The TPO does mean Hashi's. If you have Hashi's, your thyroid will work some time and not others. It can be a roller-coaster with the only constant your medication...There's no way to know when you will need it and when you won't.
Your labs don't look THAT bad, but if you have symptoms...listen to them. Both your frees should be higher. You definitely need to bump up your D. I take 2000 a day and live in CA and garden and walk my dog.
I don't know how old you are, but menopause (declining hormones) and thyroid problems can mimic each other. It would probably be wise to get all of your hormones checked.
best of luck-

Thank you StillListing! I'm 33...so hopefully menopause isn't a factor :) All of this seemed to start after I had my son a few years ago. I do work indoors and don't get outside often enough, so you're right, I should be taking Vitamin D.

Thank you again!

StillListing gave you GREAT advice.

If you're 33, you probably need to talk to your doc. Here's why:

TSH
Range: 0.400 -5.800
Result: 1.520

Free T4 0.700 -1.200
Result: 0.890
Percent of Range: 38.00%
Where you should be: 1.08-1.20 To feel "well"

Free T3 2.300 -4.200
Result: 3.000
Percent of Range: 36.84%
Where you should be (to feel well): 3.73 -3.82

At 33, you'd expect your levels to be much higher (as I listed in the where you should be range). Your levels are rock bottom. No wonder you feel like hell. And, a TSH over 1 indicates that you are hypothyroid. As a Hashi's patient - you can fall into the range, but still be hypo (TSH worshipping doctors often forget that).

You need to be started on medication immediately. If your doctor refuses or rebuffs you, try this:

"Well, since I'm having so many symptoms, could we try a small dosage for a trial period?"

If that doesnt' work...move on but bring your test results with you!

Here's some extra info, but you're hypo dear and welcome to our club (but sorry for the reason you're here)

http://emedicine.medscape.com/article/2086819-overview#aw2aab6b3

Thank you so much MButterfly - I'm just glad to have proof that I'm not crazy and there's a reason for it all. I actually have a really great doctor. She treats my Mom for her thyroid, is familiar with the family history, and does an excellent job. She already said she's willing to start me on a low dose of thyroid hormone just based on my symptoms. I'm looking forward to seeing her tomorrow and getting started on that!

I actually have a few questions if you don't mind.... For Hashi's does it matter what kind of thyroid medicine I go on? My Mom is on Synthroid and it works well for her. But I've also heard a lot about Armour and Nature Thyroid.

And then is there anything I can do to calm the immune system down so it stops attacking my thyroid? Is there a diet that's any good? Will it calm down some when I start on replacement thyroid meds?

Glad to answer. And hang on to that good doc!

DO start the meds. Usually they start you out on synthroid - like .25 mcg (standard starting dosage). It won't be a "fix it right away thing" it's a gradual PROCESS. Remember that word: PROCESS.

Meaning, your body is not ready for a big shot of thyroid hormone to get you to the levels I suggested. It has to be done slow and steady gradually increasing the dosage over four to six weeks (based on labs done at those intervals). Why? It takes about that long to "get into your system" and start working.

It works like this:
You get your starter dose and take it for four to six weeks.
You get labs at six week mark
You examine labs and get the next increase (usually the next dosage up but not always)
You take that dosage and repeat the process until you reach "optimal". Anything short of optimal will result in symptoms and feeling yucky.

Your diet is a BIG factor in any auto immune disease which is what Hashi's is. So, no junk, no sugar, no caffiene - and if you must have it - wait at least one hour after you take your meds before you eat or drink anything but water, K? There's a good deal of evidence that eliminating wheat helps - but get tested for food allergies (if you can) or choose the cheaper route and eliminate wheat for 8 weeks and see if you feel better. All gluten. period. Eat a diet rich in veggies, fruits, and hormone free meat (yes, it's important).

When you start to feel a jolt from the meds - exercise. It's important. Exercise to tolerance but do NOT overdo it, K? This too is a gradual process.

I know there's alot of synthroid haters out there, but here's the deal - if it works for you, why tinker?

How will you know if it works for you? Check your Free T3 and Free T4 levels. First your Free T4 levels have to come up to "normal" and your Free T3 should follow. If it doesn't - you're a poor converter and might need to supplement with armour or cytomel.

But first things first...I'd start with whatever the doc recommends and go from there.

As you get closer to "optimal" you'll have different symptoms come and go - it's important to keep a journal of those symptoms along with your labs. It's easy to get confused and lost in thyroid land - seeing it on paper just brings it into focus. Then you'll know what to do...or at least be able to pass it on to one of us, no?

Once you reach "optimal" it means you'll be symptom free.

Because you have Hashi's you'll need to be checked more often than six months...like I said - every six weeks if you can get it.

Good luck and keep us posted.

PS I got worse before I got better. I felt like I'd drank 10 red bulls after my initial dosage, but his will pass. It will. You just have to hang in there until your body adjusts.

We refer to it as titration...and it's a process.

Oh my gosh, so much wonderful information. Thank you so much! That was really helpful. Ok great, I'll go with what my doctor recommends, and understand that there might be an adjustment period when I first start the medicine, and that I have to slowly work my way up. I've considered going on the kind of diet you recommend. Actually my husband and I did last year for a little while because of some digestive issues that he had, and I remember feeling fantastic. But I'm so tired all the time I often just eat whatever is convenient. I guess I'll have to really knuckle down and commit to it. :)

Thank you thank you!

Just passing it on.

remember it may be four to six weeks before the medication makes you feel any different. Until then, just keep taking it at the same time EVERY day. Set an alarm if you have to.