Dizziness and "confusing" lab results. Please help?

[Rachel413]

About 3 weeks ago I started having dizzy spells once or twice a day. Within a few days, I was having them 10+ times per day (even while sitting). They are so intense at times that I feel like I might pass out. Each spell lasts anywhere from 1-5 min). Last week at work, I had a really bad one and my boss insisted that I let her take me to urgent care.
The Dr. there said he suspected that the dizziness was from severe allergies and prescribed me prednisone (which hasn't helped with the dizziness at all). But said he'd like to test my thyroid as well because of some other symptoms (dry skin, itchiness, heavy periods, blurry vision, fatigue, slow metabolism, and numbness in my hands and feet).

The lab results came back on Friday afternoon, and the nurse called to give them to me but said that they were "confusing" and that she'd have to have the Dr. look at them when he gets back from vacation. She said that normally they expect to see an increased TSH with a low Free T4 so she thinks I have a "fluctuating thyroid", but couldn't really tell me what that means for me. She also wasn't sure if these results could explain my dizziness, which I am still experiencing.

Here are the results:
TSH: 1.09 (ref range is (0.45 to 5.10)
Free T4: 0.70 (ref range is 0.8 to 1.6)

(the Dr. didn't test my Free T3 because I don't have any health insurance)

I should add that I've been under a lot of stress over the past six months due to my teenage daughter being frequently suicidal, I'm not sure if that's relevant at all but figured I should throw it out there.

I'm just not sure if I need to follow up on these results, or am I okay because the TSH was in range and the other was very close to in range? I need to find the cause of this dizziness so that I can fix it but I don't even know if this could explain it and would rather not spend the money following an unlikely culprit.

Any advice or insight would be greatly appreciated.

[Rachel413]

Thank you so much!

[goolarra]

I'd definitely follow up.  As I said, FT4 "just slightly" below range is much worse than it appears.  Thyroid test reference ranges are very flawed, and the whole bottom half of the range should probably be considered hypo.  I'd follow up sooner than a few months (there's always the possibility f lab error).  If your FT4 continues to drop, you could amass a whole pile of symptoms in that time period.  If you do follow up, make sure they test FT3, too.  It's the test that correlates best with symptoms, so it's very important.  

You might also request TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies).  Those are the two markers for Hashi's.  If you have Hashi's, you'll know that your thyroid function will continue to diminish.

[Rachel413]

Actually, my bp is high 150/95, but unfortunately not high enough to explain the dizziness. Would you follow up on results in those ranges? Maybe just repeat the labs in a few months?

[goolarra]

Your FT4 could explain your symptoms.  It's "just a little" below range, but practically speaking, many of us still have hypo symptoms until FT4 is in the middle of the range.  So, it's much worse than it initially appears.

The number one cause of hypothyroidism in the developed world is Hashimoto's thyroiditis, which is an autoimmune disease.  Autoimmune reactions are exacerbated by stress.  So, it could be that a condition that was on the back burner came to the forefront with your stressful life.

Is your BP low?  Low BP is  a symptom of hypo, and it can make you feel dizzy.