin, you should ask for those tests as well. Vitamin B-12 deficiency can also cause debilitating exhaustion and all 3 are needed for proper production/metabolism of thyroid hormones.
Even though the antibody tests indicate you don't have Hashimoto's, a thyroid ultrasound would be in order to determine if you have nodules on your thyroid.
Most doctors have the "Immaculate TSH Belief", by which they only pay attention to TSH and if it is in range, they tell you your symptoms are not thyroid related. This is very wrong. TSH is useful as a diagnostic only when it is at extreme levels. TSH has only a weak correlation with the thyroid hormones Free T4 and Free T3, and a negligible correlation with the all important "tissue thyroid status" and related symptoms. If the doctor goes beyond TSH it is usually to test for Free T4 and then use "Reference Range Endocrinology", by which they will tell you that a test that falls anywhere within its reference range is adequate. This si also very wrong. Due to the erroneous way that Free T4 and Free T3 ranges are established, they are far too broad and skewed to the low end. Also each person can have a different equilibrium among TSH, FT4, and FT3 at which they feel best.
The best way to diagnose a potential hypothyroid patient is with an evaluation for signs and symptoms that occur more frequently with hypothyroidism than otherwise. You have a long list of those. The symptoms evaluation should be accompanied by testing for Free T4, Free T3, TSH, TPO ab if TSH is high, TG ab if TPO ab is normal, cortisol, Vitamin D, B12 and ferritin. The latter 4 are because of their effect on thyroid and symptoms.
Your test for TSH and TPO ab and TG ab confirm you do not have Hashimoto's Thyroiditis, which is autoimmune system related Your relatively low TSH is indicative of central hypothyroidism. With central, there is a dysfunction in the hypothalamus/pituitary system resulting in inadequate output of TSH necessary to stimulate the thyroid gland to produce enough hormone. Your FT4 of .68 is only at 10% of its range, which is too low for most people. Your Free T3 of 3.4 is 42% of its range, which is too low for some people. Your Free T3 being higher in range than Free T4 is indicative that your body is trying to convert T4 to the usable T3 as much as possible in an effort to meet your body's needs.
So your signs/symptoms are indicative of hypothyroidism and your lab test results also are indicative of the same. A good thyroid doctor would recognize this and treat you clinically with thyroid med (both T4 and T3 if needed) to raise your FT4 and FT3 levels above mid-range and then adjust FT3 from there as needed to relieve your hypo symptoms. Symptom relief should be all important, not just test results, and especially not TSH results.
In addition you need to get the other listed tests done and see if you need to take action on any of those. Most importantly you need a good thyroid doctor that will do all this. If you think it would be futile to try t get your current doctor on board with clinical diagnosis and treatment, then we can try to help find a good thyroid doctor if you will give us your location.
If you want to confirm any of this and also learn more about the subject, click on my name and then scroll down to my Journal and read at least the one page Overview of a paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.
Would Winston-Salem be close enough for you to go see a good thyroid doctor? If not, please give me names of some towns near you.
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Hello. I have a feeling your symptoms should be addressed by consulting an OB/GYN. You mentioned a hysterectomy - I wouldn't be surprised if you would benefit from hormone replacement therapy and therefore a little testosterone .