Advise, latest test results Low Ferritin High TSH

[kstain]

Would love advice/interpretation on the results below.

I have been on thyroid meds for 10 years. These results are fasted (food 12 hrs)/no thyroid pill (24 hours).

I am 46 yrs old, 5'7' 130 lbs (feel best at 123'ish). I don't have a doctor. I currently take 1 grain naturethroid + a multi by Dr. Fuhrman. But had recently decreased dose from 1.5 grain 1 month previous because i had lots of hairloss and redish palor to my skin. Even on 1.5 gr though my hair and scalp are always a mess, brittle crazy, scalp psoriasis type issues. Always fatigued. Try to exercise daily, but it's forced and nothing too strenuous, although my inner self would love to run, swim for hours, be active, be social. Would be glad to share anything else needed. The obvious below are low ferritin and high TSH. Could anyone go a little more in depth for me. Thank you!

CURRENT Last week 7/28/2017 (Regular Blood draw Directlabs/Quest Diagnostics):

T3 UPTAKE 32 22-35 %

T4 (THYROXINE), TOTAL 7.2 4.5-12.0 mcg/dL

FREE T4 INDEX (T7) 2.3 1.4-3.8

TSH 8.92 HIGH mIU/L 0 0.40-4.50

T3 REVERSE, LC/MS/MS 17 8-25 ng/dL

T3, TOTAL 83 76-181 ng/dL

T4, FREE 1.2 0.8-1.8 ng/dL

T3, FREE 2.4 2.3-4.2 pg/mL

VITAMIN D,25-OH,TOTAL,IA 39 30-100 ng/mL

IRON, TOTAL 100 40-190 mcg/dL

IRON BINDING CAPACITY 340 250-450 mcg/dL (calc)

% SATURATION 29 11-50 % (calc)

FERRITIN 8 LOW 10-232 ng/mL

Previous Results 11/2016 (Bloodspot ZRT Labs)(on 1.5 grain)

Free T4 Blood Spot 1.0 ng/dL 0.7-2.5

Free T3 Blood Spot 2.8 pg/mL 2.5-6.5

TSH Blood Spot 2.7 U/mL 0.5-3.0

TPOab 34 IU/mL 0-150 (70-150 borderline)

[kstain]

I should add when I was diagnosed 10 years ago my TSH was 5.50. They didn't draw for any other numbers and put me on Synthroid 50.

[Clutter]

Kstain,

You are very undermedicated to have TSH 8.92. Most people taking NDT are adequately dosed when FT3 is in the upper range ie 3.5 - 4.2 which will usually mean TSH is suppressed <0.1. I would increase NDT in 1/2 grain increments at 2-3 week intervals until you are taking 2.5 grains. Hold at 2.5 grains x 6-8 weeks and retest before increasing further.

VitD is optimal around 50-60 ng/ml. I would supplement 5,000iu D3 x 6 weeks and then reduce to 5,000iu alternate days and retest in 3-4 months. Take vitD 4 hours away from NDT.

Ferritin is deficient but your iron levels look fine so you don't appear to have iron deficiency. I'm not sure whether it matters that ferritin is low if iron is good. If you don't get any replies on this feel free to write a new post asking.

TPOab was negative for autoimmune thyroiditis (Hashimoto's).

[kstain in reply to Clutter]

Thank you Thank you Clutter. I appreciate the direction and your thoughts on protocol. Looking forward to putting this into effect!!