Diagnosed with Hypothryoidism - Now What?

[HenryB19]

I am a 36 man and was recently been diagnosed with hypothyroidism.  I originally went to the doctor with muscle, joint and general fatigue symptoms.  My TSH came back at 4.58 and combined with my fatigue symptoms they decided I have hypothyroidism.  The doctor prescribed 25 MCG tabs of levothyroxine (generic) for 60 days and then they’d retest me.  Never being sick in my life I am having trouble dealing with the diagnosis.  

Is 4.58 alone enough to prescribe life long treatment?  I had a test ~10 years ago for a physical and it was 3.7.

Is 4.58 and generic symptoms (muscle/joint pain and fatigue) enough to make a definitive diagnosis, I am otherwise fit and active, with no symptoms?

Is the 25 mcg a proper prescription level, I have read under-treating can make me feel worse?

Should I wait to request more tests (FT3, FT4, Anti-TPO, TGAb) or get ASAP?

Do I need to see an endocrinologist or will they refer me back to my GP since my TSH is only 4.58?

Do I need to be concerned with generic versus brand name levothyroxine?

[Mark Lupo, M.D.]

This is a minimal hypothyroidism and does not absolutely need treatment.  Treatment is reasonable, but so is observation - particularly w/o symptoms.  The TSH 10 years ago at 3.7 is similar to current.  There is no definite indication for levothyroxine (generic or brand) at this point.

[HenryB19]

Thanks for your response.  What you recommend be my next step?  Get more tests and continue to work with my doctor (who has prescribed the treatment I am on now, that I may or may not need) or see an endocrinologist right away who is better to determine what I need?  Also, should I continue the meds without further testing based on my symptoms and the TSH level?