Free T3 and Free T4 levels are the only accurate measure of the actual active thyroid hormone levels in the blood. When one uses free hormone levels one will find that it is relatively common to find the Free T4 and Free T3 hormone levels below normal when TSH is in its normal range, even in the low end of its normal range. When patients with these lab values are treated, one typically finds tremendous improvement in the patient, and a reduction of the classic hypothyroid symptoms. These are cases of secondary or tertiary hypothyroidism, so, TSH alone is not an accurate test of all forms of hypothyroidism, only primary hypothyroidism. The most common is fatigue.
Skin can become dry, cold, rough and scaly.
Hair becomes coarse, brittle and grows slowly or may fall out excessively. Sensitivity to cold with feelings of being chilly in rooms of normal temperature. Difficult for a person to sweat and their perspiration may be decreased or even absent even during heavy exercise and hot weather. Constipation that is resistant to magnesium supplementation and other mild laxatives is also another common symptom. Difficulty in losing weight despite rigid adherence to a low grain diet seems to be a common finding especially in women.