Does your husband have a diagnosis of thyroid condition and does he take any thyroid meds?
If not then he may be looking at Central Hypothyroidism. This is where the problem lies with the pituitary or the hypothalamus rather than the thyroid, the signal isn't being sent to the thyroid to make hormone, hence very low FT4 level.
Central Hypothyroidism is diagnosed when TSH is normal, low or minimally elevated with low/below range FT4. It's not as common as Primary Hypothyroidism and many doctors are unaware of it.
I'm sorry I can't interpret the sex hormones, hopefully someone else will be able to.
Many Greetings SeasideSusie!I am posting from Ottawa, Canada.
You folks are doing well in England re: the virus, congrats!
My husband is not on any thyroid meds.
I presume the treatment would be to start on Synthroid to get the free T4 up?
It is interesting that his free T3 seems ok, in the upper 1/4 of the range, so does that mean the little free T4 he has circulating is being well converted into free T3?
Q - what causes the Central Hyp? Is there a fault in the pituitary gland?
SeasideSusie - thanks for all your care of us many members - as well as so many other knowledgeable members on this board.
Q - what causes the Central Hyp? Is there a fault in the pituitary gland?
It could be either the pituitary gland (secondary hypothyroidism) or the hypothalamus (tertiary hypothyroidism).
If it's tertiary hypothyroidism the hypothalamus produces insufficient thyrotropin-releasing hormone (TRH) leading to insufficient release of Thyroid Stimulating Hormone (TSH), if it's secondary hypothyroidism the pituitary produces insufficient TSH. Without sufficient TSH signalling the thyroid to make hormone then FT4 stays low but as T3 is the active hormone every cell in our bodies need then the body, being as clever as it is, does everything possible to make T3 hormone to keep us going for as long as possible. I expect that eventually the FT3 would fall.
As to where exactly the fault lies and what has caused it then it would need to be investigated, perhaps an MRI can, I'm not well up on Central Hypo.
The hypothyroidism would be treated with Levothyroxine, same as any other cause of hypothyroidism.
If you can find an endocrinologist specialising in thyroid rather than diabetes then hopefully further tests can be carried out to see if it is Central Hypothyroidism. Thyroid specialists in the UK are as rare as hens' teeth, I hope you are better equipped in Canada!
SeasideSusie!Thanks so much for your knowledge and your sharing.
Very helpful indeed.
No, we likely have worse access than you, in Canada we only have a public system, nothing private. It takes over a year to get an apt to a specialist and here in Ontario, 25% of the population has no family doctor.
So getting a Encrinologist will be unbelievably difficult if not impossible.
Hi there oscarbravo.Thanks so much for responding to my post.
Interesting indeed.
Wonder is the pituitary a key here - because like SeasideSusie indicated my husbands low free T4 could be linked to the pituitary and your analysis of his high prolactin level = pituitary x 2.
oscarbravo (love your name) - how is that treated?
But guess it will be tiny if not getting more issues?
Most likely bump his T up as that's low another typical sign also but be careful with T HRT watch for issues! I had issues but no one joined the dots up and ended up having a stroke as blood became so thick that couldn't be pumped round as T increase increases red blood cells that was 11 years ago still having issues now as spent week in Hospital they now found the Blood clot in my lungs so now on Blood thinners.
Many Decent quacks won't leave people on T these day's due to issues and increased cancer risks so learn to read the signs.higher BP.sharp headaches.Breathing strained.
Hi oscarbravo, thanks for your most interesting response.I am on bio testosterone, been on it for years, much for osteoporosis. My natural T level is far too low even in menopause - but yikes, I do have higher BP and strained breathing, no headaches though. I also have Hashimoto thyroid which has similar symptoms.
The husband's nipples are fine, nothing unusual. His T is rather low for sure, so is this also part of the pituitary gland situation - like wowow? Could you explain more?
We have a call next week with the Naturopath Dr, then the family doctor. Here in Ontario, Canada, there is a hate relationship beween the 2 groups - a big issue for patient care as we do not have any private medicine, none.
So the great investigative blood work done by the Naturopath Dr will force the family doctor to have to address things, it could get ugly - but the family doctor can not will away the blood test.
oscarbravo - anything you can tell us would be GREATLY appreciated.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
low ft4, high ft3 
Low TSH, low FT4 and high cortisol. Feeling crap! Help!
Overmedicated? Low T4 High FT4
Strange results on levo only. Low FT4 high FT3
Low tsh, high ft4 and ft3 - is it hyperthyroidism?
