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Slightly elevated TPO normal ranges for Free T3 Free T4 and TSH

Hi,
I am 43 years old. I had bloodwork recently because I am very active and despite not eating a lot I am tired, “soft” when I used to be solid muscle, and tired.
My TPO was 38 iu/mL
My Free T3 is 2.6 pg/mL
My Free  T4 is 1 ng/dL
TSH is .9

I have had 5 babies. (Was a lot on me). I know my iron is low. Although have not had it tested recently. Perhaps that is affecting my thyroid? When I was running up to 10 miles a day I did not lose one pound...I have horses and am up there daily and do all the cleaning, etc. Again, no matter what I eat I don’t lose weight. My mom has hypothyroidism. Everyone in my family that is female does.

What are your suggestions? Otherwise, I am healthy.
Best Answer
Avatar universal
Doctors will try to convince you that symptoms are non-specific.  It is true that a single symptom may be non-specific; however, when there are multiple symptoms typical of hypothyroidism, that is strong evidence.  Many doctors will also try to tell you that hypothyroidism occurs only when there is s  a damaged or diseased thyroid gland, reflected by a high TSH.   A much more comprehensive definition is " inadequate T3 effect in tissue throughout the body" .  And TSH has only a weak correlation with the thyroid hormones, and a negligible correlation with hypothyroid symptoms, so TSH  is useful for diagnosis only for overt primary hypothyroidism and not at all during treatment with thyroid med.  

Free T3 is biologically active and largely regulates metabolism throughout the body  T4 is important as a prohormone that is available for conversion to T3: however,  there are many variables that affect conversion, so Free T3 is not always adequate.  

Another thing that is important to understand is that everyone can have different levels of FT4 and FT3 required to feel normal.  Just being within the low end of the range does not assure adequacy.  Your FT4 and fT3 are lower than needed by most people.  Your FT4 is only 22% of its range.  Your FT3 is only 11% of its range.   And the ranges are too broad and skewed to the low end due to how they are established by the labs.  

Even though your thyroid levels are relatively low, your TSH is also  on the lower side.  Your pituitary does not seem to be secreting enough TSH to adequately stimulate your thyroid gland.  This condition may reflect central hypothyroidism and is reason to ask your doctor about your pituitary function.  

I expect that you will need to start on thyroid medication, and increase the dose as needed to relieve hypo symptoms.  Typically this will require FT4 around mid-range, and FT3 at mid-range, and adjusted from there as needed to relieve symptoms.   Symptom relief is all important, not just test results and especially not TSH levels.

You can read about this in my paper in the following link.  If your doctor resists doing these things for you then give him a copy and ask to be treat you clinically, as described above.

https://thyroiduk.org/further-reading/managing-the-total-thyroid-process/

Please keep in touch and let us know how it goes.  
1 Comments
Thank you very much. I will make an appointment and be seen and let you know within the month what happens. But I will advocate for myself and use your paper as well. I really appreciate your time and help.
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Avatar universal
Also, even more important than test results are symptoms.  What symptoms do you have other than tiredness  and difficulty in losing weight.  
Helpful - 1
1 Comments
Here are other symptoms,

My body composition changed and more fat
Low body temp
Thyroid are feels swollen sometimes
No metabolism
Lines in nails
I hardly eat and maintain weight
Workout with wild cardio etc and no weight loss
Been feeling depressed and I fight that also. I don’t talk about it. Have never had depression. Or anything chemically off neurologically.

I am not obese. My BMI is normal. But I am so careful with what I eat and how much. So if I wasn’t I think I would be really heavy.
Avatar universal
Thyroid test results and associated reference ranges vary from lab to lab.  To assess your results we need to see  reference ranges for your FT3 and FT3 results, as shown on the lab report.
Helpful - 1
1 Comments
Hi thank you so much for replying. Here are the ranges, per your request.

TPO antibodies 38.
Range normal under 70

TSH .9             Normal range .5-3.0
Free T3 2.6      Normal range 2.4-4.2
Free T4 1.0      Normal range .7-2.5
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