my tsh level is almost undetectable

[boedica]

at .02, but my tt4, ft4 and t3 are on the very low range of normal, or low out of range. and, i have severe hypo symptoms.

i was dxd with graves 20 years ago. it was very bad.....

i had RAI 19 years ago, with a hyper recurrance about 10 years ago. my thyroid died off again soon after that.

for the last 5 years i have been getting more and more hypo symptoms and becoming more and more miserable. my doctors are focusing on the tsh only.

what is a good way to go with the doctors? what tests do you recommend? how do i explain this stuff to the experts?

thank you

[boedica]

well, my pcp is going to test the prolactin, and the frees.

she DOES believe its a pituitary issue, but she has lab order restrictions, and is worried about malpractice......and she cannot find an endocrinologist that doesn't treat by the tsh test.

hopefully the prolactin will be enough.

[boedica]

thank you....i suspect it is my pituitary because of some other symptoms that aren't necessarily hypothyroid related (tinnitus, phantom smells). i have had an mri of the pituitary that came back normal.

i have been keeping am temps and they are 'normally' around 97.....but i am up around 98 by midmorning.

again, thank you. i can hopefully get these tests done.

[Mark Lupo, M.D.]

If TSH, T4 and T3 are all low - need to look at pituitary.  Usually prolactin is a good start.  Other things to test would be am cortisol level as a screen.

If you are on armour or similiar OR on T4/T3 combination the labs can look funny like this as well.

Also would test calcium as may be increased risk of parathyroid disease in patients with remote history of RAI treatment.