Do I Need Thyroid Meds?

[SkyWarn]

Over the past decade, my Free T4 ALWAYS comes in low. All other Thyroid numbers are within normal. On my most recent lab draw my Free T4 was 0.50 NG/dL, Normal is 0.78- 2.19
No doctor (all GPs) ever recommended medication and when I ask they all say no necessary.
I have trouble loosing weight, cold hands, and my normal body temperature is always 97.5
Any thoughts about this?

 

[Vvs1]

I'm not sure about low t4 only. I believe there are t4 receptors.

I'd like to see complete labs if you have them. Thyroid antibodies, reverse t3, shbg, etc. The thyroid effects other hormones so it could help or worsen symptoms.

 

[Gman86]

Ya I agree, full set of labs including at least free T3, free T4, reverse T3 and thyroid peroxidase and thyroglobulin antibodies, with lab ranges, would be needed to make any assumptions.

 

[Vince Carter]

X3 on the labs, not even testing Free T3 is really suspect.

 

[Sean Mosher]

A knowledgeable good doc would definitely have pulled the labs recommended above and then given you a therapeutic trial given the fact that you are symptomatic.

 

[Vince]

I'm not sure about low t4 only. I believe there are t4 receptors.

I'd like to see complete labs if you have them. Thyroid antibodies, reverse t3, shbg, etc. The thyroid effects other hormones so it could help or worsen symptoms.

It definitely sounds like you have hypothyroidism. I would do what everyone else said, get a full set labs. TSH, free T4, free T3, reverse T3 and both antibodies.

 

[BuzzSaw]

Why test his SHBG?

 

[Vince Carter]

Why test his SHBG?

If we limit it to just Thyroid, I would skip SHBG, but as part of a larger puzzle of TRT, SHBG is crucial.

 

[Deleted member 12831]

Over the past decade, my Free T4 ALWAYS comes in low. All other Thyroid numbers are within normal. On my most recent lab draw my Free T4 was 0.50 NG/dL, Normal is 0.78- 2.19
No doctor (all GPs) ever recommended medication and when I ask they all say no necessary.
I have trouble loosing weight, cold hands, and my normal body temperature is always 97.5
Any thoughts about this?

If it were me, I would do a full thyroid panel with free t3, total t3, reverse t3, total and free t4. I would also test antibodies, and tsh. The average healthy young person really does have a free t3 in the upper 1/3 of the range. So, a free t3 range of 2 to 4.2 (something like that) I would if it were me like to see 3.4 or so and above. That is a good level. At 3.0 and under, I gain weight.

 

[Systemlord]

You mention all thyroid labs all come in normal, thyroid reference ranges are not normal, the ranges are gathered from sick people seeking treatment, a normal TSH is <2.5.

Free T3 (not Free T4) increase metabolism, most doctors believe TSH and Free T4 is enough testing, sadly it is not enough. Free T3 should be at least midrange or higher and Reverse T3 <15 ng/dL.

Its difficult to get treatment for thyroid in HMO managed healthcare, doctors mostly go by reference ranges and almost never consider the symptoms when assessing the lab results.

 

[OMI100]

Thyroid Reference Ranges are too Broad; What is Healthy / Optimal?

 

[Tommy Wall]

When it comes thyroids labs I always ask my doc to include Free t3 and4 and the reverse and with no luck she only want to see tsh, Ft4 and t3 basta. No matter what I asks for.
My last lab tsh 2,25 (0,27-4,2) T3 1,53 nmol/L (1,3-3,10) FT4 13,67 pmol/L (12-22) and my doc is happy with these values I believe they are not optimum at all.

 

[Gman86]

When it comes thyroids labs I always ask my doc to include Free t3 and4 and the reverse and with no luck she only want to see tsh, Ft4 and t3 basta. No matter what I asks for.
My last lab tsh 2,25 (0,27-4,2) T3 1,53 nmol/L (1,3-3,10) FT4 13,67 pmol/L (12-22) and my doc is happy with these values I believe they are not optimum at all.

Man that sucks. Testing those labs is almost like not testing thyroid at all. They don’t really tell you much. Definitely not enough to assess actual thyroid function, that’s for sure. TSH is a pituitary hormone, it’s not a thyroid hormone. Knowing your free T4 level is legit pointless without knowing how you convert into free T3, and knowing your total T3 is like knowing your total testosterone without knowing your free T level, basically pointless. Before TRT my total was 700, and free was below range. Without knowing my free T I would of never known I had low T. So knowing total T3 is pretty pointless without free T3. It’s scary that actual medical doctors don’t know these things, yet random guys on a forum do. Scary.

 

[OMI100]

Man that sucks. Testing those labs is almost like not testing thyroid at all. They don’t really tell you much. Definitely not enough to assess actual thyroid function, that’s for sure. TSH is a pituitary hormone, it’s not a thyroid hormone. Knowing your free T4 level is legit pointless without knowing how you convert into free T3, and knowing your total T3 is like knowing your total testosterone without knowing your free T level, basically pointless. Before TRT my total was 700, and free was below range. Without knowing my free T I would of never known I had low T. So knowing total T3 is pretty pointless without free T3. It’s scary that actual medical doctors don’t know these things, yet random guys on a forum do. Scary.

I think the issue is that is what they are taught in Med School. The DRs that "think outside the box" and Integrative types are more open to different views than the standards that they are taught in Med School.... THEY are the needles in the hay stack that are hard to find... Defy is one of those "Needles in a hay stack" that are hard to find...

 

[Gman86]

I think the issue is that is what they are taught in Med School. The DRs that "think outside the box" and Integrative types are more open to different views than the standards that they are taught in Med School.... THEY are the needles in the hay stack that are hard to find... Defy is one of those "Needles in a hay stack" that are hard to find...

Definitely. Don’t know what I would do without Defy. They have been a godsend for me.

 

[Systemlord]

You can not get balanced on thyroid medicine testing only TSH, it's not even a thyroid hormone which is what you are replacing, TSH is a poot marker for thyroid hormones.

Any doctor only testing TSH on thyroid medicine is not very well informed and stopped learning new things a long time ago. The treatment protocols are updated all the time, some doctors are just not staying up to date and this only hurts the patient.


Optimal VS Normal Thyroid Levels for all Lab Tests & Age

 

[SkyWarn]

Went to an Endo on Wednesday, ran the full panel on thyroid (she was reluctant). I should have results Monday and will post here.

 

[OMI100]

Full panel to really do a deep dive is more than FT3, FT4. RT4 and TSH. See below:
Thyroid Blood Tests to Diagnose a Thyroid or Hormone Imbalance