Normal TSH, low FT4, normal (low end) FT3 - what's goin on?

In my opinion, everything looks fine, though I'm sure others are going to say different.  Let me explain why.  Your results in my opinion are normal because your TSH is at 1.54, which is normal, but you really don't want it much higher than that. Being your body naturally knows this, as your TSH levels rise, your Ft4 and Ft3 will lower in response to your TSH rising, to stop your body from making more TSH ( Thyroid stimulating Hormones).  Also, the same the other way around, if your TSH is lower on the scale, your Ft4 and Ft3 will rise to make your body put out more of TSH.  Your results can also be affected from what time your had your blood work done.  I was told by my endo that you should always have your blood work done first thing in the mornin and before eating.  As you go throught your day, your body naturally will have a higher TSH. Eating will raise your TSH also. Like I mentioned before, when your TSH rises, your Ft4 and Ft3 should be lower.  That's your bodys response to stop releasing more TSH's.   I would say that your next step would be, is to get the antibody testing being you are symptomatic.  You would need the Tgab and Tpo antibody test.  If either one of these is positive, then you most likely have Hashimoto's, which is when your body mistakenly destroys your thyroid thinking it's an invader.  As your body destroys the thyroid gland, you develop hypothyroidism.  Hashimoto's is the leading cause of hypothyroidism in developed countries.  

Hello IV, 

Your results seem to be borderline, but concerning because many people with thyroid disease don't show super off kilter blood work. The fact that your TSH is below 2 is a good sign, but 2 can indicate a problem. So with your other levels, I'd be concerned. If you're able to get a thyroid ultrasound, it might offer some useful information and would show if cysts are present (indicating Hashimotos). But I wouldn't pay for this test out of pocket.

Thyroid disease is autoimmune, and can be triggered by many environmental factors. Heavy metals can trigger a high reverse T3, so some detoxing could alleviate the problem. Also, low iodine can result in thyroid disease. Some of the other symptoms you have  could indicate endometriosis or PCOS. All of these are related to your endocrine system, so if one thing goes down, it affects everything else.

As a first line of defense, I'd clean up your diet and do some cleansing, herbs and supplements (thyroid support, multivitamin, minerals, chlorophyll, and many others are helpful) to see if you can improve your situation. I know this sounds condescending, but the treatment for thyroid disease isn't great and you'll spend a lifetime monitoring your blood levels, being frustrated with not being able to get the meds you want, the side effects of the meds are horrible.

Ive been around and around with thyroid disease for decades. I was able to get the disease into remission for a decade, but couldn't figure out how. Then after a move, the thyroid disease came back with a vengeance. I went through half a dozen different meds, none of which were great, many that wee horrible. I finally bagged the meds and chose a healthy lifestyle with supplements, cleansing and acupuncture. It was the most freeing thing in the world to stop the meds and not have to take them, not have to keep getting blood work done that seemed useless. Instead, I'm dealing with the root problem that causes the autoimmune disease.

Just  letting you know what you're dealing with. There are a ton of books and information available for thyroid disease.

Thank you, everyone, I do appreciate your help. I want to offer a few clarifications and what got me particularly intrigued. 

As an IBS-diagnosed woman of 35, I already have a very clean diet. I've experimented with raw foods, autoimmune paleo, fodmaps... My diet is a mixture of those three trends, I guess, mostly low carb and low on cooked fats. I'm extremely sensitive to conflict and stress, those factors alone can trigger severe bloating, cramps and diarrhea. I'm usually fast and impatient in everything I do and for the past 2 years exercise was a major ally in sleep management. That said, right now I'm the complete opposite. It's hard to get out of bed, I never feel rested, I move slowly and avoid people who will boss me around or speed me up. I still cycle and go to the gym six days a week (mostly for dance classes and Pilates), but I do so with effort. And I've put on 2,5Kgs. As you can see. something has definitely changed and I would like to find a balance between the then, which wasn't ideal either, and now. Preferrably, I won't take meds, I'd rather further work on diet, lifestyle and supplements...

These tests were taken early in the morning after a 12 hour fast. My blood pressure at that point was 9/6 and I felt beaten. When I got my results, what really hit me was FT4 count, to which the lab added an acknowledgement saying they had it doublechecked... And I've read a couple of articles enphasizing the relevance of FT4 count as opposed TSH when screening for hypo, so I'm kind of lost here...

Hi, I see you have several good responses already and I've not read through them all so I may be repeating something and if so, my apologies. I just wanted to share that in cases where a person has secondary hypothyroidism, the TSH isn't as important whereas the T3 and T4 are what is monitored. I guess what I'm saying is even though your TSH is in the normal range, the fact that your TS4 is low and TS3 is borderline, along with your symptoms, is indication enough to follow up with your physician. I hope you get some answers and feel better!