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Thyroid lab help


I'm a 45 year old female, I've always been in pretty good shape. Strength train regularly, run about 20-30 miles per week. I've been feeling bad for approx 2 years. Lost my menstrual cycle, unable to stay asleep, night sweats, cold ALL the time, always tired, hair and nails became dry and brittle, I'm extremely irritable, and gaining weight. It doesn't matter what I do, I keep gaining weight. I'm becoming quite obsessed and depressed. My doctor FINALLY checked my labs and I'm post menopausal (shocking).  Estrogen and progesterone in the toilet. Started me on HRT about 4 months ago. At that time, they also drew a thyroid panel. The results were as follows:

TSH 0.83    (0.34-5.60 reference range )
Free T3 2.38  (2.39-4.28 reference range)
T4 free 1.0  (0.58-1.64 reference range)

The only symptom my HRT helped is the hot flashes. I continue to be exhausted, cold, cranky, sleepless...and fat. I'm continuing to put on weight! It's not diet related. With the above lab results...would I benefit from thyroid medication? I'm constantly reading about how important T3 is and how it regulates your metabolism, etc...but my doctor says I'm normal. I'm over 40, it happens, basically live with it...I'm going out of my mind. I really want to feel normal again.
5 Responses
Avatar universal
Your doctor doesn't know what he is talking about regarding thyroid. If your thyroid levels are "normal" what is the cause for your symptoms?  He obviously has no idea.  Note the following.

In the words of a good thyroid doctor, "The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

Your Free T4 and Free T3 are obviously ay too low in the range.  Due to the erroneous method used to establish them, the ranges are far too broad to be functional for many people.   Basically the lower half of the ranges should be suspect.  Your TSH being in the lower part of the range points toward the possibility of central hypothyroidism, which is a dysfunction in the hypothalamus/pituitary system resulting in inadequate TSH level to stimulate the thyroid gland.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You will get some good insight from this link written by a good thyroid doctor.  

Avatar universal
Great article! Thanks for the link. The problem then, as I see with many people in this forum, is finding s doctor to LISTEN to me and treat me properly.
Avatar universal
If Ft. Myers is close enough for you to consider, then I have a doctor that has been recommended by thyroid patients.  
Avatar universal
I would most definitely consider Ft Myers.  Thank you!
Avatar universal
I just sent you a PM with info.  to access, just click on your name and then from your personal page, click on messages.  
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