Very low T3 and Free T3 Still "Normal Range"

[ASkepticalConsumer]

Greetings all you wonderful folks.

I finally, finally got an apt with an encrinologist later today.

Could you assist me in interpreting my blood results, just got them right now. Timing is tight.

TSH - 0.92 (0.35-5.00)

Free T4 - 15 (12-22)

Free T3 - 3.8 (3.4-5.9)

Total T3 - 1.2 (1.0-2.7)

It is the low normal free T4 and the low free T3 that concern me. A month ago my TSH was 2.9.

I have been a bit hyper for the last week or so, so wondering if it is a die off.

I have every symptom of hypothyroid and I am confirmed Hashi via antibodies and ultrasound.

What do you think is going on with me, I just am so fatigued, no appetite, weight around the middle, 1/3 outer eyebrows gone, puffy face, brain fog galore etc

Thanks for your help.

[SlowDragon Administrator]

So you aren’t on any replacement thyroid hormones?

Looking at Hashimoto’s and some degree of central hypothyroidism

Ft4 is lowish

Ft3 low

What vitamin supplements are you currently taking

What are vitamin D, folate, ferritin and B12 levels

As you have Hashimoto’s are you on strictly gluten free diet

If not, you need coeliac blood test first before considering trial of strictly gluten free diet

[ASkepticalConsumer in reply to SlowDragon]

Hi SlowDragon.

All my D, B12, folate and ferritin are in the top 1/4 of the normal range.

I am not gluten free yet. But going to get a coeliac blood test. I did get tested for coeliac 2 years ago when having a colonoscopy, they took a sample and it was negative.

I need to get the encrinologist to clearly understand to treat me not the blood work.

Why is my TSH under the 1 level which apparently is good, but my free T3 so low normal?

[SlowDragon Administrator in reply to ASkepticalConsumer]

Many hypothyroid people have non responsive pituitary gland

With low Ft3 your pituitary should recognise this and increase TSH, the message to thyroid to work

But pituitary is often unreliable when hypothyroid, especially with autoimmune thyroid disease, because levels hop and down so much, TSH gives up

GP will most likely not be aware of central Hypothyroidism

[ASkepticalConsumer in reply to SlowDragon]

SlowDragon. You are a public saviour. Thank you for your service.

Yes, I was wondering why my TSH is under 1 but the free T3 is so poor.

Saw the encrinologist, she says it is because of stress - and yes, I have been under significant stress dealing with a 93 year old dad having to move into a retirement home because of dementia during covid.

She said that high stress stresses the adrenals and lowers all the thyroid markers and inhibits conversion. My symptoms have definitely worsened during this stressful time.

So she gave me another blood requisition for 2 months, not the normal 6 months.

I am going to monitor my symptoms and see. I do have some Cytomel so I might try that!

I wish I could friggin hug you and buy you the best glass of wine of your life!

[SlowDragon Administrator in reply to ASkepticalConsumer]

Recommend getting both thyroid antibodies tested - TPO and TG antibodies

And try to de-stress too!

Yoga....walking...nothing too strenuous