I think you said you are like 41 years old. A total testosterone of 300 for someone your age is very low. You should be closer to 600 which is double your current level.
A level of 300 is closer to what would be expected for about a 60 to 70 year old!!
Unfortunately they lump 25 year old men in with 90 year old men to obtain the ridiculous reference range. And drs practice reference range endocrinology. Meaning that if you are anywhere in the range they call you normal. Not realizing it is NOT indexed to age.
Low testosterone can cause you the muscle weakness and fatigue as well as other symptoms that can mimic low thyroid.
I would strongly recommend you get at least the following tests for sex hormones from A single blood draw.
Total testosterone
Free Testosterone
Sex Hormone Binding Globulin (SHBG)
Estradiol
DHEA
If you have not also get all cholesterol and lipids tested
All sex hormones and most hormones are built and made from cholesterol.
I know from personal experience that when I got back into being hypo a while back, I had a couple of kidney function tests that caused the doctor to send me for more tests. That doctor only wanted to wait and see if it got any worse. It did not. When I got my thyroid meds optimized, the same tests dropped back into range.
That is pretty low , being only about 6% of the range.
And I expect that the range is typical of laboratory ranges. It is not based only on people with no testosterone issue, but instead is calculated from all the test results in their database. So it surely does not represent optimal. After you get the Free T you will know a lot more, but I expect that you will want to ask your doctor about this.
What was the reference range shown on the lab report for the total testosterone?
Okay, so you do have some of those related to low ferritin, but most of those can also can be related to hypothyroidism, plus you listed previously some additional symptoms that are typical of hypothyroidism. So if it were me, I would take the supplements for Vitamin D, and ferritin (iron). Also, in view of all your symptoms and since cortisol can have such an effect on thyroid hormone, I suggest testing for saliva (free) cortisol. Doctors usually will not do saliva testing, and will only do a morning serum cortisol (total cortisol) which is not nearly as revealing as a diurnal saliva cortisol panel of 4 tests during the day. If you are interested you can order a kit and collect samples and send and get the report in about a week. Here is a link. Cost is $135 minus a 5% discount for first order.
https://store.zrtlab.com/index.php/saliva-testing
I would also try to get your med dosage back to where you were feeling pretty good. The remaining symptoms you had at that time could have been related to low ferritin. And I would still like to see you test for testosterone, both total and free.
Sorry, Dallas, but I don't see it in the messages above. Where do I find the info?
What were the Vitamin D, B12 and ferritin results?
You have to look at it in two ways. One is the effect on TSH for FT3 compared to FT4. The ATA/AACE Guidelines for Hypothyroidism say the ratio, based on a study, is about 3:1.
The other way to consider it is the effect of symptoms, which would be more important. For that there is a lot of controversy, so I'll just stick with the effect on TSH, which is all that doctors would be concerned with.
So let's just use the 3:1 ratio. That means a grain of Armour Thyroid, which contains 38 mcg of T4 and 9 mcg of T3, is the equivalent of approx. 65 mcg of T4 (38 + 3 times 9 equals 65). Using that equivalent amount, 137 plus 60 mg of Armour would be approx. 202 mcg of T4 (137 plus 65). That is higher than the 175 mcg you listed.
An expert thyroid doctor says that he uses 88 mcg of T4 as the equivalent of one grain of Armour (60 mg). That would assume a ratio of 5.5 to 1 for T3 to T4. Interestingly conversion tables typically show 100 mcg of T4 as equivalent to one grain (60) of Armour and equivalent to 25mcg of T3. This doesn't compute. For T4 and Armour it would have to assume a ratio of almost 7 to 1. If you use 100 mcg of T4 being equal to 25 mcg of T3, then that ratio is 4 to 1. If you use that ratio in calculating the T4 equivalent of one grain of Armour it would be only74 mcg of T4 (38 + 4 times 9 equals 74)
Did I create more questions than answers? LOL
Vitamin D should be at least 50 ng/mL. B12 in the upper part of its range, and ferritin should be at least 100. Free T4 is best around mid-range, or slightly below. Free T3 needs to be in the upper half of its range, and adjusted from there as needed to relieve hypo symptoms. Each person may be different in the levels that work best for them. That is why med dosage should be based on symptom relief, not just lab tests, and certainly not based on TSH.
If you want to confirm any of this, please click on my name and then scroll down to my Journal. There you will find an Overview of a paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective. There is a link to the paper, which provides the supporting scientific evidence. for all that is recommended.
Thyroid medication dosage should never be determined by TSH level. It should be adjusted as needed to relieve hypo symptoms. Frequently that suppresses TSH below range. The suppression is due to taking the med at one time, as compared to the usual continuous low flow of thyroid hormone from the gland in the untreated state. In addition you need to assure that your Vitamin D B12 and ferritin are optimal.
Yes, exactly, I was told at Walmart over a year ago that they changed suppliers and from that point on I have not been regulated. It has been back and forth with the values. I had 100 for 25 years.. Now I am back to high. and given a different dose again. This is the fifth time.
now TSH is 0.18
Yes, exactly, I was told at Walmart over a year ago that they changed suppliers and from that point on I have not been regulated. It has been back and forth with the values. I had 100 for 25 years.. Now I am back to high. and given a different dose again. This is the fifth time.
now TSH is 0.18
Are those Free T3 and Free T4? What are the reference ranges? Reference ranges vary from lab to lab and have to come from your own report.
Do you have hyperthyroidism? Have you been diagnosed with Graves Disease or Hashimoto's?
Why are they recommending that you have your thyroid removed?
i have had thyroid detected for 4years finally they want to take it out my first reading of ,0.18tsh . I feel ill just had breast cancer and feel anxiety to wards operation.t 3 5.5. t4 is 17.6. Is it good to have it out? im very nervous. joy
I am feeling tired, but not sleeping well which is very unusual for me. I usually sleep 8 hours with no problems. The med adjustment is based purely on my TSH
What, if any, symptoms do you have? Both your FT4 and FT3 are in the upper part of their ranges, and your TSH is low, but if you don't have symptoms that might not be significant. Is your doctor adjusting your med based only on TSH?
Sorry I forgot to put in my labs ranges. TSH (0.40-4.00mU/L)
Free T4 (9.0-19.0 pmol/L)
Free T3 (2.6 - 5.7 pmol/L)
TPO Ab (<5.6 IU/ml)