# Low Free T4, Normal TSH



## Nattalee (Feb 6, 2016)

Hi. I wanted to ask your opinion on these old labs of my mother's (she's a 62-year-old female, complains of fatigue, lethargy, depression, anxiety). I'm wondering about the consistently low-normal Free T4. All reference ranges are same as indicated in the 2010 labs. I don't have immediate access to her current labs and have no Free T3 tests, unfortunately. Is there anything here worth following up on, do you think? Thank you for any guidance you can provide.

2010

Free T4 - 0.8 (0.8-1.8)

TSH - 1.400 (0.350-5.500)

2011

Free T4 - 0.9

TSH - 1.600

2012

Free T4 - 0.9

TSH - 1.220

2013

Free T4 - 0.9

TSH - 0.980


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## Pamzilla13 (Sep 9, 2013)

I would find a doctor that will test FT3 or ask them to test FT3. The FT4 is low for sure but the FT3 test tells all. The doctors who "get it" test FT3 and tend to be more knowledgable.

All of my numbers were at the very low end...(TSH, FT3, FT4) and I was diagnosed hypo.

I don't know where you live, but you could research doctors through a pharmacy. Ask the pharmacist which doctors are prescribing Armour or Naturethroid and try and set up an appointment with one of those doctors.

Hope all goes well.


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## Lovlkn (Dec 20, 2009)

With a FT-4 as low as your mothers, it is no wonder she feels like she does, she is hypo.

TSH is more of a diagnostic, since she is having hypo symptoms more testing is necessary - to include a new FT-4 and FT-3.

Other items to check, Vitamin D, Ferritin and B-12 levels. If low in any, could contribute to her fatigue.

An online testing site that I have personally used in the past is

http://www.healthcheckusa.com/thyroid-tests/panels/thyroid-panel-ii-t4-free-t3-free-with-tsh.aspx

Many doctors do not understand the importance of FT-4 and FT-3 testing and will not prescribe thyroid hormone replacement if TSH is in range. Despite your mom's decent level of TSH, her FT-4 is hypo and her FT-3 is also likely to be low.

If her current doctor has not addressed it - even with her symptoms, she may want to consider going to a different doctor to get a prescription for some thyroid hormone replacement med's.

Most doctors will look at tests provided, so if she has the lab I provided above, she can take it to her next doctor appt. They will likely re-test and hopefully prescribe her some replacement med's.


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## Nattalee (Feb 6, 2016)

Thanks for the replies. I have an appointment with my own endo next week, so I hope to ask her if she would consider seeing my mother. I just didn't know if the low FT4 on its own warranted further evaluation - I'm still so new to this stuff. So thank you. From the research I've read online, it indicated that the low FT4 could also indicate something called central hypothyroidism? Anyone know anything about that? My mom has a neurodegenerative disease, but if we could get her thyroid up to snuff, I feel like she might feel at least a little better. Docs seem to have a habit of dismissing symptoms in the setting of other disease, attributing everything to the known illness rather than looking at other causes.


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## Lovlkn (Dec 20, 2009)

Your mom is symptomatic of low thyroid and has low FT-4. That alone is reason to push the issue. However, MD's do not always agree with a thyroid patient who has symptoms of low or high thyroid so educate yourself and ask alot of questions.

Making a lab tracking sheet can reveal patterns and your mom has a pattern of low FT-4 which can indicate an under-active thyroid.


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## Nattalee (Feb 6, 2016)

Thank you very much. I will pursue this for her. And I'll definitely do the lab tracking sheet.

The online testing site you mentioned doesn't seem to include New York state, which is where we are, but my endo has been pretty open to pursuing my thyroid symptoms and tested for TSH, FT4, FT3 and TPO/TSI right out of the gate. So I'm hoping she'll be willing to fully evaluate my mom, too.

Again, thanks for your insight. It's been very helpful.


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## GandKsmommy (Feb 15, 2016)

May I ask where in NY you are? I'm in NY


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## Nattalee (Feb 6, 2016)

Hi, GandKsmommy. We're near Syracuse.


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## GandKsmommy (Feb 15, 2016)

I am in rochester. My new endo will not test my frees, so I am going to go back to a functional medicine dr. I am going to try and talk to my Pcp about testing them.


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