There is an unfortunate practice in “traditional” medicine to ignore not only the free T3 in a thyroid analysis but the patient’s symptoms as well. T3 is not produced by the thyroid but converted in the liver from T4. T3 is 5 times more biologically active than T4 and contributes more to the patient’s symptoms.
Hair loss, dry skin, fatigue, brittle or thin nails, constipation and cold hands or feet are symptom of low thyroid that need to be treated regardless of the blood studies. This is especially true in the presence of a very low TSH. A traditional provider may believe that the patient is hyperthyroid even when they have no symptoms and feel great. As we say, “listen to the patient!”