Help understanding my hypothyroid/exhaustion blood tests results please

[txgal2015]

I've never been treated for hypo although it runs in half my immediate family. I went to self test at Labcorp.
I'm beyond exhausted and last time I tested was years ago. The doctor dismissed it telling me I was normal.
Here's my (fasting) results from a comprehensive panel of bunch of tests: female in US, 40 yrs, don't have a regular doctor nor insurance but I realize hypo is a big picture type problem so I included some extra info about some extra tests I took that day that I have read on some sites are important. Maybe some one can help me or maybe someone else can learn from my situation. Thanks for your info.

TSH  = 3.110      (lab range  0.450 - 4.500)
Free T3 = 2.2      (lab range  2.0 - 4.4)
Free T4 = 1.18      (lab range  0.82 - 1.77)
T3 Uptake = 30    (lab range 24 - 39)
Ferritin serum = 71      (lab range  15 - 150)  
Iron Serum  = 93      (lab range  35 - 155)

Calcium serum = 9.4    (lab range 8.7 - 10.2)
Potassium serum = 4.5      (lab range  3.5 - 5.2)
RBC = 5.25      (lab range  3.77 - 5.28)
Hemoglobin = 13.0      (lab range 11.1 - 15.9)

These were specifically flagged by the lab:
{along with slightly high cholesterol (153 out of range 0-99) strange cause I've never had it and usually eat healthy}:
MCH = 24.8  LOW     (lab range  26.6 - 33.0)
MCHC = 31.3  LOW  (lab range  31.5 - 35.7)
RDW = 15.5  HIGH   (% lab range  12.3 - 15.4)

Thanks!

[goolarra]

What's the reference range on your FT4?  Ranges vary lab to lab and have to come from your own lab report.  Did your doctor test FT3?  

D is abysmal.  Are you supplementing?  How much?

[Glambaby2004]

Need advice too! TSH 2.390 and free thyroxine 1.10. My vitamin D is low too 16. I take levothyroxine 112 daily but that was before these results. Thinning hair, fatigue and can't lose weight. I'm 51. I'm having such a hard time with understanding my results. Thank you

[goolarra]

You have lots of hypo symptoms.  However, I have to warn you that, although I think a trial of meds would help you feel better, it's probably going to be hard to find a doctor who will prescribe them.  Most doctors don't get much beyond looking at TSH, and unfortunately, your TSH is within the range your lab uses.  Some doctors do look at FT4, but once again, yours is in range, almost respectable.  FT3 is the one many doctors ignore, and that's the one of yours that is really low.

I don't tell you this to discourage you.  I just want you to be prepared.  Since you don't have insurance, you probably want to vet your doctors pretty well over the phone, probably through a nurse, to get an idea which ones might pay more attention to FT3 and symptoms.  Otherwise, you can incur a lot of expense in wasted appointments, not to mention the frustration.  For some reason, the medical industry seems to withhold thyroid meds almost more than controlled substances.  

[txgal2015]

Thanks all for the feedback so far. @goolarra Yes I do have other symptoms: depression for years, constipation for years as well, irregular periods, fuzzy thinking/difficulty staying on track, weight gain/extreme difficulty losing, low bp, insomnia, oversleep when I do sleep, skin issues similar to hives/allergies at random times, low stamina (my 70+ yr old mother has more energy), irritability. What dosages do you guys take?

[goolarra]

Your FT4 is on the low side.  It's at 38% of range, and the rule of thumb for FT4 is 50% of range.  Around 50% is where many of us had to be before symptoms went away.

FT3 is 8% of range, which is extremely low.  50+% is the target for FT3.  FT3 is the most active of the thyroid hormones and correlates most closely with symptoms.

TSH is little more than a screening test for asymptomatic individuals.  However, yours is a little high of the AACE recommendation of 0.3-3.0.  The lab you went to, and most others, have been very slow to adopt the AACE guideline.  

T3U is considered an obsolete test.  Despite it's name, it's an indirect measure of FT4.  The direct measure is much more accurate.  

Ferritin looks good.  Beyond the thyroid tests and ferritin, I don't know enough to comment.

High cholesterol is a symptom of hypo.  Besides fatigue, do you have other hypo symptoms?

[Barb135]

Your FT3 and FT4 are lower in the ranges than most of us feel comfortable and about 12 yrs ago, AACE and ATA recommended that the reference range for TSH be lowered from the present 0.45-4.0 to 0.3-3.0, but most labs have not adopted the change.  If you consider your TSH in view of that recommended change, your TSH would actually be over that range.  Those 3 indicators would be evidence of possible hypothyroidism.

I agree that the increased RDW indicates a deficiency in iron, B-12 or folate...  Both your ferritin and iron are okay, so I think iron can be ruled out.  My RDW was elevated due to B-12 deficiency, caused by Pernicious Anemia and my exhaustion was beyond description.  I strongly recommend getting vitamin B-12 tested as soon as possible.  Even if levels are "in range", they may not be adequate... My lab puts a note on the report saying that anything below 500 can cause symptoms of deficiency and I find this to be very true, as I have to keep my level at the very top of the range in order to keep symptoms at bay.

You could have more than one thing going on.

[Red_Star]

An increase in RDW may be an early indicator of iron, vitamin B12 or folate deficiency.

Excerpt from Life Extension Thyroid Regulation...

"There is evidence that the standard blood TSH test reference range may cause many cases of hypothyroidism to be missed. Most physicians accept a reference range for TSH between 0.45 and 4.5 mU/L to indicate normal thyroid function. In reality, though, a TSH reading of more than 2.0 may indicate lower-than-optimal thyroid hormone levels.34

According to a study reported in Lancet, various TSH levels that fall within normal range are associated with adverse health outcomes.26

* TSH greater than 2.0: increased 20-year risk of hypothyroidism and increased risk of thyroid autoimmune disease

* TSH between 2.0 and 4.0: hypercholesterolemia and cholesterol levels decline in response to T4 therapy

* TSH greater than 4.0: greater risk of heart disease"