Secondary hypothyroidism - some advice please

[Durachld]

I have been experiencing hypothyroid symptoms for years but haven't put two and two together until about a year ago. I had a tsh test which came back 'normal' (0.89) so I have come to the conclusion through Internet research that I could have secondary hypothyroidism. I cannot lose weight despite strict/healthy lifestyle, my toes are always freezing, my hair dry and course, skin dry, slow heart beat (45-50 resting), slightly elevated 'good' cholesterol, depression. I could go on.
I've been back and had more tests this time
TSH 0.99
FT4 11.8pmol/L
FT3 3.5

My iron levels are low but not outside normal.
I'm sick of feeling tired along with all the other symptoms.

Can anybody help me interpret my results along with my symptoms?

[goolarra]

Most of them don't understand.

The medication will raise your FT4 level.  Hopefully, with more FT4 available for conversion to FT3, it will also raise your FT3 level.  When FT3 and/or FT4 goes up, TSH typically decreases.  Did he really say it would increase your TSH?  OMG!  This can cause more symptoms until you get to a dose where your meds are providing enough hormones.  However, what he's saying makes no sense.  

It can be very difficult to get doctors to treat when all tests are in range.  However, your FT3 doesn't have far to go before it's not in range.  The bad news on that front is that many doctors don't think FT3 is important, either.  It's the test that correlates best with symptoms, but who cares about those?  LOL  

Do you have any choice in who you are referred to?  It might be a good idea to interview some doctors on the phone before you're referred.  That can greatly increase your odds of getting one that treats clinically, by symptoms, and weed out some of them who never get beyond TSH.    

[Durachld]

My doctor wouldn't but I persisted so he reluctantly agreed to referring me to an endocrinologist but I'm worried I'll get fobbed off as my doctor was so defensive about the levels being 'normal range' he said medication would increase my TSH and cause me more symptoms. I'm thinking is this what the endo will say?

I felt like the doctor didn't understand! X

[goolarra]

Your FT4 is 28% of range, which is low of the 50% target.  Because reference ranges are very flawed, any result in the lower half of range is suspect.  As you can see, your FT3 is right on the floor of the range, way low of the 50+% guideline.  Your symptoms support hypothyroidism.  

Ferritin is necessary for the proper metabolism of thyroid hormones.  Low iron can also cause fatigue.

Secondary hypothyroidism is a good bet.  

Do you think your doctor would be amenable to s trial dose of meds to see if it will raise your FT4 and help your symptoms?

[Durachld]

My haemoglobin concentration is 12.1 g/gdL (11.5-16.5)

Red blood cell distribution width 14.1% (0-14)

Haematocrit 0.363 (0.37-0.47)

[Durachld]

FT4 range is 9-19
FT3 range is 3.5 - 8.3

Iron level was at 11 range is 10-28 not sure what the ferritin was.

Serum cholesterol level is 5.6mmol/L
Serum HDL cholesterol level is 2.37mmol/L
Serum cholesterol/HDL ratio 2.4mmol/mmol

I'm female, 5ft 2 and 9st 1lb. Have to diet to maintain this. Can't lose it.

[des900]

looks like hypothyroid with faulty pituitary. need to take levothyroxine to bring those free t4 to 15 or near it.

also worth to check your hemoglobin and red blood cells (cbc blood test) as lower values can cause such symptoms.

[goolarra]

In addition to the above, reference ranges on your FT3 and FT4, please, results of iron panel (especially ferritin).

Higher HDL is a good thing.

[ScalpMassager]

female, right?

age / height / weight?

blood test results?  (LDL, triglycerides, HDL)