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Advice Requested / Results Interpretation: High Free T3, Low TBG - Both Hypo and Hyper Symptoms

Advice Requested / Results Interpretation: High Free T3, Low TBG - Both Hypo and Hyper Symptoms

Hi There,

Background: This is my first post. I have known for some time, something hasn't been right with my health. I suspected thyroid issues, but, saw a number of doctors who ultimately told me nothing was wrong. I was also diagnosed with major depression and an anxiety disorder that I always felt were the symptoms from some other undiagnosed problem(s). Consequently, I have been searching for my root causes and I just received my lab results back. Nobody likes abnormal lab results, but, I may have uncovered my first puzzle pieces to recovery and I couldn't be happier. If I wasn't on my depression medication I'm sure I would have tears in my eyes. After telling family and friends that something isn't right and it's not all in my head, I finally feel somewhat vindicated!

Question: I would appreciate your thoughts and expertise on my lab results. I have additional lab results I can share, but, I wanted to start off with what I believe are my primary Thyroid related results. You will notice that my Free T3 is in the high range at 4.9, while the normal range is 2.2 to 4.0. The other item I noticed was my TBG was in the normal range, but barely: my result was 14.6 and the normal range was 14-31.

I am happy to post symptoms or anything else you may find helpful, but, I thought I would start off with just the results to get initial impressions and what else would be helpful.

Thank you in advance and for your time.

Kind Regards,


4 Replies

It would be helpful if you post your symptoms. Your FT3 result, while outside the normal range, isn't stunningly high, and if you had mild hyperthyroidism you would expect your TSH to be below range, whereas it is actually not low at all (something like 95% of healthy people have a TSH between 0.5 and 1.5).

If you could tell us a bit about your lifestyle too that might help - do you eat healthily, are you overweight, how physically active are you, do you take any other medication, how old are you ....

It might also be worth getting your doctor to check your basic nutrient levels - iron, ferritin, Vitamin B12 and Vitamin D.

Can you relate to the person in this post here:



Thank you so much for the informative and thoughtful reply.

My mother had issues with her thyroid and I believe thyroid issues run on her side of the family, as well. From all of the reading I have been doing I was sure I was at least subclinical hypo. Many people with my symptoms reported feeling like a "new person", when they were medicated to a TSH level of 1.0 or below, but, within the bottom normal range. A recent Free T3 blood test (about 3 months ago) came back with a Free T3 of 2.9, within was within a range of 2.3-4.2 pg/mL. My free T4 was .9, with a range of .8 to 1.8. I was told that since both my Free T3 and Free T4 were in the bottom 50% of the range, I would be a candidate for something like Armour Thyroid, which should lower my TSH. I am not sure the protocol on this website, but, I have attempted to link my lab results pdfs from another site. I apologize if I am not allowed to do this and I will retype them, if necessary.

In terms of my current medication, I take 10 mg of Lexapro and 300mg of extended release Bupropion, daily. I have been also been taking Bioton gummies for my hair and nails. Finally, I just started taking a multivitamin (but not before my recent lab results).

Background: I am a 36-year-old male. I am conscious about my diet and my go to meal is grilled chicken and vegetables. I am overweight by 20 to 30 lbs by my estimation. I am 5'10 and in high school and college while playing high level soccer and hockey I was 215 to 220 lbs. I carry the majority of my weight in my thighs and rear and have a "rugby player stocky build". So my appearance is not as "extremely overweight" as something like a BMI would tell you. I will list my symptoms below, but, I do suffer from extreme tiredness/lethargy/fatigue/3pm crash and it has been getting worse. I require a 2-3 hour nap after work just to keep my life going. I still am active on the weekend and try to play high-intensity beach volleyball one or both days on the weekend, after I have had time to sleep in (12 hours+ needed just to begin to feel myself/rested). I play tennis, as well. I sweat profusely though playing both sports and much more than people far heavier than I am. Other symptoms include "Memory Loss, Brain Fog, Depression, Irritability, unexplained weight gain and inability to lose weight, broken sleep, and insomnia, Hair Loss, brittle and ridged nails (even worse before biotin supplements) and puffiness of the face. The memory, brain fog is especially frustrating because I was a 4.0 (All "A") student and I know what it was like when my brain and body were functioning at a high level. I believe these are all hypo symptoms. On the Hyper side I have insomnia, fatigue, heartbeat sensations/fast heart rate, high blood pressure (ever since high school), a varying trembling of my hands, hair loss. I also have unexplained and easy bruising, so I don't know where that falls and I have very dry eyes that require Visine eye drops on a daily basis.

I have attached a few of my recent additional lab results at the links below. I hope this is helpful and I look forward to your response or any additional responses. If you would like previous labs to show a history, I can upload, as well. Thank you!


Lexapro is an SSRI class of antidepressant, which are known for making people slightly hypothyroid.

You are also taking Bupropion, which has a long list of side effects:

Your symptoms could be a mix of mild hypo combined with side effects of your antidepressants.

Taking a low dose of some type of NDT might work for you - it might even make you not need such a high dose of antidepressants, however if you don't need it taking the NDT will probably give you hyper symptoms. I see you are in the US - I believe the easiest NDT to source there is Armour, although since you would want to experiment with a low dose you could maybe get some thyro-gold, which has quite low amounts of hormone in.

Your very comprehensive blood test results do show some slightly odd thyroid numbers. Your FT4 and FT3 results were both quite low in the range but your TSH was only 1.2ish. Your iron result was quite low in the range too.

Depression is a symptom of hypothyroidism, and if by taking NDT you find you need less of the antidepressants, then you might be on to something. I think in your position I would at least give it a try. However you will need to read up on thyroid issues and symptoms of over-medication and become your own expert. You don't want to end up giving yourself more problems than you have already got.

Best of luck.


Thank you and very interesting. I hate being on anti-depressants, but, they do make a big difference for me. I would love to find a natural alternative though. Again, I believe my depression and anxiety meds (the buproprion is for an energy boost, I believe), are treating symptoms and not the root cause of my depression and anxiety issues. I am optimistic that my thyroid may be "the" or at least one of the root causes. I would be very happy one day if I just had to take an all purpose multivitamin (vitamins, minerals, antioxidants, omegas, etc.) and a thyroid medication.

With that said, I am still very concerned, in that I have spent thousands of dollars and went to several doctors and no one seems willing to help me. Here in the states, everyone is sue happy and doctors don't want to risk treating a patient if his/her results are in the "normal range". Since I thought I was hypo even before my most recent results and I read numerous success stories of people feeling like a brand new person just by taking a thyroid med, like Armour, I begged my doctors to please medicate me to a lower normal range TSH. I wasn't asking them to medicate me outside the range! If it didn't work, fine, I will move on, but, at least I know and can cross it off the list. It is so frustrating that I can't find someone to help me.

Now I have my new results and I am afraid it is going to make things even worse. With elevated Free T3, I'm afraid the last thing they will be willing to do is prescribe Armour, despite all my symptoms. All I can try to do is build a case, with journal articles if I can find any to persuade them. I'm afraid getting a NDT prescription will continue to be almost impossible. I also don't want to try to order a NDT over the internet, because God knows what I will get and I've read about consistency issues which have led NDT being banned in certain countries.

Again, THANK YOU SO MUCH and if you have any advice for when I talk to my doctor or what you would do if you were in my position. I am more than willing to try a NDT that is high quality. I assume I need to get a prescription and then I am happy to become my own expert. Do you have any reading you would recommend to become my own NDT expert? Finally, did you find anything interesting from the second link I posted that showed the D3 deficiency, potential B12 deficiency, etc.?

Very Much appreciated,



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