I hope that your doctor was going to tell you that you are hypothyroid. Your Free T4 is only about 10% of its range, and your Free T3 is actually below range, which is terribly low. Your TSH is relatively low in the range, which along with the low Free T4 and Free T# is indicative of central hypothyroidism. With central hypothyroidism, there is a dysfunction in the hypothalamus/pituitary system that results in TSH levels that are too low to adequately stimulate the thyroid gland to produce T4 and T3 hormone.
Many doctors only recognize primary hypothyroidism associated with Hashimoto's Thyroiditis, which is characterized by increasingly high TSH levels. Your antibody tests were negative for that. Also many doctors like to believe that FT4 and FT3 levels that are even at the bottom of the range are adequate. That is very wrong. But because of these two erroneous beliefs, you are going to have to convince the doctor of your hypothyroidism based on symptoms and also the low FT4 and FT3. So please tell us about any other symptoms you have.
With the calcium of 8.8 and the PTH result there is no need to think there is a parathyroid issue. You need to get started on thyroid med adequate to relieve hypo symptoms.. If the doctor gives you any trouble prescribing thyroid meds, you can use this link to prepare yourself, and even give the doctor a copy if needed. I recommend reading at least the first two pages and more if you want to get into the discussion and scientific evidence.
Also, be aware that hypothyroid patients are frequently deficient in Vitamin D, B12 and ferritin. You have confirmed that with a Vitamin D test, but you need to also test for B12 and ferritin and then supplement as needed to optimize. D should be at least 50, B12 in the upper end of its range, and ferritin should be at least 70.
UPDATE as of 05/29/2019:
Hello All, I have a new update with new numbers. I am still not on any thyroid meds. Can I please have some feedback on these numbers:
TSH 2.020 (.450-4.500)
T4Free 1.00 (.82-1.77)
T3 Free Serum 2.5 (2.0 - 4.4)
I've been having tinnitus and ear nerve pain and just wondering if this could be contributing...I don't know but would love some feedback and thank you very much.
Your test results for the thyroid hormones, Free T4 and Free T3 have been consistently low or below ranges that are far too broad and skewed to the low end. Of course symptoms are the best indicator of thyroid status; however your results are also indicative of hypothyroidism and need to be acknowledged by your doctor and thyroid medication prescribed and increased as needed to raise yo0ur Free T4 and Free T3 levels as needed to relieve hypo symptoms. Just continuing to test is not adequate. You need to get the doctor to accept that you are hypothyroid and take appropriate action, or else find a good thyroid doctor that will do so.
Were you also able to get tested for Vitamin D, B12 and ferritin?
To carrie 235 and Turtle67: I hope you will find answers to your questions and concerns in the following. The most important concern for you both is to find a doctor (not necessarily an Endo) that will treat clinically, for symptoms, rather than just based on test results compared to their reference ranges. I tried to make this comprehensive enough to cover most everything, but if there are further questions I will do my best to answer.
There are a number of very serious flaws in the standard of care for hypothyroidism used by most doctors. First is the almost total dependence on TSH to determine a patient's thyroid status. This is very wrong because TSH is a pituitary hormone, and it is only used as a surrogate for Free T4. There are lots of data available showing that except at extreme levels, TSH has only a very weak correlation with FT4, so it is not predictive of FT4 levels. Also, TSH has a negligible correlation with hypothyroid symptoms, which are the patient's concern. The same can be said for the lack of correlation of TSH with Free T3. So except at extreme levels, TSH is not an adequate diagnostic for thyroid status.
The next concern is that if testing goes beyond TSH it is usually for Free T4, and only occasionally Free T3. Results are compared to the so-called "normal" range established by laboratories. Unlike many tests, FT4/FT3 reference ranges are not adjudicated ranges. "Adjudicated ranges are reported when the laboratory's scientists have accepted some professional group's opinion concerning the levels that are optimal for health (e.g.,LDL cholesterol, HgbA1C, fasting glucose, Vitamin D, etc.). Adjudicated ranges are intended to be used as diagnostic and/or therapeutic ranges(“decision limits”). Because some tests are reported with adjudicated ranges, physicians assume that experts have reviewed all tests’ reference ranges and determined that they represent normality (i.e., optimal health).Therefore they believe that if any test result is normal (within the reference range) they need not diagnose or treat."
Unfortunately the ranges for FT4 (and also FT3) are not well standardised among
different test machine manufacturers, generally validated, or based on large databases
of healthy adults with no thyroid pathology. Instead those ranges are locally
established from test data available at any given laboratory, excluding only data from
patients assumed to have thyroid issues based on the flawed TSH range. Clinically
hypothyroid patients with TSH within the reference range, people with hidden
pathologies such as undiagnosed central hypothyroidism or autoimmune disease, and
patients taking thyroid medication can all be included in the database. This results in the range being very broad and skewed to the low end. No wonder most test for FT4 (and FT3) are reported back from the lab as being within the "normal" range.
Doctors tend to disregard symptoms, in favor of laboratory test results compared to those flawed ranges. Thus it is no wonder that so many patients with multiple symptoms frequently related to hypothyroidism are told their test results were within the normal range, so their symptoms are not thyroid related, so no medication is needed. It is true that a single symptom is non-specific, meaning it can have multiple causes; however, when there are multiple symptoms that are frequently related to hypothyroidism, and the patient's FT4 and FT3 results are in the lower part of their flawed ranges that is strong evidence of the need for a therapeutic trial of thyroid medication adequate to raise FT4 and FT3 levels and determine the effect on symptoms. If the symptoms ease that is further proof of hypothyroidism.
If a patient is able to get a prescription for thyroid medication, the next problem is interpretation of results. Most doctors titrate medication dosage based on getting TSH back within range. (Obviously this only pertains to primary hypothyroidism (Hashi's), not to central, or other hypothyroidism, which are generally ignored anyway. ) This approach results in pervasive under-treatment, and lingering hypothyroid symptoms.
If a patient is given thyroid med adequate to relieve symptoms, this usually results in suppression of TSH below its range. This is because our body is used to a continuous low flow of thyroid hormone from the gland. When taking a significant dose of thyroid med all at once, it results in a spike in thyroid levels for a short time, but also resultant suppression of TSH for most of the day. This has been proved in scientific studies. Taking the same, suppressive dose, and splitting it into multiple doses taken over the whole day does not suppress TSH. However, most doctors erroneously interpret a suppressed TSH as being hyperthyroidism, due to an overdose of thyroid med, and will reduce the dosage, causing a deterioration in the patient's symptoms. So instead, thyroid medication should be increased as needed to relieve hypothyroids symptoms, without creating any hyperthyroid symptoms. That "sweet spot" is called euthyroidism. That is the objective of treatment.
Hypothyroidism is correctly defined as insufficient T3 effect in tissue throughout the body, due to inadequate supply of, or response to, thyroid hormone. There are a number of variables that affect a person's response to even adequate thyroid hormone. Among those are cortisol, Vitamin D, Vitamin B12 and ferritin. So it is important to test those and assure adequacy. Cortisol should be neither too low or too high, Vitamin D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100. Of course it could be affected by the particular insurance company, but I know that with Medicare, they will cover any test for which the doctor adequately explains the need. I suspect that this is generally the case, and the doctor needs to do these tests for a thyroid patient.
I should also mention that many people taking T4 med find that due to conversion issues, they cannot get their FT3 to an adequate level without taking a large enough dose to raise their FT4 to the top of the range and above. For that reason many hypothyroid patients find that a combination of T4 and T3 work best for them, either taken separately, or a desiccated type thyroid med.