Question on Latest Thyroid Labs

My TSH has been elevated for years, and even though I have several classic low thyroid symptoms — sluggish in mornings, intermittent brain fog, the early afternoon crash — I've avoided going on thyroid meds because my free T3 is always right in the middle of the range.

For my latest set of labs, I got curious and decided to throw free T4 in as well, just to get a more complete picture. It was also in the normal range but toward the lower end.

My full thyroid labs were as follows:

TSH: 4.090 (Ref range: 0.450-4.500)
Free T4: 1.27 (0.82-1.77)
Free T3: 3.3 (2.0-4.4)

I did not get RT3 tested, though from my understanding high RT3 tends to coincide with high T4 and average or below-average FT3, which is not the case with me.

Because I'm not due for my next consult with Defy until July (this blood work was pulled by my local doctor through my insurance) I wanted to post here to see if anyone could offer insight as to what might be going on. These labs, at least the TSH and FT3, are VERY consistent with what they've looked like for the last 2+ years, when I started with Defy. So it isn't just a one-off, abnormal result.
 
Get your RT3 and the two antibodies tested. I had both T4 and T3 in the low to mid range, but my TSH and RT3 were still elevated. Added 5 mcg of liothyronine (T3) to my daily thyroid meds. Both TSH and RT3 came back down and I feel better - but still trying to dial things in. My TPO and thyroglobulin antibodies are still elevated though. Hashimotos sucks!
 
My TSH has been elevated for years, and even though I have several classic low thyroid symptoms — sluggish in mornings, intermittent brain fog, the early afternoon crash — I've avoided going on thyroid meds because my free T3 is always right in the middle of the range.

For my latest set of labs, I got curious and decided to throw free T4 in as well, just to get a more complete picture. It was also in the normal range but toward the lower end.

My full thyroid labs were as follows:

TSH: 4.090 (Ref range: 0.450-4.500)
Free T4: 1.27 (0.82-1.77)
Free T3: 3.3 (2.0-4.4)

I did not get RT3 tested, though from my understanding high RT3 tends to coincide with high T4 and average or below-average FT3, which is not the case with me.

Because I'm not due for my next consult with Defy until July (this blood work was pulled by my local doctor through my insurance) I wanted to post here to see if anyone could offer insight as to what might be going on. These labs, at least the TSH and FT3, are VERY consistent with what they've looked like for the last 2+ years, when I started with Defy. So it isn't just a one-off, abnormal result.
What did you conclude about your thyroid function?
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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