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.
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.