Qhlindsey Feb 3, 2019
Yes, a TSH of 6 is too high.
FT4 = 1.5 ng/dl = 19.3 pmol/L
FT3 = 2.6 pg/mL = 4.0 pmol/L
ratio FT3/FT4 (in pmol/L) = 4.0/19.3 = 0.21
A study in 2011 found that median FT3/FT4 ratio (in pmol/L) is 0.24 for Synthroid only patients.
So your body's conversion of the Synthroid (T4) to T3 is fairly typical for someone taking Synthroid only.
Most doctors put a heavy weight on the TSH reading, so with the high TSH and obvious hypothyroid symptoms, it should be fairly easy to convince your doctor to raise your synthroid dose. A possible plan of attack for you might be to go up to 112 mcg synthroid again while you are trying to convince him or find another doctor to try something else. I think going to 112 would make a significant difference for you.
I started thyroid medication with a TSH of 6. I had severe symptoms as it was a combination of cellular and thyroid gland issues. While TSH is not the most accurate of tests as it can be affected by various factors, over 95% of healthy people have a TSH under 2.5 mU/L .
Hi Qhlindsey and thank you for the additional information.
Yes, you're quite right that your Free T3 is too low and that you need to take another look at your thyroid medication.
As I noted, the rule of thumb is for most of us is for Free T4 to be about mid-range and Free T3 to be in the upper half to upper third of its range. As you can see your Free T3 is a long way from being in the upper half at only 16% of the range.
Your B-12 and Folate are both good - most of us find that B-12 must be kept in the upper part of its range for best result. Folate should be kept relatively high, as well, since Folate deficiency can mimic B-12 deficiency.
You don't say if you're supplementing to improve the low vitamin D you had at the end of 2017. I hope you are. Vitamin D is necessary for proper metabolism of thyroid hormones, plus vitamin D deficiency can cause some hypo-like symptoms. Ferritin is the iron storage hormone... iron is necessary for the conversion of Free T4 to the usable Free T3. Since your Free T4 is higher than it needs to be and your Free T3 is very low, that's an indication that you aren't converting... if you had adequate iron, you might convert better, if not well enough.
Typically, if Free T4 levels are high and Free T3 levels are low, T4 medication is decreased slightly and a source of T3 medication is added. This can be done in the form of cytomel or it's generic counterpart, which are both T3 only medications or one can be switched to desiccated hormones, which contain, both T4 and T3, such as Armour Thyroid, NatureThroid, NP or WP, etc. These prescription desiccated hormones are derived from pig thyroid.
You can talk to your doctor and see if s/he is willing to prescribe a T3 medication... If not, we can help you try to obtain better conversion, which sometimes helps (selenium has been shown to help in the conversion process, also) or it's to find a different doctor.
Oh, I get so disgusted with that "you're losing hair, gaining weight, having hot flashes, getting tired because you're getting older" garbage... unfortunately, that seems to be the standard come-back for many doctors.
You've done the right thing by researching and getting further tests done, though. I have some questions for you though... Are the T4 and T3 tests, Free T4 and Free T3 or are they Total T4 and Total T3? Testing for Total and Free T4 and T3 aren't the same and don't give the same information. It should say on the lab report... we want them to be Free T4 and Free T3 and they appear to be, but I'd like to verify that.
In addition to that, could you please provide the reference ranges for the T4 and T3? Ranges vary from lab to lab and have to come from your own report for the best comparison.
The rule of thumb (and where most/many of us feel best) is to have Free T4 about mid-range and Free T3 in the upper half to upper third of its range.
Many of us with thyroid conditions are low in certain vitamins/minerals that are essential for proper metabolism of thyroid hormones. Many doctors don't think to test for them, so we often have to ask; however, if you've been tested for Vitamins B-12, D and Ferritin, please also post those results, with reference ranges.
Once we have the requested information, we'll be able to better respond to your questions.
BTW - can you, please, tell us why you had your thyroid removed?