Hypothyroid or Hypopituitarism?

[cattyjane]

Hi I have been suffering for 2 years with symptoms of:
low heart rate,
Reactive Hypoglycemia,
low/normal blood pressure,
low basal body temperature,
dry skin, fatigue,
irregular periods
slow digestion.

I have all the symptoms of low thyroid regulation

My Thyroid results are Free T4 11 pmol/L
                                 TSH 0.88 mU/L

I understand that with hypothyroidism you usually have a high TSH,could this be pituitary related or not related to thyroid?
If anyone has any comments please let me know

Thank you
Cattyjane

[goolarra]

I agree with your endo that some people are quite comfortable in the lower end of the range...I'm one of them.  However, if you have hypo symptoms (I'm asymptomatic), then his argument falls apart.  Your body is telling you something.  He needs to listen to your symptoms.

I think you have an endocrine problem.  You might think about looking for a doctor who will treat your symptoms, not to mention your low FT4.  At the same time, find a doctor who will test and use FT3 to diagnose and prescribe meds.  I think you're absolutely right...a trial dose would shed a lot of light on your condition and save a lot of money and aggravation in pituitary testing.  There is really no downside to a trial dose...you can always discontinue if it doesn't help.  

It's really helpful to "pre-interview" potential doctors.  Ask if they test and use FT3 and FT4 in diagnosis and treatment.  Ask if they're open to meds other than T4-only.  Many endos have no interest whatsoever in thyroid...just want to deal with diabetes, and their lack of interest shows.

An endo who won't even treat a below-range FT4 is a pretty stubborn case.

[cattyjane]

No my endocrinologist says he doesn't think my condition is thyroid related, he was trying to explain to me that some people who have a low/borderline T4 thyroid level are at the right level for them, even if it's lower than somebody elses. I don't believe this at all, I even asked him to try me on medication but he was reluctant. He said he wants to wait until I see a dietician and get the results back from some food allergy tests before he thinks about doing a pituatary stimulation test but doesn't think I have an endocrine problem at all. I'm really stuck now as I have all the symptoms of a low thyroid and I won't see him for 3 months

[goolarra]

Your FT4 is below reference range, so you are definitely hypothyroid.  TSH is a very poor indicator of thyroid status.  If everything in the thyroid/hypothalmus/pituitary feedback mechanism is working the way it should, TSH should reflect accurately thyroid status, but that's a huge IF.  Yes, it could be a pituitary issue.  You need to be on thyroid meds.  Is your doctor agreeable?

[cattyjane]

The refernce range for FT4 i 12-22 pmol/l
Thank you

[goolarra]

Please post the reference range for your FT4.